Will Duke Health shake up Charlotte healthcare?
Plus: Lyles chides media for sharing stabbing video; Remembering lawyer Russell Robinson; 'Roofman' movie gets early Charlotte premiere; Wealthiest Charlotte ZIP codes
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With a new hospital and a partnership deal, Duke is moving into the Charlotte region, which is dominated by Atrium and Novant. For patients, it could mean more choices and lower prices, experts say
Duke Health is making its first entry into the Charlotte area with its purchase of Lake Norman Regional in Mooresville, now known as Duke Health Lake Norman. It could be the first step in an expansion that creates more competition in healthcare.
By Michelle Crouch
Co-published with N.C. Health News
For years, Charlotte’s health care market has been dominated by two names: Atrium Health and Novant Health. Between them, the two hospital systems hold a near lock on the region’s hospitals, a growing share of its doctors and much of its specialty care.
Now, a third player is muscling into the market.
In April, Duke Health paid $284 million to acquire Lake Norman Regional in Mooresville, rebranding it as “Duke Health Lake Norman.” It’s the first Duke-branded hospital outside the Triangle.
Around the same time, Duke announced a partnership with Novant to open joint campuses across North Carolina.
Although details about the partnership are tightly guarded, Novant indicated at a recent regulatory hearing that the partnership would bring more of Duke’s specialty expertise, such as advanced cancer and gastrointestinal surgery, directly into the Charlotte market.
“This is a big deal,” said Bryan Blitstein, a Huntersville surgeon in private practice who is joining the Lake Norman hospital as a surgeon. “For my entire career, Charlotte has been teal (Atrium) versus purple (Novant). Duke coming in disrupts that and creates a third option. Healthy competition is good for everybody.”
For now, Atrium and Novant control nearly all hospital care in the Charlotte region. Atrium commands about half of the market, while Novant holds roughly 35%, according to national financial ratings agencies.
Duke’s moves won’t transform Charlotte’s health care landscape overnight. But the presence of a third provider could ultimately bring more choice and competition to the area’s health care market and provide an alternative for the many patients who choose to drive to the Triangle for care, industry observers said.
“This is good news for Charlotte and for North Carolina,” said Barak Richman, a health policy expert and George Washington University law professor who formerly taught at Duke. “It brings competition to a market dominated by Atrium, which is healthy for patients. For people in Charlotte, it might even lower some prices.”
Duke pivots to expansion
Across North Carolina, hospital systems including Atrium, UNC Health and Novant have been aggressively growing — buying up smaller hospitals and merging — to attract more patients, achieve economies of scale and boost their negotiating power with insurers. While the hospitals promise efficiencies and better care, critics point to research that shows consolidation typically eliminates competition and drives up prices without improving quality.
Until now, Duke had largely resisted following its rivals in pursuing geographic expansion, Richman said, preferring to build its reputation as a national destination for complex care.
But that strategy is shifting. In a June 2025 bond prospectus, Duke said it was transitioning “to a regional health system.”
In the financial document, Duke leadership also set an ambitious expansion goal: to “touch 25% of the lives in North Carolina,” while nearly tripling revenue to more than $20 billion, up from $6.8 billion in fiscal 2024.
Duke Health declined to answer questions about its plans, saying in an email: “We don’t have updates to share beyond our Lake Norman announcement in April and Novant partnership announcement in March. We will include you on any related announcements moving forward.”
‘Duke-itizing’ a hospital
Duke’s purchase of the 123-bed Lake Norman hospital included nearby medical office buildings and physician offices, including nine primary care and seven specialty practices. It plans to add an imaging facility and more office space, according to its filing.
Blitstein, who will start his job at Duke Lake Norman Hospital in October, said Duke has already poured millions into the facility to upgrade its technology and infrastructure to Duke standards.
“They call it ‘Duke-itizing’ the hospital,” he said. “They like that word.”
Many Charlotte-area patients already drive to Durham to see Duke specialists, especially for cancer care, cardiology and complex surgeries, Blitstein said.
The idea now is to bring that care closer to home, he said, with the Mooresville hospital serving as “a point of access” where all Charlotte-area patients — not just those in Iredell County — can begin treatment, participate in clinical trials or get follow-up care if they are already being treated at Duke.
Duke is frequently ranked as the top hospital in North Carolina and one of the best in the country.
“The hope is to bring that level of excellence from Durham to the Charlotte market,” Blitstein said. “Patients shouldn’t have to drive two hours for follow-ups or routine imaging. Those can be done here, with results sent seamlessly back to their doctors in Durham.”
Still, not everyone is convinced the pivot is a good one for Duke. By chasing market share, Richman said, Duke risks diluting its academic mission.
