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Monday, March 4, 2024

North Carolina’s best hospitals 2023

By Kevin Ellis, David Mildenberg and Ebony Morman

Moses Cone Hospital received top honors in Business North Carolina’s annual ranking of the state’s best hospitals. The largest hospital owned by Greenboro-based Cone Health tied for the No. 1 spot in the 2022 ranking. 

The list uses calculations of more than 25 health care metrics, including data sourced from the U.S. Centers for Medicare & Medicaid Services. The report includes patient-satisfaction surveys, infections, readmissions and mortality rates for common procedures. Other data includes findings from safety report cards by the Washington, D.C.-based nonprofit The Leapfrog Group, distinction awards from insurer Blue Cross and Blue Shield and national performance ratings from U.S. News & World Report.

Various hospitals improved their rankings this year. WakeMed Health & Hospitals moved from fifth in 2022 to second place. FirstHealth Moore Regional Hospital jumped from 14th to a tie for third.

The methodology to create this list tends to favor large institutions because they gain more points based on national awards and performance rankings. Smaller hospitals perform fewer procedures, which eliminates those institutions from select categories that are used
for calculations.


Cone Health is adding a five-story, 156,000-square foot tower at its flagship Moses Cone Hospital campus to aid heart and vascular patients. The project broke ground late last year and is expected to be completed in 2025. An adjacent 775-space parking deck is planned. The project complements a smaller heart and vascular center that is under construction at Cone Health’s Alamance Regional Medical Center in Burlington. It involves a renovation of 49,000 square feet and 14,000 square feet of additional space. 

Also last year, Mary Jo Cagle became the health system’s first female CEO and first physician to serve in the role. She was previously chief operating officer after joining the
authority in 2011.


The Raleigh-based not-for-profit entity controls more than half of Wake County’s licensed hospital beds, though it is a smaller institution than local peers UNC Health and Duke Health. WakeMed is seeking state approval for two major projects: a $137 million, 150-bed behavioral health hospital in Knightdale and a 45-bed acute-care hospital in Garner. Knightdale Town Manager Bill Summers wrote a letter in October opposing the WakeMed plan, saying the town doesn’t believe it is the best use for the land to be developed into a hospital. Duke and UNC are also seeking to expand in the county, arguing their plans are better than WakeMed’s Garner expansion.

WakeMed had a lengthy battle last year with UnitedHealthcare after the big insurer and hospital system argued over reimbursement politics, rates and insurance claim errors. The two sides signed a three-year contract in November, after WakeMed hospitals and clinics had been out-of-network for thousands of patients for four months.   


Eugene Washington, president and CEO of Duke University Health System and Duke’s chancellor for health affairs, plans to step down from both roles — which he’s served in since 2015 ­— in June. During his tenure at Duke Health, he was instrumental in creating new strategic initiatives and shifting Duke’s focus to promoting health, especially during the pandemic. His successor is Chief Operating Officer Craig Albanese.

One of the institution’s cardiology researchers is the first U.S. investigator to receive funding from the National Institutes of Health, which will aid in the creation of a drone network able to deliver automated external defibrillators, a life-saving intervention during heart attacks.

Last summer, the hospital launched its hospital-based violence intervention program through a partnership with Bull City United. The anti-gun violence agency, which is funded by Durham County and the city of Durham, meets victims’ families in the hospital, attempts to mediate disagreements and connect involved parties with social services.


A $68 million cancer center opening in March on the Moore Regional Hospital campus in Pinehurst will change the way FirstHealth treats cancer patients from diagnosis to treatment to survivorship. Patients will not only receive treatment at the 120,000-square-foot, four-story outpatient center, but also be able to receive support or visit a yoga studio there. Research and clinical trials will also be part of the center.

A $5 million project this year in Women & Children’s Services will expand the number of triage rooms from six to 10 and labor and delivery rooms from six to nine. A longer-term solution is building a tower for women and children care on the Moore Regional campus. Planning for that project will occur through the summer.

FirstHealth of the Carolinas serves 15 counties in the mid-Carolinas. Moore Regional is its flagship hospital.


UNC Chapel Hill received more than $1 billion in research awards for the third consecutive year, with the college’s School of Medicine getting almost $624 million. The sister organization of UNC Rex Healthcare is a national leader in medical innovation.

