Healthy hospitals.

• Author: Mildenberg, David
• Position: NC TREND: Charlotte Region

While politicians and patients rail about health care reform and rising costs, Charlotte's two dominant hospital systems are raking in serious dough. Novant Health and Carolinas HealthCare System have earned a combined $2.9 billion over the last five years, including $942 million in 2016, according to their financial reports. The profit includes investment gains, which were robust last year amid a frothy stock market.

"There's a very simple explanation for [the profitability]: Monopoly power," says Duke University economist Barak Richman, who studies health care finance.

CHS has a 52% market share of hospital stays in the Charlotte metropolitan area, according to a Standard & Poor's report in September. Having consolidated various hospitals and physician practices across central North Carolina, the two organizations had combined revenue topping $13.5 billion last year.

Winston-Salem-based Novant reported record results after repaying $350 million in debt, issuing employee bonuses totaling $83 million and providing charity care and other community benefits of $725 million, according to a press release. In addition to Mecklenburg County, Novant operates hospitals in Forsyth, Brunswick and Rowan counties and Manassas, Va.

CHS' market dominance is a factor in an antitrust lawsuit filed last year by the U.S. Department of Justice and N.C. Attorney...