Remarks by Vickie Adamson
81 remarks on the record, newest first · Page 3 of 4
- Play at 3:26:08
“I saw South was here when we were taking pictures with the cup.”
Board of Commissioners · Sep 21, 2026
- Play at 3:26:14
“But he left. Okay, he didn't stay to answer questions. Is there any legal or contractual reasons why the vote must occur today?”
Board of Commissioners · Sep 21, 2026
- Play at 3:26:24
“That's up to the board. Okay. If we vote today based on what we don't have in the documents, then it's, I guess then that leverage that we have is your approval of the agreement between Wake Med and Atrium.”
Board of Commissioners · Sep 21, 2026
- Play at 3:26:58
“Oh, it'll be, so if we vote it today, then you still have to approve the cap?”
Board of Commissioners · Sep 21, 2026
- Play at 3:27:26
“Okay, thank you. So I had some more questions about the five-year cap. And if we could, I know you don't have the information now, but from Googling, I feel like I've gotten to be a master of Googling healthcare things. So I was trying to look at Medicare reimbursement rates. which I've never had a reason to look at. And there seems to be like all kinds of different ones, right? There's something called an inpatient IPPS update. There's an OPPS update, market-based, physician fee. So I guess when the document's completed, it will spell out which Medicare measure we're looking at. And the…”
Board of Commissioners · Sep 21, 2026
- Play at 3:29:35
“So there's no way for us to see the last five years what their rate increases were and what they would have been if we would have applied this Medicare 1.5 times the annual Medicare reimbursement increase. So we don't have that.”
Board of Commissioners · Sep 21, 2026
- Play at 3:29:54
“We don't have it. So we can't see what it would have looked like before.”
Board of Commissioners · Sep 21, 2026
- Play at 3:30:03
“Sorry, let me read some of these. So I'm assuming this will apply to every commercial ACA insurer included self-funded employee in the state health plan. Now, And I'm assuming it'll apply not just to inpatient, but outpatient, their medical practices, everything as well. And is that, if they have a current contract, that has rate increases built into it. Would they follow those or would they go to the 1.5 if this passes today? We don't know.”
Board of Commissioners · Sep 21, 2026
- Play at 3:31:13
“Okay, so if those contracts have rate increases that are higher than the 1.5, then I guess those would be honored. Yeah. Okay. Independent. So what will happen if Atrium, and I guess we don't have this information, violates the cap? Can the county obtain repayment for patients and employers, monetary damages, injunctions? I guess we don't know what happens if they don't follow it.”
Board of Commissioners · Sep 21, 2026
- Play at 3:31:55
“And we don't know what happens at the end of five years? No. Okay. The two billion commitment. The governor's announcement said it would fully fund. The letter, the sources of the funds Could that also include, does that equivalently $2 billion from atrium, or could they play a shell game with Wake Med's revenue? Could they move it to an atrium source and then take a different source and move to us? Is there anything to make Wake Med's profits stay at Wake Med?”
Board of Commissioners · Sep 21, 2026
- Play at 3:33:23
“Because, you know, the devil's in the details. That's what we found with the first agreement. That's true. Right. I mean, you know, because we were told a bunch of stuff, and when I finally threw a public fit and got to see it, I was shocked at the difference between that and what we had been told. So with atrium sources, so that means they can't borrow money from and use any Wake Med as collateral, and then have Wake Med make the repayments of principal and interest out of their earnings?”
Board of Commissioners · Sep 21, 2026
- Play at 3:34:14
“So who's going to audit this and report it to the public? The board members?”
Board of Commissioners · Sep 21, 2026
- Play at 3:34:29
“Okay, so that's... Yes, I can allow someone else to ask questions and then I'll come back to mine. Okay. But I do, Mr. Chair, plan to, since this is our first time to do this, I don't want to be rushed. I want to have my full time for this.”
Board of Commissioners · Sep 21, 2026
- Play at 3:54:39
“I only have one page left. Mr. Chair, so you'll know where I'm at. I've done three pages. So, So at this point, and thank you for all your work. I know this has been nights, weekends, and a lot of work. So at this point, we talk about these municipalities that are gonna get hospitals, the main campus is gonna get renovated. But there's no specific projects in the agreement, it just says $2 billion. And then at some point we should, if this is approved today, at some point we'll get a schedule of when these things are gonna happen. When will we know when hammers are gonna start hammering at…”
Board of Commissioners · Sep 21, 2026
- Play at 3:56:25
“Right, thank you all for that. Now the charity care and the community fund. the 8% instead of the 4.83 or whatever's in the agreement now. And I understand that Wake Med normally does 12% now. How is that defined? Is that like, can they do like bad debt, Medicaid shortfalls? Can they count any of that as, as charity care, or is that, I understand charity care is an IRS term. Will they use the IRS definition for charity care?”
Board of Commissioners · Sep 21, 2026
- Play at 3:58:10
“Okay, and so do we know if that applies to just emergency care or general services? I think we talked about that in the work session. If I need my knee replaced and I can't afford it and I'm not an emergency, can I get Charity Care to get my knee done?”
Board of Commissioners · Sep 21, 2026
- Play at 3:58:41
“So with the medical debt, I assume that there's no protections beyond what's under the federal law, the IRS standards.”
Board of Commissioners · Sep 21, 2026
- Play at 4:00:15
“Okay, thank you. So there's guardrails around the whole health program. So can they veto any of our, as long as it's not a competitor, right? Can they veto any funding? Like let's say we wanted to fund a community health clinic.”
Board of Commissioners · Sep 21, 2026
- Play at 4:00:45
“Okay, thank you very much, that's good to know. And competition would be like getting UNC to run the clinic. That's pretty straightforward, right?”
Board of Commissioners · Sep 21, 2026
- Play at 4:01:08
“Thank you. Roger, I sent you an article that I found about, it was from the beginning of, I believe August, September, where the FTC turned down a hospital merger strategic partnership.”
Board of Commissioners · Sep 21, 2026
- Play at 4:01:30
“In Ohio. And I saw the article and we confirmed that it was legitimate.”
Board of Commissioners · Sep 21, 2026
- Play at 4:01:37
“Yeah, right. we found the press release the FTC put out. And they stated that the hospital had not done due diligence in looking at a partner. And that means they had not done some kind of RFP process, they had not looked at any other partners. and they rejected it and said, you basically go back to the drawing board. And one of the quotes in the press release from the FTC was the director saying he wasn't gonna approve any where due diligence wasn't done. So we've been assuming the FTC is a given, but since there was no competitive process year, there was data looked at on other hospitals,…”
Board of Commissioners · Sep 21, 2026
- Play at 4:03:06
“There'll be null and void. So there's no, we don't have to have a provision in there that says if the FTC, is there something in there about regulatory has to approve it?”
Board of Commissioners · Sep 21, 2026
- Play at 4:03:38
“Yeah, and I guess something that I've, and Mr. Chair, this is my last question, but I do have comments before I vote, but they are short. My questions were long, but my comments are short. You know, this has felt, this whole process has felt uncomfortable to me, because I'm so used to what we get from y'all being so orderly, and here it is, and ask your questions, and here's the final document, you've got them a week in advance to ask questions. Well, as we know, this has been a moving target, and Last week, you and the county manager's office decided to bring this forward for a vote today,…”
Board of Commissioners · Sep 21, 2026
- Play at 4:05:22
“So it wasn't an atrium date. It was our date.”
Board of Commissioners · Sep 21, 2026