Issue link: https://beckershealthcare.uberflip.com/i/1543326
10 CFO / FINANCE Dartmouth Health's new CFO charts course for rural care innovation By Madeline Ashley W endy Fielding, named CFO of Lebanon, N.H.-based Dartmouth Health Jan. 10, is looking to innovative care delivery models and strategic facility partnerships to help address the industrywide challenges facing rural healthcare. "It's been important for us to make sure that people can have local access to care, and are not driving crazy distances or choosing to not get care at all," Ms. Fielding said during a Becker's CFO+Revenue Cycle Podcast episode. "By virtue of bringing [facilities] into the Dartmouth Health family, we're able to provide additional security…and we're able to make sure that care remains at the best place, which is locally." To that end, in July 2024, Dartmouth integrated Valley Regional Hospital in Claremont, N.H., into its network. e system also signed a letter of intent in mid-September 2025 to make Littleton (N.H.) Regional Healthcare a member, a process that is still in the works. e $4.3 billion academic health system spans across New Hampshire and Vermont, comprising an academic medical center, associated specialty physician practices, two community hospitals and a visiting nurse and hospice organization. Ms. Fielding, who has been with Dartmouth for more than 16 years, is also prioritizing addressing the aging rural population the system serves. "Our demographics affect our payer mix," she said. "is impacts our revenue stream, which is shiing over time more and more to governmental payers like Medicare and Medicaid, meaning we expect our future payment rates to keep dropping. At the same time, knowing that we're getting to a higher percentage of elderly folks, the demands for services are likely to increase, so I'm very interested in trying to figure out how to make this work." e demographic shi has driven Dartmouth to explore innovative care delivery models, like telehealth and hospital-at-home services. Innovation, however, must be paired with appropriate payment reform, Ms. Fielding underscored. "In order for it to work, we need an accompanying financial architecture that's going to support these new models of care delivery," she said. "We still have a pretty strong fee-for-service environment in New Hampshire and Vermont. ose models got us where we are today, and they're not really the types of models that are going to pay for innovative care delivery and get us where we need to be in the future. It can be hard to invest in these different ways of delivering care when you're not actually getting paid to do so." She expressed excitement over the $50 billion Rural Health Transformation Program, a five-year initiative aimed at improving access, infrastructure and workforce capacity in rural areas. "It feels like [the funds] could enable just the right type of community investments that are going to allow us to make that step forward," she said. "We don't have a lot of the specifics yet, as I know the state offices are really working hard to bring their plans to life, but I'm excited about it." Looking ahead, Ms. Fielding said she was also excited to collaborate with and get to know the leadership teams across Dartmouth. "I do believe that by tackling some issues together, we're going to be so much more successful than by applying our individual manpower to them," she said. "Being able to really understand each member organization's perspective on how they are dealing with these challenges, and what we can learn from them and also bring to them in order to do the best thing for our communities. I'm excited about what we could unleash." n Image Credit: Supply Chain World