Novant Health
Novant Health is a not-for-profit integrated healthcare system headquartered in Winston-Salem, North Carolina, operating hospitals, physician clinics, outpatient facilities, and other medical services across North Carolina, South Carolina, and Virginia.[1] Formed on July 1, 1997, through the merger of Carolina Medicorp of Winston-Salem and Presbyterian Health Services of Charlotte, the organization has grown into a network of more than 850 locations, including over 700 physician clinics and urgent care centers.[2][3] In fiscal year 2024, Novant Health reported operating revenue of $10.2 billion and net income of $919.8 million, while delivering care to over 185,000 inpatients, conducting more than 7.28 million physician clinic visits, and managing upwards of 705,000 emergency room visits.[1] The system employs tens of thousands of staff and emphasizes community investment, generating significant economic activity in its service areas, including an estimated $18.2 billion impact in the Carolinas as of recent analyses.[4][5] Novant Health has faced notable controversies, including a 2024 Federal Trade Commission lawsuit successfully blocking its $320 million acquisition of two hospitals from Community Health Systems on antitrust grounds, citing risks of higher prices and reduced competition in local markets.[6] Additionally, the organization has been embroiled in employment discrimination litigation, such as the 2024 Fourth Circuit ruling in Duvall v. Novant Health, where a white male physician alleged wrongful termination to advance diversity, equity, and inclusion initiatives, highlighting tensions between corporate DEI policies and anti-discrimination laws.[7][8] Other legal challenges include privacy violations resulting in multimillion-dollar settlements and patient care disputes.[9]
Overview
Organizational Structure and Mission
Novant Health functions as a 501(c)(3) not-for-profit integrated healthcare system, serving as the parent organization for a network of affiliated hospitals, outpatient facilities, and physician practices primarily in North Carolina, South Carolina, and Virginia.[10] [11] The system's governance is provided by a Board of Trustees, chaired by Christine Katziff, which oversees strategic direction, executive compensation, and growth initiatives through committees such as the Executive, Compensation & Leadership, and Strategic Growth Committees.[12] Executive leadership is headed by President and Chief Executive Officer Carl S. Armato, supported by a team of executive vice presidents responsible for core functions including operations (John Gizdic), finance (Alice Pope), clinical operations and nursing (Denise Mihal), legal affairs (Frank E. Emory, Jr.), transformation (Sanjay Gupta), digital and information services (Onyeka N. Nchege), medical affairs (Pamela Alston Oliver, MD), administrative operations and culture (Kim Henderson), and strategic transactions (David Haufler).[13] In early 2025, Novant Health implemented a restructured leadership model to scale resources, evolve regional operating models, and redefine hospitals' roles within a broader care ecosystem, emphasizing payor integration and enterprise-wide efficiency under figures like Senior Vice President and Chief Operating Officer Bill Schiff.[14] [15] The organization's mission, framed as its unifying "Cause," is to create a healthier future and bring remarkable experiences to life through compassionate care, innovation, and accessible healthcare services.[16] This entails a commitment to improving community health outcomes on an individual basis, fostering a culture of belonging, enhancing care safety and quality, and addressing social determinants of health via targeted community investments.[17] [18] Supporting this are foundational principles to innovate amid evolving healthcare dynamics, such as value-based care transitions and resource optimization across an integrated delivery network.[16]Scale and Geographic Footprint
Novant Health operates as a large integrated not-for-profit health system primarily in the southeastern United States, with 19 hospitals, more than 850 locations including outpatient centers, physician clinics, and urgent care facilities, and approximately 40,000 employees as of late 2024.[19][1] In fiscal year 2024, the system reported $10.2 billion in operating revenue and cared for over 185,000 inpatients, 705,000 emergency department patients, and 7.28 million physician clinic visits, reflecting its substantial capacity to deliver care across acute, ambulatory, and preventive services.[1][20] The organization's geographic footprint centers on North Carolina and South Carolina, where it maintains a dense network of facilities serving both metropolitan areas and rural communities.[1] In North Carolina, major operations include flagship hospitals in cities such as Charlotte, Winston-Salem, Greensboro, and Wilmington, supporting a broad regional presence that covers over half the state's population through inpatient and outpatient services.[21] Expansion into South Carolina accelerated in 2024 with the acquisition of three hospitals and additional clinics, enhancing coverage in areas like Charleston and surrounding regions, and contributing an estimated $1.2 billion in economic activity from those facilities alone.[2][4] This Carolinas-focused model allows Novant Health to leverage economies of scale while addressing local healthcare needs, though it has pursued limited partnerships and administrative presence in adjacent states like Virginia for specialized initiatives.[4]History
