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WakeMed Health, a nonprofit hospital that has served the Raleigh area since 1961, is moving to combine with Atrium Health, the state's largest hospital system, they said in a joint release Friday. 

Why it matters: WakeMed is the third-largest healthcare provider in the Triangle, giving Atrium a large foothold here, if the combination is approved by regulators.

Atrium, which has a significant presence in Charlotte and the Triad, is part of the nonprofit healthcare company Advocate Health. 

Between the lines: There has been a lot of consolidation within the healthcare system and many are feeling the pressure to expand their footprint. UNC Health and Duke Health have also sought to expand their presence across the state. 

Already some state officials are calling for scrutiny of the potential merger. State Treasurer Brad Briner said Friday he hoped the attorney general's office and the Federal Trade Commission would look closely at the deal between WakeMed and Atrium. 

"There is a simple business principle that when suppliers consolidate and competition is reduced it is the consumers who suffer," Briner said in a statement. "This has been proven to be true time and again in the health care landscape, where prices continue to rise and patients are left with mounting medical debt."

Driving the news: The Wake County Board of Commissioners is meeting Monday to give its approval to the merger. 

The county owned the hospital network until 1997 when it became a nonprofit. 

Zoom in: As part of the combination, Atrium Health is expected to invest $2 billion into WakeMed, which has three hospitals in Wake County. 

Some of that money will go toward expanding its flagship campus on New Bern Avenue in Raleigh and an expansion of its hospitals in Cary and north Raleigh. 

It will also further enhance its Garner campus, which is under development. 

The merger is anticipated to create 3,300 new jobs, according to the hospitals. 

Flashback: Atrium previously tried to merge with UNC Health, but it ultimately called off that deal in 2018 after failing to reach a final deal.

What they're saying: "For more than 65 years, WakeMed has been a beacon of hope and healing for the Wake County area and beyond," WakeMed CEO Donald Gintzig said in a statement. "This combination represents a significant next step in building upon this legacy, expanding our impact and ensuring a thriving nonprofit health care future for all we serve." 

WakeMed is seeking to combine with Atrium Health

WakeMed, previously owned by the Wake County until 1997, has three hospitals in Wake County

Outdoor white sign showing the number 2600 at the top, with WakeMed and Center for Community Health text and a red circular logo on the right, brick building and trees in background.

WakeMed Health, a nonprofit hospital that has served the Raleigh area since 1961, is moving to combine with Atrium Health, the state&#x27;s largest hospital system, they said in a joint release Friday. Why it matters: WakeMed is the third-largest healthcare provider in the Triangle, giving Atrium a large foothold here, if the combination is approved by regulators.<ul><li>Atrium, which has a significant presence in <a class="gtmContentClick" data-vars-link-text="Charlotte" data-vars-click-url="https://www.axios.com/local/charlotte/2026/04/29/south-charlotte-arts-hub-nonprofit-campus-plan-feasibility-study-funding-theater" data-vars-content-id="0814822d-8981-4ce6-b306-90cfb940f0af" data-vars-headline="WakeMed is seeking to combine with Atrium Health" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/charlotte/2026/04/29/south-charlotte-arts-hub-nonprofit-campus-plan-feasibility-study-funding-theater" target="_self">Charlotte</a> and the Triad, is part of the nonprofit healthcare company Advocate Health. </li></ul>

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A Raleigh startup trying to help e-commerce companies navigate new AI-based tech and trends has raised $13.6 million in a seed round from investors. 

Why it matters: The company, called ReFiBuy, is the latest startup from Scot Wingo, a serial entrepreneur and investor who is influential in the Triangle's startup scene. 

His previous ventures include the e-commerce company ChannelAdvisor, the on-demand car-care company Spiffy and the Triangle Tweener Fund. 

Driving the news: The new round, led by NewRoad Capital Partners, will allow the company to expand its sales and marketing and engineering team, Wingo told Axios. 

