Mascoma Community Health Center races to raise funds for medical services

CANAAN — Whether the Mascoma Community Health Center can continue to provide medical services will become clear in a matter of weeks.

Mascoma Community Healthcare, the nonprofit that owns and provides dental services at the 14,000-square-foot facility at the corner of Roberts Road and Route 4, announced in a news release earlier this month that it would take over medical services when the current provider, HealthFirst Family Care Center, departs at the end of October.

But Mascoma Community Healthcare Board Chairwoman Sandra Hayden said the nonprofit first has to raise about $200,000.

“We need some initial operating fund to kind of see us through the first three months or so for medical,” Hayden said.

She said the group is hoping for “grassroots community” support and donations from major employers in the area.

If the nonprofit receives funds or donation pledges by early October, Hayden said they will be prepared to go ahead for a launch with a “smooth transition” as soon as HealthFirst leaves Nov. 1.

HealthFirst is a federally qualified health center, or FQHC, with locations in Laconia and Franklin, N.H. The FQHC took over providing medical services in Canaan in November 2023.

HealthFirst announced in a July news release that it would be suspending service two years after launching the partnership that took years to arrange, citing high costs and low patient volumes.

HealthFirst expected a patient volume of 6,000 when it took over, but only managed to see about 1,900 unique patients over two years, HealthFirst CEO Ted Bolognani told the Valley News in July.

Hayden said the clinic did have 5,500 medical patients when the operation of the health center was turned over in 2023 and this was “verified” by the New Hampshire Charitable Trust Unit of the Department of Justice.

A July 2023 report from the Charitable Trusts Unit states that the clinic had 5,500 patients at the time. The same report states that the two nonprofits formed a partnership because the Mascoma Community Health Center was deemed “not financially sustainable.”

At the time, 29% of the clinic’s patients were covered by Medicare or Medicaid, 11% took advantage of a sliding scale payment program offered at the clinic, and about 27% were uninsured or underinsured leading to reimbursement rates that did not cover costs, according to the report. The clinic’s debt service and expenses exceeded its operating revenues and the pandemic worsened financial challenges.

Hayden said she does not know why HealthFirst was not able to achieve the patient volume the health center had previously had.

“We’re befuddled,” Hayden said. “We have no idea how that could have happened.”

Many patients have told Hayden and the Board that they plan to come back to the health center when Mascoma Community Healthcare takes over in November, she said.

From 2017 when the facility first opened to July 2022, Mascoma Community Healthcare operated both the medical and dental clinic. Dental services were paused from July 2022 to October 2023 after the health center lost its dentist.

During that time, Hayden said two-thirds of the total revenue came from the dental clinic.

The Mascoma Community Healthcare Board expects to rely on the dental service again to help make the finances work.

In the past few months, Hayden said the board has been working on expanding the clinc’s dental staff. The expansion is expected to increase patient volume and revenues.

The board recently hired a new full time dentist and a part-time dentist who is expected to start in the coming weeks, bringing the total up to four. They have also gone from one dental hygienist to two, hired a third dental assistant and brought on two front desk staff.

The increase on the dental side is expected to offset costs and lost revenue from HealthFirst paying rent, she said. In 2023, HealthFirst agreed to pay more than $25,000 a month in rent with annual increases, according to the Charitable Trusts report.

In the fiscal year that ended March 31, Mascoma Community Healthcare reported revenue of $1.5 million and expenses of $1.7 million, for a loss of about $200,000, according to a separate report submitted to the Charitable Trust Unit.

The money the organization is working to raise now will allow it to operate the medical service as new medical providers are being credentialed by insurance companies so that the companies will pay the health center for services, Hayden said. The process typically takes three to four months.

Dr. Ben Gardner, who is credentialed and has been at the health center since it opened in 2017, will stay on as medical director, the Mascoma board announced in the early September news release.

It’s not yet clear how many other providers the organization will hire, Hayden said. She expects to hire at least one nurse practitioner, a nurse and “a couple” of people to work the front desk “to start off with.”

HealthFirst has had five full-time and two part-time providers at the clinic.

As long as the nonprofit has the funds, Hayden said any providers it hires will be allowed to work under Gardner right away, but insurance companies won’t pay the organization for the work they do until each is certified.

The organization’s leaders have no plans to pursue FQHC status, a funding tactic they unsuccessfully attempted in 2019, Hayden said. The organization’s leaders also “haven’t given any consideration” to finding another similar partnership to the one it held with HealthFirst.

Facing changes to Medicaid that have many Upper Valley health care providers worried, “I think we’ve just got to go with it and support those people who are underserved and do our best,” Hayden said.

“We don’t refuse anyone care,” she said. “We always take care of them.”