Formation and Early Development
Novant Health was formed on July 1, 1997, through the merger of Carolina Medicorp, a three-hospital nonprofit system headquartered in Winston-Salem, North Carolina, and Presbyterian Health Services, a five-hospital system based in Charlotte, North Carolina.[22][2] The combined entity operated as a not-for-profit integrated health system, initially generating $1.5 billion in annual revenue and employing 12,000 staff across multiple facilities in the Piedmont region.[23] Carolina Medicorp's core assets included Forsyth Medical Center, which originated from earlier community efforts dating to the late 19th century but opened as a modern facility in 1964 on Silas Creek Parkway in Winston-Salem; the organization had acquired the hospital property from Forsyth County in 1984.[24] Presbyterian Health Services traced its primary hospital to 1903, when it established Presbyterian Hospital in Charlotte as a 20-bed facility supported by local churches and medical professionals, expanding over decades to include additional sites and services like a nursing school.[25][26] In its initial years, Novant Health focused on operational integration, linking disparate hospitals, physician practices, and outpatient services into a unified network to enhance efficiency and care coordination amid the late-1990s shift toward managed care and consolidation in U.S. healthcare.[27] This period marked the system's early emphasis on regional dominance in North Carolina, with foundational steps toward system-wide standardization of protocols and technology adoption, though specific expansions remained limited until later in the 2000s.[28]Key Mergers and Expansions
Novant Health was established on July 1, 1997, through the merger of Carolina Medicorp, based in Winston-Salem, North Carolina, and Presbyterian Health Services, based in Charlotte, North Carolina, creating a not-for-profit integrated health system spanning multiple facilities across the state.[2] This foundational merger combined resources to enhance service delivery in the Piedmont region, marking the system's initial expansion beyond single-hospital operations.[2] A significant expansion occurred on February 1, 2021, when Novant Health acquired New Hanover Regional Medical Center in Wilmington, North Carolina, along with Pender Memorial Hospital, in a transaction valued at approximately $1.5 billion to $2 billion, transitioning the county-owned facilities into Novant ownership.[29][30] This acquisition added over 800 beds and extended Novant's footprint into southeastern North Carolina, facilitating growth in coastal markets.[31] In November 2023, Novant Health announced a $2.4 billion agreement to acquire three hospitals from Tenet Healthcare—Hilton Head Hospital in Beaufort County, Coastal Carolina Hospital in Jasper County, and East Cooper Medical Center in Charleston County—expanding into South Carolina for the first time; the deal closed on February 1, 2024.[32][33] This move incorporated approximately 400 beds and associated physician clinics, strengthening Novant's regional presence in the Lowcountry.[34] Further consolidation in South Carolina followed on November 4, 2024, with the acquisition of UCI Medical Affiliates from BlueCross BlueShield of South Carolina, adding 52 urgent care centers under the Doctors Care brand and 20 physical therapy locations, positioning Novant as the state's largest urgent care provider.[35][36] These transactions reflect a strategy of geographic diversification through targeted acquisitions amid competitive healthcare consolidation.[33]Reorganizations and Internal Challenges
In February 2025, Novant Health implemented a redesigned leadership operating model that reshuffled responsibilities among its senior executives, formalizing a regional reporting structure to enhance operational integration across its facilities.[37] This included adding two senior vice presidents and further embedding the organization's business incubator into core operations, aimed at streamlining decision-making amid evolving healthcare demands.[38] By May 2025, the company finalized its Triad Region leadership team, appointing Chris Brown as president and Jon Mercer as chief operating officer to support this transformed model.[39] Novant Health has faced internal workforce challenges tied to multiple organizational redesigns, particularly in response to a strained healthcare environment characterized by rising costs and labor pressures. In October 2023, the system reduced its workforce by 160 full-time positions as part of a broad redesign to optimize structure and efficiency, marking the largest such cuts since 400 employees were laid off in 2015.[40] These reductions affected administrative and support roles across its network.