Our goal is to position the North Country for a secure health care future
July 21, 2014—Over the last year and more, the four hospitals in the North Country have been meeting to explore whether or not affiliating in some way would help us deal with the challenges we face as small, rural community hospitals in a health care environment that is in the midst of significant change.
We face an environment in which our ability to deliver on our missions to our communities, and our financial viability, is not a sure thing. Health care costs are growing faster than any other part of the economy. Government payment, especially Medicaid, frequently doesn't pay enough for us to cover our costs. Employers paying for employee health insurance find themselves paying more and more, and as a result are increasingly shifting insurance costs and choices to employees. And importantly, the demographics and economy of the North Country are changing. According to a recent estimate, the population of the North Country now ranks as the poorest and sickest in the state.*
To address these challenges, and after careful consideration and the receipt of a good deal of expert advice, the Boards and leadership of Androscoggin Valley Hospital, Littleton Regional Healthcare, Upper Connecticut Valley Hospital and Weeks Medical Center have signed a non-binding Letter of Intent to create a common parent organization that would serve all communities in the North Country.
This Letter of Intent provides a way forward for each of the organizations working together with the others to seek both the regulatory approvals we will need for any type of true business affiliation, as well as to do the detailed business planning that would guide it.
There is every belief that this idea is a good one; that it will provide an affiliation that will serve all the communities in the North Country and preserve quality, value driven and caring health services to people in the communities we serve. We’ll be stronger together.
From a technical perspective, what we are considering is to create a common, nonprofit parent organization for the four North Country Hospitals.
Under this arrangement, our four hospitals would each exchange some of our autonomy (giving it to the parent organization) to enable us to develop a highly-coordinated health care network that will improve quality, increase efficiencies and lower cost of health care delivery in the region.
The Letter of Intent states that our four community hospitals will remain as four nonprofit organizations providing the same core programs and services that we do today. Each organization’s assets, including charitable endowments, will remain in their respective community. Each hospital’s Board of Trustees will continue its community oversight role, and, in coordination with the new parent organization, establish strategy and set direction for each hospital. Each hospital’s relationships with its physicians, patient care staff and employees will remain largely the same.
We are regulatorily prohibited from working closely together under our current independent structures. Forming a common parent organization, governed by an independent Board, would give us the ability to do this. We view this as crucial given the challenges we face in continuing to provide local access to care throughout the North Country.
We see this as an innovative, local, North Country solution to both meet the challenges we face and maintain four, locally oriented, community hospitals.
Over the coming months, our managements, advisors and Boards will be working to develop a definitive working agreement that may lead to the formation of this new parent organization in 2015.
The parties to this process will continue to keep all stakeholders in North Country healthcare informed as to our progress in this process – community members, government, staff, suppliers and insurers. More information on the affiliation may be found at www.northcountryhealth.org and it will be updated regularly.
As Boards of Trustees, it’s our job to position our hospitals for the future. We are committed to a positive outcome, but please know that we have considerable work to do to finalize an agreement and get all the regulatory approvals we need. While we are committed to the process, the final outcome will depend on that effort and its success.
We plan to hold a community information meeting in each hospital community next month to share with you the possibilities this affiliation brings to the communities we are privileged to serve, and answer any questions you may have.
With respect,

For Androscoggin Valley Hospital
Mark Kelley, Chair
Russell Keene, Chief Executive Officer
For Littleton Regional Healthcare
Stevan Trooboff, Chair
Warren West, Chief Executive Officer
For Upper Connecticut Valley Hospital
Greg E. Placy, Chair
Peter Gosline, Interim Chief Administrative Officer
For Weeks Medical Center
David Atkinson, Chair
Scott Howe, Chief Executive Officer