Latest / Becker’s Healthcare Podcast / Wendy Fielding, Chief Financial Officer at Dartmouth Health

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Wendy Fielding, Chief Financial Officer at Dartmouth Health · Becker’s Healthcare Podcast

0:02
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Becker's sixteenth annual meeting brings together more than
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details,
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visit beckershospitalreview.com
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and click on the events tab in the
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upper right.
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This is Madeline Ashley with the Becker CFO
0:48
and Revenue Cycle podcast, and I'm excited to
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be joined today by Wendy Fielding, CFO of
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Dartmouth Health. Wendy, thanks for joining me. Thanks
0:57
for having me.
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So before we kick things off, do you
1:00
mind sharing just a little bit about yourself,
1:02
and your organization? And and, again, congrats on
1:04
the new role of CFO.
1:06
Great. Thank you. Yeah. I'm very excited to
1:09
step into my new role as the system
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CFO for Dartmouth Health.
1:14
I've been with the organization
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for more than sixteen years, and it has
1:18
truly been a pleasure,
1:20
as the system grow
1:22
to also have my own role grow at
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the same time.
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For those of you who aren't familiar with
1:29
Dartmouth Health,
1:30
we're a $4,300,000,000
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system
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in rural New England. And so our system
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members span across New Hampshire and Vermont
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and include,
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an academic medical center and associated
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multispecialty
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physician practices,
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two community hospitals
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or critical access hospitals and a visiting nurse
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and hospice organization.
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And so we really,
1:58
have some great ways of touching the members
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of the communities that we serve.
2:03
Wonderful. Thank you so much for sharing. And
2:05
as we both noted, when we first got
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on, little chilly where we both live right
2:09
now, so hope everybody is staying warm.
2:13
So Wendy, wanted to kick things off with
2:14
you. You know, as you mentioned, you've been
2:16
with the system for, I think you said,
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a little over sixteen years.
2:20
Entering into 2026 now, already, you know, in
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full swing into January. Could you share maybe
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some of the financial trends or shifts that
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you're keeping a close eye on as system
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CFO
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and why these trends are so important to
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you specifically?
2:33
Yeah. That that's a great question, and thanks
2:35
thanks for asking, Madeline.
2:38
One of the things that top that's top
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of mind for me right now has to
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do with the demographics
2:44
associated with our aging rural population.
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And so if you think about that, our
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demographics
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affect our payer mix, which
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affects our revenue stream, which is
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shifting over time more and more to governmental
3:01
payers like Medicare
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and Medicaid, which basically means
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we expect our future payment rates to keep
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on dropping.
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While at the same time, you know, knowing
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that they were getting to a higher percentage
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of elderly folks,
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the demands for services
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are likely to increase. And so I'm very
3:21
interested in trying to figure out how to
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make this work.
3:25
We know that we can be efficient from
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a operating
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perspective. I feel like that's
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just the basics of what you have to
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do these days, and we'll only get us
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so far.
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Efficiency only gets us so far. So we
3:39
have probably thinking about ways to,
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innovate within the way that we deliver care
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to our communities,
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delivering
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health at home
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through teleservices.
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Our hospitals
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are track a block full with patients who
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are driving sometimes several hours to get to
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a facility.
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And it seems like there should be a
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better way of delivering care to them
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that is more cost effective
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both for them and for us.
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So can we find that setting that way
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of doing that?
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But I have to say, and it's kind
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of a big but that comes along with
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it. In order for in order for it
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to work, we need a accompanying
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financial
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architecture that's going to actually,
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support these new models of care delivery. So,
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you know, we still have a pretty strong
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fee for service environment in New Hampshire and
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Vermont, and those models got us where we
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are today, quite frankly. And they're not really
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the types of models that are going to,
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pay for innovative
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care delivery and get us where we need
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to be in the future. And so it
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can be hard to invest
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in these different ways of delivering care when
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you're not actually getting paid to do so.
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And so,
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like, we one of our sayings in New
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Hampshire is if we're getting too far ahead
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of our skis,
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then it can really we'll take it on
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the chin financially. Meaning, if we go too
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far into innovative care delivery without making sure
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that the payment mechanisms are there so that,
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we're able to have a more holistic
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way of getting financially covered for our patients,
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it could be really challenging for us. So
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we we need to advance
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both pieces of the puzzle together.
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And so that that's probably what's top of
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mind for me right now.
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No. And I would be curious to hear
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too, you know, everyone's been talking about the
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rural,
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transformation funding. Is that something that you're also
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looking towards just on on this topic here?