The company has around 20 employees based in downtown Raleigh and will likely hire another 10 in the coming months. 

What it does: Increasingly, e-commerce is being done through the lens of artificial intelligence. Humans are no longer the only ones searching for things to buy online, but also AI agents. 

Previously, companies focused on how to get their products to show up on search engines. But now the goal is also to surface in results of agentic shopping engines, which let AI autonomously research, compare and buy products.

ReFiBuy builds tools that help brands make sure their products are considered by AI buying agents and also consults with companies to keep up with trends in the space. 

By the numbers: Between 30% to 45% of U.S. consumers now use generative AI to research items to purchase, according to research from Bain, whether that is using ChatGPT, Claude, Perplexity or Google search, which now also uses AI. 

What they're saying: "We want to make sure every fact about your product is known by these [large language models], so that they can almost be an outsourced sales representative for you," Wingo told Axios. 

Raleigh e-commerce startup raises $13.6M seed round

The startup is helping companies navigate AI trends in e-commerce.

Illustration of a cursor hand holding a price tag.

A Raleigh startup trying to help e-commerce companies navigate new AI-based tech and trends has raised $13.6 million in a seed round from investors. Why it matters: The company, called <a class="gtmContentClick" data-vars-link-text="ReFiBuy" data-vars-click-url="https://refibuy.ai/" data-vars-content-id="3741b1e7-5ebc-4639-953a-65133f96df66" data-vars-headline="Raleigh e-commerce startup raises $13.6M seed round" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://refibuy.ai/" target="_blank">ReFiBuy</a>, is the latest startup from <a class="gtmContentClick" data-vars-link-text="Scot Wingo" data-vars-click-url="https://www.axios.com/local/raleigh/2022/08/16/local-limelight-entrepreneur-investor-scot-wingo-raleigh" data-vars-content-id="3741b1e7-5ebc-4639-953a-65133f96df66" data-vars-headline="Raleigh e-commerce startup raises $13.6M seed round" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2022/08/16/local-limelight-entrepreneur-investor-scot-wingo-raleigh" target="_self">Scot Wingo</a>, a serial entrepreneur and investor who is influential in the Triangle&#x27;s startup scene.

Demolition of the former DMV headquarters on New Bern Avenue is about halfway complete, but city leaders are beginning to get a clearer picture of what the site could become. 

Why it matters: The city spent $20 million to buy the roughly 6-acre property in 2023 with a goal of maintaining control of an influential piece of land in a rapidly transforming neighborhood and on a future bus-rapid transit line. 

State of play: The hope, city leaders have said, is that site could both provide density for the future transit line, as well as community benefits through affordable housing, more retail space and community gathering spaces. 

Driving the news: City staff presented three sketch options for the future of the site at a meeting Tuesday. 

Demolition of the site is currently behind schedule due to the scale of asbestos abatement that exists on the site. 

Zoom in: The city has been engaging with community members for the past two years on what they would like to see built there and working with consultants on financial feasibilities. 

Between the lines: The city is hoping to not subsidize the site much further than the $20 million it's already spent on the land. 

But due to a glut of new apartments suppressing rent growth, city staff said apartments are a less attractive investment at the moment and might need more subsidizing than previous years. 

"Unfortunately where we are at in the market today is there is a glut of multifamily supply and still relatively high construction pricing and interest rates," Ken Bowers, Raleigh's deputy director for planning and development, told city council. 

A typical mid-rise apartment in today's market, he said, would likely require giving away the land and also a further subsidy to attract a developer to build it. 

Zoom in: Given that reality, staff presented three options as most feasible: 

Option 1 includes the city winning a 9% low-income housing tax credit for the site and building 269 apartments. 

Sixty of them would be set aside as affordable, and the project would include 20,000 square feet of retail, 300 parking spaces and 36 townhomes.

This option would likely not require further subsidy from the city, per staff.

