When Michael Wagner, MD, joined Care New England Health System as president and CEO in 2022, he had a big challenge ahead of him. The system had spent roughly a decade previously cycling through acquisition and combination talks with a succession of health systems while its financial position deteriorated. Care New England closed fiscal year 2022 with a loss of approximately $55 million.
The board’s message on hiring Dr. Wagner was direct: no more merger discussions. He told the board: “I think this organization is very sustainable, but it needs discipline. It needs focus. I’ll come on board and let’s get this organization back on track,” Dr. Wagner said on a recent episode of the “Becker’s Healthcare Podcast.”
Four years later, Care New England has returned to profitability, executed three major strategic initiatives and has construction underway at all three of its hospitals.
The turnaround moved on three tracks simultaneously:
1. Technology. Care New England went live on Epic in October 2024, migrating all three hospitals from Cerner in a single go-live. The transition produced no revenue drop, and Dr. Wagner described the clinical cutover as seamless.
2. Brand consolidation. In January 2025, the system moved from a house of brands — with each hospital operating under a distinct identity — to a shared master brand structure across the organization, anchored by a new strategic positioning: Care New England as Rhode Islanders’ partner in their life’s healthcare journey.
3. Debt structure. Care New England entered Dr. Wagner’s tenure carrying approximately $125 million in outstanding debt, including a bullet payment of roughly $21 million due in 2026. The system had achieved eight consecutive quarters of positive operating margins before a challenging stretch that extended through the first half of the current fiscal year. With margins stabilized at approximately 1%, Care New England was able to refinance on significantly improved terms, retiring the existing debt and drawing down an additional $100 million in new capital, subject to a covenant requiring the system to maintain at least a 1% operating margin.
“That $100 million that we’ve taken down has enabled us to have shovels in the ground at Kent Hospital with a new ambulatory pavilion,” Dr. Wagner said. “We have renovations in the emergency room adding a cath lab, and we have renovations at Women and Infants Hospital.”
The capital deployment reflects a longer strategic outlook. Kent Hospital, located roughly 10 miles south of Providence and serving Rhode Island’s southern tier, has been central to Care New England’s vision of keeping residents from traveling to Providence or Boston for higher-level care. A new ambulatory pavilion and a catheterization laboratory move that goal from plan to construction.
The financial turn has also reoriented how Care New England presents itself to the state and to its own workforce.
“We’ve demonstrated not only to the market, to the Rhode Islanders, the legislature, the leaders, but also to our own organization, that we’re a sustainable organization,” Dr. Wagner said. “We’ve invested hundreds of millions of dollars over the last four years, and we’re just getting started.”
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