Dr. Joanne Conroy and Dr. Joseph Pepe

Dr. Joseph Pepe, CEO of GraniteOne Health, answers a question during a June listening session in Peterborough about the system’s potential merger with Lebanon-based network Dartmouth-Hitchcock Health. At left is the latter system’s president and CEO, Dr. Joanne Conroy.

Two major health care systems with campuses in Keene and Peterborough filed for approval from state officials this week to merge into one.

Dartmouth-Hitchcock Health — a Lebanon-based network of five hospitals, including Cheshire Medical Center in Keene — and GraniteOne Health first announced plans to merge in January. GraniteOne Health formed in 2017 with three hospitals — Peterborough’s Monadnock Community Hospital, Catholic Medical Center in Manchester and Huggins Hospital in Wolfeboro.

In October, the two systems signed an agreement to become Dartmouth-Hitchcock Health GraniteOne.

The proposal received approval from the systems’ boards, and Rev. Peter Libasci, bishop of Manchester, also issued a declaration of no objection to allow the merger to continue. This latter assent was sought due to Catholic Medical Center’s religious affiliation.

But the merger still needs to be approved by the N.H. Attorney General’s Office, as well as by federal regulators.

Lauren Collins-Cline, director of communications and public relations for Catholic Medical Center, said in an email Tuesday the filing to the Attorney General’s Office was made Monday.

She added that the office’s Charitable Trust Unit, which will review the request, will look to ensure the combined system complies with state law and is in the best interest of patients.

“The [Charitable Trust Unit] has up to 120 days to review, hold hearings and make a decision,” she said.

Filings to the Federal Trade Commission are expected to be sent in late January, she noted.

If the merger is approved, all of the organizations involved would keep their current names, identities and local leadership, according to a joint October news release from the health systems.

Meanwhile, the Dartmouth-Hitchcock Health GraniteOne Board of Trustees would oversee the system’s strategic direction, Collins-Cline said previously.

In addition to Cheshire Medical Center, Dartmouth-Hitchcock Health also has hospitals in Lebanon, New London and Windsor, Vt., as well as 24 clinics in the Twin States.

By forming one combined entity, the member organizations aim to better address the growing demand for integrated patient care throughout the region, the previous release stated.

Officials from the systems have also said the merger would give Dartmouth-Hitchcock, already the largest hospital system in New Hampshire, access to new markets, such as Peterborough and Wolfeboro, and expand its foothold in Manchester.

In turn, GraniteOne Health could benefit from lower prices for supplies and medications as part of a larger system and get better rates for employee health benefits.

“The combination of our health care systems will ultimately strengthen the quality of care offered throughout each of our members organizations, including Cheshire Medical Center,” said the Keene hospital’s CEO Don Caruso in an email Tuesday. “... physicians will have the ability to collaborate in new ways that tighten our relationship between the two organizations and offer increased access to specialty services.”

Mergers have become increasingly popular among health care systems nationwide, as hospitals — especially in rural areas — continue to deal with financial pressures from federal Medicare cuts and decreasing Medicaid payments from states, according to a 2018 report in the academic journal Health Affairs.

This latest proposal marks the second time Dartmouth-Hitchcock Health has tried to join with Catholic Medical Center. In 2010, then-N.H. Attorney General Michael Delaney opposed a merger between Dartmouth-Hitchcock Health System and what was then called Catholic Medical Center Healthcare because it would have changed the governance and structure of the Catholic hospital.

Olivia Belanger can be reached at 352-1234, extension 1439, or obelanger@keenesentinel.com. Follow her on Twitter @OBelangerKS.