Option 2 envisions the city getting a 4% low-income housing tax credit and building 269 apartments again. 

Under this scenario, though, 110 units would be set aside as affordable while also building 22 townhomes, more than 300 parking spaces and 20,000 square feet of retail. 

This option, however, would likely need between $6 million to $10 million in additional subsidies. 

Option 3 was also modeled under a 4% low-income housing tax credit and would build 368 apartments. 

In this option, 111 of the apartments would be affordable while also building 20 townhomes, 448 parking spaces and 20,000 square feet of retail. The parking would be in a city-subsidized deck. 

Staff said this option would require between $6.4 million and $7.4 million in additional subsidies from the city. 

What's next: The city plans to put out a request for interest on the site to gauge how strong of demand exists from private developers. 

Raleigh pitches affordable housing and retail for old DMV HQ site

But the math for building affordable housing has gotten complicated by a glut of new apartments.

Red brick government building with a circular emblem and the Division of Motor Vehicles sign on the facade. A parking lot with barriers and road signs, including a yield sign on the right.

The old DMV headquarters on New Bern Avenue in 2023. Photo: Zachery Eanes/Axios

Demolition of the former DMV headquarters on New Bern Avenue is about halfway complete, but city leaders are beginning to get a clearer picture of what the site could become. Why it matters: The city spent $20 million to buy the roughly 6-acre property in 2023 with a goal of maintaining control of an influential piece of land in a rapidly transforming neighborhood and on a future <a class="gtmContentClick" data-vars-link-text="bus-rapid transit" data-vars-click-url="https://www.axios.com/local/raleigh/2025/04/28/raleigh-tries-again-to-get-bus-rapid-transit-construction-started" data-vars-content-id="57bc969d-0efd-4747-8f2e-2c5a909ca0e9" data-vars-headline="Raleigh pitches affordable housing and retail for old DMV HQ site" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2025/04/28/raleigh-tries-again-to-get-bus-rapid-transit-construction-started" target="_self">bus-rapid transit</a> line.

Development

WakeMed Health's leadership said Tuesday that a merger with Atrium Health is needed to ensure the Wake County-based hospital network will be thriving a decade from now. 

Why it matters: Atrium's potential takeover of WakeMed, which was founded by Wake County in 1961 and is a safety-net provider, has been the talk of the town since it was announced last Friday afternoon. 

State and local officials, however, have raised strong opposition to the speed and the scope of the deal. 

Driving the news: WakeMed hosted a press conference Tuesday for the first time since announcing the deal and after the Wake County Board of Commissioners delayed a potential vote that would have initiated Atrium's takeover. 

In comments to the media, WakeMed's CEO Donald Gintzig said he viewed this as a combination rather than a sale of WakeMed. 

The merger, which is two years in the making, calls for Atrium to invest $2 billion into WakeMed. The hospital's board would have a majority of members still approved by Wake County under the deal. 

State of play: The deal, he believes, maintains WakeMed's influence in a way that might not be possible if its position weakens in the coming years due to Medicaid cuts and increased competition from Duke Health and UNC Health.

But a more immediate concern is that its main campus on New Bern Avenue, originally built in the 1960s, needs at least a billion dollars worth of redevelopment. 

What they're saying: "Do I think WakeMed will survive in the future [without this merger]? Yes. But I can see a world in which it doesn't thrive and that's really what this is about," Gintzig said. 

"I envision and see the challenges that we face to rebuild the [main] campus. Our finance folks have advised us it's unlikely we're going to have the financial capacity to rebuild the Raleigh campus ... and it needs to be rebuilt." 

Between the lines: That is an argument that officials like state Treasurer Brad Briner have pushed back on, saying WakeMed has a strong enough bond rating to fund a renovation itself. Briner, for his part, is concerned that the consolidation will lead to higher prices for care for the State Health Plan. 

On Tuesday, Gintzig said he looked forward to sitting down with Briner and explaining the hospital's debt capacity. 

