FROM THE RALEIGH NEWS&OBSERVER:
... For years, Rex and WakeMed managed a delicate dance. They competed heartily for every bit of hospital growth the state allowed in Wake County, quarreling over every 20-bed expansion or suburban satellite.
Still, they operated in relative harmony. Doctors could practice at both hospitals; patients had choices. Each developed a niche. WakeMed claimed a speciality in heart care; Rex, bought by UNC Health Care in 2000, developed cancer treatment and a robust surgery business.
In 2010, their civility eroded as health care reform brought dizzying changes to the market. Hospitals were driven to get bigger in order to harness better reimbursement rates from insurance companies. Doctors' practices, long independent, sought shelter in hospital systems as they faced declining reimbursements and rising costs.
Even in vibrant markets such as the Triangle, hospitals were forced to decide whether they'd be predator or prey. Hospitals that sat still could struggle to survive, leaving doctors and their patients with fewer choices. ...
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