1. What is the “The Seacoast Healthcare Initiative?” The Seacoast Healthcare Initiative is an awareness campaign to describe the proposed affiliation among Exeter Health Resources, Wentworth-Douglass Hospital and Massachusetts General Hospital which would create a new, Seacoast, NH-based, not-for-profit healthcare network for the Seacoast Region.

    The affiliation agreement, which centers on combining the strengths of our three organizations in a way that would enable us to integrate clinical care, share resources, increase efficiency and bring more services to the NH Seacoast, has been submitted to regulatory officials, and we are currently engaged in the federal and state regulatory review process.   

    The Seacoast Healthcare Initiative aims to engage and educate our communities about our proposed affiliation agreement – which calls for the formation of a new, New Hampshire based, regional, not-for-profit entity that will serve as the parent of both Exeter Health Resources and Wentworth-Douglass Hospital and will be part of the Massachusetts General Hospital family.  Once approved, each hospital is expected to keep its own identity, and a name for the newly formed regional entity will be announced. 

    The collaboration of these three mission-driven organizations is just beginning and the Seacoast Healthcare Initiative is just our way of keeping you informed about how this plan will evolve and, once approved, improve the healthcare of the NH Seacoast in a substantial and impactful way.

    In the coming weeks and months, we will continue to engage in an active conversation with members of the Seacoast community to provide additional information, details and answers to important questions and concerns. This important initiative is meant to create an on-going public awareness and community dialogue about our intention to create an integrated, sustainable healthcare delivery system for Seacoast residents.  It is vitally important that members of the communities we serve be invited to participate in the regulatory process that we believe will result in our ability to deliver world-class healthcare right here at home in the Seacoast. 
  2. Will Exeter Hospital and Wentworth Douglass Hospital remain not-for- profit and continue to invest in our local communities?  Exeter Health Resources, Wentworth-Douglass Hospital, and Mass General Hospital will remain not-for-profit organizations.  

    As not-for-profit organizations, any excess of revenue over expenses stays in the community and is used to reinvest in equipment, facilities and new programs and services to benefit the community.

    Our investments in community benefits, including financial assistance/charity care, community benefits funding, and support for civic organizations and community services, will remain a top priority. The proposed affiliation provides the sustainability necessary to ensure Seacoast residents have access to local high-quality care.
  3. How will this affect the mission of my local healthcare system?  Incorporating the best practices and safety initiatives provided by Mass General, local healthcare will improve. Our local care teams will still be here to support your healthcare needs. This proposed affiliation will expand and enhance care that Seacoast region patients can receive close to home. With the support of Mass General, we can bring services such as more advanced care in orthopedics and joint care, obstetrics and neonatal care, cardiovascular services, behavioral health and substance use disorder treatment.  A great example of this would be the possible development of a Level II Special Care Nursery to care for newborns needing advanced care.  These services would not be cost-effective for stand-alone community hospitals to provide.  