"I would welcome a $2 billion investment from the treasurer ... from the county and the state to make that happen," he said. But, "I don't see that happening without this combination." 

Zoom in: Steve Smoot, Atrium's division president for North Carolina, said that in addition to a $2 billion investment and new jobs, the merger would boost WakeMed's virtual health care network and add more specialty care. 

He also said Atrium was committed to preserving WakeMed's charity care, and that it would raise the poverty level eligible for it. 

Those between 300% to 400% of the poverty level would be eligible for financial assistance — while those below 300%, which is under $100,000 for a family of four, would not get a bill. 

What's next: WakeMed and Atrium need the Wake County Commissioners to approve a change to its articles of incorporation to file for the merger. 

That change has been delayed at least 90 days to give WakeMed more time to talk to the public about the merger. 

Once that happens, WakeMed and Atrium can file for regulatory approval from the Federal Trade Commission and Department of Justice. 

WakeMed's CEO makes his case for a merger with Atrium

WakeMed says its main campus needs at least $1 billion to be redeveloped.

Modern glass-front hospital building with a red brick tower bearing the WakeMed logo. A Children's sign atop the building; a white elevated pedestrian bridge crosses the foreground under a blue sky.

WakeMed's campus on New Bern Avenue in Raleigh. Photo: Zachery Eanes/Axios

WakeMed Health&#x27;s leadership said Tuesday that a merger with Atrium Health is needed to ensure the Wake County-based hospital network will be thriving a decade from now. Why it matters: Atrium&#x27;s potential takeover of WakeMed, which was founded by Wake County in 1961 and is a<a class="gtmContentClick" data-vars-link-text=" safety-net provider," data-vars-click-url="https://www.nyu.edu/about/news-publications/news/2023/september/safety-net-hospital.html" data-vars-content-id="7603ba51-0c04-418d-ac5c-c0e82ec37b27" data-vars-headline="WakeMed&#x27;s CEO makes his case for a merger with Atrium" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.nyu.edu/about/news-publications/news/2023/september/safety-net-hospital.html" target="_blank"> safety-net provider,</a> has been the talk of the town since it was <a class="gtmContentClick" data-vars-link-text="announced" data-vars-click-url="https://www.axios.com/local/raleigh/2026/05/01/wakemed-is-seeking-to-combine-with-atrium-health" data-vars-content-id="7603ba51-0c04-418d-ac5c-c0e82ec37b27" data-vars-headline="WakeMed&#x27;s CEO makes his case for a merger with Atrium" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2026/05/01/wakemed-is-seeking-to-combine-with-atrium-health" target="_self">announced</a> last Friday afternoon. <ul><li>State and local officials, however, have <a class="gtmContentClick" data-vars-link-text="raised strong opposition" data-vars-click-url="https://www.axios.com/local/raleigh/2026/05/04/atriums-acquisition-of-wakemed-receives-significant-pushback" data-vars-content-id="7603ba51-0c04-418d-ac5c-c0e82ec37b27" data-vars-headline="WakeMed&#x27;s CEO makes his case for a merger with Atrium" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2026/05/04/atriums-acquisition-of-wakemed-receives-significant-pushback" target="_self">raised strong opposition</a> to the speed and the scope of the deal. </li></ul>

A vote on a proposed merger between WakeMed Health and Atrium Health  has been delayed after significant pushback from state and local officials. 

Why it matters: The potential merger would give Atrium Health, the state's largest health care provider, a significant foothold in the Triangle.

 The deal was announced last Friday afternoon and the Wake County Board of Commissioners were scheduled to vote on it Monday evening. 

But that vote has been delayed for at least 90 days, after commissioners voted to remove it from Monday night's consent agenda. 

State of play: Local and state officials have pushed back on the potential deal, saying that the move has been rushed without public comment and transparency, and could create higher prices for residents. 

