Negotiations over the proposed merger between Atrium Health (formerly Carolinas Healthcare) and UNC Health Care have yet to settle one important question: Who will be in charge of the combined organization, which will be one of the largest health systems in the nation?

The Raleigh News & Observer reported this disagreement came to light after UNC Health Care CEO William Roper updated a university committee on the merger talks. In an interview, Roper said they’ve made “some progress in narrow the differences but we have not yet reached an agreement.”

“Both sides are interested in the key questions of who’s in charge, how are decisions going to be made, how can we balance the interests so that both sides feel fairly represented in the decision-making process,” he said. “Those are the big questions and we’re still working on them.”

The leadership structure laid out in the initial merger announcement would have Atrium CEO Gene Woods become CEO of the combined system while Roper would serve as board chair. When his term ended, Atrium’s board chair would assume the role, with terms then alternating between Atrium and UNC. Among the issues which remain unresolved, Roper said, was how long those terms would be.

“If it’s not properly balanced then we won’t have a deal,” Roper said. “It’s as simple as that.”

The lack of a definitive agreement between Atrium and UNC hasn’t stopped the former from pursuing other expansion plans. Earlier this month, just after changing its name to reflect a shift to a regional health system, Atrium signed a letter of intent to merge with Macon, Georgia-based Navicent Health.

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