Moody’s upgraded Manchester, N.H.-based Elliot Health System’s credit rating to “A2” as the system is in the midst of a significant transition.
In 2018, Elliot and Nashua-based Southern New Hampshire Health combined to form SolutionHealth. In July, however, the boards of SolutionHealth and its members submitted a dissolution proposal to New Hampshire state officials. The regulatory process surrounding the dissolution is expected to be completed in the spring or summer of 2026.
“I appreciate that the two organizations came together, really in high hopes that we could advance an integrated regional health system,” Elliot Health System CEO Greg Baxter, MD, told Becker’s. “Over multiple separate efforts, we worked hard to do that in good faith. We just couldn’t find the level of strategic alignment that was necessary for our boards to take that crucial governance step to push those chips into the middle of the table.”
Dr. Baxter said just over a year ago, his board asked him to “focus on how we would deliver our mission as Elliot.”
“And since we’ve been doing that, one of the fruits that we see is this bond rating upgrade,” he said. “As we began to spend time focused on us as an organization, as opposed to the development of a regional [two hospital] health system. So in some ways it’s a validation of the progress and success we’ve had with a change in focus. But I would say all of that is built on how we can better serve the community.”
Moody’s said in its Nov. 5 report that the upgrade reflects Elliot’s increasing patient demand and volume growth, “translating into stronger market positioning, financial performance and liquidity.”
Dr. Baxter said that the upgrade is “derivative of hundreds, if not thousands of individual decisions that led us to be viewed as a strong organization.”
Mike Turilli, Elliot’s senior vice president and CFO, said Elliot has a mantra around “knowing your business.”
“It may seem pretty simple and straightforward, but you have to understand all of the financial and operational levers and metrics that help drive what you’re trying to accomplish.”
He said they’ve worked to build a culture where employees desire to know more about how they are contributing to their overall picture. Dr. Baxter added that to build a strong culture, “you have to be consistent and clear in your message.”
“You’ve got to have a really, really strong ‘why’ and the ‘what’ and the ‘how’ come after that,” Dr. Baxter said. “And one of the key tenets for us is to be a learning organization that emphasizes respect for people. That sounds like a soft characterization. I think it’s very, very firm. What it means is I’ll respect you, you’ll respect me. We’ll both come prepared. If we’re not prepared, we’ll acknowledge in the moment, we’ll correct the gap and learn. I’m a big fan of ‘sometimes you win, sometimes you learn.'”
Mr. Turilli said the business plans that Elliot built to support its strategic investments are also part of its success.
“I would say that’s creating a foundation for some of the success that we’ve seen,” he said. “It’s not any one specific financial or operational imperative. I think it’s a combination of knowing your business and building out business plans to support sound decisions and monitor those decisions.”
The upgrade also comes as the system has made advancements to clinical programs, including cardiac and vascular care, including cardiac surgery, maternal care backed by a Level III NICU, and comprehensive neurology, neurosurgical and spine care.
“There was a lot of work that needed to be accomplished over this past year, whether it’s working to realign the shared service function or advance the implementation of our strategic investments,” Mr. Turilli said. “It’s been done and it’s been done well. We wouldn’t have been able to do that without the team we have.”
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