New London — Lawrence + Memorial Healthcare and the Yale-New Haven Health System will file regulatory documents within the next month seeking permission to affiliate, with Yale-New Haven pledging to invest $300 million in new equipment and services in the smaller healthcare network’s territory in eastern Connecticut and western Rhode Island. 

“We already know them well through the many clinical partnerships we have had over the years, and we are truly fortunate to have such a world-class organization to affiliate with,” Alan Hunter, president of the L+M board, said during a news conference Wednesday. 

The announcement came after unanimous votes of the board of directors of L+M last Thursday and of Yale-New Haven on Friday.

The next step will entail a complex regulatory review and approval process in both Connecticut and Rhode Island, as well as with the Federal Trade Commission, that could take up to 18 months before a decision is issued.

Dr. David Reisfeld, an L+M surgeon for 25 years and president of its medical staff, said the two organizations have been well acquainted for many years, having established clinical partnerships in radiation oncology, telestroke, neonatology, pediatric emergency medicine, invasive cardiology, angioplasty and vascular surgery. 

“Our hospitals have been dating each other for a long time, and now it’s time to get married,” he said, adding that the affiliation will ensure that the region maintains high-quality health care for future generations.

If approved, L+M Healthcare, the parent of L+M Hospital in New London, The Westerly Hospital, The Visiting Nurse Association of Southeastern Connecticut and L+M Medical Group, would become part of the larger Yale-New Haven network that extends from Greenwich to Bridgeport to New Haven, with outpatient facilities in more than a dozen communities in Fairfield, New Haven and Middlesex counties.

Acute care hospitals in the Yale-New Haven network include Greenwich Hospital, Bridgeport Hospital, as well as Yale-New Haven Hospital and its Saint Raphael campus. 

The $300 million investment from Yale-New Haven will be used over the next five years toward a new electronic medical records system for L+M and Westerly hospitals, enhancements to the region’s primary care, orthopedics, obstetrics, neurosurgery, maternal-fetal medicine, vascular, neurology and stroke care, and endocrine medicine and psychiatry, the two organizations said. 

“This is a very significant investment that will improve access to care and grow services,” L+M President and Chief Executive Officer Bruce Cummings said. 

Asked whether the affiliation would result in staff cuts, he said that is “hard to predict” but said, “I believe we could be adding personal and capabilities over time.” 

The two organizations said all current labor contracts would remain in place, and they would “work to minimize any impact on employees.” 

Leaders of the three unions that represent L+M workers issued a statement that they “have been and continue to be engaged in this process.” They encouraged union members, patients and community members to take advantage of opportunities to participate in the regulatory review process. 

“It is critical that we make our voices heard to ensure ‘patients before profits’ at our community hospital and throughout our health network,” the statement said. 

State Senate Minority Leader Len Fasano, R-North Haven, issued a statement Wednesday raising concerns about the affiliation, criticizing Yale-New Haven for proposing to invest in L+M at the same time it prepares to close outpatient clinics in its “core community” in East Haven and Branford. He also said it would give Yale-New Haven a near monopoly on health care along the shoreline. 

“We’ve seen this coming for a long time now and it remains an issue of great concern,” he said. “This move will give Yale almost complete market power across the southern portion of our state into Rhode Island. From Greenwich eastward many patients will only have one option for care. Limiting patient choice and perpetuating single provider market dominance all too often translates to higher prices — something patients cannot afford.” 

He added that patients are best served in a competitive health care market, and that Yale-New Haven’s expansion, “does not foster that competition.” 

Marna Borgstrom, president and chief executive officer of Yale-New Haven, said the affiliation will enable both organizations to better weather changes in health care. 

“Health care is going through amazingly challenging times right now,” she said. “We have to create better value for patients at lower cost. To get that value equation right, you have to build some scale.” 

As a larger affiliated organization, the Yale-New Haven-L+M network will have more leverage with employers and health insurance companies to negotiate rates, and will be able to achieve administrative and operational efficiencies, she said. 

Southeastern Connecticut can be assured, however, that it is not losing its community hospital, but gaining a strong one, she said. 

“L+M is part of this community, and that’s not going to change,” she said. 

Cummings said L+M sought the affiliation for “practical and aspirational reasons.” Other hospital networks have approached L+M about affiliating, he said, but Yale-New Haven is the only one it seriously considered. 

Cuts in Medicare and Medicaid funding — a main source of hospital revenue — plus the need for access to financial capital to update services and equipment, and the $9.5 million L+M will be paying annually due to increases in the state hospital tax make an affiliation with a larger organization necessary, he said.

In addition, Medicare is changing the way it reimburses for care from “volume based to outcome based,” he said. 

“Aspirationally,” he said, “we don’t want to report to our community that we’re just getting by. Our community deserves better than that.” 

With the access to Yale-New Haven’s expertise, services and reputation, he said, L+M will be able to advance its offerings and quality. 

The proposed affiliation between L+M and Yale-New Haven continues a decade-long trend toward smaller community hospitals becoming part of larger networkers and is expected to continue, as Medicare, Medicaid and insurers that provide the main sources of revenue for hospitals are increasingly favoring larger institutions with integration of services.

Two years ago, The William W. Backus Hospital in Norwich became part of the Hartford HealthCare network. 

Statewide, there are four main hospital networks that incorporate smaller community hospitals — the Western Connecticut Health Network, the Eastern Connecticut Health Network, Hartford HealthCare and the Yale-New Haven Health System. 

The most recent hospital to join one of these was New Milford Hospital, which joined the Western Connecticut network in October.

Currently pending with the state Office of Healthcare Access, the regulatory authority for hospital mergers and affiliations, is the proposed acquisition of Johnson Memorial Hospital in Stafford Springs by Saint Francis Hospital and Medical Center in Hartford.

Saint Francis proposes buying the smaller hospital for $33.9 million. 

j.benson@theday.com 

Twitter: @BensonJudy