[41] Further layoffs occurred in 2024, linked to a shift toward a new IT operating model announced the prior year. In June 2024, Novant notified employees of 171 permanent reductions effective August 25, including 90 in the Charlotte region and 81 IT workers in Winston-Salem, primarily targeting redundant or outsourced functions.[42][43] Additional reports in early 2025 indicated over 170 more impacts in the Carolinas, concentrated in areas like Lancaster County and Winston-Salem, reflecting ongoing efforts to control expenses amid financial headwinds.[44] A significant external challenge intersecting with internal strategy was the collapse of Novant's proposed $1.2 billion acquisition of two hospitals from Community Health Systems in North Carolina. Initially cleared by a district court in June 2024 despite FTC antitrust objections—citing a "failing firm" defense for the target hospitals—the deal unraveled after the Fourth Circuit granted an injunction pending appeal, halting the merger and disrupting expansion plans.[45] This failure, attributed to regulatory scrutiny over market concentration, forced Novant to redirect resources and reassess growth initiatives without the anticipated assets.[46]Recent Acquisitions and Growth Initiatives
In February 2024, Novant Health completed its $2.4 billion acquisition of three hospitals from Tenet Healthcare Corporation—Hilton Head Hospital, Coastal Carolina Hospital, and East Cooper Medical Center—along with associated physician clinics and ambulatory surgery centers, marking a significant expansion into South Carolina's coastal regions. This deal, initially announced in November 2023, added approximately 700 beds and enhanced Novant Health's footprint in the Lowcountry area, serving over 1.2 million patients annually across the acquired facilities.[47] On November 4, 2024, Novant Health acquired UCI Medical Affiliates, Inc., a network of over 60 primary and specialty care clinics in South Carolina, from BlueCross BlueShield of South Carolina for an undisclosed amount, integrating these sites to bolster outpatient services and physician recruitment in the state.[35] Earlier in 2024, the system also acquired 52 Doctors Care urgent care centers and 20 Progressive Physical Therapy clinics, further diversifying its ambulatory care offerings.[48] In April 2025, through its joint venture partner MedQuest Associates, Novant Health acquired 18 imaging centers from OrthoCarolina, expanding diagnostic capabilities in musculoskeletal radiology across North and South Carolina.[49] These moves align with broader growth strategies, including a March 2025 approval for a new 50-bed hospital campus in Bluffton, South Carolina, set to open by 2028, and ongoing primary care expansions such as eight new clinics and providers added in the Lowcountry by October 2025.[48][50] In North Carolina, initiatives include multiphase expansions at facilities like Novant Health Hemby Children's Hospital and detailed plans for enhanced access in Brunswick County announced in October 2025.[51] Additionally, workforce development efforts, such as the August 2025 launch of a debt-free prepaid tuition program for team members and a Charlotte residency expansion targeting 100 new physicians by 2032, support operational scaling.[52][53]Facilities and Operations
Flagship Hospitals
Novant Health Presbyterian Medical Center, located in Charlotte, North Carolina, serves as the system's flagship facility in the Mecklenburg County market, providing comprehensive acute care services including emergency medicine, cardiovascular care, oncology, neurology, and maternity. This 590-bed hospital operates as a Level II Trauma Center and has been ranked high-performing in 18 adult procedures and conditions by U.S. News & World Report, tying for seventh among hospitals in North Carolina. It handles a significant volume of complex cases, contributing substantially to the system's net patient revenue of over $1.7 billion annually from this site alone.[54][55][56][57] Novant Health Forsyth Medical Center, based in Winston-Salem, North Carolina—near the system's headquarters—functions as another core flagship hospital, delivering a full spectrum of inpatient and outpatient services such as surgical interventions, rehabilitative care, and specialized treatments for cardiac, orthopedic, and neurological conditions. As one of the system's largest facilities by operational scale, it supports regional referral patterns and integrates with affiliated clinics for seamless care delivery across the Piedmont Triad area. The center has earned recognition for consistent top-quality heart attack care from the American College of Cardiology, reflecting its role in advancing clinical outcomes in high-acuity settings.[58][55][59] These hospitals anchor Novant Health's operational strategy in North Carolina's major urban centers, emphasizing high-volume procedures and quality metrics amid competition from larger systems like Atrium Health. Together, they exemplify the organization's focus on integrated networks, with Presbyterian and Forsyth driving expansions in specialized services while maintaining not-for-profit status dedicated to community health needs.[55][60]Regional and Specialized Facilities
