Q & A's

Frequently Asked Questions

“Our pledge throughout this process is to provide our employees, patients, providers and the public with as much up-to-the minute information as possible, so they can provide valued feedback and learn why we are so excited about coming together and the future of healthcare in New Hampshire.”

  • Douglas Dean, President and CEO Elliot Health System
  • Michael Rose, President and CEO, Southern New Hampshire Health System



The Basics


What are Elliot Health System and Southern New Hampshire Health announcing?

After careful review and consideration, Elliot Health System (Elliot) and Southern New Hampshire Health (SNHH) are proud to announce that we have reached a binding agreement to establish a regional healthcare system, SOLUTIONHEALTH.

SOLUTIONHEALTH would be a new New Hampshire non-profit organization, with an integrated governance system, within which both SNHH and Elliot would each retain their respective names, identities, current corporate structures, licenses, medical staffs, employed physician networks, and local governance through their community Boards of Trustees.

The combination of SNHH and Elliot under SOLUTIONHEALTH as the sole member will protect and enhance the ability of each Hospital System to continue to carry out their respective historic charitable mission in the rapidly changing health service environment while allowing the regional corporate board to address financial and operational functions in a shared governance structure to improve access to care and quality of clinical services, and control the cost of healthcare in southern New Hampshire.


Through SOLUTIONHEALTH, we are proud to bring forward a New Hampshire solution for New Hampshire healthcare.


Why are Elliot and SNHH talking about combining?

The purpose of this proposed combination is to strengthen and expand our charitable missions to provide the very best healthcare possible to the communities we serve in a rapidly changing health care environment. Our approach anticipates a solution to address the increasingly complex health care challenges faced by hospitals in New Hampshire and around the country, such as:

  • our aging population which requires easy and affordable access to quality care;
  • consumer preferences around how care is delivered;
  • addressing emerging challenges relating to behavioral and mental health, and the opioid crisis;
  • the way healthcare is paid for; and
  • technological advancements, such as a shared and comprehensive electronic medical record systems to help improve patient care.

Faced with these many challenges, we would be far better positioned to serve our communities working together to provide the best health care possible for tomorrow and for generations to come.

Our vision to develop a highly-coordinated, community-based regional health care network to increase local access to affordable care while improving the quality of healthcare in southern New Hampshire is reflected in SOLUTIONHEALTH - a New Hampshire solution to serve the healthcare needs of our state.

What factors did you consider when deciding to announce exclusive discussions about combining?

Beginning with our shared values and visions, the leadership at Elliot and SNHH carefully considered a number of factors, including:

  • The compatible missions of both Elliot and SNHH;
  • The ability of both organizations to improve and increase access, quality, value and community benefits, while enhancing the affordability and sustainability of health care for patients in the communities served;
  • Integration sufficient to establish a highly-coordinated health care system to enable collaboration of care and sharing of best practices;
  • The opportunity to implement and optimize state-of-the-art health care information technology;
  • The ability to collaboratively develop and maintain clinical services;
  • Improving local access to specialty services throughout southern New Hampshire;
  • Greater access to financial capital to support the charitable and community-focused missions of both organizations;
  • Recognition of the rapidly changing landscape for community-based hospitals, and creating long-term organizational sustainability


Why can’t SNHH and Elliot continue to grow independently like they have been?

The challenging and dynamic pressures of the economics of healthcare are compounded by our rapidly aging patient population. With the second highest per capita rate of baby boomers in the nation, New Hampshire’s capacity must evolve and expand to be able to provide timely access to the spectrum of clinical specialties and sub-specialties in a convenient and cost-effective manner for these and all of our patients. This is why SOLUTIONHEALTH makes sense -- it would allow us to collaborate in clinical care, expertise and technologies and grow over time to meet our communities’ needs in ways that assure access, high quality care and value.


Why Elliot and SNHH?

Elliot and SNHH are natural partners, as we are closely aligned in our missions, values and vision. Although we serve different markets and communities, the fact that we are only sixteen miles apart would help our collaboration in areas like population health and expanded sub-specialty care capabilities.




The Next Steps in the Process


How does the process work?

Elliot and SNHH began exploring a proposed combination with a Letter of Intent, a non-binding, exclusive commitment to work together to carefully explore how best to align our organizations around a shared vision. We have completed a careful and thorough process known as “due diligence” to negotiate and agree upon a final binding combination agreement to formally join the parties together in an integrated regional healthcare system for New Hampshire.

After thorough review and consideration, each Board has unanimously approved the combination agreement. This means that SNHH and Elliot have entered into a binding agreement to establish SOLUTIONHEALTH as a new New Hampshire voluntary, non-profit corporation which shall serve to combine SNHH and Elliot as a regional healthcare system.

With this announcement, we are now beginning the formal, required regulatory process of seeking state review for our proposed combination. We will also host public meetings to invite questions and obtain input from our communities.


How long will this process take?

The State has 120 days following notice that the parties have reached final agreement to review the proposed transaction. It is our hope that the entire transaction, including obtaining all governmental approvals, would be completed sometime during the first quarter of 2018.


How will information be shared?

With our announcement of the Letter of Intent, and now the announcement of a Combination Agreement to form SOLUTIONHEALTH, we are continuing to engage our valued employees, patients, providers and the public in discussions that provide information, answer questions, as well as invite input and ideas. Our website will continue to be updated as discussions continue, and will include schedules and information for meetings and open forums for the communities to share comments and questions.


How do I comment?

