North Carolina is about to rewrite the playbook for pediatric medicine. On January 28, 2025, longtime Triangle rivals UNC Health and Duke Health filed articles of incorporation to create NC Children’s, a private, tax-exempt 501(c)(3) organization that will unite its pediatric expertise under one banner.
At the heart of the venture is a 500-bed, standalone children’s hospital, flanked by an outpatient care center and a dedicated behavioral health facility, creating the first fully freestanding children’s health system in the state’s history. The facilities will sit on 100-plus acres in the Research Triangle region, allowing room for gardens, playgrounds, Ronald-McDonald-style family lodging, and a translational research hub that links laboratory science directly to bedside care.
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A Vision Rooted in Collaboration
UNC Health and Duke Health have independently ranked among the nation’s top academic health systems for decades. Yet the reality is that many North Carolina families travel out of state for highly specialized pediatric care. By pooling their clinical talent, research infrastructure, and philanthropic strength, the UNC and Duke systems intend to keep those families closer to home while accelerating breakthroughs in child health. Under a joint board of directors, NC Children’s will blend UNC’s strengths in population health with Duke’s expertise in biomedical discovery.
Both UNC School of Medicine and Duke University School of Medicine will rotate students, residents, and fellows through the new system, enriching the learning environment with higher case volumes and a broader pathology mix. Joint faculty appointments and shared simulation centers will foster cross-campus mentorship and standardized best practices. A partnership with North Carolina Central University and other historically Black colleges is also under discussion to expand diversity in the pediatric workforce, with the goal of eliminating racial disparities in child health outcomes.
The Need for NC Children’s
UNC Health and Duke Health both run pediatric programs, but they are embedded within adult hospitals. Standalone children’s hospitals offer several important advantages:
- Child-Centered Design—Every detail, from lower radiation imaging protocols to décor that reduces anxiety, is tailored to kids.
- Concentration of Subspecialists—Cardiology, oncology, neurosurgery, and rare disease teams can collaborate in real-time, improving outcomes for the sickest patients.
- Family Services Under-One-Roof—Lodging, social work, school liaisons, and child therapy become integral parts of the care continuum.
- Research Synergy—Dedicated pediatric research space accelerates clinical trials and streamlines the translation of scientific discoveries into health interventions aimed specifically at childhood diseases.
With the state’s under-18 population exceeding 2.5 million and projected to grow faster than the national average, NC Children’s will enable North Carolina to meet the rising demand for pediatric hospital care without moving patients to Atlanta, Cincinnati, or Boston.
A Multi-Billion-Dollar Undertaking
With early cost projections exceeding $2 billion, NC Children’s is one of the largest healthcare capital projects ever attempted in the Southeast. State lawmakers have already appropriated $320 million, with an additional $535 million under consideration, which would bring public support to about 43% of the lowest cost estimate. The remainder will be financed through philanthropy, hospital system reserves, and tax-exempt bond issuances.
NC Children’s will be a boon for employment in the area. Construction alone is expected to generate thousands of jobs, while long-term operations will require physicians, nurses, allied health professionals, researchers, and support staff. Local chambers of commerce are already promoting the hospital as a magnet that should draw biotech startups and family-oriented employers to the Triangle.
Project Timeline
By the end of this year, the initial board will have been seated, and the site for NC Children’s will be selected. The preconstruction phase will consume 2026 and most of 2027, with a groundbreaking ceremony anticipated in late 2027. During the preconstruction phase, planners will set specific sustainability goals, aiming for LEED Gold certification with rooftop solar arrays and green space preservation. Ribbon-cutting and the first patient admissions will occur in 2033.
A Transformative Moment for Child Health
If successful, NC Children’s will knit together clinical excellence, research innovation, and compassionate family support into a single statewide resource. Parents will have one phone number to call for everything from routine orthopedics to cutting-edge gene therapy trials. Physicians will gain a powerful referral hub, and North Carolina will bolster its reputation as a life science powerhouse. The vision is clear, and the momentum is unmistakable. UNC Health and Duke Health have set aside their rivalry to bet on North Carolina’s kids, and the entire state stands to win.
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