A North Carolina county projected to run short on hospital beds has multiple nonprofit health organizations asking state regulators for permission to fill the gap with a new acute care hospital.
According to North Carolina Department of Health and Human Services records, Cone Health filed a certificate of need (CON) application April 15 to build the Cone Health Mebane Hospital, a 46-bed acute care hospital it believes will cost $250 million to construct.
A press release from Cone announcing the proposal said the system plans to spend up to $275 million on the hospital to support “the health of Alamance County and the surrounding area.” If approved, construction would wrap in 2028 with an opening in 2029, with the facility also supporting 15 ED bays, four operating rooms, two procedure rooms and 10 additional beds for observation and obstetrics.
However, also April 15, the state department received a CON application from Novant Health and Duke Heath—a recently announced alliance—to build the 46-bed Duke Novant Mebane Hospital, which they told the state would cost $225 million.
The joint application was confirmed by spokespeople for the two organizations, with a Duke Health official saying in a statement the proposed facility “would expand access to acute care services and clinical expertise in the region, including emergency department services, inpatient services, and labor and delivery care.”
North Carolina is one of several states with a law on the books prohibiting new healthcare facilities without CON approval. The requirement is intended to restrict rising healthcare costs by limiting “unnecessary health services and facilities based on geographic, demographic and economic considerations,” according to the department’s website. North Carolina’s CON law has, however, been under fire both in the courts and in the general assembly.
That said, the North Carolina State Health Coordinating Council in its most recent annual recommendations on the state’s healthcare needs, which are used to guide CON approvals, projected a 46-bed acute care bed deficit for 2027 in Alamance. Statewide, the council projected a 1,042-bed deficit.
Both parties described a potential hospital as an answer to Alamance’s shortage and an extension of their existing presence within the county.
Cone Health, in its announcement, noted that the proposed hospital would be built adjacent to its existing Cone Health MedCenter Mebane clinic and said the construction would save residents the 10-mile trip to the nearest facility, Alamance Regional Medical Center—also part of Cone Health.
“Cone Health has successfully helped meet the healthcare needs of eastern Alamance County close to home for more than a dozen years,” President and CEO Dr. Mary Jo Cagle, M.D., who is set to step down at the end of May, said in the announcement. “This major investment positions Cone Health Mebane Hospital to become a significant part of this community for decades to come.”
Four-hospital Cone Health is slated for growth under its new owner, Kaiser Permanente’s Risant Health subsidiary, which committed at least $1.7 billion in funding for the system over the next five years. Cagle, in prior comments to press, had suggested that those funds would primarily be allocated toward updating existing facilities or potentially pursuing organic growth in its markets, rather than outright expansion through a hospital acquisition, for instance.
Novant and Duke, meanwhile, made their intentions of new North Carolina campuses explicit in an early March announcement of their partnership. At the time, they said they expected construction on such sites—which would be staffed by both organizations’ clinicians—to begin in the summer and fall, bringing residents “shorter wait times and more appointment availability.” Both multibillion-dollar organizations already have substantial footprints within the state.
The statement from Duke Health officials directly cited Alamance’s care needs as outlined in the state report. The proposed hospital would be built on Duke Health-owned property in the city of Mebane and “will build upon Duke Health’s decade of multi-specialty care in the community at Kernodle Clinic” in nearby Burlington, they said.
A Novant Health spokesperson, in a statement, also pointed to expanded specialty services and expert care within the region. The Mebane hospital would be the “latest example of Novant Health’s commitment to transforming the health and wellness of communities throughout the Carolinas,” they said.
Despite its efforts, Novant’s attempts to expand in North Carolina have faced some roadblocks from regulators. Within the state’s Triangle region, which includes Alamance, its $287 million bid for a hospital was rejected in February in favor of a bid from AdventHealth. Two requests for an expansion into Asheville have also been shot down, and its March application for a 50-bed, $336 million hospital in Cabarrus is facing off against a $208 million 126-bed addition from Atrium Health, per state health department records.
North Carolina is an appealing target for healthcare organizations looking to expand. Outside the potential for looser regulatory requirements should CON reform come to fruition, the state’s own Department of Commerce has highlighted an aging populace and the substantial chronic disease burden these seniors carry.
“North Carolina’s population is getting older—a process that has been underway for well over a decade due to a growing wave of Baby Boomer retirements,” the department wrote in a blog post earlier this year. “This demographic shift underscores the importance of the healthcare sector in meeting the complex care needs of older adults.”
The North Carolina State Health Coordinating Council, in its recommendations, projected a deficit of 1,042 acute care beds by 2027. Among the greatest service areas in need are nearby Wake County—which is also in the Triangle, will be 267 beds short and is currently served by Duke Health—WakeMed and UNC Health facilities.
The state health department’s CON application log shows several new proposals from the state’s major health system players to meet the statewide demand. Of note, in the 82-bed-short Durham county, Duke also applied for a $12.3 million plan to add 82 beds to its main Duke University Hospital campus while UNC Hospitals asked to spend $78.8 million adding a total of 34 beds to its Cary hospital for a total of 136 beds.