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Dartmouth-Hitchcock CEO James Weinstein questions whether New Hampshire has long-term health plan

Dartmouth-Hitchcock CEO Jim Weinstein. (Valley News - Jennifer Hauck)

Dartmouth-Hitchcock CEO Jim Weinstein. (Valley News - Jennifer Hauck)

While legislators and officials spent hours inching toward a debate about whether the state should expand the Medicaid program, the leader of the state’s largest health care system wondered whether anyone in Concord knows what the goal is.

“What are we trying to achieve? The arguments I hear in the news are, ‘Are we going to take money or not take money?’ But to what end? To do what? For who? Who’s going to measure it? When that money runs out, what’s the next plan?” James Weinstein, CEO of the Dartmouth-Hitchcock health system, said in a meeting with the Monitor.

Weinstein said the absence of a cohesive vision for a sustainable health care system in New Hampshire amounts to a failure of leadership that, among other effects, creates damaging uncertainty for businesses.

“As one of the larger employers in the state, I’m concerned about where we’re going,” he said. “Or where we’re not.”

Weinstein said the state’s plan – whatever it is – should address the health needs of the state’s population through care that is connected to value, through integration and better coordination among hospitals and health systems.

Better coordination on electronic health records, instead of providers and hospitals each contracting with a different technology, would mean better patient care, he said.

Better coordination on services could move the state away from a fee-for-service payment model that has been driving up health care costs for decades, he said.

“Over-utilization of technology is a problem in this country. How many MRI machines do we need? Every time you have one in a fee-for-service world, people use these machines to generate revenues. I don’t like that. There’s over-utilization there.

“What does the population need? Do they need MRI machines or do they need drug abuse programs? Do they need mental health or do they need more cardiac surgery centers? What does the population need, and let’s build that.”

That vision, Weinstein said, is at least partially realized through the new insurance product that Dartmouth-Hitchcock announced last week with Harvard Pilgrim Health Care and Elliot Health Systems in Manchester.

Insurance policies through the program, called ElevateHealth, would cost 10 percent less than Harvard Pilgrim’s standard plans, and feature larger roles for care coordinators to help patients navigate the health system in the most efficient way possible.

The program makes progress toward achieving his vision of a sustainable health system, Weinstein said. But, he added, “I’d like a little help.”

It’s up to Gov. Maggie Hassan and the leadership in the Legislature to take charge of the long-term planning for addressing care and costs, he said.

“Given the independence of the state and of New Englanders in general, the tendency is to try to plan for their future. Some people don’t like to see federal intervention. Others think we should get as much as we can. I think the notion is, ‘How do we help the people of New Hampshire in the most significant way?’

“I have a view, and quite frankly it’s working pretty well for (Dartmouth-Hitchcock) despite all the problems we’ve faced. If you have another view, let’s see it,” Weinstein said. “But ‘no plan’ doesn’t work. ‘No plan’ is unacceptable.”

(Sarah Palermo can be reached at 369-3322 or or on Twitter @SPalermoNews.)

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