Can confirm that this did not help Wilkesboro. As it is my hometown and Lowes was the company my mom was formerly employed at, basically all of the jobs that weren’t customer service/call center jobs were ultimately relocated to Mooresville. If your job was part of the move you had the option to receive a severance or get shuttled to the office everyday (an hour each way). (You could also obviously drive, but that’s a huge time commitment and expense when formerly it was maybe 15-20 minutes away, at most.)
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The WakeMed CEO was quoted today as saying WakeMed can no longer go it alone. I’m sure that’s true. Their single largest customer is Medicare, which is beating down the payments for hospital services. The larger, more efficient systems can still stay above water but the smaller, less efficient systems like WakeMed cannot. The larger systems have more purchasing power and more distributed overhead costs. The same thing is happening with Medicaid payments for hospital services; the State’s benefit manager is driving costs down. Because of its history, WakeMed is particularly sensitive to Medicare and Medicaid income. In the private sector, Duke and UNC (and, ironically, Atrium) are very stiff price competition for WakeMed when it comes to getting in-network contracts with BCBSNC and the other employment-based coverage providers.
Something’s gotta give. Wake County cannot bail them out. The reason why WakeMed was made semi-independent from the County was that we were in this exact same situation 20 years ago.
Any entity buying WakeMed is necessarily larger than WakeMed, and unless you want a duopoly in the Triangle healthcare market, any entity buying WakeMed is necessarily outside the Triangle.
Nobody likes it, and the WakeMed board deserves to be pilloried over the way they brought the matter (or didn’t!) to the public’s attention. Obviously, these talks have been going on for quite some time.
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WakeMed is profitable & has a AAA debt rating .
Why do they need to sell out to anyone?
Partner with UNC or Duke. At least they are localish world class academic institutions & medical schools.
Atrium is nothing but a company hiding behind a “not for profit” moniker. They are no different than HCA….ask Asheville how that’s working out. It doesn’t mean they are not profit driven. It’s just a tax scheme like a damn church.
There is ZERO reason WakeMed needs to do this deal….period. All you had to do was listen to the CEO & Atrium guy today with their word salad. They couldn’t even provide a straight answer as to why the fuck they hid the fact they were even having discussions & thought they could slip it by on a Monday vote. Wait til they are forced to disclose the pay package this jackass CEO is getting by agreeing to this “deal”.
i love the shift to “helping the poor” to try and win support.
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As of December 2025, Fitch has WakeMed at A+ not AAA. Big difference.
https://www.fitchratings.com/entity/wakemed-health-hospitals-nc-credit-summary-96248102#ratings
If WakeMed floated enough new bonds to maintain capacity growth and keep up with Duke and UNC, Fitch would probably knock them down a notch or two. Incidentally, Fitch has Atrium at AA.
Note that technically, Atrium is a d/b/a for the Charlotte-Mecklenburg Hospital Authority. As public as WakeMed. Nowhere near the same as HCA. Everybody agrees Asheville is a disaster.
If people want a duopoly in the Triangle, then let Duke or UNC get WakeMed. But remember, just a few years ago UNC nearly merged with Atrium. The deal fell apart because the two CEOs couldn’t agree on who would be CEO going forward. Nothing in the healthcare market is cast in stone. Duke could just as well put its healthcare business into a JV with another party (and not necessarily a party in North Carolina). We’re talking about running a collection of dispersed hospitals with thousands of beds overall. UNC now runs hospitals all over the state. That’s not the same as running a world-class med school.
I wonder where ECU is in all this.
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ECU has a string of hospitals in Eastern NC. Taken my mom to the Outer Banks one in Nags Head.
I think if Wake Med were in financial trouble or didn’t have a signature position in Wake County, this would be received differently. As is, they do things Rex and Duke Raleigh can’t (or won’t) do, they have one of the busiest ER’s in the country, and they are financially strong. Certainly Atrium can swallow them (or UNC or ECU or Duke) like they did Wake Forest, but that doesn’t mean they should.
I think you make a good point there. It is obvious to anyone who’s been to their ER that they depend heavily on Medicaid and are struggling due to it.
I’ve been to the ER of all three of Raleigh’s hospitals, and compared to Rex or Duke-Ral, Wakemed was almost like going to a developing country, in comparison. Note, this is no shade to the staff or doctors—they were doing the best they could in a horrible situation! But I mean, I was the sickest of my life and in 9 hours there they never once put me in a bed, just shifted me from one chair to another. Only time I laid down was 60 seconds in the CAT scan. There were dozens of ill people just lying around the waiting room screaming in pain getting practically no help. You couldn’t walk hardly without bumping into someone’s IV stand—in the Waiting Room!