Novant Health maintains a network of regional hospitals tailored to serve communities beyond its core urban hubs in Charlotte and Winston-Salem, North Carolina. Novant Health Rowan Medical Center in Salisbury, North Carolina, operates as the fourth-largest facility in the system, providing emergency services, surgical care, imaging, and inpatient treatment to Rowan County and adjacent areas.[61] Similarly, Novant Health New Hanover Regional Medical Center in Wilmington, North Carolina, delivers comprehensive regional care including behavioral health services through its dedicated Behavioral Health Hospital, supporting southeastern coastal populations with advanced medical and emergency capabilities.[62] Additional regional outposts include Novant Health Kernersville Medical Center near Winston-Salem, functioning as a satellite department of Forsyth Medical Center with focused inpatient and emergency services for the Piedmont Triad suburbs, and smaller community sites like Pender Medical Center in Burgaw, North Carolina, emphasizing local access to primary and acute care.[63][21] These facilities integrate with the broader system to extend inpatient capacity, with Novant Health reporting 19 such medical centers overall as of recent operations.[1] In specialized facilities, Novant Health operates dedicated centers for targeted medical domains. The Novant Health Charlotte Orthopedic Hospital provides elective and multispecialty orthopedic surgeries, focusing on musculoskeletal conditions with short-stay inpatient options.[64] The Cancer Institute maintains multiple locations for oncology, including medical, surgical, and radiation treatments tailored to breast, gynecologic, and other cancers, often co-located with regional hospitals for integrated care.[65] Complementing these, the Heart & Vascular Institute delivers specialized cardiovascular interventions across sites, while women's health facilities offer gynecologic oncology, maternity, and fibroid management services emphasizing interdisciplinary approaches.[66][67]Service Delivery Model
Novant Health employs an integrated care delivery model that coordinates services across its network of hospitals, physician clinics, outpatient facilities, and virtual platforms to ensure seamless transitions and personalized patient experiences. This approach emphasizes continuity from preventive care to acute interventions and post-discharge support, leveraging clinical integration to align providers and reduce fragmentation.[1][68] Central to the model is the NovaLinc Clinically Integrated Network (CIN), which collaborates with independent physicians and practices to standardize protocols, share data, and optimize resource use, aiming to improve clinical outcomes while controlling costs. Community Connect facilitates secure data exchange between Novant facilities and external providers, enhancing collaborative care delivery. Virtual components, such as Care Connections, integrate multidisciplinary teams—including nurses, social workers, pharmacists, and dietitians—for remote triage, referrals, education, and resource navigation, supported by technology to extend access beyond physical sites.[68][69][70] Mobile Integrated Health extends the model into pre-hospital settings, where emergency medical services teams initiate treatment on-site and coordinate transport to appropriate facilities, minimizing delays in critical care. The framework prioritizes patient-centered innovation, including high-reliability practices outlined in the HeRO Playbook for safety, quality, equity, and experience, alongside targeted expansions like community clinics and senior care partnerships that address social determinants beyond clinical needs.[71][72][73] Operational evolutions, including a 2025 leadership redesign across regions, support scalable delivery by empowering local teams to adapt services while advancing a vision that repositions hospitals as hubs within a broader ecosystem of ambulatory and digital care. Employer solutions further customize delivery for workforce health, offering tailored clinics and wellness programs.[14][15][74]Clinical Achievements and Partnerships
Certifications and Quality Metrics
Novant Health facilities have achieved Magnet recognition from the American Nurses Credentialing Center (ANCC) for nursing excellence, a designation held by fewer than 10% of U.S. hospitals. In December 2024, two Novant Health hospitals earned their fourth Magnet designation, placing them in the top 2% nationally for sustained nursing quality.[75] Previously, eight hospitals renewed Magnet status in 2019, including Presbyterian Medical Center, which has maintained the credential since 2008.[76] [77] The Joint Commission accredits multiple Novant Health hospitals for overall performance and specialized services, such as advanced spine surgery certification at Charlotte Orthopedic Hospital and Presbyterian Medical Center.[78] This accreditation, renewed periodically, evaluates compliance with national patient safety and quality standards based on on-site surveys and data submission.[79] In patient safety metrics, The Leapfrog Group awarded nine Novant Health hospitals "A" grades in Fall 2024, the highest number in North Carolina, reflecting strong performance in preventing errors, infections, and medical complications.