PORTLAND — MaineHealth trustees have approved an agreement to include as a member Memorial Hospital in North Conway, N.H., hospital officials announced Monday.

Memorial is the first hospital outside Maine to join the MaineHealth system, which includes Maine Medical Center in Portland, Goodall Hospital in Sanford and several other Maine hospitals and health care affiliates.

Memorial already had a strong relationship with Maine Medical Center, MaineHealth President Bill Caron said in a news release.

“Approximately 90 percent of Memorial’s inpatient referrals and the vast majority of its outpatient ambulatory referrals go to Maine Medical Center,” Caron said.

The two organizations negotiated for about 18 months before MaineHealth’s trustees approved the agreement.

Memorial officials sought a strategic partnership that would position their organization to adapt to growing technology needs and anticipated changes in hospital payment systems. Both advancements present significant financial challenges for small community hospitals.

“We feel strongly that Memorial can’t continue to go it alone,” said Scott McKinnon, Memorial’s president and CEO.

Memorial, which includes a 25-bed hospital and 45-bed nursing home, will hold a public hearing on April 11 to outline the membership agreement, answer questions and receive comments.

Following the hearing, Memorial’s trustees will submit the agreement for review by the New Hampshire Attorney General’s Office.

Kelley Bouchard can be contacted at 791-6328 or at: kbouchard@mainetoday.com