Public Meeting on Exeter Hospital Merger
How Has the Merger with Beth Israel Lahey Health (BILH) Impacted Local Access and What’s Next for Patients?
The New Hampshire Healthcare Consumer Protection Advisory Commission (HCPAC) will hold a public meeting in Exeter—its third community hearing, following earlier sessions in Rochester (focused on Frisbie Memorial Hospital and HCA) and Claremont (focused on Valley Regional Hospital and Dartmouth Health).
The meeting will be held on Wednesday, April 29 from 4:30–6:30 PM at Exeter Town Hall (10 Front Street, Exeter, NH),
Each of the HCPAC’s regional meetings is focused on hearing from community members and healthcare consumers about how hospital mergers and affiliations are shaping access, cost, and quality of healthcare in that region of the state.
Now, the focus turns to Exeter.
When Exeter Hospital announced an acquisition by Boston's Beth Israel Lahey Health (BILH) in 2022, it was presented as a major investment in local care — $375 million in new spending and a long-term commitment to essential services like mental health and labor and delivery. The message was compelling: this merger was about strengthening the network of care in the Seacoast, not reducing it.
But soon after the ink dried, that promise was tested.
Within its first year, Exeter Hospital BILH moved to eliminate or transfer out of the community several key services, including neurology, pediatric dentistry, podiatry, allergy/immunology, and its ALS paramedic-intercept program. For many families—particularly those relying on Medicaid—these changes had real consequences. Patients were forced to seek care farther away, sometimes across state lines, while others lost trusted providers with little notice. Local municipalities, fire departments and emergency responders were left scrambling to fill the need for ambulance coverage. Community concern and a call for accountability followed.
For many in the Seacoast region, trust was shaken in BILH with these sudden and unexpected cuts to certain programs. Local leaders, including Executive Councilor Janet Stevens, have raised concerns about whether the terms of the affiliation are being fully met. The Attorney General found that Exeter Hospital had not provided adequate notice or communication around the service reductions. In response, the state secured a six-month pause and required that future service changes include at least six months’ advance notice.
Even with those safeguards in place, the impact has been lasting. Community members have made it clear that they want transparency, accountability, and a voice in what comes next.
And there is a broader question underlying all of this—one that extends beyond Exeter.
Across the country, research shows that hospital consolidations to form larger health systems lead to higher costs for patients and payers. Inpatient prices at system-affiliated hospitals have been found to be roughly 13–15% higher than at independent hospitals. When physician practices are absorbed into hospital systems, costs tend to rise as well—primary care visits at hospital-owned practices are nearly 11% more expensive, in part due to facility fees and billing structures that shift care into higher-cost settings. Moreover, in highly consolidated markets, independent physician practices and providers - those not connected to the larger health system - are squeezed out of networks and referral relationships.
These cost increases are not necessarily tied to better outcomes. Instead, they are often driven by the pricing power and administrative complexity of larger systems. More consolidation makes it harder for independent health care providers to maintain sufficient patient volume and sustainable revenue. That tension—between promised investments and real-world impact—is exactly what communities across New Hampshire are now grappling with.
Has your care changed since the BILH affiliation? Have you experienced disruptions in services? Are you concerned about costs, access, or communication?
The HCPAC was created to advise the Attorney General on how to use the Healthcare Consumer Protection Trust Fund to support patients and communities. But its work depends on hearing directly from the people and communities affected.
The importance of this public conversation is bigger than any one hospital transaction.
It is about how healthcare cost and access is impacted by hospital consolidation, whether the promises made during mergers must be fulfilled and whether communities have a meaningful role in shaping the future of their health care in New Hampshire.
Public Meeting Details
The New Hampshire Healthcare Consumer Protection Advisory Commission (HCPAC) will hold a public meeting on Wednesday, April 29 from 4:30–6:30 PM at Exeter Town Hall (10 Front Street, Exeter, NH), with a virtual option available via Microsoft Teams.
HCPAC advises the Attorney General on the management of the Healthcare Consumer Protection Trust Fund, which is dedicated to benefiting healthcare consumers across New Hampshire.
The Commission is seeking public input—particularly on how Beth Israel Lahey Health’s acquisition of Exeter Hospital has impacted cost, access, quality, and transparency, as well as broader concerns around access to primary care.
Community members do not have to attend to weigh in. Written comments are encouraged and may be submitted to HCPAC@doj.nh.gov. All comments will become part of the public record.
