EXPANDING OPTIONS?
Duke Health eyes entering Charlotte with 2 hospitals
Lake Norman Regional Medical Center in Mooresville was acquired by Duke on April 1, 2025, for $284 million. It is now known as Duke Health Lake Norman Hospital.
HEALTHCARE
The competition for healthcare market share in North Carolina's three metro areas could be ratcheted up with Duke Health's certificate-of-need application to open two hospitals in Charlotte.
Duke said Wednesday it will partner with CaroMont Health to open a 120-bed hospital in the University City area and an 80-bed hospital in west Charlotte's River District.
CaroMont's network is focused on Cleveland and Gaston counties in N.C. and York County in South Carolina.
If approved by state health regulators, Duke would enter Atrium Health's backyard for the first time, as well as a pivotal No. 2 market for Novant Health Inc.
It is likely Atrium and Novant will submit certificate-of-need applications to fill some, if not all, of the 389-bed gap.
Duke Health's plans for the two Charlotte hospitals come about 18 months after the system unveiled in March 2025 a collaboration with Novant that was designed to expand their presence statewide through developing new campuses.
On Thursday, Duke said in a statement that "Duke Health and Novant Health have concluded our partnership. We remain focused on improving the health of people across North Carolina and increasing healthcare options in Charlotte."
Novant acknowledged Thursday the end of its Duke joint venture in a brief statement, but provided no details on the reasoning.
Duke and CaroMont said they are attempting to help fill the need for 389 new hospital beds in Mecklenburg County as identified by the 2026 State Medical Facilities Plan.
By regulating access to healthcare facilities and equipment in a region, the state's certificate-of-need laws are designed to control costs, enhance quality and ensure equitable access to care. Among the responsibilities of certificate-of-need laws is setting the number of hospitals and ambulatory surgical centers in a region.
"The rapidly growing Charlotte region needs more access to care and more options for the highest quality care locally," Dr. David Zaas, chief executive of Duke University Health System, said in a news release.
Zaas took over as Duke University Health System's chief executive on May 1 after less than three months in the same role with Atrium Health Wake Forest Baptist. Zaas' departure comes unexpectedly since he was named Baptist's president and chief executive on Jan. 1, the day after Dr. Julie Ann Freischlag retired after more than eight years in the role.
"Duke Health is bringing its specialty expertise, research and education to Charlotte so more people can access leading academic care closer to home," Zaas said. "As two North Carolina health systems with deep roots in this state and a shared commitment to quality, we are the right partners to expand these options for patients."
Duke-Novant partnership
The first Duke-Novant combined attempt was applying to open a 46-bed, $225-million community hospital in Mebane.
State health regulators turned down their application in favor of Cone Health's application for a 46-bed, $275 million Mebane hospital. Cone already owns and operates the 238-bed Alamance Regional Medical Center in Burlington.
The Duke-Novant hospital would have been Novant's first hospital entrance into Alamance County, while expanding significantly on Duke's presence beyond the Kernodle clinics in Burlington and Mebane.
Since announcing their joint venture, Duke and Novant have provided limited information about their collaboration other than to say clinicians from both systems will be available in new locations, increasing access to both primary care and advanced specialty treatments.
Carl Armato, president and chief executive of Novant, said in a March 2025 statement that the systems "have a shared vision for what healthcare can look like."
"Our collaboration means the communities we serve together will benefit from our combined focus on quality, innovation and excellence in patient care and experience," Armato said.
The systems said the collaboration represents their efforts at "developing novel partnerships to improve health outcomes for more communities across the region, and provide an exceptional patient experience for all."
Duke CON details CaroMont and Duke expect the N.C. Division of Health Service Regulation to make a decision in March, with the hospitals potentially opening in 2031.
The hospitals would be owned and operated by a new company equally owned and jointly led by Duke and CaroMont.
The Duke application comes as Atrium awaits federal regulatory approval, as well as the blessing from state Attorney General Jeff Jackson, for its controversial acquisition of WakeMed.
Atrium has made a $2 billion capital investment pledge to WakeMed as the centerpiece of its bid to establish a major presence in Charlotte, the Triad and the Triangle.
"With the region's continued growth, the organizations are planning now to help ensure healthcare infrastructure and services can keep pace with the needs of patients and families," according to a joint news release.
"The proposed hospitals in the northern and western parts of the county would give patients and families more options for accessing specialty and advanced care closer to home."
Chris Peek, CaroMont's president and chief executive, said that "together with Duke Health, we have an opportunity to bring more choices and more advanced care to one of the fastest-growing regions in the country."
Duke said patients at the two proposed hospitals would gain access to advanced specialty and subspecialty care, clinical research and trials, innovation and medical education.
"Through the partnership, Duke Health will help expand clinical capabilities and access to advanced care in the Charlotte region while working alongside a health system with deep local knowledge and relationships," according to the news release.
Duke's Charlotte metro presence
Duke moved into the Charlotte metro area in April 2025 with its $284 million acquisition of Lake Norman Regional Medical Center and related businesses.
Duke took over the renamed 123-bed Duke Health Lake Norman Hospital on Oct. 12 from subsidiaries of Community Health Systems Inc.
Duke said the Mooresville hospital "represents a significant expansion of Duke Health clinical services outside the greater Triangle area."
The Duke Health acquisition comes after Novant ended in June 2024 its attempt to purchase the hospital and Davis Regional Psychiatric Hospital of Statesville for a combined $320 million.
Novant cited "continued roadblocks" from the Federal Trade Commission, particularly federal court challenges, as major factors in its decision.
Novant signed an agreement in February 2023 to purchase the two hospitals from subsidiaries of Community Health Systems. Novant co-owned both hospitals for an 18-month period in the early 2000s.
A three-judge panel of the federal Fourth Circuit Court of Appeals voted 2-1 on June 18 to implement the FTC's preliminary injunction request on the potential Novant purchase.
A top Federal Trade Commission official touted as "a win for consumers" Novant's withdrawal of trying to acquire the two struggling Iredell hospitals.
rcraver@wsjournal.com 336-727-7376 @rcraverWSJ