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How are you planning to assess that?
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Yeah. Meaning the rural health transformation
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fund dollars.
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Yes. We're actually very excited to see how
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those funds will play out for our states
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in in New Hampshire and Vermont because it
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feels like it could
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enable just the right type of community investments
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that are gonna allow us to make that
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step forward. So we don't have a lot
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of, the specifics,
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yet. As I know, the state offices are
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really working hard to,
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bring their plans to life, but I'm I'm
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excited about it. And,
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you know, even amid some of the industry
6:22
uncertainties right now, Dartmouth has, in the last
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few years, seen some growth. You have acquired
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a few hospitals.
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Just just for our listeners, for example,
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Littleton Regional Healthcare, that's a 25 bed critical
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access hospital. They signed a letter of intent
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with Dartmouth in September 2025, I believe.
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And then,
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in 2024,
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Dartmouth also added, Valley Regional Hospital, which is
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a 25 bed facility. So this in mind,
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looking ahead just in terms of growth, do
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you see more academic health systems kind of
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following this path and maybe what differentiates those,
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that succeed in these types of partnerships?
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Yeah.
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So I just wanted to clarify. Our relationship
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with Littleton isn't,
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is in the works. It hasn't made it
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through the due diligence process yet. So I
7:09
just wanted to to to highlight that.
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Basically, we've seen it as a really important
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part of our strategy in our given our
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rural environment. So when you look at how,
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the geography of the state is laid out,
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it's been pretty important for us to make
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sure that people can have local access to
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care and, again, are not,
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driving crazy distances or choosing not
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to, get care at all.
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And so by
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honestly, I have to say many of our
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small organizations,
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I think, nationally, are pretty financially challenged
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to be an I don't
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to be a vibrant
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ongoing concern in their communities. And so by
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virtue of bringing them into,
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the Dartmouth Health family,
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we're able to provide additional
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security. You know, the wherewithal of the system
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is is certainly more so than, like, each
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individual part by itself.
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And we're able to make sure that,
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care remains
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at the best place, which is really locally.
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And so I can't really comment too much
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nationally. You know, does this work for everyone?
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But certainly, in our environment, it's been an
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important element of,
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making sure that those resources continue to exist
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in the communities that we serve.
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Yeah. And, again, as we touched on, you
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know, there's there's growth going on at your
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system. There's, you know, everything going on in
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the industry right now. So now you've been
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in your role just for a a few
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weeks at this point, but, again, with the
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system for a good amount of time. So
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how have you found it to be successful
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in keeping finance teams resilient amid amid so
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much change?
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Maybe engage there is do you have a
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secret sauce?
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Oh, what the jeez. I wish I had
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a secret sauce.
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I I think one of the things we've
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found is really important is to make sure
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that folks
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see how their work is connected to the
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patients
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and to the community. You know, when you're
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a finance person and you're working on, I
9:14
don't know, spreadsheets all day, you know, you
9:16
you name it. It is really hard to
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appreciate that your work actually has an impact
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on your community, on your neighbors that you
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run into at the grocery store, you know,
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that we're also taking care of in our
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organization. And so whenever we have a chance
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to
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remind our teams
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about that, like, for example, we're recently,
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in the middle of completing,
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a couple of floors that were previously
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shelled in our inpatient hospital,
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at our main academic campus.
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And one of the reasons why we're able
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to
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do that
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is because of the financial
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analysis work that was done
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to prove the, the importance of the project,
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and then, of course, the financial benefits of
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the project for the overall health of the
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system. And so just reminding folks, like, hey.
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That wouldn't have happened
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if you weren't a part of the team.
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And even though you're not
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touching patients directly, so to speak, you know,
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your stewardship is really making a difference for
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the organization.
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And then just to say, I I really
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don't think there's a special sauce. I mean,
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I was kind of a little bit flipped
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when I responded, but I I actually,
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I feel like,
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as a leader, you have to be a
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really good listener
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and,
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consider what matters the most to each of
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your team members.
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And so,
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it's not like the same sauce bottle is
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gonna fit
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for each person. Yep. You know, you you
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wanna be
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you wanna be supporting them. You gotta make,
10:56
I think you have to make them feel
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a little bit uncomfortable
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so that they are growing, you know, professionally,
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and let them know that you always have
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their backs if should that ever arise. So,
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I don't know. I I it's,
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you know, recognizing the individual,
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person for what they are they are. That's
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some incredible advice there, from a leadership perspective.