    In short, our common goal is to deliver even higher quality care, enhanced access and value in the delivery of expanded services and the promotion of community wellness in an ever-changing healthcare environment.
  4. What is the status of the proposed affiliation?  Exeter Health Resources, Wentworth-Douglass Hospital and Massachusetts General Hospital filed  an Affiliation Agreement with the NH Attorney General’s Office and the Federal Government in May of 2019.  Following a 90-day review, on September 20, 2019 the Consumer Protection and Antitrust Bureau, with support of the NH Attorney General announced that the Charitable Trust Unit would formally object to the proposed transaction citing antitrust concerns. While the State has issued its objection, the affiliation remains under review by the Federal Trade Commission (FTC). All three organizations (Exeter Health Resources, Wentworth-Douglass Hospital and Massachusetts General Hospital) remain resolute in their commitment to see the affiliation to completion and have been actively reaching out to both the Attorney General and the Governor to request a meeting to collaboratively discuss and work to resolve any concerns the State may have. You can add your voice of support by visiting the Take Action page of SeacoastHealthcareInitiative.org.
  5. Can Wentworth-Douglass Hospital, Exeter Health Resources and Mass General still work through the affiliation with the state?  Our hospitals are absolutely committed to moving this proposed affiliation forward.  The hospitals have been asking to meet with the NH AG’s office to discuss any issues with the transaction and to work together to make any necessary changes to move this affiliation to completion.  Other states have found ways to address the potential for future anti-trust concerns in order to allow important affiliations like ours to move forward.  To do that the State needs to be willing to share their analysis and concerns in detail and be willing to join hospital leadership in a discussion focused on doing what is best for the community.  This is too important to the future availability of not-for-profit healthcare on the NH Seacoast for the state to just say “no” and not even try and find a solution.
  6. What is the state’s specific objection to the transaction as proposed?  They point to the potential for future negative impacts on the cost of care but we disagree with how they are evaluating the impact of our affiliation.  They aren’t taking into account the reality that patients in our region get their healthcare not just at Exeter Hospital, Wentworth-Douglass Hospital and Portsmouth Regional Hospital.  They go to Frisbie, to York, to hospitals and outpatient facilities in Manchester and to hospitals just over the border in Massachusetts.  There is an ever-expanding set of options for patients in this region with new EDs, new physician practices and new surgery centers popping up across the Seacoast.  In addition, other states have figured out how to address similar concerns in the best interests of their residents.  NH should be able to do the same.
  7. How might this decision by the NH Attorney General’s office affect other proposed hospital mergers in the state including HCA New Hampshire’s proposed acquisition of Frisbie Memorial Hospital?    We are not sure how the objection by the NH AG’s office would affect other discussions.  HCA is a for-profit company based in Nashville, TN that already owns Portsmouth Regional Hospital (Portsmouth, NH) and Parkland Medical Center (Derry, NH).  The Frisbie acquisition would transition another hospital in our region to become a for-profit company under their control.  As part of our proposed affiliation, Exeter Health Resources, Wentworth-Douglass Hospital, and Mass General Hospital will remain not-for-profit organizations and as not-for-profit organizations, any excess of revenue over expenses stays in the community and is used to reinvest in equipment, facilities and new programs and services to benefit the community.  Our investment in community benefits, including financial assistance/charity care, community benefits funding, and support for civic organizations and community services, will remain a top priority. The proposed affiliation provides the sustainability necessary to ensure Seacoast residents have access to local high-quality care.  The people of New Hampshire – especially those in the Seacoast Region - deserve to have the option of receiving their healthcare from a local, not-for-profit health system that gives back to the communities it serves, rather than to out of state shareholders.
  8. What are elected officials doing to try to move the affiliation deal forward?  We have reached out to NH Governor Chris Sununu requesting to meet with the Attorney General’s office to discuss our proposed affiliation and to address any concerns the State may have. State Senators’ David Watters (Dover) and Jon Morgan (Exeter) wrote to their colleagues asking them to encourage the Attorney General and the Governor to work with Exeter Health Resources, Wentworth-Douglass Hospital and Massachusetts General Hospital to find a path forward for our proposed affiliation. To view the letter click here.  
  9. What can I do as a patient and member of the Seacoast community to let the State know I want the affiliation to move forward?  We encourage you to contact the Governor or other legislative officials in your area to share your support of this affiliation and the impact to healthcare in our community should this affiliation not move forward.  There is a lot at stake.  Your community’s future access to the best healthcare services is dependent on getting public officials to sit down with hospital leaders and find a way to address their concerns AND approve the affiliation.  There are substantial benefits to the Seacoast community from securing the services they already receive from Exeter Hospital in the future, to adding new services like a level II nursery and substantial new investments in mental and behavioral health.  This affiliation will have a positive impact across the Seacoast bringing more care and more jobs to the region.  We need your help!  
  10. What does this mean for Exeter Hospital?  Can Exeter sustain itself in years to come given all the changes in healthcare and the costs affiliated with providing a high level of care?   The rejection of this affiliation would not only deny Seacoast residents enhanced access to local healthcare services, but worse, would jeopardize the long-term sustainability of Exeter Health Resources and compromise our ability to keep up with necessary investments in clinical technology, improvements in patient care facilities and information systems. This comes down to a simple choice.  If the affiliation is approved the high quality services that Exeter provides currently will be more secure.  Without the affiliation, we will face the very real likelihood that over time, we will provide the community less support in the future than we do today.
  11. Will the objection by state regulators of the proposed affiliation affect important services provided locally by Mass General now or those proposed in the future?  The world-class clinical, educational and financial resources of Mass General would enable us to expand our clinical offerings and strengthen the quality of patient care and make long-term investments in innovative, sustainable services. (Initial classes of services under discussion for enhancement include: musculoskeletal, obstetrics, cardiovascular services, neonatal services, primary care, behavioral health and substance use disorder treatment.) A great example of this would be the development of a Level II Special Care Nursery for higher level neonatal care needs.  Currently, hundreds of newborns who are in need of advanced care must leave our community to receive this care.  If we came together we could provide a higher level of care right here.  Families would not need to travel far distances and experience the financial and emotional hardships that are often attributed to this.  If we are not able to get to “yes” with state regulators advanced care options like these will not be available. 
  12. What will this mean to the behavioral health and substance use disorder treatment programs proposed as part of the affiliation?  As part of our proposal to state, we committed to reinvesting savings generated by the affiliation into millions of dollars per year of new investments in mental and behavioral health services that won’t happen if the affiliation does not go through.  It is clear that our community wants more access to mental health services and we are excited to partner with other existing community providers to channel new investments in to programs that are consistent with the State’s 10 year mental health plan.
  13. Can the state legislature or Governor take action on this situation?  All we are asking for is the chance to sit down with the state, discuss their findings and work collaboratively with them to address any real and legitimate future concerns that they have, so that we can address the very real concerns and opportunities that exist today related to the accessibility of healthcare services on the NH Seacoast.  The Governor and our other elected officials could help lead that discussion.  There is too much at stake for state leaders to just say no and ignore the impact the failure to approve this affiliation will have on the NH seacoast.
  14. What are the Boards of Directors doing at Wentworth-Douglass Hospital and Exeter Hospital to deal with this setback? Can they take additional action?  Our Boards of Trustees are fully committed to completing the proposed affiliation and are actively working to move discussions forward.  Members are reaching out to the Governor, talking with legislators and asking you for your support. As volunteer community based Trustees they believe they have a duty to ensure that they act in the best interests of the community and our patients.  We need to get to “Yes”, and we need your help.
  15. What does this mean to jobs and economic impact and longer-term healthcare investments in our community?   Exeter Hospital and Wentworth-Douglass are two of the largest employers and economic engines in their respective counties.  Their economic health and financial sustainability are connected with the health of the Region’s economy.   All you have to do is look at what has happened in Dover in the three years post their initial affiliation with Mass General.  They have brought in more services, helped lead the communities response to the opioid crisis, invested in substantial new construction at Pease to bring local access to primary care and lower cost urgent care and they have added 300 new jobs.  This affiliation will bring the potential for similar growth across Exeter’s service area to the south.