Our goal is to make it easy for you to provide us with your comments and questions.  All documents, releases and other updates will be posted on this website for public review. We will also be posting dates and locations of community forums as we schedule them, so you have ample notice to attend, listen and ask questions. You can also visit the “Your Voice” section of this website to enter your questions or comments.




Organizational Structure and Governance



SOLUTIONHEALTH is the combination of Elliot and SNHH in a proposed new Regional System. It would be the sole member of both hospital systems and a supporting organization with an integrated governance and management system.


Would each organization continue to be governed locally?

Both SNHH and Elliot would continue to be governed by our respective local Boards of Directors. SOLUTIONHEALTH's proposed board, comprised of trustees elevated from each organization's local board, would engage with the local boards under an integrated governance system to coordinate the delivery of health care services across all communities served by Elliot and SNHH.


The SOLUTIONHEALTH Board of Trustees would provide decision-making with respect to certain corporate powers that are expressly ceded to the Regional System. Elliot and SNHH would retain independent local decision-making with respect to all other retained powers that are not expressly ceded to the Regional System.


Would the names ‘Elliot’ and ‘Southern New Hampshire Health’ change?

No. Both Elliot and SNHH would would retain their names and identities, and add that each is “a member of SOLUTIONHEALTH.”


What happens to Southern New Hampshire Medical Center and Elliot Hospital?

Both medical centers would continue to be known as Southern New Hampshire Medical Center and Elliot Hospital respectively, and each would maintain their own medical staffs dedicated to the communities they faithfully serve, and continue to pursue their respective missions and to serve their communities. The regional health system named SOLUTIONHEALTH is intended to enhance each organization’s ability to provide more affordable and accessible care to our region and to create and benefit together from technologies that support our patients and providers in improving the health and well-being of the greater Nashua and Manchester communities.


Who would lead this regional healthcare system?

SOLUTIONHEALTH proposes a governing Board of Trustees comprised of 11 members: 5 members nominated by SNHH, 5 members nominated by Elliot. The remaining member would be the CEO of the new regional system.


The nominated members of the SOLUTIONHEALTH Board of Trustees are:


From the Elliot Board of Directors:

Dianne Mercier

Howard Brodsky

Stephen Loosigian, DO

Lawrence Hoepp, MD

John Hession


From the SNHH Board of Trustees:

James Steiner

The Honorable Clifford Kinghorn

Martha O’Neill, Esq.

Praveen K. Suchdev, MD

Timothy Sullivan, Esq.


In addition to the Board of Trustees, SOLUTIONHEALTH would have a regional CEO to oversee the management of the Regional System.


Who would lead SNHH and Elliot?

SNHH and Elliot would continue to maintain their own boards and management teams. Their local leaders would work with SOLUTIONHEALTH to coordinate activities across the communities served by the regional system.


How would SOLUTIONHEALTH impact the charitable assets of both Elliot and SNHH?

The proposed combination does not involve any transfer of assets from Elliot or SNHH, including any charitable or endowment assets. These assets would continue to be held by our current organizations, and would continue to support the charitable missions of each entity, and to benefit our respective communities without disruption.




Financial and Economic Considerations

How would SOLUTIONHEALTH improve value?

SOLUTIONHEALTH would allow SNHH and Elliot to combine in planning and coordinating healthcare services for nearly half a million residents in southern New Hampshire. By using population health data and enhanced technologies, our providers would be able to collaborate and coordinate in delivering high quality care, proven by outcomes, locally and easily accessible to area residents. These are the drivers of health care costs – value is our ability to meet our patients’ and communities’ needs when and where they live, using the most efficient, effective and advanced tools, resources and relationships at our disposal.


How would SOLUTIONHEALTH achieve efficiencies?

Our intention is that the proposed combination would allow the regional system to expand and introduce special clinical programs that allow providers to manage the care of their patients locally, with the confidence that high quality care is both accessible and affordable. To have providers and patients rely on clinical subspecialists located outside of our area is burdensome and costly. With the increased scope of services and demand from our combined populations, we can bring clinical expertise into our communities in areas where alone we would be unable to do so. By sharing technologies and the costs associated with optimum care management and delivery, we can afford enhancements and innovation we couldn’t fund on our own. This includes development of a shared, innovative electronic medical record platform that benefits providers and patients alike.


How would SOLUTIONHEALTH enhance medical staff development potential?

As members of SOLUTIONHEALTH, SNHH and Elliot would have the potential to serve more than half a million residents in southern New Hampshire. We are positioning ourselves to be a state leader and the organization of choice for employees and providers, by together developing an innovative IT infrastructure, a strong population health-driven model of care delivery that is responsive to our communities, and our enhanced ability to offer patients access to high quality care across a greater spectrum of services in demand, all as easily and affordably as possible.


Would this combination result in layoffs or jobs lost?

It is neither the goal nor the intention of this process to reduce the number of employees at either organization, particularly as our intention is to expand our scope of care and expertise in response to the evolving needs of our communities. As we adapt our delivery models and supporting infrastructure, our expectation is that new needs for workforce would emerge. While we can’t state with 100% certainty that the combination would not see a decline in the number of employees down the road, our goal would be to expand and grow in response to the growing and diversifying needs of our communities for care that can be delivered locally.


Are there services where you see enhanced collaboration in the short term and if so, which?

While some limited discussions of possible collaborations may occur during the months prior to completing the combination, substantive steps toward collaboration must wait until the regional system is actually established.