Healthcare CFOs Grapple with Aging Population Demands

BJC Health and Dartmouth Health focus on access and sustainability as demographics shift

Published on Feb. 24, 2026

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Healthcare systems like BJC Health and Dartmouth Health are facing rising demand for services driven by an aging population in their communities. CFOs at these organizations are focused on addressing access, financial sustainability, and innovative care delivery models to meet the needs of their growing elderly patient populations.

Why it matters

The aging population trend is a major challenge for healthcare systems across the Midwest and beyond, as they must adapt their care delivery, revenue models, and operational strategies to serve an increasingly older demographic. How CFOs at leading health systems respond to these shifting demographics will shape the future of sustainable healthcare in their communities.

The details

BJC Health, a 24-hospital system in Missouri and Kansas, recently merged with St. Luke's to create a larger organization focused on access and innovation. CFO Scott Hawig is prioritizing ways to bring care closer to aging patients, including virtual offerings and micro-hospital models. At Dartmouth Health in New Hampshire, CFO Wendy Fielding is also grappling with the financial implications of a growing elderly population, as the payer mix shifts more toward government programs with lower reimbursement rates.

  • BJC Health merged with St. Luke's in 2024 to form a 24-hospital system.
  • BJC Health rebranded from BJC Healthcare in late 2025.
  • Scott Hawig joined BJC Health as CFO in September 2025.

The players

Scott Hawig

The executive vice president and CFO of BJC Health, a 24-hospital system in Missouri and Kansas.

Wendy Fielding

The CFO of Dartmouth Health, a healthcare system in Lebanon, New Hampshire.

BJC Health

A 24-hospital healthcare system formed in 2024 through the merger of BJC Healthcare and St. Luke's.

Dartmouth Health

A healthcare system based in Lebanon, New Hampshire.

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What they’re saying

“We have overwhelming demand for our services. The severity of the issues we're seeing in our community is rising.”

— Scott Hawig, Executive Vice President and CFO, BJC Health (Becker's CFO+Revenue Cycle Podcast)

“Our demographics affect our payer mix. This impacts our revenue stream, which is shifting 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.”

— Wendy Fielding, CFO, Dartmouth Health (Becker's Hospital Review)

What’s next

BJC Health and Dartmouth Health will continue to monitor the evolving demographics in their communities and adapt their care delivery and financial strategies accordingly. This may include further investments in virtual care, micro-hospitals, and other innovative models to improve access for elderly patients.

The takeaway

The aging population trend is a major challenge facing healthcare systems across the country, as CFOs must balance rising demand for services with the financial realities of shifting payer mixes and lower reimbursement rates. Innovative approaches to care delivery and a focus on sustainability will be critical for health systems to effectively serve their communities in the years ahead.