Citing a $12 million loss and a negative 0.8 percent operating margin for 2016, Dartmouth-Hitchcock this week said the New Hampshire trauma center and health system will lay off 84 employees.
In his memo addressed to the Dartmouth-Hitchcock Community, CEO James Weinstein did not release information about which employees or positions would be affected, and a hospital spokeswoman also declined to give specifics.
The health system also declined to release financial information for 2016, beyond what was given in Weinstein's memo. The 2016 financial data for the nonprofit is not yet available through nonprofit state filings.
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The health system is currently engaged in a performance improvement process, mostly related to reducing overall expenses, Weinstein said in the memo.
"Our commitment to our patients and families has never been greater, despite living in very challenging times of diminishing reimbursements and ever-rising costs," he said. "In the face of a 0.8 percent -- or $12 million -- negative margin for FY16, we anticipated the need for a reduction in force."
Weinstein said the New Hampshire Medicaid reimbursement rate was the lowest in the nation.
Weinstein previously had said he would seek $100 million in cost cutting measures, which could require Dartmouth-Hitchcock to lay off up to 460 positions, according to published reports.
In the memo, the CEO said he has directed the leadership team to reduce actual layoffs through the attrition, drawing on a turnover rate of 800 positions a year; through leaving open positions unfilled and delaying new hires, except those necessary for clinical operations.
"As a result," he said, "actual layoffs will be limited to 84 employees across the system."
Those affected will be encouraged to apply for open positions within Dartmouth-Hitchcock affiliate organizations, and also to Dartmouth College, Weinstein said.
Financially, Dartmouth-Hitchcock Medical Center suffered over $3 million in losses for two consecutive years in the federal Pioneer Accountable Care Organization program, despite having good quality scores.
Robert Greene, MD, executive vice president and chief population health management officer, said at the time that the health system would defer a decision on joining Next Generation until 2017 because of the financial targets set by the Centers for Medicare and Medicaid Services.
To help move from volume to CMS's shared risk model rewarding value, Dartmouth-Hitchcock has been growing telemedicine, tele-emergency and tele-pharmacy programs, initiated an in-home monitoring program ImagineCare, and is continuing to focus on population health, according to Weinstein's memo.
Twitter: @SusanJMorse