After merging, New Hampshire hospital systems move to separate

Seven years after merging, two New Hampshire health systems say they are ready to separate.

Elliot Health operates Elliot Hospital, a not-for-profit, 296-bed facility in Manchester.

SolutionHealth has filed a “disaffiliation agreement” with New Hampshire state officials. Elliot Health System and Southern New Hampshire Health joined forces in 2018 to create SolutionHealth. In 2022, the system added Home Health & Hospice Care.

System officials say the leadership of the entities say the separation is in their best interest, and would be best for the communities they serve.

Elliot Health, Southern New Hampshire Health and Home Health & Hospice are now seeking approval to once again be separate entities with their own governing boards.

“Over time, we have learned a great deal about our ability to integrate each of the three healthcare systems into a regionally coordinated delivery system and have recognized that the three organizations cannot be integrated in a way that enhances their missions,” SolutionHealth said in a message on its website.

• Read more: Hospital mergers drop in the first half of 2025

The boards of SolutionHealth, Elliot Health and Southern New Hampshire Health filed papers July 14 with New Hampshire’s Charitable Trusts Unit, which oversees healthcare mergers and acquisitions.

Officials say the process of securing approval to separate could take six months.

SolutionHealth noted that the system held public listening sessions for community members to share their thoughts about the plans to separate.

In its message to the public, SolutionHealth said the three organizations initially joined forces with hopes of offering better care and better access to care, while also managing costs more effectively.

But the various entities have concluded that they aren’t able to achieve all of its goals together.

Southern New Hampshire Medical Center, a 188-bed hospital in downtown Nashua, is operated by Southern New Hampshire Health.

Elliot Health operates Elliot Hospital, a not-for-profit, 296-bed facility in Manchester. Southern New Hampshire is anchored by Southern New Hampshire Medical Center, a 188-bed hospital in downtown Nashua. Both systems also have a host of clinics.

Dr. Greg Baxter, president and CEO of Elliot Health System, told the Union Leader of Manchester in April that Elliot is aiming to be a regional referral center, while Southern New Hampshire is more aligned to Boston providers, given Nashua’s proximity to Boston.

Southern New Hampshire Health CEO Colin McHugh told the Union Leader that it has had a long relationship with Massachusetts General Hospital in Boston, and many providers and patients gravitate to that facility. Nashua, which sits near the Massachusetts border, is about 45 miles from Boston.

SolutionHealth said the health systems have been delivering high quality care and “are committed to continuously improving their delivery of medical care for the benefit of the health and well-being of our communities.”

Elliot Health System and Southern New Hampshire Health say they are focused on serving their communities, and say they have partnerships with other providers.

Still, Elliot and Southern New Hampshire also are not ruling out other partnerships in the future.

“With regard to any potential broader partnerships in the future, the organizations and their boards will ensure that any partnerships under consideration align with their health system’s mission and care delivery, and the needs of their community,” the systems said on the website.

SolutionHealth largely provides administrative services to the providers.

The systems say they will continue to focus on top-notch care to patients if the separation agreement is approved.

As far as the ramifications for employees, SolutionHealth said some staff could be moved to roles at Elliot or Southern New Hampshire as needed.

Earlier this month, S&P Global Ratings affirmed Southern New Hampshire Health’s “A-” rating, which is the highest rating the system has had. S&P noted the system’s improving patient volume and strong performance.