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D-H’s Manchester surgery center targets NH’s southern tier; telehealth looks even farther afield

Valley News Staff Writer
Published: 4/23/2021 10:30:16 PM
Modified: 4/23/2021 10:30:27 PM

LEBANON — Dartmouth-Hitchcock Health opened its newly expanded $62 million ambulatory surgery center in Manchester last month and is preparing to begin same-day surgeries there next week.

New Hampshire’s southern tier is a critical market for the Lebanon-based health system because it is the largest and most densely populated part of the state, and the population there also is younger and growing, D-HH Chief Strategy Officer Steve LeBlanc said during a conference call to update bond investors on Thursday.

It’s also a region where D-H faces competition from Boston-based health systems, he said. It’s “important for us to have a strong position,” said LeBlanc.

Separately, D-HH this week also announced a new service targeting rural patients via telehealth. Through D-HH Virtual Urgent Care, which is a collaboration with the Florida-based MDLIVE, patients in need of non-emergency care can now connect with D-H or MDLIVE-affiliated providers by phone, laptop or mobile device 24 hours a day, seven days a week, D-H said in a news release.

“With nearly 2 million people residing in rural communities across northern New England, virtual care will play an increasingly vital role in providing patients with access to the care they need, where and when they need it,” the release said.

For $59, the service allows patients with private insurance or who pay out of pocket to see the next available provider or schedule a same-day visit for more than 30 common conditions, including a cold, flu, allergies, insect bites, rashes, gastrointestinal issues and urinary tract infections, the release said. When appropriate, physicians will prescribe medications to be sent to a patient’s preferred pharmacy.

It is not available to patients with Medicare or Medicaid due to “billing rules and regulations,” according to the D-H website.

In the meantime, the 90,000-square-foot expansion located at Hitchcock Way in Manchester includes six extended-stay ambulatory surgical center rooms with room to add more, LeBlanc said. The facility includes space for medical infusions, an expanded medical office and a fixed magnetic resonance imaging system.

For D-HH, which does not have a hospital in the southern part of New Hampshire, the expansion allows it to capture some of the revenue associated with hospital-based services that patients require, LeBlanc said. He also said that the project is aimed at reducing health care costs for patients, in part by allowing them to recover from surgery at home rather than in a hospital.

Patients at the Manchester facility can stay as long as 23 hours, according to a news release this week announcing the center’s opening.

Reducing health care costs for D-H patients in the southern part of the state also will help D-HH financially as the organization participates in value-based contracts that pay it a per-patient amount to keep people healthy, rather than a fee-for-service payment, LeBlanc said.

At the same time D-HH also is seeking to shore up its presence in that market through a combination with GraniteOne Health, which includes the 330-bed Catholic Medical Center in Manchester. John Kacavas, D-HH’s chief legal officer, on Thursday’s call said the system is on track to close this summer on the combination with GraniteOne, which also includes two of New Hampshire’s critical access hospitals.

The deal, which was first announced in January of 2019, has been delayed somewhat by the pandemic. The parties, which signed a formal agreement in October of 2019, returned to the negotiating table after the pandemic hit to assess their financial positions, Kacavas said. CMC has financial targets it is required to meet before the deal closes, but Kacavas said he is “confident” that CMC will be able to achieve those goals.

The deal also is pending regulatory approval from the Federal Trade Commission, as well as the New Hampshire Attorney General’s Charitable Trust Unit, Kacavas said.

Amid the ongoing pandemic, D-HH leaders painted the hospital’s financial position as positive, with operating margins hovering around breakeven since the system’s loss on operations of $84 million on a total operating budget of $2.4 billion for the fiscal year that ended June 30.

“In spite of everything we’ve been through (I) still continue to believe we’re well-positioned; as well-positioned as any organization can be,” said Daniel Jantzen, D-HH’s CFO.

Following the cancelations of elective procedures early on in the pandemic, D-HH has pivoted to care for COVID-19 patients at the same time it cares for others. As of Wednesday, Jantzen said D-H had 17 patients hospitalized with COVID-19, including three on ventilators. That number was down to 15 by Thursday, he said.

To support the ongoing COVID-19 response, the health system has stockpiled a full year’s worth of personal protective equipment, he said.

Once the pandemic is over, Jantzen said D-HH aims to return to the financial performance it had in fiscal year 2019. That year, the system saw a positive operating margin of nearly $70 million on a total budget of $2.23 billion.

In the meantime, D-HH continues construction on a new $150 million patient tower at Dartmouth-Hitchcock Medical Center in Lebanon. Like the Manchester expansion, it was financed before the pandemic. The tower is slated to be completed in November of 2022.

Nora Doyle-Burr can be reached at or 603-727-3213.

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