Dartmouth Health, GraniteOne call off merger after regulatory objection

Following opposition from New Hampshire’s attorney general, Dartmouth Health and GraniteOne Health have officially called off plans to merge, a representative of the former confirmed.

The two organizations had signed a letter of intent back in January 2019 to form a combined non-profit health system they said would expand access to care for New Hampshire patients, particularly across the state’s southern and rural regions.

On May 13, Attorney General John Formella released a report formally objecting to the proposed merger.

Combining two systems that are in direct competition would violate New Hampshire antitrust and consumer protection laws, preventing the ”free and fair competition in the trades and industries” required by New Hampshire’s Constitution, Formella’s office wrote in a statement.

Formella had “worked tirelessly for many months” with Dartmouth Health and GraniteOne Health on potential adjustments to the proposed merger, according to the statement, but was unable to find common ground with the systems.

"Free, fair and robust competition is critical to providing employers and patients with options for lower cost and high-quality healthcare services," Formella said in a statement. "Our state has experienced significant consolidation in healthcare over the past several years, and this transaction seeking to combine two of our top four largest systems is unacceptable without appropriate protections for consumers in place."

That same day, Dartmouth Health CEO and President Joanne Conroy, M.D., sent an email to staff saying the two systems had decided to throw in the towel.

“Although we disagree with, and are deeply disappointed by, the result of the regulatory review, we respect the process that led to this decision,” she wrote.

Conroy noted that the healthcare landscape inside and outside of New Hampshire had changed dramatically since 2019. Although the two parties continued to pursue the merger even through the pandemic, she said “it has become clear to us that those benefits and promises that we envisioned several years ago are no longer practical and realistic in the current environment.”

“We had hoped to join with GraniteOne to make strategic investments in offering a New Hampshire-based alternative to more costly out-of-state care and to build capacity in southern New Hampshire. We will continue our work together to provide exemplary care for every patient, right here in New Hampshire,” Conroy wrote.

Dartmouth Health consists of Dartmouth Hitchcock Medical Center, the state’s only academic medical center, a physician group, a community hospital and three critical access hospitals. It employs more than 10,000 permanent full- and part-time employees at locations across New Hampshire and Vermont.

GraniteOne was formed in 2017 to connect three New Hampshire Hospitals, Catholic Medical Center, Monadnock Community Hospital and Huggins Hospital. The first of those was previously the target of a proposed acquisition by Dartmouth Health, although that was also rejected by the state and abandoned in 2010.