[80] For Spring 2025, several facilities, including Brunswick Medical Center, retained "A" grades, though Brunswick later received a "B" in November 2024 amid broader safety score trends.[81] [82] Centers for Medicare & Medicaid Services (CMS) overall hospital star ratings vary across Novant facilities; for instance, New Hanover Regional Medical Center scored two out of five stars based on 2023 data, incorporating measures like readmissions, mortality, and patient experience.[83] [84] Vizient Inc. recognized three Novant hospitals in September 2025 for superior safe, patient-centered care using clinical data from July 2024 to June 2025, and two others in 2024 as top performers in quality.[85] [86] Additional accolades include Newsweek's 2025 ranking of East Cooper Medical Center among America's best for physical rehabilitation, and Mint Hill Medical Center's designation as one of the nation's 100 top hospitals with the Everest Award for five-year growth.[87] [88] South Carolina facilities earned 21 Certified Zero Harm Awards from the South Carolina Hospital Association in 2024 for low infection and complication rates.[89] Novant Health New Hanover's Physician Quality Partners achieved a 96.3% quality score in 2023 across patient outcomes and satisfaction metrics.[90]Research and Educational Affiliations
Novant Health maintains primary educational affiliations with the University of North Carolina at Chapel Hill School of Medicine, supporting residency programs in family medicine, internal medicine, and obstetrics/gynecology at facilities such as New Hanover Regional Medical Center in Wilmington.[91][92] This partnership provides residents access to UNC's academic resources, including faculty oversight and research opportunities, while emphasizing community-based training.[93] In November 2020, Novant Health, UNC Health, and UNC School of Medicine formalized an agreement to expand medical education, clinical services, and research collaborations across Novant facilities in Mecklenburg and Forsyth counties, aiming to address regional physician shortages through joint residency expansions and training initiatives.[94] Additional affiliations include Campbell University School of Osteopathic Medicine for medical student rotations, where third- and fourth-year students engage in hands-on clinical experiences at Novant sites, such as those in Salisbury, North Carolina, integrated with Novant physicians since at least 2015.[95][96] In March 2024, Novant Health partnered with Elon University for clinical rotations in its Physician Assistant Studies program, enabling students to train at Novant practices and facilities in the Charlotte area to enhance practical skills in primary and specialty care.[97] These programs are supplemented by collaborations with entities like the South East Area Health Education Center for broader training support.[91] In research, Novant Health's clinical trials—encompassing over 300 active studies as of May 2024, with nearly 1,500 participants primarily from North Carolina—focus on areas like oncology, cardiology, and neurology, governed by site-specific institutional review boards.[98] A key affiliation is with St. Jude Children's Research Hospital, established on April 21, 2015, which integrates advanced pediatric cancer protocols into care at Novant Health Hemby Children's Hospital in Charlotte, allowing local access to St. Jude's research-driven treatments without requiring travel to Memphis.[99] The 2020 UNC partnership further extends research ties, facilitating joint studies and data sharing to advance evidence-based practices in Novant’s network.[94] Novant also supports continuing medical education through its Office of Continuing Medical Education, offering accredited activities for healthcare professionals, though these are primarily internal rather than tied to external academic institutions.[100]Innovation and Technology Adoption
Digital Health and AI Initiatives
Novant Health established the Institute of Innovation & Artificial Intelligence in June 2019 to advance personalized care through technologies like artificial intelligence, focusing on actionable insights from data analytics and machine learning.[101] The institute integrates AI to enhance clinical safety, operational efficiency, and patient outcomes, including predictive analytics for equipment maintenance, patient forecasting, and resource demand prediction.[102] Since 2019, the organization has built a data science team to deploy AI and machine learning models, with expansions into areas like full patient chart reviews to capture revenue and improve care quality.[103][104] In clinical applications, Novant Health adopted DAX Copilot, an AI-driven ambient documentation tool integrated with its Epic electronic health record system, to automate note-taking and reduce clinician burden across multiple specialties, with ongoing rollout to emergency departments.[105] For imaging, a partnership with Aidoc deploys AI algorithms to prioritize urgent cases, accelerating triage and potentially improving outcomes in radiology workflows.[106] Additionally, a 2020 collaboration with Jvion utilizes prescriptive AI to identify at-risk patients, prevent harm events, and lower costs by enabling proactive clinical interventions.