“It’s not surprising that they’re finally starting to do what everybody else is doing,” he said. “But this country already has way too much hospital expansion. … If I had my druthers, Duke would not be competing with Atrium for knee replacements. They would be competing with (the) Mayo Clinic for the most complicated brain surgeries.”
Proposed Duke-Novant centers along I-77 corridor
Duke’s partnership with Novant adds another layer to Duke’s entrance into the Charlotte market.
In a March news release, the two hospitals said they planned to “jointly develop new campuses across North Carolina that will expand access to affordable, high-quality care,” but they provided few details.
Novant and Duke declined to answer questions about the partnership, including what types of facilities they’ll open or where they will be located.
However, the two hospital systems have already requested state approval to build a jointly operated hospital in Mebane, a fast-growing town about halfway between Durham and Greensboro.
Duke’s financial filing also outlines plans for the hospitals to jointly develop a network of outpatient centers across the state, including along Charlotte’s I-77 corridor. The sites would offer primary care and such specialty services as cardiology, neurosciences and cancer care, along with laboratory and imaging services — and potentially surgery, infusion and urgent care services, according to the filing.
The move comes as the North Carolina legislature has moved to loosen the state’s certificate of need regulations for ambulatory surgical centers beginning this November, which would make it easier for hospitals to open them in urban areas.
At an August hearing where it requested state approval for more operating rooms, Novant also hinted that Duke specialists may perform surgeries and do other work in Novant hospitals.
Matthew Hanis, a Charlotte-based consultant and expert in the business of health care, said the partnership gives Novant a credibility boost by tying it to Duke’s research and academic reputation. That could help Novant compete with Atrium, which partnered with the Wake Forest University School of Medicine to recently open Charlotte’s first medical school, Hanis said.
Steve Lawler, a former CEO of the North Carolina Health Care Association and now a health care consultant, said the deal should also make it easier for Novant to participate in advanced research and treatments and give its patients smoother access to Duke’s specialized services and clinical trials.
“Novant could act as a navigator to make it easy and seamless for people to access that type of high-end care,” he said.
Just a partnership — or a step toward a merger?
In its financial filing, Duke hinted at the possibility of deeper integration with Novant, saying the partnership “could serve as a launching point for future collaborative opportunities between the organizations.”
Hanis said he doesn’t have any inside information, but he wouldn’t be surprised if the alliance was the first step in the systems coming together. “Both have the need to build scale” to compete, he said.
He noted that Duke also partners with Tennessee-based Lifepoint Health, which owns nine smaller community hospitals in North Carolina. “Combine Duke, Lifepoint and Novant, and you have serious scale and brand,” he said.
For now, many questions remain about the partnership: Will Duke doctors actually practice in Novant hospitals, or will Novant doctors collaborate with Duke specialists virtually? Could Duke alone, or the two systems together, open new hospitals in the Charlotte region? And how will Duke’s debut in Charlotte affect health care costs and access to care?
For Marlene Tontodonato of Charlotte, the stakes are personal.
Tontodonato, 77, said she traveled to Duke for a third opinion after two local doctors disagreed about whether she should get spine surgery and a rod for her scoliosis — a curvature in her spine. Duke doctors suggested a more conservative approach, she said, and she still sees a spine specialist in Durham.
Tontadonato said she would welcome the chance to get that same level of care closer to home. But she said she hopes Duke brings its own doctors to Charlotte rather than absorbing local physicians.
“I have more faith in Duke because it’s a teaching hospital,” she said, “and they have expertise that I think we are lacking in Charlotte.”
Michelle Crouch covers health care. Reach her at mcrouch@northcarolinahealthnews.org.
This article is part of a partnership between The Ledger and North Carolina Health News to produce original health care reporting focused on the Charlotte area. We make these articles available free to all. For more information, or to support this effort with a tax-free gift, click here.
Today’s supporting sponsor is Landon A. Dunn, attorney-at-law in Matthews:
After light rail murder, Mayor Lyles says she’ll work to make Charlotte ‘a place where everyone feels safe’; praises those who didn’t share newly released attack video
Charlotte Mayor Vi Lyles weighed in again on the fatal light rail stabbing of 23-year-old Iryna Zarutska over the weekend — and threw some shade at local media who chose to distribute the video and images of the moments surrounding the attack.
The Charlotte Area Transit System on Friday released surveillance video from the Blue Line light rail car.
Charlotte TV stations aired portions of the video and shared it on social media, while editing out the moment of the unprovoked stabbing. Some obscured the faces of people on the train.
The video shows Zarutska board the train and sit in front of suspect Decarlos Brown for several minutes.
Zarutska is wearing a black Zepeddie’s Pizzeria T-shirt and cap and is focused on her phone and wearing earbuds. (Zepeddie’s Pizzeria is located in Charlotte’s LoSo area. Zarutska lived in NoDa and was believed to be returning home from work.)
