Compensation for Atrium Health's top executives rose by an average of 21 percent in 2025, according to records the Charlotte-based system released to North Carolina Health News and The Charlotte Ledger. The report, published September 9, lists 11 executives earning between about $906,000 and $5.2 million as Atrium seeks approval to combine with Raleigh-based WakeMed Health & Hospitals.
Chief Financial Officer Bradley Clark received the largest increase, with compensation up 83 percent to $5.18 million. Atrium has said competitive pay is needed to recruit and retain leaders who can run increasingly complex hospital systems. The report again left out Gene Woods, CEO of Atrium's parent Advocate Health, whose 2024 pay totaled $25.8 million according to Advocate's tax filing. Atrium has said Woods is excluded because he is an Advocate Health executive, not an executive of the hospital authority.
For patients in Wake County and across the Triangle, the pay figures matter less on their own than as a window into the system that could soon gain significant control over WakeMed. Whether the combination raises costs or narrows patients' choices is the question state officials, independent experts and residents are pressing before any vote.
Record Revenue and Double-Digit Raises
Atrium reported a record $14.1 billion in revenue in 2025 and $1.66 billion in revenue over expenses, the nonprofit equivalent of profit, a 26 percent increase from 2024. Those figures exclude Wake Forest Baptist Health and the Illinois and Wisconsin hospitals that joined with Atrium to form Advocate Health in 2022.
Among executives with comparable 2024 figures, raises averaged 21.5 percent in 2025, below the 41 percent average increase the year before. Chief clinical officer Scott Rissmiller earned $4.59 million, up 14 percent, and chief legal officer Brett Denton earned $4.48 million, up 15.9 percent.
By comparison, WakeMed CEO Donald Gintzig earned about $1.9 million in 2024, and Novant Health CEO Carl Armato earned about $8.2 million, the outlets reported. Woods' 2025 pay will not be public until Advocate files its federal tax return, which typically happens in November.
State Sen. Jim Burgin has proposed capping nonprofit hospital CEO pay at 400 times the compensation of the lowest-paid full-time worker. His bill, SB 978, cleared two Senate committees and was referred to the Senate appropriations committee in June, where it remains. The legislature has halted most work until after the November election.
Price Questions Hang Over the WakeMed Combination
Under the proposal, Atrium would become WakeMed's corporate member, and the systems have promised at least $2 billion in capital investment over 10 years and 3,300 new jobs. Rather than guaranteeing that investment, the public transfer agreement says Atrium intends to make capital expenditures of at least that amount, according to an NC Health News review of the deal. Because WakeMed was once county-owned, Wake County commissioners must approve changes to its articles of incorporation and a transfer agreement before the deal can proceed. As of that August 31 report, no vote had been scheduled.
WakeMed and Atrium say in public materials that the combination "won't drive up your health care costs," and Gintzig has said WakeMed would keep negotiating its own insurance rates. But the State Health Plan already pays Atrium 15 to 40 percent more than WakeMed for the same services, according to plan officials. At a July event in Southeast Raleigh, Gintzig told the crowd that WakeMed does not adopt Atrium's rates, then added, "Lord, as the CEO, I wish we would, because we're paid so much less."
A Brown University analysis of Atrium's 2020 combination with Wake Forest Baptist found that average inpatient prices there rose 28 percent from 2020 to 2024, compared with 20 percent at other North Carolina hospitals. That comparison shows faster price growth after the deal, but it does not by itself prove the combination caused the difference. WakeMed has not formally agreed to cap future price increases.
Outside Experts Question Whether WakeMed Needs the Deal
Nancy Kane, a professor emerita of health policy and management at the Harvard T.H. Chan School of Public Health who reviewed WakeMed's finances for NC Health News, calculated a total margin of 15 percent for the first nine months of fiscal 2026, far above the 3 to 5 percent margins she typically sees. She said the deal is not driven by financial trouble. "This is a financial opportunity deal," she said.
Hayden Rooke-Ley, an assistant professor of health law at Brown University, argued that commissioners have more leverage than the county's public statements suggest. "There's not much they couldn't ask for here," he said. Brianna Miller of the health policy nonprofit United States of Care noted that two Indiana hospitals agreed to more than 45 conditions, including price caps, to win state approval of their merger. Gov. Josh Stein's office has also written to WakeMed that the proposed combination "deserves close scrutiny and careful consideration."
Charity care is another pressure point. Both systems provide free care to families earning up to 300 percent of the federal poverty level, and Atrium offers partial help up to 400 percent. Still, WakeMed's net charity care costs were about 4 percent of patient revenue in 2024, compared with 1 percent across Atrium's North Carolina hospitals, according to the National Academy for State Health Policy's hospital cost tool, as cited by NC Health News.
Steps Wake County Patients Can Take Before a Vote
Nothing about patients' coverage changes today. People insured through the State Health Plan, which covers many teachers and state employees, and those with employer plans can confirm that WakeMed and Atrium facilities are in network and use their insurer's cost estimate tools before scheduled care.
Uninsured and lower-income patients can ask either system for a financial assistance application before or after care. Residents who want a voice can follow the Wake County Board of Commissioners' agendas and public comment opportunities, since the board has already delayed the vote once to allow more public input.
The next data point on executive pay arrives when Advocate files its tax return, likely in November. For now, the facts are rising executive pay, record revenue, and an existing price gap between the two systems, along with research cited by NC Health News suggesting that consolidation can raise prices. The two systems maintain that this deal will not.
Key Questions Answered
How much did Atrium's executive pay rise? An average of 21 percent in 2025, according to records released to NC Health News and The Charlotte Ledger. The CFO's pay rose 83 percent to $5.18 million.
Why wasn't Advocate CEO Gene Woods included? Atrium says Woods is an Advocate Health executive, not an executive of the hospital authority. His 2025 pay should appear in Advocate's tax filing, which typically comes out in November.
What is the proposed WakeMed deal? Atrium would become WakeMed's corporate member and gain significant control, and it has pledged at least $2 billion in capital investment over 10 years. Wake County commissioners must approve changes to WakeMed's governing documents.
Would prices go up? The systems say no. The State Health Plan already pays Atrium 15 to 40 percent more than WakeMed, and a Brown University analysis found faster price growth after Atrium's Wake Forest Baptist deal.
Has Wake County voted on the deal? No vote had been scheduled as of late August, according to NC Health News.
What can patients do now? Check network status, use insurer cost estimate tools and ask about financial assistance, which both systems offer.
Is there a proposal to cap hospital CEO pay? SB 978 would cap nonprofit hospital CEO pay at 400 times the lowest-paid full-time worker's compensation. It remains in the Senate Appropriations Committee.
