Duke Health and Novant Health said they will work together to develop new locations across the state to improve health outcomes. No specific projects or financial details were mentioned in a press release issued today.
The partnership represents an unexpected connection between the state’s second-largest hospital operator (Novant had about $10 billion in annual revenue last year) and third-biggest (Duke had $6.8 billion of revenue in fiscal 2024.) Novant is a not-for-profit authority run by a board of directors, while Duke Health is part of Duke University, one of the most elite U.S. private universities
The organizations said construction for the first sites would begin this summer, with the facilities opening about 18 months later.
In a release, the organizations said they “share a commitment to developing novel partnerships to improve health outcomes for more communities across the region and provide an exceptional patient experience for all.”
The two organizations “believe collaboration is the way forward for reaching new heights and helping their team members and patients succeed.”
Novant said it had no comment beyond the press release. Requests for comment by Duke Health were not returned.
Novant wants to triple its revenue to $30 billion in coming years, officials said at a recent health care conference. The Winston-Salem-based company trails Charlotte-based Advocate Health, which has more than $32 billion in annual revenue.
The press release was full of generalities and few specifics about how the partnership would improve health outcomes, says Barak Richman, a George Washington University law professor and longtime observer of North Carolina hospitals. He formerly taught at Duke.
“This is stuff their PR offices keep repeating in their sleep and there’s no evidence [that] any hospital acquisition or any hospital collaboration of this kind has done any of that,” Richman says.
Richman says Duke’s ownership structure would make a merger difficult. “But I can tell you that hospital affiliations are the new merger,” he says. “The idea is you secure patient flows and you lock up different parts of the market. And, sometimes, that requires less regulatory scrutiny or oversight.”
N.C. leaders have “not prioritized addressing the costs of hospital consolidation,” which Richman says is costly to citizens and businesses, he adds.
N.C. Attorney General Jeff Jackson, who has voiced concern about hospital mergers in North Carolina, declined to comment on the Duke-Novant statement.
Last month, Novant filed a plan with state regulators to add a $336 million hospital in Cabarrus County. The fast-growing county abutting Charlotte now has a Concord hospital that Atrium acquired in 2007. It’s unclear if the new hospital would be part of the partnership with Duke.
North Carolina regulates addition of acute-care hospital beds and other healthcare spending through its Certificate of Need process. The state’s 2025 medical facilities plan greatly expanded the ability of N.C. hospitals to add more beds, with little explanation from state healthcare officials about the change in policy.
Duke has traditionally focused on its internationally recognized flagship hospital in Durham. It also is a partner with Brentwood, Tennessee-based LifePoint Health in the ownership of nine smaller community hospitals, including several in North Carolina.
Novant CEO Carl Armato says, “We have a shared vision for what healthcare can look like, and our collaboration means the communities we serve together will benefit from our combined focus on quality, innovation, and excellence in patient care and experience.”
Added Duke University Health System CEO Craig Albanese: “We’re taking bold steps to bring the excellence and innovation of Duke Health to more patients, in more ways, across more communities, and we’re energized by the possibilities of what we can accomplish in collaboration with Novant Health for communities across our region.”
Having more locations would mean shorter wait times and more appointment availability, the groups said. Novant employs about 40,000 people at its key markets in Winston-Salem, Charlotte, Wilmington and coastal South Carolina. Duke Health employs about 26,000.
Earlier this year, Forbes rated North Carolina as the nation’s most expensive state for healthcare.