The video then shows Brown unfolding his pocket knife and quickly standing up and raising the knife in his right hand. Zarutska was stabbed in the neck and died at the scene. In the moments after the attack, the video shows no passengers on the train sought to help her or to confront Brown.
Police arrested Brown minutes later at the East/West Boulevard station on Camden Road in South End. Brown, who had a history of mental illness and had served more than five years in prison on armed robbery charges, is being held without bond.
The images — particularly of Brown with the knife raised above the head of an unsuspecting Zarutska just seconds before the attack — spread quickly on social media.
The attack has made national and international news. Elon Musk and the U.S. Transportation Secretary posted on social media about it, and President Donald Trump was asked about it by a reporter on Sunday. (Trump said he wasn’t familiar with the incident.) The Mecklenburg County Republican Party plans to hold a news conference Wednesday to highlight what it called “a dangerous pattern of neglect and failed policies from our city’s leadership.”
In a post on X (formerly Twitter) on Saturday morning, Lyles wrote: “The video of the heartbreaking attack that took Iryna Zarutska’s life is now public. I want to thank our media partners and community members who have chosen not to repost or share the footage out of respect for Iryna’s family.”
(In case you are wondering, The Ledger has not published the footage. We linked to local TV coverage of the video in our Saturday newsletter so that readers could view it if they chose to.)
Lyles called the killing a “senseless and tragic loss” and said she is praying for Zarutska’s loved ones.
She added:
Like so many of you, I’m heartbroken — and I’ve been thinking hard about what safety really looks like in our city. I remain committed to doing all we can to protect our residents and ensure Charlotte is a place where everyone feels safe.
She did not provide details.
Social media criticism: Like her initial statement on the stabbing, Lyles’ post on Saturday was widely mocked by social media commentators, who suggested that she didn’t want news of the attack to spread and that she leads a city that is soft on crime and lenient on criminals.
In meetings last week, city officials said they are examining security on transit as well as ways to ensure that transit passengers have tickets. Brown did not have a ticket to ride the train, they said.
Lyles is on the ballot in Tuesday’s Democratic primary election. She is running for a fifth term and faces four opponents. —Tony Mecia
Related Ledger articles:
“Remembering young Ukrainian artist killed in South End stabbing” (Aug. 27)
“New details show South End stabbing was random attack” (Aug. 29)
Russell Robinson II, architect of one of N.C.’s top law firms, dies at 93; supported institutions from UNC Charlotte to The Duke Endowment
Charlotte’s Russell M. Robinson II, an iconic attorney who built one of North Carolina’s most prominent law firms, died Friday after a period of declining health. He was 93.
Robinson helped found Robinson Bradshaw in 1960, devoting 53 years in all to the firm. He also wrote the definitive book on N.C. corporate law, entitled “Robinson on North Carolina Corporation Law.”
He retired from Robinson Bradshaw in 2013 with the title of founder emeritus. His vision included one big miss: He anticipated a firm of five lawyers. Today, it is home to 180 lawyers, making it Charlotte’s third-largest law firm.
“Russell was a brilliant practicing lawyer who also was an academic and scholar,” said Allen Robertson, managing partner of Robinson Bradshaw.
Former UNC Charlotte chancellor Jim Woodward said: “He was the most unpretentious, distinguished person I have ever known. He was a giant of a man.”
Robinson attended Eastover Elementary and Alexander Graham Junior High in Charlotte before attending high school at Woodberry Forest in Virginia. He played baseball there and later at Princeton University (he was a catcher). The national pastime became his passion. Late in life, he was glued to the MLB Network.
Russell started out at Princeton before transferring after two years to Duke University to be closer to Charlotte coed Sally Dalton. He finished his undergraduate degree and earned his law degree from Duke.
The Robinsons first “met” in kindergarten. They marked their 72nd wedding anniversary on Thursday (Sept. 4).
Russell and Sally Robinson’s impact on his native state and city extends beyond the boardroom, courtroom and offices of Robinson Bradshaw. Philanthropic giants, “Russell and Sally” rolled off the tongue of appreciative civic leaders.
Among the charitable and educational institutions that benefited from his (and her) wisdom and generosity: UNC Charlotte, Morehead-Cain Foundation, Duke University, The Duke Endowment, the Mecklenburg and N.C. bar associations and Presbyterian Hospital (now Novant Health).
The funeral is scheduled for 2 p.m. Friday, Sept. 12, at Christ Episcopal Church, 1412 Providence Road. Visitation follows at the church. —Ken Garfield
This is an edited version of the full article on Robinson’s life that The Ledger published online on Friday.
Locally filmed ‘Roofman,’ based on a bizarre true story from 20 years ago, to premiere early at the new Carolina Theatre
Local film fans will have an early chance to check out the latest Hollywood movie shot in Charlotte and determine if it’s a worthy addition to the lineup of other locally filmed movies such as “Talladega Nights” and “Shallow Hal.”
