Our annual hospitals report dives into the data to determine which medical centers are most successful at their fundamental goal: providing quality care for patients. The result is Business North Carolina’s 2019 Best Hospitals list.
The list is calculated by the hospitals’ performance in 25 metrics, including information provided by the U.S. Centers for Medicare & Medicaid Services. We examine patient-satisfaction surveys, rates of commonly acquired hospital infections, and readmission and death rates for common procedures. Also considered are safety report cards from The Leapfrog Group, a Washington, D.C.-based nonprofit, and ratings from insurer Blue Cross and Blue Shield and U.S. News & World Report. We rank the state’s adult, acute-care medical centers with at least 50 beds, excluding specialty and psychiatric hospitals.
While the top two performers on this year’s list employ a combined 18,000 people and include about 1,500 beds, the list shows that being part of a large, multihospital system isn’t a requirement to perform at a high level. In four of the last five years, CarolinaEast Medical Center in New Bern has landed in the top five, while CaroMont Regional Medical Center in Gastonia has appeared three times.
“You can’t find a hospital this size in the state with the sophistication and breadth of services that we have,” says CarolinaEast CEO Ray Leggett III. But with rising health care costs and increased consolidation, how much longer will the state’s independent health care systems be able to stand on their own?
“Right now, we’ve been successful enough clinically, operationally and financially. We’re a strong organization,” says Leggett, who has worked at the New Bern medical center for nearly three decades, including 10 years as CEO. “I have seen health care change so much over the last 28 years. Who the heck knows in five to 10 years?”
(tie) Cone Health1
Beds: 802 | 2018 rank: 4 | CEO: Terry Akin
Cone has expanded from its flagship Moses H. Cone Memorial Hospital, which opened in 1953, to a six-hospital system that employs about 12,000 people. Recent investments include the $100 million, 196,000-square-foot Cone Health Women’s and Children’s Center, expected to open later this year at Cone Hospital’s main campus. Cone’s Triad Healthcare Network ranks among the top-performing Medicare accountable care organizations in the U.S., according to federal data. Launched in 2012, the network of about 2,000 providers deploys health care professionals to monitor patients after surgeries and other procedures, yielding fewer return visits.
Challenge: Cone faces increasing competition from larger Winston-Salem-based Novant Health and Wake Forest Baptist Health as the systems jockey in the Triad, which lacks the explosive growth of Charlotte and the Triangle.
(tie) UNC Rex Healthcare
Beds: 660 | 2018 rank: 2 |
President: Steve Burriss
It’s been three years since UNC Health Care changed the name of its Raleigh health system to UNC Rex Healthcare, 15 years after purchasing the not-for-profit organization. Since then, the university-led system has shown an innovative, growth-minded strategy. In 2012, it launched Rex Health Ventures, one of the nation’s first venture-capital funds run by a community hospital. It has made about a dozen investments. Construction will start this spring on a $65 million cancer center that is expected to open by early 2021, more than doubling space dedicated to cancer care.
Challenge: UNC Rex faces nimble Triangle-based competitors in WakeMed and Duke University Health as the region’s rapid population growth provides a steady stream of potential new customers.
Beds: 730 | 2018 rank: 1 |
President: Jill Hoggard Green
Mission gained muscle after Nashville, Tenn.-based HCA Healthcare completed its $1.5 billion purchase of the 12,000-employee system last month. HCA, a publicly traded company with 2018 revenue of $46.7 billion, plans to build a 120-bed behavioral health hospital in Asheville, replace the aging Angel Medical Center in Franklin, complete the build-out of a $400 million medical tower already under construction and invest $232 million in existing facilities. Mission, which covers the state’s 18 westernmost counties, spent more than $210 million in community investments in 2017; a foundation established as part of the HCA deal will support continued local outreach.
Challenge: Maintaining its prominence as one of the state’s top-performing hospitals could be a challenge for HCA, which has a reputation for stringent cost controls and, unlike not-for-profit Mission, must consider stockholder demands for robust earnings.
CaroMont Regional Medical Center
Beds: 435 | 2018 rank: 6 | CEO: Chris Peek
Last year, CaroMont was named among the Top 100 hospitals by IBM Watson Health for the fifth time. U.S. News & World Report ranks CaroMont as high-performing in treating heart failure and chronic obstructive pulmonary disease. In BNC’s study, CaroMont earned high marks for low rates of common hospital-acquired infections.
Challenge: With population growth picking up in Gaston County, it could be a target market for Charlotte-based Atrium Health, which plans to invest $1 billion over seven years in expansions and improvements.
CarolinaEast Medical Center
Beds: 350 | 2018 rank: 4 |
CEO: Raymond Leggett III
Top-notch heart care is the hallmark of this Craven County hospital. In February, CarolinaEast was named an American Heart Association Cardiovascular Center of Excellence, the first North Carolina hospital to receive the designation. The county-owned medical center is in the midst of its largest expansion and renovation, including a new three-story tower that will house administrative offices and a clinical lab; a new women’s and children’s health pavilion; and an ER expansion and renovation. The SECU Comprehensive Cancer Center, a collaboration with UNC Health Care, will open later this year.
Challenge: Attracting and retaining a talented staff in a small community are challenges. CarolinaEast’s relatively small size could limit its ability to negotiate contracts with dominant insurers including Blue Cross.
Carolinas HealthCare System NorthEast
Beds: 457 | 2018 rank: 11 |
President: Phyllis Wingate
Carolinas HealthCare System, now Atrium Health, acquired the Cabarrus County hospital in 2007. The first phase of a $115.2 million modernization project, a new 165,000-square-foot heart and vascular tower, will open later this year. The tower will include a catheterization lab, cardiovascular intensive care unit, 60 replacement beds and new cardiac operating rooms.
