Cheshire Medical Center and Dartmouth-Hitchcock Affiliation Agreement Approved

Sharing a strong commitment to improving population health and value-based care for the benefit of the citizens of New Hampshire and Vermont, Cheshire Medical Center (Cheshire) and Dartmouth-Hitchcock (D-H) are moving forward with plans to strengthen the long-standing relationship between the two institutions.

On Monday, March 2 the proposed closer affiliation between Cheshire and D-H was finalized. The affiliation was cleared by the Consumer Protection and Antitrust Bureau of the New Hampshire Office of the Attorney General, and the New Hampshire Charitable Trusts Unit, and all required filings were completed.

Dartmouth-Hitchcock’s vision of a sustainable health system includes Cheshire serving as a center for population health strategy and practice, in recognition of Cheshire’s focus on population health and its work with the region’s Healthy Monadnock 2020 initiative. Under the affiliation agreement, negotiated in February, 2014, and approved by the boards of both Cheshire and D-H, Cheshire will further align its governance, clinical, financial, and administrative activities with D-H.  Subject to certain approval powers reserved to D-H, Cheshire will retain its status as a separate legal organization that has its own board of trustees, management and employees.

Included in the agreement is the plan to strengthen Cheshire as a regional resource for southwestern New Hampshire and southeastern Vermont, so that more patients can receive care closer to home. That regional resource, in turn, is expected to free up bed capacity for tertiary care patients at Dartmouth-Hitchcock Medical Center in Lebanon.

“This arrangement takes us to the next level of affiliation after a successful 17-year relationship with Dartmouth-Hitchcock, and is based on the shared values of local control, access to local health care services, and improved population health,” said Sylvia McBeth, chair of Cheshire Medical Center/Cheshire Health Foundation board “On behalf of the Cheshire Board of Trustees, I share our mutual enthusiasm that the affiliation is moving forward. This closer affiliation will enhance Cheshire’s ability to meet the current and future health needs of the residents of Cheshire County, strengthening the sustainability of the clinical services offered and continuing our focus on prevention and wellness.”
“As we move toward our goal of population health and a sustainable health system, we promote seamless, high-quality care, provided locally and at lower cost,” added Dartmouth-Hitchcock CEO and President Dr. James N. Weinstein. “Cheshire has been strongly aligned with, and is a nationally recognized leader in, population health, most recently through the Healthy Monadnock 2020 initiative. I’m delighted that we are able to continue to evolve our relationship with Cheshire and, through this affiliation agreement, be better able to serve the people of Cheshire County and the Monadnock region.”

Cheshire Medical Center and Dartmouth-Hitchcock have worked together since 1998, by means of a Joint Operating Agreement involving Dartmouth-Hitchcock, a multi-specialty group practice that comprises the majority of Cheshire Medical Center’s medical staff. This new affiliation agreement is seen as a natural step that will enable both organizations to more effectively pursue a common vision of the future of health care that is based on creating a sustainable health system, focusing on population health, delivering value-based care, and embracing the opportunities provided by new payment models.

Upon successful completion of a thorough due diligence process, a filing was made to the NH Attorney General’s office in August, 2014, which began a 120-day Charitable Trusts review, and consideration of the affiliation in the context of State anti-trust regulations. Cheshire Medical Center held two public forums on the proposal in March of 2014 and presented information on the proposed affiliation in 21 additional presentations to local businesses, civic organizations and community groups throughout the Monadnock Region.

The approval of the affiliation agreement concludes a 17-month process commenced in September, 2013 when Cheshire and D-H announced their intention to pursue a closer affiliation.

For more information, visit the Cheshire Medical Center website at

ABOUT CHESHIRE MEDICAL CENTER:  Cheshire Medical Center / Dartmouth-Hitchcock is a nonprofit community hospital and clinic with a mission to lead our community to become the nation's healthiest through our clinical and service excellence, collaboration, and compassion for every patient, every time. Founded by CMC/DH, Healthy Monadnock 2020 (formerly Vision 2020) is a community-wide health initiative designed to actively engage the citizens of Cheshire County in the process of becoming the nation's healthiest community by 2020. For information, please call (603) 354-5400 or visit

ABOUT DARTMOUTH-HITCHCOCK: Dartmouth-Hitchcock (D-H) is a nonprofit academic health system that serves a patient population of 1.2 million in New England. Anchored by Dartmouth-Hitchcock Medical Center in Lebanon, NH, the system includes the Norris Cotton Cancer Center, one of only 41 Comprehensive Cancer Centers in the nation; the Children’s Hospital at Dartmouth-Hitchcock; affiliate hospitals in New London, NH, and Windsor, VT; and 24 Dartmouth-Hitchcock Clinics that provide ambulatory services across New Hampshire and Vermont. D-H provides access to more than 1,000 primary care doctors and specialists in almost every area of medicine. In partnership with the Audrey and Theodor Geisel School of Medicine at Dartmouth and the White River Junction VA Medical Center in White River Junction, VT, it trains nearly 400 residents and fellows annually, and performs world-class research.