UNC-Duke partnership to expand pediatric care with North Carolina’s first freestanding children’s hospital
Writer: Mirella Franzese
February 2025 — UNC Health and Duke Health, two of North Carolina’s largest academic health systems, are teaming up to build the first free-standing children’s hospital in the state.
NC Children’s Hospital, a $2 billion-plus undertaking that’s expected to break ground in 2027 and finish in the next decade, aims to improve access to highly specialized pediatric care, which has become a pressing social concern in recent years.
“As North Carolina grows…we need to grow our health systems and our talent base to keep up with that. We must keep up with not only today’s demand, but also future demand,” Steve Lawler, president & CEO of North Carolina Healthcare Association, told Invest: in an interview for the upcoming Invest: Charlotte edition.
North Carolina is the third-fastest growing state in the country and ninth largest by population, adding around 100,000 new residents every year since 2020. But rapid growth has led to unintended consequences, including constrained hospital capacity and limited access to care.
According to UNC Children’s Physician-in-Chief Stephanie Davis, hospital staff are currently struggling to manage overflowing capacity and being forced to send patients and their families back to hospitals closer to their home, attributing the challenge in part due to the state’s population growth, as cited by Chief Health Executive.
Hospitals statewide have been operating at around 80% capacity since February 2024, according to The North Carolina Pediatric Society’s dashboard of available pediatric ICU beds. In data from the past 431 days, UNC Children’s and Duke Children’s pediatric ICU capacity were 94.7% and 95%, respectively.
Meanwhile, North Carolina’s primary and secondary school age population continues to grow, with an increase of 17,000 children since 2020.
By the hospital’s expected completion time in 2033, there will be an estimated 1,742,000 children in the primary and secondary age group.
Despite the growing need for children’s medical care, the number of pediatric inpatient facilities has decreased steadily over the past decade, according to an October 2023 UNC Health study. Interfacility transfers — referring to patients relocated from one facility to another before discharge — increased by 12.7% from 2000 to 2019.
According to Morgan Jones, chief strategy officer of Duke Health, out-of-state hospital transfers are becoming increasingly common in the Carolinas.
“Some families have taken their kids out of North Carolina to go to pediatric hospitals in Washington, D.C. or Georgia…We’re really excited to be able to keep our patients and our populations local, as well as hopefully serve a broader region as well,” Jones told Chief Health Care Executive.
The lack of specialized care facilities for children across North Carolina also remains a pressing social issue, with approximately 40% of state residents living in an area without access to mental health professionals, according to the Carolina Across 100 initiative.
“Children (wait) in these emergency departments sometimes for weeks or months for a psychiatric bed when in crisis,” noted Mike Estramonte, founder and CEO of StarMed and Katie Blessing Center to Invest: “We realized it was not just a lack of beds, but it was a lack of continuity of care. These children are being sent not just to nearby states like Virginia, but all the way to Illinois and California for psychiatric beds.”
To address some of these challenges, NC Children’s will house 500 in-patient beds, a behavioral health center, outpatient clinics, research and development facilities, hospitality infrastructure (such as Ronald McDonald’s), and other mixed-use spaces.
“We both want the same thing for the children of North Carolina – the best care, close to home,” said Wesley Burks, CEO of UNC Health and dean of the UNC School of Medicine, in a January press release.
In addition to improving access to pediatric care in the region, the UNC-Duke partnership will transform North Carolina into a premier destination for children’s medicine and attract top talent to the Triangle region.
The 100-acre hospital will be strategically located in the state’s premier innovation center, Research Triangle Park, home to hundreds of academic institutions and corporations. “That is part of why we want a very large amount of land in the Triangle,” Davis said. “We’ve seen at other freestanding children’s hospitals and facilities, we visited a number of them, that the ability to grow is critical. So that is part of the plan.”
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