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Dartmouth-Hitchcock, GraniteOne health systems ink proposed combination

  • Joanne Conroy, CEO and President of Dartmouth-Hitchcock Health, and Joseph Pepe, CEO of GraniteOne Health, are photographed at a meeting in Manchester, N.H., on Jan. 16, 2019. The two organizations have signed a letter of intent to merge into a combined non-profit health care system, Dartmouth-Hitchcock Health GraniteOne. (Dartmouth-Hitchcock Health - Mark Washburn) Dartmouth-Hitchcock Health — Mark Washburn

  • Diane Murphy Quinlan (Courtesy photograph)

Valley News Staff Writer
Published: 10/2/2019 1:04:06 PM
Modified: 10/2/2019 10:22:40 PM

LEBANON — The boards of Dartmouth-Hitchcock Health and GraniteOne Health have signed an agreement to combine the two health care systems, hospital officials announced Wednesday in a news release.

If the transaction, which the two entities first announced in January, is approved by state and federal regulators, it would bring two of the state’s largest hospitals together as Dartmouth-Hitchcock Health GraniteOne.

GraniteOne — the three-hospital health system including Manchester’s Catholic Medical Center — would join forces with the Lebanon-based health system that includes Dartmouth-Hitchcock Medical Center, the state’s only academic medical center, as well as four other hospitals and a visiting nurse organization.

“Our board unanimously approved this agreement because we truly believe it is a positive and transformative step for the people of New Hampshire and our respective organizations,” D-H Board Chairman Vincent Conti said in the release. “Every one of us is anxious to begin the work to fully realize the potential of our new relationship.”

In addition to the two boards’ approval, the Most Rev. Peter Libasci, the bishop who oversees the Catholic Church in New Hampshire, has issued a declaration of no objection, allowing what hospital officials are calling a “combination” to proceed.

The agreement, which is available online at, lays out the details of how the combined organization would function in terms of governance, administrative management and clinical programming.

Though CMC and D-H have previously attempted to join together, Alex Walker Jr., GraniteOne’s chief operating officer, said in a phone interview that this time is different.

“The world has changed dramatically in the last 10 years,” Walker said.

Since then, the Affordable Care Act was enacted, the population of New Hampshire has aged and it’s become more difficult to find workers, he said. In addition, both organizations have grown and they’ve expanded their clinical partnerships.

The two organizations need to come together now in order to compete in the southern part of the state with Massachusetts’ hospitals that have an increasing presence in New Hampshire, John Kacavas, D-HH’s chief legal officer and general counsel, said in the same phone call.

“If we’re hanging separately,” Kacavas said, “that’s trouble for New Hampshire health care.”

By further combining services, he said, the organizations aim to “offer New Hampshire-based alternatives to more expensive out-of-state providers.”

The next step for the transaction will be for the organizations to file for approval from the New Hampshire Attorney General’s Charitable Trusts Unit and Consumer Protection Bureau, and the Federal Trade Commission.

Meanwhile, an opponent of the combination is raising questions about the fact that a former employee of the Diocese of Manchester who also served on the CMC board is now working for the Charitable Trusts Unit.

Diane Murphy Quinlan worked for the diocese for 17 years before she retired on June 5 and then joined the Attorney General’s Office as the assistant director of charitable trusts.

She first came to the diocese in 2002 as vice chancellor and then became chancellor in 2004. She holds a bachelor’s degree from the College of the Holy Cross in Worcester, Mass. and a law degree from Suffolk University in Boston, according to her LinkedIn profile. During her time with the diocese, she worked to address the clergy sexual abuse crisis by creating policies and programs to prevent further abuse.

Kate Spiner, a spokeswoman for the AG’s office, said that Quinlan has been recused from the review of the proposed combination.

Quinlan “has not and will continue to not have any involvement in this transaction,” Spiner said.

Former Republican state Rep. Barbara Hagan, an anti-abortion activist from Manchester, said she was not convinced that Quinlan’s recusal in the matter would be sufficient to separate her from the transaction.

“I think it screams conflict of interest,” said Hagan. “…What are we going to do to be sure she doesn’t have … undue influence?”

D-H spokesman Rick Adams said in an email on Tuesday that D-H has confidence in the state review.

“The N.H. Attorney General’s Office has a tradition of operating with the highest ethical standards and in strict compliance with the rules of professional responsibility, including recusal policies, and we trust it will do so in reviewing our proposed Combination,” Adams wrote.

State Rep. Susan Almy, D-Lebanon, who said when the two systems announced the proposed combination last January that she would like to have assurances that patients would continue to have access to abortions at D-H, said on Monday that she hadn’t heard of Quinlan’s move to the Attorney General’s Office, but said that it would make sense for her to be recused from the transaction.

Hagan opposed the previous attempt to bring the two organizations together because they have “very different mission statements,” she said. That plan fell apart in 2010, when then-New Hampshire Attorney General Michael Delaney objected to what he likened to a takeover of CMC by D-H.

Hagan isn’t alone in her views. New Hampshire Right to Life President Jason Hennessey sent a letter on Tuesday to Attorney General Gordon MacDonald and the Charitable Trusts Unit Director Tom Donovan asking for their assurances that Quinlan would not participate in the D-H/GraniteOne review.

“We ask you to guard the public perception of the integrity of the CTU review for the CMC/DHMC combination by providing assurance that Atty. Quinlan will be fully isolated/recused from the decision process in this upcoming review,” Hennessey wrote.

Anti-abortion advocates also expressed concerns about the combination in a meeting the two health systems held in May.

CMC CEO Joseph Pepe and D-H CEO Joanne Conroy have said that the proposed combination will protect the organizations’ separate missions, allowing CMC to retain its Catholic identity and D-H to remain secular. Each of the member hospitals would continue to operate under their own boards of trustees.

Conroy would be the CEO of the combined system and president of one region, while Pepe would be the president of the second region, they said in January. Nine of the new system’s board members would be appointed by D-H, and six would come from GraniteOne.

Valley News Staff Writer Nora Doyle-Burr can be reached at or 603-727-3213.

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