Courtesy HHHN
By Carol Ann Conover
As Hudson Headwaters Health Network looks toward 2026, the nonprofit organization is advancing a growth strategy centered on capital investment, workforce sustainability and long-term financial stability — priorities that increasingly shape the region’s health care and economic landscape.
As one of the North Country’s largest nonprofit employers and safety-net providers, Hudson Headwaters is moving forward with a multiyear plan to expand dental and primary care capacity across its seven-county service area, while working to protect critical revenue streams that help offset rising operating costs and persistent reimbursement challenges.
A recent Northern Border Regional Commission grant will serve as a catalyst for expanding dental services — an area leaders identify as both a pressing community need and a significant operational investment. The funding supports planning and early development for expanded dental capacity in Ticonderoga, the addition of a new dental site in northern Saratoga County, and upgrades to HHHN’s existing dental office in Warrensburg.
“As one of the region’s only nonprofit safety-net dental providers, Hudson Headwaters accepts all patients regardless of insurance status or ability to pay,” said Pam Fisher, director of external affairs for Hudson Headwaters. “We see how deeply insufficient access to dental care affects families, seniors and children every day. The NBRC funding is an important start toward gaining the significant resources required to close the dental-access gap in our community.”
Hudson Headwaters Health Network currently serves approximately 157,000 patients annually through dozens of health centers across a largely rural region. Limited access to dental providers — particularly those able to serve Medicaid and uninsured patients — has placed increasing demand on safety-net organizations, driving the need for expanded infrastructure and workforce recruitment.
HHHN leaders say the dental expansion will be paired with a fundraising campaign later in 2026 as the organization works to secure the capital and operational resources needed to recruit providers, equip clinical spaces and sustain long-term operations. Beyond improving patient outcomes, the initiative is expected to reduce preventable emergency department use and downstream medical costs — factors with broader implications for regional health systems and employers.
Alongside dental investments, Hudson Headwaters Health Network is continuing to expand primary care capacity. In early February, the organization will open a new Malone Family Health center, replacing a temporary site established in December 2023 on the University of Vermont Health–Alice Hyde Hospital campus. The new 13,000-square-foot facility is designed to address long-standing primary care shortages in Franklin County.
“Since establishing a temporary location in Malone, the network has steadily recruited providers and built patient relationships while constructing a permanent facility near the hospital campus,” Fisher said. “Thanks to 340B savings, the Network could invest in this important capital project and honor our nonprofit mission to expand access where there are significant health care shortages. That ability to invest while maintaining operations is critical in rural markets.”
Many of these capital projects have been supported, in part, by savings generated through the federal 340B Drug Pricing Program. Established by Congress in 1992, the program allows eligible safety-net providers like HHHN to purchase outpatient medications at lower prices and reinvest those savings into services and infrastructure that expand care access and meet community needs.
For Hudson Headwaters, 340B savings have become an important financial stabilizer amid rising labor, supply and facility costs. Since 2018, the network estimates it has reinvested approximately $68 million in 340B savings into capital projects and service expansions throughout the region.
Those investments have included preserving obstetrics services at Glens Falls Hospital after the closure of a private OB-GYN practice, helping keep nearly 1,000 births annually in the region. In Plattsburgh, Hudson Headwaters expanded pediatric services following the closure of a private office, supporting care for roughly 6,000 children. In Washington County, the organization opened Salem Family Health in 2025, a more than 14,000-square-foot primary care center with on-site laboratory services operated by Glens Falls Hospital.
Each year, 340B savings are also used to offset losses in core service lines, including preventive care, dental, pediatrics, obstetrics and gynecology, behavioral health and care management — services that are often financially unsustainable under current reimbursement models.
Hudson Headwaters is working alongside other safety-net providers, including Glens Falls Hospital, through the Community Health Care Association of New York State, to advocate for safeguards that protect 340B savings from further erosion. While 37 states have enacted laws to protect the program at the state level, New York providers continue to push for stronger protections.
“The 340B program is a lifeline for health centers and their patients,” said Fisher. “Hudson Headwaters is an active member of the Community Health Care Association of New York State (CHCANYS), a membership organization representing New York’s 80 community health centers statewide. CHCANYS’ 2026 legislative agenda includes safeguarding 340B savings from erosion by third parties. We are in regular contact with fellow health centers and safety-net providers, like Glens Falls Hospital, in our efforts to educate our communities on 340B protections, and to share how critical this program is to health care sustainability and advancement. We also regularly meet with elected officials to discuss how the 340B Program supports critical services and expands access to care, without costing taxpayers.”
HHHN leadership notes that continued growth in demand reflects increasing community need and the expanding role of nonprofit providers as private practices reduce services or close.
“Due to the growing needs of our communities, we anticipate reaching 500,000 patient encounters in 2026!” said Fisher. “Reaching this milestone shows how critical Hudson Headwaters is to families throughout our region, and how important it is to continue to do all we can to support our talented workforce and optimize care delivery. We know that with creativity and foresight, we will continue to show up for our community, even while encountering complex problems every day.”
Planned expansions in dental and primary care are expected to deliver measurable economic benefits, including job creation, workforce retention and increased regional stability.
“Strategic planning and financial foresight are essential as we move forward,” said Fisher.
“As Hudson Headwaters moves into 2026, our focus remains on balancing growth with sustainability,” Fisher adds. “Not only do these efforts result in greater access to care, but also more job opportunities and greater economic impact throughout the region.”