Forum discusses GraniteOne, MCH merger

  • Monadnock Community Hospital Staff photo by Ben Conant

Monadnock Ledger-Transcript
Published: 10/11/2021 3:25:54 PM

A panel of executives from Monadnock Community Hospital, GraniteOne Health, and Dartmouth-Hitchcock Health presented on and answered questions about the proposed transaction between GraniteOne and Dartmouth-Hitchcock, focused specifically on its potential impacts to MCH.

The forum, held at Hilltop Golf Course in Peterborough on Wednesday, was well-attended and garnered many questions on the nature of the transaction, its potential impact on the Monadnock community, and what changes will be made if the transaction goes forward.

The proposal is to combine GraniteOne Health with Dartmouth-Hitchcock Health to “form an NH-based, integrated, and regionally distributed health care system,” as they put it in the forum’s presentation portion. This process began in early 2019, when Dartmouth-Hitchcock Health and GraniteOne Health signed a Letter of Intent to combine the two systems, followed by the signing of a Combination Agreement the same year. Now, the Charitable Trusts Unit with the New Hampshire Attorney General’s Office must review the transaction and issue a report.

Tom Donovan, Director of Charitable Trusts, started the forum by explaining his office’s job, and that their goal was to ensure that the transaction would be in the best interest of the hospitals and the communities they serve.

Katharine London, Principal for Health Law & Policy at UMass Medical School, presented the findings of a review performed by her and her team. 

One of the main takeaways, London said, is that the transaction would be “very complex,” as the organization that would be formed would be very large. That said, she listed many potential benefits as put forth by the two health organizations: better access to care closer to home, improvement of mental health services, better coordination of care, workplace development and supporting Dartmouth-Hitchcock in its role as an academic medical center. 

London also brought up some concerns, including the possibility of higher rates for services and a potential conflict between standard practices at the Catholic facilities to be included in the transaction and those that are secular. 

Along with other concerns related to hospital autonomy, London said that the transaction proposal does address this issue by having each hospital maintain its own board with a system-wide board to oversee the organization, within which Catholic Medical Center would also report to the Bishop of Manchester to maintain its own religious and ethical obligations. The Bishop already issued a declaration of no objection in 2019.

During the Q&A portion of the forum, attendees were chiefly concerned with matters of local access and impacts on MCH, as well as what kind of growth the community could expect if the transaction were to succeed. 

With substance use being an issue in the region, multiple people asked questions about future plans for investing in behavioral health care, which Joanne Conroy, CEO of Dartmouth-Hitchcock Health, said had already received significant investment at Dartmouth-Hitchcock, in terms of training and integrating that type of care into more general health care.

Cynthia McGuire, CEO of MCH, said that behavioral health would be expanded in the future, potentially along with MCH’s plans to expand telehealth services, which McGuire said could address any number of other issues including urgent care. 

Concerns were also raised about staffing shortages and how the transaction could address that issue – McGuire said that as of that morning, there were 92 open positions at MCH, and since the hospital was too small to have a big training system, the transaction would help them recruit and regain top talent.

“We’re looking to expand our services,” she said, and for that, they will need more workers. This, she added, will hopefully increase local employment as well.  

“Deep in our hearts, we believe it will improve the care of people in these communities and across the state,” said Conroy. This would also include sharing research from Dartmouth-Hitchcock, she said, one of the top benefits of combining with an academic medical center. “We would hope to expand our cutting-edge research to wherever people access our system.”

“As a rural hospital, we struggle,” McGuire said, a sentiment echoed by all members of the panel and some audience members. These struggles, she said, could be alleviated by moving forward with the transaction. 

“We are looking forward to a bright future ahead,” she said. 

Donovan closed the meeting by asking for further comments and questions on the topic of the transaction from anybody who might have them.

The Charitable Trusts Unit will be collecting comment through Oct. 15, and they can be submitted by email to


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