State regulators rejected plans by WakeMed and Rex Healthcare to continue building satellite campuses in rapidly growing sections of Wake County.

In separate decisions mailed this week to hospital officials, the regulators denied requests by the county's two largest health-care providers to build almost $80 million worth of projects.

The proposals would have brought urgent care centers and other services to North Raleigh, Cary, Holly Springs and Garner.

Analysts from the state's Division of Health Service Regulation questioned hospital officials' projections that involve market share and the rate at which services would be used. The officials suggested that the areas are already adequately served.

Two smaller projects involving new radiation treatment equipment at Rex and an additional cardiac catheterization unit at WakeMed were approved.

Rex, which is owned by UNC Healthcare, plans to appeal the state's denials. WakeMed is reviewing the state reports.

"We are confident there is a need for all three plans we sent to the state," Rex spokeswoman Melody Hunter-Pillion said.

Hospitals in the Triangle are pushing hard to attract a booming population of affluent patients by adding patient centers in outlying communities. The centers offer services such as urgent care, day surgery and doctor appointments.

WakeMed and Rex's fight for market share is especially intense in Wake County.

But the denials by state regulators raise questions about whether some areas have become at least temporarily saturated.

One of the projects proposed by Rex, for example, called for a $6.8 million urgent care center in Holly Springs. It is less than 10 miles from a center in Apex that WakeMed opened about three months ago.

Rex did not mention that point in its application, but Gene DePorter, project analyst for the state, made it clear.

"The applicant fails to identify or discuss the new WakeMed Apex Healthplex located near the intersection of NC 55 and Highway 64," according to the report, which called Rex's market share predictions "questionable."

Holly Springs' letdown

Carl Dean, town manager of Holly Springs, said officials there see the issue differently.

"We have more than 20,000 people now in Holly Springs, and we have talked with Rex for a number of years about getting something located in this area," he said. "We feel like it is a quality-of-life issue."

Rex's request to build an urgent care center in west Cary was turned down for similar reasons, although that facility would include a separate cancer center.

The state turned down the cancer center request because it wanted more information about the patients it would likely serve.

Hunter-Pillion said she isn't sure what Rex will do if it wins permission to build the cancer center but not the urgent care facility, given that both are proposed for the same address.

"Right now, our plan is to successfully appeal both parts," she said.

The state's objections to WakeMed's plan to build centers in Garner and the Brier Creek area of North Raleigh involved the hospital's calculations of how many people would use the centers.

WakeMed proposed a $34.5 million facility near the Durham County line. It wants to build a $25 million healthplex in Garner near the Johnston County line.

"The approval process is based on a lot of very technical information, and it's not unusual to get a denial," said Stan Taylor, vice president of corporate planning at WakeMed.

"So we'll review our options over the next few weeks and then make a decision about what to do."

WakeMed is moving ahead with previously approved plans to build a healthplex in Wendell by the fall of 2009.