The movie “Roofman,” starring Channing Tatum and Kirsten Dunst, will debut at the newly restored Carolina Theatre uptown on Sept. 23, as part of the 2025 Charlotte Film Festival hosted by the Independent Picture House. The film is scheduled to be released nationally on Oct. 10.
“Roofman” is a comedy/crime drama that chronicles the bizarre but true story of Jeffrey Manchester, a former Army Ranger turned robber who broke into McDonald’s locations via their roofs and later escaped prison, hiding out for six months inside a Toys “R” Us on Independence Boulevard in Charlotte before his arrest in 2005.
Tickets go on sale Friday. —Tony Mecia
Related Ledger article:
“Charlotte’s burglar on the roof,” (May 2024)
🇺🇸 Visit The Election Hub for all the info you need on Tuesday’s primary election
Don’t forget: There’s an election tomorrow (Tuesday). Polls are open from 6:30 a.m. to 7:30 p.m.
Races for Charlotte mayor and City Council are on the ballot. Democrats and unaffiliated voters citywide are eligible to vote, as are Republicans in City Council District 6 (the SouthPark area).
➡️ The Election Hub has everything you need to cast an informed vote.
You might be interested in these Charlotte events
Events submitted by readers to The Ledger’s events board:
FRIDAY: “Dancing With The Sharon - Stop the Clock,” 7-10 p.m., at SouthPark Church, 3151 Apex Drive. Barbara McKay hosts an evening of food and entertainment that features performances from residents and professional dancers from CT Dance Studio. Your ticket will provide you with an experience that features dance duos performing live, two drink tickets and heavy hors d’oeuvres. Cocktail attire is requested. $120/ticket ($55 is tax-deductible).
FRIDAY through SEPTEMBER 28: “Little Shop of Horrors,” 8-10 p.m., at Theatre Charlotte, 501 Queens Road. The funniest — and hungriest — musical in town takes the stage Sept. 12-28! Experience the man-eating, award-winning mashup of sci-fi, horror and musical theatre as meek floral assistant Seymour discovers a plant that turns his world upside down. $34/adult ticket. $28/senior ticket (62+). $20/student ticket.
SATURDAY: “‘A Little Prayer’ Talkback With Director Angus MacLachlan,” 6:15-8:45 p.m., at The Independent Picture House, 4237 Raleigh St. The new film “A Little Prayer” focuses on a loving father (David Strathairn) grappling with how to protect his daughter-in-law (Jane Levy) when he discovers that his son (Will Pullen) is having an affair. The screening will be immediately followed by an in-person discussion with writer/director Angus MacLachlan. $14.85/ticket.
OCTOBER 23: “Carolina Charm: A Night of Reality TV-Inspired Entertainment & Impact,” 7-10 p.m., at The Revelry, 701 Keswick Ave. Hosted by Southern Charm’s Shep Rose and Austen Kroll, this girls’ night out blends celebrity, cocktails, and a cause, benefiting fertility preservation for kids with rare cancers.
➡️ List your event on the Ledger events board.
In brief:
Charlotte’s wealthiest ZIP code: An analysis of data by the Charlotte Business Journal shows that the wealthiest ZIP code in the Carolinas is 28207, which includes parts of the Myers Park and Eastover neighborhoods. That ZIP code has per-capita income of more than $184,000 and a typical home value of nearly $1.6M, and the wealth there “is tightly concentrated in an area with only about 4,500 housing units across a land area of 2.4 square miles,” the publication said. (Charlotte Business Journal, subscriber-only)
Record enrollment at UNC Charlotte: UNC Charlotte set a new record this fall with 32,207 students, including its largest-ever first-year and engineering classes, reflecting the university’s continued growth and rising demand for its STEM programs. (Niner Times)
FBI director invests in Krispy Kreme: FBI director Kash Patel bought $50,000 of stock in Charlotte-based Krispy Kreme in May, according to financial disclosures. The FBI said in June that it is investigating a company suspected of cyberattacks against businesses including Krispy Kreme. Patel said there is no conflict with his stock ownership. (The Assembly)
More drinks from wastewater: Charlotte Water is teaming up with Lenny Boy Brewing and Town Brewing to launch new drinks made with purified recycled water: Crown Bucha, a raspberry-lemon-ginger kombucha; and Renew Brew Fall Classic Märzen, a malty Oktoberfest-style beer.
Axios readers get it right on dog poop: An unscientific poll of 933 Axios Charlotte readers revealed that a clear-thinking 81% said dog owners should dispose of dog poop at home or in public bins, while a psychopathic 19% said it’s acceptable to leave the poop in a neighbor’s trash can. (Axios Charlotte)
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