UNC Hospitals expects to open its seven-story surgical tower in early 2024. The $425 million building will be the largest on the UNC Hospital campus at 357,000 square feet. Its 26 operating room suites will be double the size of current surgical rooms, and beneficial in more complicated surgeries such as organ transplants or open heart surgery.

Roper Hall, the School of Medicine’s new educational building, will open in the next few months. A mix of state bonds and private donations paid for the $100 million-plus project, and will give the school the ability to increase the class size of its medical students from 190 to 230.

Plans to build a 74-bed hospital in Durham County remain on hold as Duke Health has questioned state regulators on the need for UNC Hospitals’ plans.

UNC Health has partnered with the state Department of Health and Human Services to convert the R.J. Blackley Alcohol and Drug Abuse Treatment Center in Butner to a 54-bed, in-patient psychiatric hospital for children as old as 18. The center plans to open in July.

UNC Health had revenue of about $5 billion in its 2021 fiscal year. It has among the strongest credit ratings among U.S. hospitals.


The UNC Health affiliate tripled its space for oncology care when it opened its $65 million UNC Rex Cancer Center next to the west Raleigh hospital last March. The outpatient center has lots of windows to give patients a healing environment by providing them natural light and allowing them to look out over a forest. The 145,000-square-foot building also offers support and education programs.

Rex Healthcare’s Holly Springs hospital in fast-growing southeast Wake County completed its first full year of operation in 2022. The 50-bed, $170 million hospital has a birthing center, 24-bed emergency department and surgical area. More than 550 babies were delivered there in 2022, compared with about 5,000 at the main Rex hospital. 

UNC Rex is the sole hospital in North Carolina, and among only 22 nationally, to receive
21 consecutive “A” grades every year since the Washington, D.C.-based Leapfrog Group started rating hospitals for patient quality and safety in 2012.


Michael Smith succeeded Ray Leggett as CEO of the hospital’s parent organization, which formed a partnership with UNC Health in 2021. Leggett worked at CarolinaEast for 32 years, including 14 as CEO. He led the expansion of Craven Regional Medical Center into a multi-facility system that includes a 80,000-square-foot cancer center that opened in 2020. Smith is a New Bern native who worked for accounting firms before joining the system in 2010. He had been vice president of physician practice management.

The system employed about 2,700 people in 2021, making it Craven County’s second-biggest employer behind the Department of Defense. It had revenue of $846 million in the June 2021 fiscal year, according to a Craven County annual filing. 

In January, CarolinaEast added six orthopedic surgeons who had been part of a practice with offices in New Bern and Jacksonville. CarolinaEast Physicians now has 11 practices
in its network.


The hospital had an average daily census of 594 in the first half of 2022, making it the second-busiest hospital in the Novant Health group behind the New Hanover Regional Medical Center in Wilmington, which averaged 624 patients. Novant Health opened a $120 million neurosciences institute at the Wilmington campus in February, aiming to provide comprehensive stroke, brain, spine and neurological care. 

The not-for-profit group’s bid to expand with a new hospital in Asheville failed in November when state officials selected Altamonte Springs, Florida-based AdventHealth to add a 67-bed facility there. HCA Healthcare, which owns Asheville’s dominant hospital, also made a bid for expansion. More than 2,000 people sent comments on the competition to the state.

Novant is increasing its minimum wage to $17 an hour in early March, a move expected to affect more than 4,400 workers throughout the 29,200-employee system.


More than 3,500 people work at the hospital, which Durham County opened in 1976 upon the merger of Lincoln and Watts hospitals. Duke University took control of the hospital in 1998 under a 20-year agreement that was extended for rolling 40-year terms. The name was changed from Durham Regional in 2013 to take advantage of Duke’s brand. 

Last year the nonprofit Lown Institute ranked it as the second-most “socially responsible” hospital in the U.S., based on patient outcomes, value of care and health equity. Duke Regional received A grades in each of the three categories. 

Hospital President Dev Sangvai is a family practice doctor and a former president of the N.C. Medical Society. He earned an M.D. degree from the Medical College of Ohio and he has a Duke MBA. In 2022, he succeeded Katie Galbraith, who had led Duke Regional since 2014 before moving to become president of a hospital near Philadelphia.

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