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Elliot, Southern New Hampshire Health To Explore Affiliation

Elliot Hospital, in Manchester, could become part of a larger network that includes facilities within the Southern New Hampshire Health System.

The last few years have seen a wave of consolidations in New Hampshire healthcare. Now, Southern New Hampshire Health and Elliot Hospital are looking at forming a new “regional healthcare system” — though the details of what, exactly, that partnership might look like are still unclear.

If the affiliation goes through, the hospitals say they would still keep their own boards and management teams, but they could operate within a larger network where they would be able to more easily share doctors, technology and other resources. The regional health system would have its own board, made up of members from both hospitals plus a CEO of the new system.

On a website the health systems rolled out in conjunction with the affiliation announcement, they nodded to the changing healthcare landscape in New Hampshire as a factor in their plans.

“In New Hampshire alone, increased partnerships within the past five years have made the environment more challenging for independent hospitals like Elliot and Southern,” the website says.

In an interview with NHPR, SNHH CEO Mike Rose cited a number of “external forces” driving the hospitals toward affiliating, including shifting financial incentives driving hospitals to focus less on a fee-for-service model and more on patient outcomes, as well as a growing demand for walk-in appointments and tele-health services.

Another big factor: The growing population of older Granite Staters who will likely require more specialized care as they continue to age.

“We know that as that population segment ages, we’re going to see changes in utilization, we’re going to see increased demand for certain services — particularly chronic disease — and we need to be well-positioned to manage those changes in demand,” Rose said.

Both health systems sometimes struggle to maintain specialty services on their own, Rose added, because there aren’t enough patients to support the number of providers needed for a practice.

“By working together and collaboratively deploying those specialty resources, we think we can create more stable access, in many cases more efficient access,” Rose said. “And in some cases, because we’re planning for a population of 500,000 rather than 200,000, we may be able to stand up services in our markets that don’t exist today.”

This is just the first step in a long process before any formal relationship between the hospitals is final. The hospitals aim to have a more detailed agreement of what that will look like by this fall, and hope to get final approval from state and federal regulators by early 2018.

For the time being, Elliot CEO Doug Dean said patients will see “very little to no change” in care.

“The only potential change will be that at Elliot facilities and Southern facilities, my suspicion will be there will be a time where they will say, ‘An Affiliate Of…’” Dean said. “And we haven’t named ‘Of…’ yet.”

The hospitals’ joint website says employees of both institutions would remain employed by the individual health system where they’re currently employed.

“Staff at both organizations (including nurses and physicians), in good standing, would remain employed at competitive wages and benefits,” the website says.

This isn’t the first time Elliot’s been involved in a discussion about expanding its regional reach within the state. Last year, Dartmouth-Hitchcock and Elliot Health System also considered affiliating but called off those plans in February.

Dean, with Elliot Health, said both hospitals have “significant activities from Dartmouth physicians” in many clinical areas. Moving forward, Dean said it will be up to the leadership of the new regional health system to figure out “how partnerships are crafted and what form they take, be that with other community hospitals or other major academic centers.”

Dartmouth-Hitchcock, currently the state’s largest health system, released its own statement following news about the possible affiliation in the southern part of the state — reiterating its position that “collaboration among providers, as well as competition, is the most effective way to deliver” care.

“We value our relationship with our colleagues at both The Elliot and Southern New Hampshire Health,” the statement added, “and as the details of their proposed Combination are clarified we will continue to build upon our commitment to transform health care delivery for the patients and families we serve.”

Casey McDermott is a senior news editor at New Hampshire Public Radio. Throughout her time as an NHPR reporter and editor, she has worked with colleagues across the newsroom to deepen the station’s accountability coverage, data journalism and audience engagement across platforms.

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