This is Jennifer.
She’s a legal aid attorney turned policy strategist, and one of the sharpest minds working to solve one of New Hampshire’s toughest challenges: the high cost of healthcare.
As Director of the New Hampshire Health Cost Initiative, Jennifer Frizzell is building something rare—a long-view, inclusive, statewide conversation about how to rein in healthcare costs without sacrificing care. She doesn’t shy away from tough questions, like why costs are skyrocketing or how consolidation is reshaping care access. But her focus is always forward.
From her early advocacy in Berlin’s legal aid clinics to championing upstream solutions across sectors, Jennifer brings a deep moral clarity and a fierce belief that we can—and must—do better. She knows this isn’t just about balance sheets; it’s about babies no longer born in rural hospitals, families choosing between care and housing, and the simple, radical idea that healthcare should work for everyone.
Jennifer Frizzell is a systems-thinker and “upstreamist” with a mission: bend the cost curve, build trust, and chart a more abundant future for New Hampshire.
Notes:
This episode was produced in partnership with NH Possible, focusing on the NH Health Cost Initiative.
NH Possible is a collaboration between:
Health Strategies of NH
NH Health Cost Initiative
HealthForce NH
Foundation for Healthy Communities
NH Center for Justice & Equity
NH Fiscal Policy Institute
and NH Businesses for Social Responsibility
Together, they are building a statewide movement envisioning a New Hampshire where individuals, families, communities and businesses all have what they need to thrive, including a sense of belonging, opportunities for civic engagement, optimal health, and access to educational and financial opportunity.
Recorded at the Endowment for Health office in Concord, NH.
Music provided by Sneaky Miles.
Episode Summary*
What is the New Hampshire Health Cost Initiative?
It’s a collaborative effort to understand and address the rising cost of healthcare in the state. We’re building a movement—connecting stakeholders across sectors to find transparent, inclusive solutions that bring costs down without sacrificing care.
What is New Hampshire Possible, and how does it relate to your work?
New Hampshire Possible is about building a broader vision for economic and social well-being in the state. The Health Cost Initiative is one pillar of that—because healthcare is deeply tied to housing, workforce, and community vitality. Together, we’re working toward a future where all Granite Staters can thrive.
Why is healthcare so expensive in New Hampshire?
There’s no single answer. It’s a combination of workforce shortages, hospital consolidation, aging demographics, and administrative complexity. But a major driver is the shift toward for-profit motives and the lack of transparency in where our dollars actually go.
What’s different about your approach?
We’re playing the long game. This isn’t about quick wins in one legislative session—it’s about building a shared vision and aligning people around meaningful reform. We’re focused on transparency, consumer protection, and investing in primary and preventive care.
How did you get into this work?
I started as a legal aid attorney in Berlin, NH, helping people navigate basic needs like housing and healthcare. One of my first cases was a family about to lose their home because of a hospital bill. That experience showed me how interconnected these systems are—and how policy change can prevent that kind of harm.
What’s something people don’t realize about healthcare costs?
That the system often punishes people twice. You get sick, then get buried in paperwork, fees, and confusion. People are exhausted just trying to understand their bills—and that mistrust makes real reform harder.
What are some solutions you’re advocating for?
We’re pushing for better oversight, more investment in primary care, and creating a statewide consumer advocate program—someone to help individuals navigate care, understand their rights, and spot systemic failures that need policy change.
What does it mean to be an “upstreamist”?
It means addressing the root causes instead of reacting downstream. I want to change the system so that people don’t have to fight for care or face bankruptcy because of an accident. That means designing healthcare around prevention, fairness, and people’s real lives.
How does healthcare consolidation affect us?
When hospitals and provider groups merge, costs often go up and local decision-making goes down. You lose community control and transparency. People feel disconnected from the systems that are supposed to serve them.
Why is this work urgent right now?
Because we’re at a tipping point. Costs are outpacing wages, care is harder to access, and people are losing faith in the system. But there’s still time to shift course—if we act collaboratively and intentionally.
What role does New Hampshire’s culture play?
New Hampshire values local control and accountability—direct democracy is in our DNA. That’s what we’re trying to bring into healthcare: more community voice, more transparency, and more decisions made close to home.
How does this connect to the broader economy?
Skyrocketing healthcare costs hurt families and businesses alike. They affect workforce retention, rural development, and quality of life. If we want to grow our economy and keep communities vibrant, we have to fix this system.
What gives you hope?
The people. I see business leaders, patients, advocates, and policymakers who are ready to have hard conversations and move forward together. We have enough resources—we just need the will and coordination to use them differently.
*This episode summary was generated by an AI analyzing a transcript of the interview. The questions, wording, and written meaning of particular sections may contain slight differences to the original conversation. We include these summaries to give listeners a brief, readable synopsis of the episode. The full episode transcript is available on granitegoodness.com.
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