Another Large Nc Independent Practice Joins Hospital Ranks

By Michelle Crouch  

Carolina NeuroSurgery & Spine Associates, 1 of nan nation’s largest independent neurosurgery practices, will subordinate Atrium Health connected Oct. 1, 2025, nan 2 providers announced past week.  

Nearly 300 Carolina NeuroSurgery & Spine unit members crossed 7 Charlotte-area clinics will go portion of Atrium, which operates nether nan firm banner of Advocate Health, nan country’s third-largest nationalist wellness attraction strategy pinch $34.8 cardinal successful yearly revenue.

“By combining our expertise, we will fortify surgical and nonsurgical attraction for neurosurgery and spine patients and their families,” Dr. Mark Smith, president of Carolina NeuroSurgery & Spine, said successful a news release.

The move reflects a broader inclination successful wellness care, arsenic ample infirmary systems successful North Carolina and nationwide grow and consolidate their power. 

While headlines often attraction connected horizontal integration — erstwhile hospitals grow their footprints by acquiring aliases merging pinch different hospitals — they are besides going vertical, bringing independent expert groups into their networks to grow marketplace share, streamline attraction and chimney patients to their facilities.

To sanction conscionable a fewer examples successful caller years: UNC Health collaborated pinch Blue Ridge Medical Group successful occidental North Carolina, Duke Health absorbed nan Private Diagnostic Clinic successful Durham, and Novant Health purchased UCI Medical Affiliates successful South Carolina. 

Other ample practices acquired by Atrium see Pediatric Surgical Associates and Mecklenburg Medical Group successful Charlotte and nan Harbin Clinic successful Georgia.

Independent practices consciousness nan squeeze

The stock of physicians nationwide moving for hospitals, alternatively of functioning successful a backstage practice, astir doubled betwixt 2008 and 2016, according to nan nonprofit National Bureau of Economic Research. 

Today, only astir 42 percent of physicians activity for an independent practice, down from 60 percent successful 2012, according to nan American Medical Association. 

“The stock of doctors moving successful practices wholly owned by physicians is unraveling nether compounding pressures,” Bruce Scott, nan AMA’s contiguous past president, said successful June erstwhile nan statistic were released. “The cumulative effect of burdensome regulations, rising financial strain and relentless cuts successful costs poses a dire threat to nan sustainability of backstage practices.”

Scott said inflation-adjusted Medicare payments to backstage physicians person fallen 33 percent complete nan past 25 years, making it difficult for backstage practices to enactment successful business. The Medicare programme pays higher rates to physicians employed by hospitals, making independent practices an charismatic target for acquisition.

Neurosurgery is 1 of nan astir profitable work lines successful wellness systems, said Matthew Hanis, a Charlotte-based wellness attraction consultant, successful an email.

By aligning pinch Carolina NeuroSurgery & Spine, Atrium “gets each nan downstream referrals: rehab, vascular surgery, oncology, etc.,” Hanis said. “They besides get a boatload of really talented surgeons, which is difficult to travel by.”

Carolina NeuroSurgery & Spine will use from having entree to Atrium’s billing and scheduling systems, consequence guidance and different infrastructure — on pinch added financial stability, Hanis said.

What does it mean for patients?

Barak Richman, a wellness argumentation master astatine George Washington University and a professional of wellness attraction consolidation, said mergers and acquisitions betwixt hospitals and expert practices typically thrust up wellness attraction costs and tin wounded nan value of care.

“The increasing and overwhelming grounds is that these transactions are bad for patients,” Richman said. “They unambiguously summation prices and, on respective important dimensions, tin trim quality.”   

He added that nan transactions besides often consequence successful little expert occupation satisfaction, pinch galore physicians who sold their practices “soon regretting it bitterly.” 

A paper published by nan National Bureau of Economic Research successful July 2025 examined what happened erstwhile hospitals bought OB-GYN practices. It revealed that 2 years aft an acquisition, prices for labour and transportation jumped an mean of $475, and physician prices roseate by $502.  

The paper’s authors called for much scrutiny of vertical mergers. They besides called connected policymakers to destruct nan financial incentives that promote nan deals, specified arsenic Medicare rules that salary doctors a higher complaint if they activity for a infirmary alternatively than an independent practice. 

Atrium’s woody pinch Carolina NeuroSurgery & Spine is different successful that it does not look to beryllium a straight-up acquisition. While its unit will go portion of Atrium, nan physicians will not go infirmary employees, making it much of a hybrid model, unit members told nan Ledger/NC Health News. 

Patients astatine Carolina NeuroSurgery & Spine will beryllium capable to spot their aforesaid doctors successful nan aforesaid locations, nan merchandise said. The practice’s clinics successful Greensboro and Kernersville are not portion of nan deal. 

This article is portion of a business betwixt The Charlotte Ledger and North Carolina Health News to produce original wellness attraction reporting. You tin support this effort with a tax-deductible donation.

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