[107] Digital health efforts emphasize virtual care expansion, including the 2021 launch of Novant Health Now, a platform featuring a virtual assistant for symptom triage and integration with on-demand video visits available 24/7 without appointments for mild conditions across North Carolina, South Carolina, and Virginia.[108][109] Telehealth supports specialized uses, such as remote neurologist consultations for stroke diagnosis, achieving coverage for 90% of cases as of December 2024, alongside remote patient monitoring and community-based virtual services.[110] In February 2023, Novant unveiled a digital health innovation program targeting underserved communities to enhance equity in outcomes through scalable tech solutions.[111] These initiatives have earned recognition, including CHIME's Digital Health Most Wired designation in 2020 and 2024, reflecting advanced adoption of health IT for connectivity and analytics.[112][113]Infrastructure Investments
Novant Health has directed substantial capital toward physical infrastructure, including hospital expansions, new medical campuses, and emergency departments, primarily to enhance capacity in underserved areas of North Carolina and South Carolina. In 2023, construction investments alone generated over $36 million in regional labor income, forming part of broader capital expenditures supporting facility growth.[4] These efforts align with a strategy to address population growth and access gaps, with recent projects financed through bonds and internal funds for sites in coastal and upstate regions.[114] Key expansions include the $169 million renovation and addition at Novant Health Matthews Medical Center, initiated in 2022 to increase inpatient beds and procedural capacity.[115] In Pender County, North Carolina, following the 2023 acquisition of Pender Medical Center, Novant committed $50 million over 10 years for facility upgrades and new builds to modernize infrastructure.[116] The Forsyth Medical Center Critical Care Tower project added specialized units for improved patient flow and safety, completed as part of ongoing Winston-Salem campus enhancements.[117] Recent groundbreakings underscore accelerated development in South Carolina. In April 2025, construction began on a Bluffton emergency department and medical office building to serve growing suburban demand.[118] August 2025 saw starts on the first Upstate medical campus at Patewood Drive, featuring a medical office building and ambulatory surgery center with future hospital phases.[119] In October 2025, Novant broke ground in Summerville for a 32,000-square-foot medical office and 11,000-square-foot freestanding emergency department.[120] Similarly, a $24.2 million 20-bed hospital in Leland, North Carolina, received certificate-of-need approval in October 2025, slated for 2028 opening under the Brunswick Medical Center license.[121] Additional facilities opened or planned include the Scotts Hill Medical Plaza in December 2024, expanding primary and specialty services in Wilmington, and a proposed 50-bed hospital in Cabarrus County announced in August 2025 with emergency, imaging, and labor capabilities.[122][123] A 20-bed Greenville, South Carolina, hospital gained state approval in June 2025 to bolster regional presence.[124] These initiatives reflect annual capital outlays exceeding $1 billion in community-related spending, though precise infrastructure allocations vary by fiscal reports.[4]Financial Performance
Revenue Sources and Profitability
Novant Health generates the majority of its operating revenue from net patient service revenue, which totaled $8.97 billion in 2024, representing about 88% of total operating revenues of $10.17 billion.[125] This category encompasses fees from inpatient and outpatient services, with payer sources including Medicare (27.9% of net patient service revenue), Medicaid (10.7%), other third-party payors (57.5%), and direct patient payments (3.9%).[125] Within net patient service revenue, outpatient ancillary services contributed 37%, followed by inpatient ancillary and other services at 24%, outpatient clinic and emergency services at 26%, and inpatient routine services at 9%.[89] Other operating revenue and gains added $1.20 billion in 2024, including $814 million from pharmacy operations, revenue from pay-for-performance contracts, federal disaster assistance (FEMA), rental income, and gains from asset sales or acquisitions.[125] Nonoperating income, primarily from investments, contributed $359 million, supporting overall financial results.[20] For the year ended December 31, 2024, Novant Health reported net income (excess of revenues over expenses) of $920 million, including $556 million in operating income, reflecting a 5.5% operating margin on $10.2 billion in total operating revenues.[20] [89] This marked improvement from 2023, when operating revenues were $8.3 billion, operating income $147 million (1.8% margin), and net income $461 million.[125] As a not-for-profit health system, these surpluses fund reinvestments in facilities, technology, and community benefits exceeding $1.6 billion annually, including uncompensated care and subsidized services.[89]| Financial Metric (2024) | Amount (millions) |
