LEBANON, N.H. — Dartmouth Health, the hospital system that operates eight hospitals and clinics throughout New Hampshire and Vermont, announced this week that 124 employees have been laid off and 303 openings canceled, for a total of 427 positions terminated.
The layoffs impact two tele-health programs — Tele-ICU and Tele-ED — that the hospital determined were “unsustainable”; two employee training programs that will now be outsourced; and the New England Alliance for Health, a partnership established between hospitals and other health agencies in 2009.
Dartmouth Health, which has been rapidly expanding by taking over smaller hospitals throughout the region, said the alliance was no longer necessary because so many of the members had merged with Dartmouth Health and other systems. It also said it is working with patients affected by the closure of the tele-health programs to find alternative care plans.
“Patient revenues continue to be outpaced by escalating operating expenses, which have grown by 12%,” the hospital system wrote in a news release. “Labor, supply, and drug costs continue to rise, while insurance companies are paying less and taking longer to pay. While DH has taken many steps to address operations, the current pace of expenses is unsustainable and further adjustments were necessary.”
It is a challenging time for hospitals economically. In 2025, the New Hampshire Hospital Association wrote in a report that seven hospitals in the state, both rural and nonrural, had negative operating margins.
It also reported that operating expenses rose 44% from 2019 to 2024 and labor costs rose 36.1%. Many hospital system executives have argued the way forward toward financial sustainability is mergers and acquisitions in the face of critics who say that hospital consolidation increases patient costs and does little to improve health outcomes.
In April, Dartmouth Health launched the Acceleration to Transformation Office, which is tasked with reviewing the system’s finances to identify ways to improve financial health.
CEO Joanne Conroy said Tuesday that “today’s eliminations are a result of that informed work.” She also said the “decision to eliminate a position or program does not diminish the value of the work these colleagues have done and the contributions they have made.”
“Eliminating positions is among the most difficult decisions any organization can make, given the impact on our colleagues and their families,” she continued. “At times, however, difficult choices are necessary to ensure Dartmouth Health is sustainable and well-positioned for the future.”
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