Challenge: Rival Novant Health is expanding aggressively in the Charlotte region but has limited operations in Cabarrus County, one of the state’s fastest-growing areas.
Duke University Hospital
Beds: 957 | 2018 rank: 11 |
President: Thomas Owens
A top U.S. research hospital — its affiliated medical school was awarded more than $356 million in National Institutes of Health grants in 2017 — Duke also earns high marks with patients: 87% said they would recommend the hospital to others, per Medicare data compiled for this report. Duke hosts more than 1 million outpatient visits annually.
Challenge: While it dominates Durham County and benefits from an international reputation, Duke Health’s Wake County operations are smaller than rivals WakeMed and UNC Health Care. Expansion plans in west Cary were hobbled in January when the state denied Duke’s proposal to add four operating rooms as part of a planned 1 million-square-foot facility.
Carolinas Medical Center2
Beds: 1,080 | 2018 rank: 3 |
Interim president: Chris Bowe
After a proposed merger with UNC Health Care fell through in early 2018, Atrium responded by announcing a $1 billion investment across its 40-plus hospital system. Enhancements at the flagship location include a 12-story tower with 384 beds that will replace current infrastructure, a new building and parking deck for its Carolinas Rehabilitation center, and an expanded emergency room.
Challenge: The state’s biggest system has suffered publicity blows over the last year with a prominent 90-physician medical practice breaking away; a feud with the region’s biggest anesthesiologist organization; and settlements of federal antitrust allegations. As Atrium expands outside the state — it completed a merger with Georgia’s Navicent Health in January — it will have to prove that bigger is indeed better.
(tie) UNC Hospitals
Beds: 929 | 2018 rank: 15 | President: Gary Park
UNC Hospitals broke ground in September on a seven-story, 335,000-square-foot surgical tower, expected to be complete in 2022. The $290 million structure will allow for the replacement of operating rooms that were constructed in 1952. UNC earned high marks for patient satisfaction and low rates of common hospital-acquired infections.
Challenge: Factors that pressed UNC officials to seek a collaboration with Atrium Health remain in place. Wesley Burks has succeeded merger advocate Bill Roper as the system’s CEO.
(tie) Wake Forest Baptist Medical Center
Beds: 885 | 2018 rank: 9 |
CEO: Julie Ann Freischlag
Wake Forest’s acquisition of High Point Regional Health didn’t slow plans for growth at its main campus: In July, the medical center said it would renovate two floors, establish a general acute-care unit with 30 licensed beds and expand the neonatal intensive care unit. The hospital is nationally ranked by U.S. News in seven specialties, including No. 19 in cancer care.
Challenge: The system’s growth potential remains in question with Cone, Duke and UNC Health Care to the east, Atrium and Novant to the south, and HCA/Mission to the west. A history of fairly benign competition with Novant could be fraying, reflected in Wake Forest’s re-entry into the delivery of low-risk pregnancies on its main campus.
11 (tie) Atrium Health
Beds: 235 | 2018 rank: 7 | President: Chris Hummer
11 (tie) FirstHealth Moore Regional
Beds: 501 | 2018 rank: 11 | CEO: David Kilarski
13 Wake Forest Baptist Health – High Point
Beds: 351 | 2018 rank: 7 | president: James Hoekstra
14 (tie) Cape Fear Valley Medical Center
Beds: 666 | 2018 rank: 17 | CEO: Michael Nagowski
14 (tie) Duke Regional Hospital
Beds: 369 | 2018 rank: 16 | President: Katie Galbraith
14 (tie) Novant Health Presbyterian Medical Center
Beds: 597 | 2018 rank: 14 | President: Paula Vincent
17 Novant Health Matthews Medical Center
Beds: 146 | 2018 rank: 22 | President: Roland Bibeau
18 New Hanover Regional Medical Center
Beds: 769 | 2018 rank: 9 | CEO: John Gizdic
19 (tie) Frye Regional Medical Center
Beds: 355 | 2018 rank: 22 | CEO: Gar Atchison
19 (tie) Novant Health Forsyth Medical Center4
Beds: 971 | 2018 rank: 25 | President: Chad Setliff
19 (tie) WakeMed Cary Hospital
Beds: 156 | 2018 rank: n/a | Administrator: Thomas Gough
22 (tie) Pardee UNC Health Care
Beds: 222 | 2018 rank: 22 | CEO: James Kirby II
22 (tie) Vidant Medical Center
Beds: 909 | 2018 rank: 20 | President: Brian Floyd
22 (tie) WakeMed Raleigh Campus
Beds: 726 | 2018 rank: 17 | administrator: Rebecca Andrews
25 (tie) Johnston Health
Beds: 199 | 2018 rank: 25 | CEO: Chuck Elliott
25 (tie) Novant Health Huntersville Medical Center
Beds: 91 | 2018 rank: n/a | President: Mike Riley
1 includes The Moses H. Cone Memorial Hospital (Greensboro, 517 beds), Wesley Long (Greensboro, 175 beds) and Annie Penn (Reidsville, 110 beds)
2 includes Carolinas Medical Center (907 beds) and Carolinas Medical Center Mercy (173 beds)
3 includes First Health Moore Regional (Pinehurst, 402 beds) and First Health Richmond Memorial (Rockingham, 99 beds)
4 includes Novant Health Forsyth (921 beds) and Kernersville Medical Center (50 beds)