Cheshire, D-H to Form Affiliation

Lebanon — Yet another New Hampshire hospital wants to hitch itself to Dartmouth-Hitchcock’s wagon amid a rapidly changing health care industry, one in which hospitals collaborate rather than compete for patients.

Cheshire Medical Center in Keene, N.H., has negotiated an affiliation agreement with Dartmouth-Hitchcock that would strengthen ties between the two institutions. Cheshire is the fourth hospital in the Granite State, and the third in recent weeks, to pursue a formal affiliation with the state’s largest health care system.

“This agreement will enhance Cheshire’s ability to meet the current and future health needs of the residents of Cheshire County, strengthening the sustainability of the clinical services offered,” said Sylvia McBeth, chairwoman of Cheshire’s board, in a news release on Monday. “We will continue to provide our community the highest quality of medical care, and will strengthen our focus on prevention and wellness. We look forward to discussing the affiliation agreement with the community over the next couple of months.”

The affiliation is not a merger, but will “further align (Cheshire’s) governance, clinical, financial and administrative activities with Dartmouth-Hitchcock,” according to the news release. Dartmouth-Hitchcock would have certain reserve powers, though Cheshire would remain a separate legal organization with its own board of trustees, management and employees.

This is not the first time that Cheshire and Dartmouth-Hitchcock have worked together. Since 1998, they have jointly run a multi-speciality group practice called Dartmouth-Hitchcock Keene that comprises the majority of Cheshire’s medical staff. This affiliation “is seen as a natural step that will enable both organizations to more effectively pursue a common vision of the future of health care,” the news release said.

“Dartmouth-Hitchcock and Cheshire Medical Center have a long history of working together to ensure the health of our population and to innovate in constantly improving the delivery of health care,” Dartmouth-Hitchcock CEO Jim Weinstein said. “We look forward to strengthening the relationship that already exists between our institutions, to jointly deliver high-quality, high-value care that patients, when well-informed, want and need.”

Monday’s announcement follows similar moves by Alice Peck Day Memorial Hospital in Lebanon and Mt. Ascutney Hospital in Windsor to strengthen ties to Dartmouth-Hitchcock. Last October, New London Hospital began its affiliation with Dartmouth-Hitchcock, which gave the Lebanon health system seats on New London’s board, allowed it to be involved in New London’s major governance decisions, sign off on capital and operating budgets, major borrowing and changes in clinical services.

Partnering with Dartmouth-Hitchcock will help the hospitals streamline care for patients and eliminate redundant costs in the local health care network, officials have said.

For example, back-office functions, such as billing, could be shared.

Dartmouth-Hitchcock has partnerships with other hospitals in New Hampshire and Vermont through accountable care organizations, in which they work together to care for Medicare patients. And last September, Elliot Hospital in Manchester and Dartmouth-Hitchcock announced a new partnership with insurer Harvard Pilgrim Health Care called ElevateHealth, which aims to lower patients’ insurance premiums by 10 percent.

Cheshire and Dartmouth-Hitchcock still need to do their due diligence and the agreement is subject to a regulatory review by the New Hampshire Attorney General’s office and the Director of Charitable Trusts. If all goes according to plan, the affiliation is expected to become effective this fall.

Cheshire will host public forums on the affiliation soon, though the dates and locations have not yet been announced.

Chris Fleisher can be reached at 603-727-3229 or