{"id":250691,"date":"2025-09-24T04:42:24","date_gmt":"2025-09-24T04:42:24","guid":{"rendered":"https:\/\/www.europesays.com\/us\/250691\/"},"modified":"2025-09-24T04:42:24","modified_gmt":"2025-09-24T04:42:24","slug":"another-large-nc-independent-practice-joins-hospital-ranks","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/us\/250691\/","title":{"rendered":"Another large NC independent practice joins hospital ranks"},"content":{"rendered":"

By Michelle Crouch\u00a0\u00a0<\/strong><\/p>\n

Carolina NeuroSurgery & Spine Associates, one of the nation\u2019s largest independent neurosurgery practices, will join Atrium Health on Oct. 1, 2025, the two providers announced<\/a> last week.\u00a0\u00a0<\/p>\n

Nearly 300 Carolina NeuroSurgery & Spine staff members across seven Charlotte-area clinics will become part of Atrium, which operates under the corporate banner of Advocate Health, the country\u2019s third-largest public health care system with $34.8 billion in annual revenue.<\/p>\n

\u201cBy combining our expertise, we will strengthen surgical and nonsurgical care for neurosurgery and spine patients and their families,\u201d Dr. Mark Smith, president of Carolina NeuroSurgery & Spine, said in a news release.<\/p>\n

The move reflects a broader trend in health care, as large hospital systems in North Carolina and nationwide grow and consolidate their power<\/a>.\u00a0<\/p>\n

While headlines often focus on horizontal integration \u2014 when hospitals expand their footprints by acquiring or merging with other hospitals \u2014 they are also going vertical, bringing independent physician groups into their networks to expand market share, streamline care and funnel patients to their facilities.<\/p>\n

To name just a few examples in recent years: UNC Health partnered with Blue Ridge Medical Group in western North Carolina, Duke Health absorbed the Private Diagnostic Clinic in Durham, and Novant Health purchased UCI Medical Affiliates in South Carolina.\u00a0<\/p>\n

Other large practices acquired by Atrium include Pediatric Surgical Associates and Mecklenburg Medical Group in Charlotte and the Harbin Clinic in Georgia.<\/p>\n

Independent practices feel the squeeze<\/strong><\/p>\n

The share of physicians nationwide working for hospitals, instead of functioning in a private practice, nearly doubled between 2008 and 2016, according to the nonprofit National Bureau of Economic Research<\/a>.\u00a0<\/p>\n

Today, only about 42 percent of physicians work for an independent practice, down from 60 percent in 2012, according to the American Medical Association<\/a>.\u00a0<\/p>\n

\u201cThe share of doctors working in practices wholly owned by physicians is unraveling under compounding pressures,\u201d Bruce Scott, the AMA\u2019s immediate past president, said in June when the statistics were released. \u201cThe cumulative impact of burdensome regulations, rising financial strain and relentless cuts in payment poses a dire threat to the sustainability of private practices.\u201d<\/p>\n

Scott said inflation-adjusted Medicare payments to private physicians have fallen 33 percent over the past 25 years, making it difficult for private practices to stay in business. The Medicare program pays higher rates to physicians employed by hospitals, making independent practices an attractive target for acquisition.<\/p>\n

Neurosurgery is one of the most profitable service lines in health systems, said Matthew Hanis, a Charlotte-based health care consultant, in an email.<\/p>\n

By aligning with Carolina NeuroSurgery & Spine, Atrium \u201cgets all the downstream referrals: rehab, vascular surgery, oncology, etc.,\u201d Hanis said. \u201cThey also get a boatload of really talented surgeons, which is hard to come by.\u201d<\/p>\n

Carolina NeuroSurgery & Spine will benefit from having access to Atrium\u2019s billing and scheduling systems, risk management and other infrastructure \u2014 along with added financial stability, Hanis said.<\/p>\n

What does it mean for patients?<\/strong><\/p>\n

Barak Richman, a health policy expert at George Washington University and a critic of health care consolidation, said mergers and acquisitions between hospitals and physician practices typically drive up health care costs and can hurt the quality of care.<\/p>\n

\u201cThe growing and overwhelming evidence is that these transactions are bad for patients,\u201d Richman said. \u201cThey unambiguously increase prices and, along several important dimensions, can reduce quality.\u201d\u00a0\u00a0\u00a0<\/p>\n

He added that the transactions also often result in lower physician job satisfaction, with many physicians who sold their practices \u201csoon regretting it bitterly.\u201d\u00a0<\/p>\n

A paper published by the National Bureau of Economic Research<\/a> in July 2025 examined what happened when hospitals bought OB-GYN practices. It revealed that two years after an acquisition, prices for labor and delivery jumped an average of $475, and physician prices rose by $502<\/a>.\u00a0\u00a0<\/p>\n

The paper\u2019s authors called for more scrutiny of vertical mergers. They also called on policymakers to eliminate the financial incentives that encourage the deals, such as Medicare rules that pay doctors a higher rate if they work for a hospital rather than an independent practice.\u00a0<\/p>\n

Atrium\u2019s deal with Carolina NeuroSurgery & Spine is unusual in that it does not appear to be a straight-up acquisition. While its staff will become part of Atrium, the physicians will not become hospital employees, making it more of a hybrid model, staff members told the Ledger\/NC Health News.\u00a0<\/p>\n

Patients at Carolina NeuroSurgery & Spine will be able to see their same doctors in the same locations, the release said. The practice\u2019s clinics in Greensboro and Kernersville are not part of the deal.\u00a0<\/p>\n

This article is part of a partnership between The Charlotte Ledger and North Carolina Health News to produce\u00a0original health care reporting<\/a>. You can support this effort with\u00a0a tax-deductible donation.<\/a><\/p>\n

Republish This Story<\/p>\n

\"Creative<\/a><\/p>\n

Republish our articles for free, online or in print, under a Creative Commons license.<\/p>\n","protected":false},"excerpt":{"rendered":"By Michelle Crouch\u00a0\u00a0 Carolina NeuroSurgery & Spine Associates, one of the nation\u2019s largest independent neurosurgery practices, will join…\n","protected":false},"author":3,"featured_media":250692,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[95609,77016,86610,132787,132788,210,1141,132789,1142,132790,67,132,68,132791],"class_list":{"0":"post-250691","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-advocate-health","9":"tag-american-medical-association","10":"tag-atrium-health","11":"tag-barak-richman","12":"tag-carolina-neurosurgery-spine","13":"tag-health","14":"tag-health-care","15":"tag-health-care-consolidation","16":"tag-healthcare","17":"tag-mark-smith","18":"tag-united-states","19":"tag-unitedstates","20":"tag-us","21":"tag-vertical-integration"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115257445521142126","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/250691","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=250691"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/250691\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/250692"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=250691"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=250691"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=250691"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}