HealthFirst, the provider of health care services at Mascoma Community Health Centers, will end its Upper Valley operations on Oct. 31, on the eve of its two-year anniversary in Canaan.
HealthFirst Family Care Centers has provided primary care and behavioral health services in Canaan since November 2023, but the Board of Governors decided to end operations in Canaan at a special meeting on July 16 and announced the news to employees and the public on Tuesday.
HealthFirst cited Medicaid reimbursement issues, federal funding adjustments, high operating costs and insufficient patient volume as the main reasons for the closure of the clinic in a news release.
“This is a difficult time for the Canaan and Mascoma Valley communities, and we are uncertain about the future direction of the clinic,” said CEO Ted Bolognani.
The federally qualified health center (FQHC) has locations in Laconia and Franklin, New Hampshire. The Canaan clinic, located at the intersection of Roberts Road and Highway 4, shares office space with an independent dental office operated by the nonprofit Mascoma Community Health Care Corporation. The nonprofit owns the 14,000-square-foot property.
HealthFirst is actively helping patients find alternative care options. The clinic’s five full-time and two part-time caregivers have agreed to transfer to other locations of the organization.
HealthFirst leases the property and subleases the dental clinic to Mascoma Community Healthcare. The nonprofit has been providing medical and dental services since 2017.
Bolognani said HealthFirst expected about 6,000 patients when it took over the clinic, but only saw about 1,900 patients, a number far lower than the 6,000 patients at other locations such as Franklin and Laconia. HealthFirst spent $150,000 on promotions in its first year to increase patient volume.
Mascoma Community Healthcare’s financial problems also affected HealthFirst’s ability to operate, including not receiving rent reimbursement for the dental clinic.
Mike Samson, finance director and board member, noted that while the loss of HealthFirst is regrettable, the reduction in Medicaid eligibility is a common challenge affecting all community health centers.
In June, Ammonoosuc Community Health Services, another FQHC in Woodsville, also announced the closure of its branch clinic due to insufficient financial support, highlighting the common difficulties faced by regional health centers.
Samson emphasized that Mascoma Health Center will continue to provide uninterrupted dental services, and the board is committed to keeping the medical institution and dental clinic operational to ensure the continuity of community health services, but specific plans are still being developed.
Bologniani estimated that it would take about $500,000 in additional external funding each year to keep the Canaan branch running. From October last year to June this year, the clinic’s operating costs exceeded $2 million, but its revenue was only about $1.5 million. Despite receiving a $300,000 loan from the state government, it was still not enough to balance the budget.
He also mentioned that although the clinic received federal reimbursement for eligible patients, it failed to obtain additional funding support from the U.S. Health Resources and Services Administration (HRSA). The state government is unable to provide more help due to budget constraints.
In addition, recent adjustments to the state Medicaid program and cuts in federal health spending have also led to a decrease in the number of insured people and an increase in the number of uninsured people, putting more pressure on medical institutions.
After the clinic is closed, patients can choose to go to HealthFirst’s clinics in other areas, but the nearest location is about an hour’s drive from Canaan. HealthFirst also collaborates with partners such as Mid-State Health to help patients refer. Telemedicine services will also continue to provide behavioral health and primary care.
Bolognani revealed that HealthFirst has reached an agreement with the Mascoma Valley School District to continue to provide behavioral health services to schools. “As long as the school needs it, we will continue to provide services in the community.”