Friends of mine in the health field told me later on I should never have gone there, but when you’re sick and can’t drive far you do what you need to do.
But I digress—the point is that the situation that the hospital is in at this moment is simply not sustainable and if a merger with another company will improve anything, then I’m open to hearing them out.
That said, I agree with you that the transparency about this has been appalling and the county needs to get some answers to some hard questions.
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The best ED in Wake County that I’ve been to is Wake Med North. One doesn’t usually have good experiences at any of them though, and Duke Raleigh and Wake Med main were tied for the worst. Rex’s just feels tiny. A lot of the experience at ED’s is location-specific.
At any rate, I doubt Atrium or anyone else will view revamping the ED as a moneymaker endeavour.
WakeMed says it needs to merge with Atrium because Medicare and Medicaid are squeezing them, but merging doesn’t change what the government pays you. What it does change is your leverage over private insurers, who then pass the cost straight to your premiums.
So the pitch is: “We need to get bigger so we can charge your employer’s health plan more, so your premiums go up, so we can renovate our building.” Atrium’s promising a $2 billion “investment” in Wake County, but Wake County is the one who’ll be paying for it every time someone opens an EOB. Premiums are already out of control here.
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I’ve had nothing but good experiences taking my kids to the WakeMed Childrens ER. Much better than taking my kids to Rex or WakeMed Cary. In addition to excellent care and quality providers, I’ve seen the staff there handle heartbreaking things with absolute calmness, sensitivity, professionalism and dignity. Nothing but respect.
Makes me a bit sad to think that there is a possible future where “the good childrens ER” is going to be way out at Veridea (“central” my @$$).
If this really is necessary and beneficial then I can support it but I’m skeptical and I’m glad the county commission is taking a chance to think about it before pushing forward.
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I don’t know enough about the hospital business to weigh in intelligently in this debate. But I do know that anytime a deal is rushed through under the cover of darkness, there is usually a very shady reason for why it was kept secret until the last moment.
Its stinks of cigar smoke combined with rotten fish. I’m glad the brakes were put on this. If for no other reason that the stakeholders, including the public, need proper time to evaluate and provide input.
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It sounds like we need to have several rounds of surveys and public comment periods before any decision is made 
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King Canute: “Halt!”
This is one such case where that would actually be invaluable.
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The UNC deal fell apart because the egomaniacs in clt thought they would control a public asset in UNC’s school of medicine.
The NC legislature quickly said F THAT & ended that nonsense.
whoever said “ECU/Vidant” could be on to something.
i constantly hear Vidant struggles because they are mostly in poor ENC areas. Shoring up their financial situation with WakeMed could help ECU/Vidant be bringing in a large metro financial source & WakeMed gets to spread its exposure over a larger community….
Which is exactly what atrium is trying to do. Atrium has charlotte metro then they added some poor hospitals in Georgia & Illinois. They need Raleigh more than Raleigh needs atrium.
no hospitals can survive on Medicare/medicaid patients any longer.
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Novant crashed and burned badly here and I hear they have already basically pulled out this market altogether. Not sure how that relates to this but its anecdotal somehow I supposed.
A merger with ECU definitely gives better warm fuzzy vibes compared with Atrium, but could they provide the capital needed in order for WakeMed to stay relevant and competitive with in-county rivals Duke Raleigh and UNC Rex?
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a Vidant/WakeMed alliance would pull revenue from a much larger pot (granted ENC is hit & miss on growth) however Greenville is obviously growing as are some of the coastal areas. Both of these areas are not all low-income. Vidant controls hospitals in places like Roanoke Rapids & Ahoskie in rural NE NC. Those areas are definitely distressed & probably see most of their funds from medicare/medcaid. Combining Raleigh & Greenville could help shore up rural healthcare in some of those areas by spreading the costs across a larger area.
As a side note, its baffling that the primary reason medicare/medicaid continues to get cut is Republican legislators who are heavily from these same areas. They are the reason rural hospitals are closing & yet the people that live there still vote for these people……WTF. Sorry, I’m from one of these rural areas & am baffled every day by people voting against their own interest…
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While I agree / lament the idea of merging / diluting Wake Med, Vidant is absolutely not the place to plant your flag. Take it from pained personal and familial experience…..
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I’m sorry for your experience. It sucks I know. I’ve got negative experiences with Duke. None of them are perfect but if Vidant & WakeMed create a much stronger economic engine combined, they can make more money as a single entity, pay doctors more, help focus on rural medicine without ‘breaking the bank’, etc. This model should be music to the NC politicians ears with a model such as this.
Perhaps if Wake Med were absorbing / reforming Vidant, but if the reverse, then I must say there will not be improved outcomes for patients or employees based on experience.