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Delay In Major Health System Combination

UNC Health Care

There appear to be more disagreements than initially thought in a proposed combination of UNC Health Care and Charlotte-based Atrium Health – formerly Carolinas HealthCare System.

In August, the massive health care systems announceda plan to "join their clinical, medical education and research resources ... with the goal of entering into final agreements by the end of the year."

UNC Health Care CEO Dr. Bill Roper offered few details about the ongoing discussions Thursday, but acknowledged that talks have lasted longer than expected.

"We had originally said in August when we announced this that we hoped to have the definitive integration agreement done by the end of December. And here we are in March, and we're not done yet," he said, but would not give details about where the sides disagreed. "I'd like to give you a more plainspoken answer, but these are the big issues around how the most crucial decisions are going to be made. And if we can find ways to be mutually comfortable on this, we are going to have an agreement. If we can't, we won't. It's as simple as that."

If combined, the new health care entity would have more than 90,000 employees and 4,000 doctors across 50 hospitals. Blue Cross and Blue Shield of North Carolina, the state's largest health insurer, opposed the combination saying it would increase prices for patients.

Letter from Blue Cross and Blue Shield of North Carolina CEO Patrick Conway to UNC Health Care CEO Dr. Bill Roper and Atrium Health CEO Gene Woods.
Credit BCBSNC

"After a thorough review of independent research which shows that when health care systems combine costs for consumers go up, Blue Cross NC cannot support your proposed combination." wrote BCBSNC chief executive Patrick Conway in a letter to Roper and Gene Woods, Atrium Health CEO.

The UNC Board of Governors, which oversees the state's public university system, including UNC Health Care, was reviewing the proposed combination. Roper said Thursday that system leadership was keeping the interests of patients and all North Carolinians as its main focus.

"(The Board of Governors) wants to be sure that the interests of the university and the state are fully taken account for. And that the interests that the state has in the missions that we carry out through UNC Health Care are going to be continued," he said. "I just would say that we are down to the most important things, and we are spending all our time and effort on these (issues). We will be done when we're done. I wish that I could give you – and my wife – an estimate of when this process will be done, but I can't because we are not fully in control; it's a two-sided process."

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Jason deBruyn is WUNC's Supervising Editor for Digital News, a position he took in 2024. He has been in the WUNC newsroom since 2016 as a reporter.
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