How Hospital Consolidation is Transforming Healthcare in New Hampshire: What You Need to Know

Financial pressures and staffing shortages have triggered a wave of hospital consolidations in New Hampshire. This trend raises questions about access to healthcare and the quality of care, especially as patients face rising costs.

In New Hampshire, only five out of 26 acute care hospitals remain independent. Many recent acquisitions involve large out-of-state companies like HCA Healthcare, based in Tennessee, or major Massachusetts academic medical centers. This situation sparks concerns about whether these entities truly understand the healthcare needs of local communities.

Interestingly, New Hampshire has not consistently tracked the effects of these mergers. However, the state recently formed the Healthcare Consumer Protection Advisory Commission to address this gap and provide oversight.

Lucy Hodder, a law expert from the University of New Hampshire, notes that the pressures on hospitals are significant. Insurance policies are becoming stricter, leading to higher operational costs, especially with the rise of expensive specialty drugs. She warns, “Without a clear plan, consolidations will continue.”

On the flip side, hospital leaders argue that mergers can enhance patient care by providing access to specialists. Steve Ahnen, president of the NH Hospital Association, suggests that smaller hospitals benefit from partnering with larger ones, gaining resources and expertise. Yet, some doctors share a different view. Dr. Archana Bhargava, an oncologist, highlights how closures of key services at acquired hospitals leave vulnerable patients without necessary care options.

A survey by the Altarum Institute reveals that 69% of New Hampshire residents believe hospitals contribute significantly to rising healthcare costs. Such sentiments reflect a growing unease about the impact of consolidations on care affordability and availability.

Looking at the broader picture, trends show that consolidation isn’t unique to New Hampshire. Nationwide, approximately 2,000 hospital mergers have taken place from 1998 to 2023, indicating a significant shift in the healthcare landscape.

Despite arguments that consolidations improve efficiency, research indicates the opposite might be true—prices often rise without clear benefits in care quality. This pattern can hurt patients, especially when out-of-state organizations make decisions that don’t align with local needs. Josephine Porter from the NH Center for Justice & Equity warns that these decisions can overlook essential community services.

Maternity care, for instance, is jeopardized by such mergers. After HCA acquired Frisbie Memorial Hospital, it closed its labor and delivery unit, reducing access for many local families. “Patients without reliable transportation are left without care,” Dr. Bhargava explains, emphasizing the hardships many face.

Workforce challenges exacerbate the situation. More than one-third of nonprofit hospitals in New Hampshire report financial losses, and significant vacancies persist across various hospital roles. Experts believe more consolidations are likely as hospitals struggle to compete in a challenging environment, leading to further cost increases and potential care declines.

In summary, the future of healthcare in New Hampshire faces many uncertainties. Regular assessments will be crucial to ensure that community needs guide healthcare policy and provider decisions.

For more detailed statistics and insights on national hospital consolidation trends, visit KFF.

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