Not exactly a new group. I’d heard this shake-up was in the works for a while, but was not aware that it was official.
What you describe is the community practice of Atrium Wake Forest Baptist Health (formally known as Wake Forest Baptist Health). This is very different from the Wake Med Health System in Raleigh, NC. I know, all of the “Wakes” in NC can get confusing.
Wake Forest Baptist Health was the $3B health system headquartered out of Winston Salem and was the system affiliated with Wake Forest Health Sciences and Wake Forest School of Medicine. They had an academic/faculty practice that ran the residency out of Wake Forest Baptist Medical Center, and a community practice that staffed community and free standing EDs affiliated with the health system as well as a couple of non-affiliated contracts such as Cone Health in Greensboro. The structure of these contracts were very similar to a small contract management group with sites having local leadership but major admin decisions flowing through the academic Chair at Baptist Medical Center in Winston Salem. Unlike a CMG, physicians in the community practice were employed by the health system which relied heavily on its own residency graduates for labor.
Well, Wake Forest Baptist Health entered a “strategic partnership“ (aka was acquired by) Atrium Health System which is the $10B system with a clinical headquarters at Carolinas Medical Center in Charlotte. Although Carolinas Medical Center is a faculty academic practice similar to Baptist in Winston Salem, Atrium had several community hospitals around Charlotte that were staffed by USACS and ApolloMD. It was pretty much understood that the USACS contracts were in immediate jeopardy as soon as Atrium Health System acquired Wake Forest Baptist Health since the Baptist leadership was telling the Atrium leadership how great it was to have hospital-employed emergency physicians whose fees they could harvest. After all, why allow a 3rd party CMG to collect those fees when you have $13B mega health system that can apply economies of scale to the operating expenses for a physician practice spanning 20+ hospitals? Moreover, Atrium emerged from the acquisition having 2 established EM residencies across NC (Carolinas Med Center in Charlotte and WF Baptist in Winston Salem) and a future new Charlotte medical school campus of Wake Forest School of Medicine to supply the labor.
I’m not going to say that this is a good or bad thing for physicians. I will say that this is more evidence that CMGs are being replaced by large health systems; many of them non-profits. It is also worth mentioning that Atrium Health is currently looking to merge with WI/IL-based Aurora-Advocate Health to make one of the largest health systems (roughly $24B I think) in the country spanning the South and Midwest. I will also note that this concept of physician ownership of practices and exclusion of private equity is all fine and dandy, but starting a practice takes capital - capital that banks are often no longer willing to lend. I can see CMGs/private equity supplying that capital; I can see large health systems supplying it. Unfortunately, I don’t invison many physicians willing to supply it making physician ownership unlikely.
