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The Wake County Board of Commissioners plans to vote Monday on a proposed merger between WakeMed and Charlotte-based Atrium Health.
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The commissioners’ meeting starts at 2 p.m. Monday in the board’s chambers in the Wake County Justice Center on Salisbury Street in downtown Raleigh.
Commissioners initially had their decisions related to the merger placed on the consent agenda in a May meeting. Consent agenda items are considered non-controversial and are voted on all at once, unless a board member pulls them for separate consideration.
After state officials and the public raised concerns about the merger this spring the commissioners decided to delay their vote for at least 90 days. Questions about the $2 billion healthcare investment promised as part of the merger, potentially increased healthcare costs, and local control of WakeMed have pervaded the discussions.
Now, 131 days later, commissioners are preparing to vote. That came after numerous forums and information sessions hosted by WakeMed — that county commissioners asked the hospital system to do — and a public hearing held by the county.
Commissioners have consistently not answered The News & Observer’s questions on their opinions about the merger, but the county has scheduled media availability with commissioners after the vote.
Residents can typically weigh in during a public comment period in commissioners’ meetings.
And the commissioners have negotiated significant changes to the initial merger proposal, including an additional promise to provide $150 million for “community commitment and enhanced charity care,” and a guarantee that Atrium wil pay the promised $2 billion out of its own pocket rather than WakeMed’s, according to WakeMed spokesperson Kristin Kelly.
State and federal officials will have the chance to weigh in on the merger if it makes it past commissioners.
But first, the commissioners have to approve changes to two key documents.
The first is WakeMed’s articles of incorporation. The nonprofit health system exists because the county built its flagship hospital and later gave it to the nonprofit to operate.
Agreements that were made as part of the creation of WakeMed give county commissioners significant control over the nonprofit.
They appoint eight of WakeMed’s 14 governing board members.
As part of the merger, Atrium and WakeMed are asking the county commissioners to significantly alter the articles of incorporation.
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Those changes would hand over much of the control of WakeMed to Atrium, despite initial statements by WakeMed CEO Donald Gintzig that the merger would be a “marriage” and that local control would be maintained.
The second document is the agreement transferring ownership of the hospital property from the county to WakeMed.
The changes to the transfer agreement would remove some restrictions on the sale or lease of that property.
More recently, the county negotiated changes to the proposed articles of incorporation, loosening some of Atrium’s control over WakeMed’s board.
New details emerged about the $2 billion investment in recent weeks. Gintzig said in communications with the office of Gov. Josh Stein that the agreement merely guaranteed that much investment would happen. Some or all of it could come from WakeMed instead of Atrium.
That drew criticism from a state official and local advocates.
Sen. Jim Burgin, an Angier Republican who chairs the Senate Health Care and Health Appropriations committees, told The News & Observer he doesn’t see what WakeMed is getting from the deal.
He previously said he plans to revive legislation he sponsored that would give state officials more oversight of hospital mergers, The N&O previously reported.
Rob Stephens, the organizing director of healthcare advocacy group The Patients Union, previously told The N&O it was “shocking” that Atrium might not pay the $2 billion.
His organization intends to lead a rally against the merger at 12:30 p.m. on Monday at Nash Square.
Gintzig has said the investment is necessary to help make improvements to the hospital system’s aging main campus and build new facilities in the area.
Now, it appears as though the health systems have adjusted the deal to guarantee the $2 billion won’t be coming from WakeMed.
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This story was originally published September 17, 2026 at 8:49 PM.