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And in that same vein,
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how would you say finance leader roles, particularly
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now CFO roles, are are evolving,
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in the industry? I mean, it is not
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just all,
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numbers crunching and spreadsheets anymore. It's it's communication.
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That is such a huge piece. So how
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would how do you feel it's evolving?
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Yeah. Yeah. I absolutely
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agree,
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with your thoughts about communication. I mean, I
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feel like over the years,
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my role really changed from,
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providing the financial data and kind of making
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sure all the transactions
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were accurate, and that was pretty much,
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a very major part of the role.
11:58
To now, you are being one of the
12:00
decision makers and more of a, I guess,
12:03
a strategic thought partner to the other executives
12:06
on the team. And so,
12:09
aside from
12:10
communicating the context for a particular
12:14
decision or financial situation or what have you,
12:17
I think that,
12:19
I often find myself also talking with them
12:21
about the risks
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associated
12:24
with it. So,
12:25
jeez, you know, you can think as, you
12:27
know, again, as finance person, what are the
12:30
things I might have gotten wrong
12:32
about the assumptions for this particular case? Are
12:34
there things that would make it go better
12:36
or worse?
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But then you also have to be,
12:40
prompting your team, like, you know, what what
12:42
are the odds? What could we do that
12:43
would make this more successful? How are we
12:46
feeling about the team
12:48
that's poised to execute on this strategy? Do
12:51
they need more support?
12:53
Are my confident that they're gonna get us
12:56
there? I guess and then are we actually
12:58
responding
12:59
fast
13:00
enough? You know? Creating a sense of urgency
13:03
sometimes, I feel like, is a really
13:06
important,
13:07
element when you're trying to get folks to
13:09
do hard stuff.
13:12
Just reminding them of how,
13:15
necessary it is,
13:17
and keeping their eye on the long on
13:19
the long view.
13:21
Oftentimes, especially today's environment, we're really,
13:25
it's easy to get bogged down in kind
13:27
of feeling like,
13:29
jeez, you're dealing with problems every day. How
13:32
are you putting out the fires? And so
13:34
part of a role of a,
13:38
finance leader, I think, is really to help
13:41
raise folks' gaze to the horizon
13:44
and be like, we're taking the long view.
13:46
This organization
13:48
is gonna be in place, this health system
13:50
for our community for a very long time,
13:53
and,
13:54
we're gonna figure it out. You know? Give
13:57
folks that sense of,
14:00
optimism and remind them, you know, we've been
14:02
through challenging times before,
14:04
and we're able to to get there again.
14:07
So
14:08
anyway.
14:09
No. No. It is I mean, to your
14:11
point, it is an ever shifting industry. This
14:13
is so true. So keeps us all on
14:15
our toes, but it's good to have a
14:16
forward thinking mindset.
14:18
So my final question for you here, you
14:21
know,
14:22
I just would
14:23
love to hear a little bit more about
14:25
what you're most excited about right now at
14:26
the system. Just looking forward in your new
14:29
role,
14:30
any any future growth plans, any partnership plans,
14:33
anything that you're just like, yay, I can't
14:35
wait for it.
14:36
Yeah. Well, I think I'm actually, I'm really
14:39
excited about getting to know each of the
14:42
leadership teams at our member organizations
14:46
more because I do believe that by,
14:49
tackling some issues together, we're going to be
14:52
so much more successful than by kind of,
14:55
applying our individual manpower to them.
14:59
As I mentioned, we have a we have
15:01
a lot of patient demand that we're trying
15:04
to,
15:05
settle out throughout our system. And so being
15:07
able to really,
15:10
understand each member organization's
15:12
perspective
15:13
on how are they dealing with these challenges
15:16
and what we can learn from them and
15:19
also
15:20
bring to them in order to do the
15:22
best thing for our communities.
15:24
I mean, I'm I'm excited about what we
15:27
could unleash. I'm I don't mean to say
15:29
we haven't done some of that already, but
15:31
I'm like, this is it just feels like
15:32
a great
15:33
opportunity
15:34
to,
15:36
for, like, one plus one to equal three
15:39
instead of two.
15:41
Well, you can definitely hear the, excitement and
15:43
passion in your voice, so that's great to
15:45
hear. Wendy, again, congratulations on the new role.
15:47
It was such a pleasure having you on
15:49
the podcast, and I'm excited to chat with
15:51
you again down the line.
15:53
Sounds great. Thank you so much for having
15:55
me. Thank you.