NC Hospital Systems Battle Over Billions in New Facility Projects
North Carolina Health News reports that the state's largest hospital systems, Duke Health, Atrium Health, Novant Health and CaroMont Health, are racing to expand into each other's traditional territories through new facility construction, partnerships and competing state approval filings. Duke and CaroMont have proposed two new Mecklenburg County hospitals totaling nearly $1.2 billion, while Novant has filed a competing $364 million proposal nearby; Atrium is building a $450 million hospital in Fort Mill, SC and a behavioral health facility in Charlotte. Analysts say the expansion is driven by population growth, competition for privately insured patients, and strengthened hospital balance sheets tied to Medicaid expansion payments received since 2023. The piece notes looming threats to this growth, including federal Medicaid funding cuts under H.R. 1 and the expiration of enhanced ACA subsidies, which could increase uncompensated care.