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Wake commissioners vote 5-2 for Atrium-WakeMed merger. September 22, 2026 The Wake County Board of Commissioners voted 5-2 at its meeting on Monday in favor of the merger between Atrium Health and Wake Med. State Treasurer Brad Briner released a video Tuesday afternoon criticizing the deal. The commissioners voted on the Articles of Incorporation and the Transfer Agreement, but not before protestors disrupted the voting process numerous times and were then escorted out of the room. The more than five-hour meeting included nearly two hours of comments from both supporters and opponents of the merger. Those against it said that the community would lose the type of care they have come to expect from WakeMed, as well as affordability, local accountability, and transparency. Those for the merger said it was a positive step in the right direction, making the Raleigh-area hospital system stronger and helping fund much-needed renovations. County attorneys said that despite the merger, WakeMed will continue to operate as a nonprofit community general hospital. The revised agreement includes the following: * Atrium Health will invest $2 billion over the next 15 years, a change from the original agreement, in an effort to modernize and expand WakeMed's facilities, including upgrades to WakeMed's Raleigh Campus on New Bern Avenue. The revision specifies that Atrium, rather than WakeMed, will fully fund the investment. * Atrium will also pay $15 million a year over the next 10 years for the new Wake County Whole Health Program, which will focus on addressing access to affordable care, mental health, placement of foster youth in crisis, supportive housing, homelessness, food insecurity, senior healthcare, and other issues. * WakeMed will increase its minimum annual indigent-care commitment from 4.8% to 8% of adjusted revenue. * Eight of WakeMed's 14 board members will be appointed by Wake County commissioners and must reside in Wake County. The remaining six will be appointed by Atrium. * Price increases will be capped at no more than 1.5 times the annual increase in Medicare costs for the next five years. * Debt collection practices, including their reporting, will not be as stringent. * Atrium will be named as a third-party beneficiary under the Transfer Agreement. * Atrium will have the right to dismiss WakeMed's CEO. Some changes were made to the agreement last week after Democratic Gov. Josh Stein sent a letter to Atrium and WakeMed on Sept. 17, according to a press release he issued on Sunday. Commissioners who were in favor said that WakeMed needed the partnership with Atrium to support the necessary upgrades and that initiatives like the Wake County Whole Health Program would be a true benefit to the community. District 4 Commissioner Susan Evans, one of the commissioners who voted in favor of the merger, said that although she was very pleased with the agreement, she had concerns about Atrium having the right to dismiss WakeMed's CEO. "I will say that one of the things I was concerned about was understanding that Atrium would have the ability to unilaterally dismiss the WakeMed CEO, and that made me uncomfortable," she said. But after talking with numerous people, including former corporate CEOs and the county manager, she said she had to accept that the agreement made sense in this environment. The two commissioners who voted no - Tara Waters of District 5 and Vickie Adamson of District 7 - voiced their concerns about the agreement and the process. Waters said she was concerned that many could not attend the meeting to voice their concerns because of the 2pm start time and the fact that it was Yom Kippur, which is considered the holiest day for people of the Jewish faith, a concern that was repeated several times earlier in the meeting. "I feel like today will go down in history as a very sad day in Wake County, when we turned our taxpayer-built community hospital over to a corporate conglomerate," Adamson said. "We were initially told what the agreement was, and after having to go to the press and throw a public fit, I finally got to see it. And it was very different than what we had been told." She said she also spoke with people who said Atrium hasn't lived up to its promises. Additionally, she said she felt the process was rushed and not how the commissioners normally do business as a board, adding that she was trying to process documents she had received on Thursday. "This is all about raising prices," Adamson said. "I can't vote for it." Board Chair Don Mial, who represents District 1, said the merger would make WakeMed stronger and shape healthcare for years to come. A joint statement from Atrium and WakeMed said that over the past few months, officials spent countless hours listening to county leaders, community organizations, faith leaders, employees, care providers, and residents who wanted to understand what this combination would mean for Wake County. "Through it all, one thing was clear: people care deeply about WakeMed, its caregivers, its patients, and the future of this community," the release said. "We greatly appreciate everyone who took part in that conversation and helped make it stronger." The organizations said the vote "brings us to the next chapter of the process, and important work remains ahead... We recognize that trust is earned, and our focus now is to follow through on what we've outlined, continuing to listen to the community and demonstrating, through our actions, the value this combination will create for the people of Wake County and beyond." Gov. Josh Stein also released a statement after the vote. "Today the commission voted to approve the Atrium-WakeMed merger," he said. "I thank the commissioners for their work on patients' behalf, and I am pleased that Atrium and WakeMed agreed to my request to protect families by capping price increases at WakeMed for the next five years. Now that the commission has voted, I welcome the Attorney General's review of the proposed transaction and his office's independent assessment of it." The merger has been controversial since it was announced this past spring. Talks between the two hospital systems began in 2022, when WakeMed put out a request for proposal (RFP) looking for a partnership in oncology. According to Dr. Thad McDonald, chairman of the board for WakeMed, Atrium was the only system that replied, noting that WakeMed is "almost a mirror image" of Atrium. "In January of 2024, this concept of a combination was presented to the executive committee of the board," he said. "Our initial response as an executive committee was much the same as some of you here and members of the community: What? Give up our autonomy? We've always been fiercely proud of our independence; however, looking at the future of health care and especially the challenges facing safety net hospitals like ours, we felt it would be irresponsible not to give it vigorous due diligence." Advocate Health, the health system that includes Atrium, resulted from the merger of Advocate Aurora Health and Atrium Health in December 2022. In May, state Treasurer Brad Briner, among others, voiced his concerns about the proposal. "There is a simple business principle that when suppliers consolidate and competition is reduced, it is the consumers who suffer," Briner said in a prepared statement. "This has been proven to be true time and again in the health care landscape, where prices continue to rise and patients are left with mounting medical debt." In his video message on Tuesday, the treasurer said he remains profoundly concerned about the deal, adding that nothing has fundamentally changed from the original proposal, and that WakeMed's CEO, Donald Gintzig, said in an interview last week he hoped costs would go up if the merger went through. Briner also said it will make it harder for Stein's Health Care Affordability Commission, of which he is co-chair, to be successful, and it will make it even harder to keep the State Health Plan and other employer plans solvent. He is calling for North Carolina Attorney General Jeff Jackson, along with federal regulators, to conduct a thorough assessment of prices, competition, and access, and that it isn't too late to back away from the deal. Tom Friedman, executive administrator of the State Health Plan (SHP), said at SHP board meeting in June that Atrium is anywhere from 15-40% more expensive in aggregate than WakeMed, and if WakeMed were to apply those rates based on State Health Plan utilization, it would be on average between $7-$11 more per member per month. The merger still needs approval from the Federal Trade Commission and the Department of Justice before it can be completed. Topics on this page.

Wake County commissioners voted 5-2 to approve a merger between Atrium Health and WakeMed following months of negotiations. The agreement includes capping price increases at WakeMed for five years at no more than 1.5 times the annual increase in Medicare costs, creating a $150 million community fund, and granting Wake County access to financial information. Atrium Health committed to investing $2 billion in WakeMed over 15 years. Wake County will appoint eight board members, whilst Atrium will appoint six. The decision faced opposition from patients, state employees, and advocacy groups who argued the merger would increase healthcare costs. Deputies cleared the public from the room before the vote after disruptions. The deal now requires regulatory review by the Attorney General's office.