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Vital Signs

An alliance by any other name . . .

By Katherine Vonderhaar

When the clock strikes midnight on New Year's Eve, the 25-year-old Dartmouth- Hitchcock Alliance (DHA)—a consortium of 11 health-care organizations in New Hampshire, Vermont, and Massachusetts—will have a new structure and a new name: the New England Alliance for Health (NEAH).

Since its establishment in 1983 as the parent holding company for Mary Hitchcock Memorial Hospital (MHMH) and Alice Peck Day Memorial Hospital, the DHA has grown to include nine hospitals, a behavioral health service, and a visiting nurse association. Alliance members save money through group purchasing; collaborate on quality improvement, patient safety, and staff training and recruitment; and share financial and technology expertise.

Plan: It was partly a new Dartmouth- Hitchcock strategic plan that led to the restructuring of the Alliance. After January 1, 2009, as a limited liability company owned and managed by MHMH,NEAHwill give Hitchcock more flexibility in developing legal and organizational relationships outside the Alliance. Stephen LeBlanc, DHMC's chief operating officer, will be the NEAH's executive director.

Word: The limited liability structure will benefit members, too. As a parent holding company, the DHAtechnically had the final word on members' budgets, trustee appointments, and strategic plans. But since the DHA board rarely exercised that power, some members felt the oversight process was unnecessarily bureaucratic. The NEAH will not have any power over members' decisions.

All current members of the DHA have agreed to participate in the new organization. In addition to MHMH, they are New Hampshire's New London Hospital, Upper Connecticut Valley Hospital, Valley Regional Health Care, Weeks Medical Center, and West Central Behavioral Health; Vermont's Central Vermont Medical Center (CVMC), Mt. Ascutney Hospital, and Northeastern Vermont Regional Hospital; the Visiting Nurse Association and Hospice of Vermont and New Hampshire (VNAH); and Massachusetts's Cooley Dickinson Health Care.

Cost: "It was a pretty simple decision" to remain a member, says Judy Tarr, CEO of CVMC in Barre, Vt. The NEAH "is providing the same services to us that the DHA was providing . . . at a little bit lower cost."

Tarr adds that some people were concerned "about losing the name of Dartmouth-Hitchcock because the name itself is so well-respected." But she says the change "didn't get as much buzz, I think, in the community as we thought it might get." CVMC has not yet removed the DHA name from its signs; Alliance members have until the end of 2009 to do so.

A plus of the new name is that it "opens up the possibility for people" not nearby to "feel more included," notes Gaye La- Casce, the VNAH's vice president of development and community relations.

Join: Other area hospitals will "absolutely" want to join the restructured Alliance, feels Bruce King, CEO of New London Hospital. "Taking away the governance controls has made other small hospitals feel more comfortable" about the organization, he says.

Although DHMC isn't "out there selling the [NEAH] right now . . . people are calling us," notes Deanna Howard, DHMC's vice president of regional development. The renamed and reorganized "Alliance is still designed to be a collaborative forum where we can move forward efforts to improve patient care [and] the health of the population we serve," she says. "And that's really fundamental to the work of Dartmouth . . . to the work of all the members."

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