Officials ranging from state Treasurer Brad Briner, state Auditor Dave Boliek, state Rep. Mike Schietzelt and Raleigh Mayor Janet Cowell have all objected to the speed and scope of the deal.

Driving the news: The county commissioners were set to consider amending WakeMed's articles of incorporation on Monday to allow for Atrium and WakeMed to begin the regulatory process of merging. 

Wake County does not have the legal authority to approve the merger, but the delay will give the public more time to engage on a potential merger. 

"While the joining of these hospitals may be positive for Wake County, we want to be fully open and transparent about the process, and that includes allowing ample time for public feedback," Don Mial, chair of the Wake County Board of Commissioners, said in statement.

Zoom in: WakeMed has served Wake County since 1961 and was originally built with tax payer money. The county owned the hospital network until 1997 when it became a nonprofit.

It is a significant health care provider in the Triangle with three hospitals and several outpatient facilities. WakeMed offers a significant amount of charity care and is an important player in mental health services. 

The deal between Atrium does not include a purchase price, but instead a commitment to invest $2 billion into WakeMed. 

Cowell, a former state treasurer, said she did not believe that was a fair price for WakeMed, especially considering similar community-founded hospitals in Buncombe and New Hanover counties were acquired for much more.

Those sales also created trusts that invest in the health of Buncombe County and New Hanover County.  

What they're saying: "Why does Buncombe get $1.5 billion and New Hanover get a billion-plus when their hospitals changed hands?" Cowell said. "What is it that makes this situation so different, after all of these decades of local investment into this institution, that Wake County gets nada?" 

"I think people think of me as a fairly calm, level-headed person, and this just makes me really angry," Cowell said. 

Atrium and WakeMed have not responded to a request for comment, but the two are expected to hold a press briefing Tuesday. 

State of play: Briner agreed that he does not believe this was a fair price to acquire WakeMed. 

But his concern, as the steward of the State Health Plan, is that the merger would lead to higher prices for patients, especially since Atrium has much more bargaining power with insurers. 

Studies have shown that hospital mergers raise health care costs. But at the same time, hospital networks are facing financial pressures to expand their footprints. 

What they're saying: "The State Health Plan is a major purchaser of WakeMed services. I don't think we've publicly said exactly how much that is, but you'd be right to guess it's a nine-digit number," Briner told Axios. "And if you assume, as you see in all the academic research, that prices go up 10%, that's an eight-digit number that we simply can't afford." 

Briner said he thinks it's important to maintain the competitive mix that exists in the Triangle between Duke Health, UNC Health and WakeMed. 

"We probably will have three providers [here] until we change something about certificate of need [laws]," Briner said. "And I think it's really important that we keep those three who they are, and not allow the kind of cross-jurisdictional leverage that would apply in Atrium's case."

Atrium's acquisition of WakeMed receives significant pushback

The merger would give Atrium, the state's largest hospital network, a foothold in the Triangle.

Animated GIF of two hospitals merging, with a dollar sign appearing in between them

two hospitals together forming a dollar sign.

A vote on a <a class="gtmContentClick" data-vars-link-text="proposed merger" data-vars-click-url="https://www.axios.com/local/raleigh/2026/05/01/wakemed-is-seeking-to-combine-with-atrium-health" data-vars-content-id="dea2f66d-d10e-45c5-b2bc-62f7be2313b7" data-vars-headline="Atrium&#x27;s acquisition of WakeMed receives significant pushback" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2026/05/01/wakemed-is-seeking-to-combine-with-atrium-health" target="_self">proposed merger</a> between WakeMed Health and Atrium Health has been delayed after significant pushback from state and local officials. Why it matters: The potential merger would give Atrium Health, the state&#x27;s largest health care provider, a significant foothold in the Triangle.

Zachery Eanes

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Atrium's acquisition of WakeMed receives significant pushback

WakeMed is seeking to combine with Atrium Health