|---|---|
| Total Operating Revenues | $10,174 |
| Net Patient Service Revenue | $8,972 |
| Operating Income | $556 |
| Net Income | $920 |
Debt, Investments, and Fiscal Strategies
Novant Health's long-term debt stood at $5.245 billion as of December 31, 2024.[125] This figure reflected a significant increase following the $2.4 billion acquisition of three South Carolina hospitals—Coastal Carolina Hospital, East Cooper Medical Center, and Hilton Head Hospital—from Tenet Healthcare, completed on January 31, 2024, which approximately doubled the system's outstanding debt.[126] [127] To finance this and related facility projects, Novant issued $1.91 billion in Series 2024A revenue bonds and $400 million in Series 2024B, C, and D bonds in May 2024, using proceeds to repay bridge loans.[125] In August 2024, the South Carolina Jobs-Economic Development Authority issued $1.9 billion in bonds to support the acquisition, while the North Carolina Facilities Finance Agency issued $400 million for construction and equipping initiatives.[128] [129] The debt expansion prompted S&P Global Ratings to revise its outlook on Novant's bonds to negative in May 2025, citing limited balance-sheet flexibility and an elevated debt load, while affirming an 'A+' rating.[130] Fitch Ratings assigned 'AA-' to the Series 2024A bonds with a stable outlook.[131] Novant's investment portfolio, valued at $3.836 billion in long-term holdings as of December 31, 2024, encompasses U.S. and international equities, fixed income securities, hedge funds, private equity, emerging markets, and real estate.[125] Managed as a total return strategy with a long-term horizon, the portfolio allocates approximately 80% to liquid assets and 20% to illiquids, with over 50% in global public and private equities, less than 15% in U.S. Treasuries, about 15% in hedge funds, and 15% in real assets, alongside cash equivalents.[132] The primary objectives include exceeding the system's weighted average cost of capital, outperforming benchmarks over five years, sustaining credit ratings, funding capital expenditures and mergers, and providing liquidity for contingencies.[132] Investment income contributed $358.9 million to 2024 results.[20] Fiscal strategies emphasize growth through acquisitions and infrastructure, balanced by operational efficiencies and revenue diversification. Capital expenditures reached $564 million in 2024, supporting facility expansions like the Scotts Hill outpatient center, financed in part by up to $855 million in proposed tax-exempt bonds approved in April 2025.[125] [114] The system reported $919.8 million in net income for the year, with $556.3 million from operations on $10.17 billion in revenues, enabling $1.6 billion in community benefits including uncompensated care.[20] Novant employs self-insurance through a captive entity for certain risks since 2020 and participates in value-based care models via MedVenta Health Solutions to enhance reimbursement stability.[125] [20] These approaches aim to mitigate debt pressures amid expansion, though rating agencies have flagged potential strains from leverage on future flexibility.[130]Leadership and Governance
Executive Leadership
Carl S. Armato serves as President and Chief Executive Officer of Novant Health, leading a $7.5 billion integrated healthcare system with over 37,000 team members across hospitals, physician clinics, and outpatient centers in North Carolina and South Carolina.[133] Armato joined Novant Health in 1998 as vice president of finance and operations and has overseen key expansions, including the $5.3 billion acquisition of New Hanover Regional Medical Center in 2020, contributing to the organization's recognition as one of the safest healthcare networks by The Leapfrog Group.[134] [133] Under his leadership, Novant Health has been named to Forbes' 2021 America's Best Employers for Diversity list and earned industry accolades for Armato, such as Most Admired CEO from Charlotte and Triad Business Journals.[133] The executive leadership team reports to Armato and focuses on operational, clinical, financial, and strategic functions to support Novant Health's growth and service delivery.[13] Key members include:| Executive | Title |
|---|---|
| Frank E. Emory, Jr. | Executive Vice President and Chief Legal Officer[13] |
| John Gizdic | Executive Vice President and Chief Operating Officer, overseeing acute care, integrated care solutions, nursing, and clinical services[13] [14] |
| Sanjay Gupta | Executive Vice President and Chief Transformation Officer[13] |
| David Haufler | Executive Vice President and Chief Transaction Officer[13] |
| Kim Henderson | Executive Vice President and Chief Administrative Officer, managing people, culture, and team member well-being[13] [135] |
| Denise Mihal | Executive Vice President and Chief Nursing and Clinical Operations Officer[13] |
| Onyeka N. Nchege | Executive Vice President and Chief Digital and Information Officer[13] |
| Pamela Alston Oliver, MD | Executive Vice President and Chief Medical Officer[13] |
| Alice Pope | Executive Vice President and Chief Financial Officer[13] |