‘Why do it?’ New WakeMed-Atrium deal details prompt an NC GOP leader’s scrutiny

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As more details about the proposed WakeMed and Atrium merger have come out, a Republican lawmaker who has hefty influence over healthcare policy in the state legislature has become increasingly concerned about the deal.

That’s prompted him to renew calls to revive legislation he sponsored that would give state officials more oversight of hospital mergers.

“What are they getting out of this? I see nothing,” Sen. Jim Burgin, an Angier Republican who chairs the Senate Health Care and Health Appropriations committees, told The News & Observer.

WakeMed has “a billion dollars in the bank” and about $900 million in construction projects currently underway, Burgin said.

“They’re making money. Why would you merge with somebody that’s going to just harvest more money and profit out” of the deal, Burgin said. “Why do it?”

One of the benefits touted by officials for both health systems is an Atrium investment of $2 billion over 10 years. But a letter from WakeMed CEO Donald Gintzig to Gov. Josh Stein’s office shows that WakeMed would fund part — if not all — of that investment itself, with Atrium promising to make up any shortfall, The News & Observer previously reported. In this letter, Gintzig said the merger is necessary for WakeMed’s longterm future and to meet Wake County’s growing healthcare needs.

Burgin floated having the state help WakeMed finance improvements through bonds and take a position in the hospital. He also said that, if WakeMed were bought, Wake County should receive money for a foundation, similar to Dogwood Health Trust in Hendersonville, west of Charlotte, which was created after the sale of Mission Health.

“If it’s what I’ve been told it’s worth, they (Atrium) should be willing to put $2 billion up into a foundation and $2 billion of their money as a cash infusion,” Burgin said.

Another benefit touted is the creation of more than 3,300 healthcare jobs. But Burgin worries the deal could lead to higher costs that ultimately hit consumers as the hospital system gains more leverage, as well as job losses and doctors leaving.

“Atrium wants to grow and they see Wake — the second-largest market in North Carolina — and they already control the largest market,” in Mecklenburg, Burgin said. Atrium is part of Advocate Health, the third-largest nonprofit health system in the country, with hospitals and care sites across numerous states.

“I just don’t want North Carolina to become two or three large hospital groups and everybody else is just out,” Burgin said.

The bill Burgin filed earlier this year came after news broke in May about the proposed merger. It would have increased oversight of hospital mergers by Council of State members. That bill was gutted in June to remove the oversight provision but amended to implement an annual cap on nonprofit hospital CEO compensation at 400 times the pay of the lowest-paid full-time employee. That would mean WakeMed CEO Donald Gintzig could see a pay raise and Atrium CEO Gene Woods a pay cut. That bill did not pass and lawmakers in the GOP-led legislature aren’t expected back until November, after the election.

Burgin told reporters at the time that he removed the central provision because the hospital systems were “so far into that” and he did not want lawmakers to “put a finger on it one way or another.” Senate Leader Phil Berger later told reporters in a gaggle that he had not asked Burgin to remove the merger provisions.

Burgin said he’s meeting with Berger next week and will discuss the merger.

The N&O reached out to Senate Leader Phil Berger and House Speaker Destin Hall’s office for comment on Friday but did not hear back.

Burgin is also concerned about what Wake County commissioners could lose in terms of authority over WakeMed under the proposed articles of incorporation.

WakeMed has a 14-member board of directors. Commissioners currently appoint eight of those directors. Under the articles made public so far, Wake County’s appointees would remain at eight but would have to come from a slate of nominees approved by two-thirds of the WakeMed board — nine of the 14. Atrium’s six appointees face no such nomination process.

Gintzig said in his letter to Stein that some changes had been made to the language. The N&O asked, but those changes have not been released by WakeMed or Wake County.

“They will have no power. They will have no say and basically, they are giving up the hospital for nothing,” Burgin said. Commissioners must approve changes to the hospital’s articles of incorporation and a transfer agreement with the county. When that vote will happen is unknown.

For Burgin, this echoes Atrium’s structure, where commissioners approve board members nominated by Atrium. But recently, when the board rejected Atrium’s nominees, Atrium refused to replace its slate, meaning the members have not changed, Burgin said.

Transparency is also a concern for Burgin.

News of the WakeMed-Atrium merger broke via a news release on a Friday afternoon in mid-May, with a vote scheduled for the following Monday. County commissioners delayed their decision following pushback, and WakeMed held a series of public forums on the topic.

Meanwhile, the text of the agreements between WakeMed and Atrium has not been made public. A Wake County attorney has said that’s because the county is prohibited from sharing certain competitive information provided to it. Gintzig told attendees at one of the public meetings in July that WakeMed had shared the documents with county commissioners and their legal counsel.

The News & Observer reported Friday that county commissioners and WakeMed attorneys had been meeting behind closed doors to discuss the merger.

Burgin said he believes the documents should be made public.

“If it’s a great idea, make it public,” Burgin said. “Make them public and let’s all talk about it and see. And if it’s a great idea, I’ll be the first to say, ‘Hey, this is a great idea.’”

As nonprofits “we let them not pay property taxes, not pay income taxes, and not pay sales tax. So they have an obligation to us to be involved, and for them to say that it’s a private matter and that it is no concern to anybody — is just not true,” Burgin said.

The N&O attempted to reach all of the county commissioners on Thursday and Friday. Only Commissioner Vickie Adamson responded.

She said via text on Friday she “will be giving interviews after the vote” on WakeMed’s altered articles of incorporation and added that she’s still doing research.

Rob Stephens, the organizing director of health care advocacy group The Patients Union, echoed Burgin’s sentiment on the new details of the deal.

He said on Friday that the fact that WakeMed will pay for at least some of the investment is shocking.

“This entire time the public has been led to believe that Atrium is going to be investing this,” Stephens said.

Stephens added that WakeMed is still publicly referring to the $2 billion as an investment from Atrium.

Between the way that the county’s involvement in the merger was initially buried in a consent agenda and the misleading information provided on the investment, Stephens said it’s clear that the deal is “rotten.”

“It’s really disturbing the way this has been laid out,” he said. ”Either Atrium and their army of attorneys are misleading WakeMed and Wake County about this or WakeMed knows.”

Gov. Josh Stein’s office has shown great interest in the proposed merger. In June, it sent a four-page letter to WakeMed with dozens of questions about its decision to join Atrium, including why it rejected a $5 billion offer to become part of UNC Health.

“Any arrangement between Atrium and WakeMed will have a significant effect on healthcare in Wake County, as well as North Carolina more broadly,” said the letter, signed by South Moore, Stein’s deputy general counsel. “It is therefore imperative that state and local leaders, as well as the public, fully understand the transaction Atrium and WakeMed are proposing.”

After WakeMed responded to those questions, the governor’s office sent a second letter in August with more. It released WakeMed’s answers to those questions, which included the acknowledgment that some of the $2 billion investment WakeMed officials have said would occur as a result of the merger might actually come from WakeMed rather than Atrium.

So far, though, Stein’s office has refused to release WakeMed’s response to its initial letter in June.

This story was originally published September 5, 2026 at 7:00 AM with the headline “‘Why do it?’ New WakeMed-Atrium deal details prompt an NC GOP leader’s scrutiny.”