Becker’s Healthcare Podcast: Nick Olson, EVP & CFO of Sanford Health

Date: January 30, 2026
Host: Madeline Ashley, Becker’s Healthcare
Guest: Nick Olson, Executive Vice President & CFO, Sanford Health

Episode Overview

This episode features a conversation with Nick Olson, Executive Vice President and CFO of Sanford Health, the largest rural health system in the U.S. Nick shares insights on Sanford’s strategic priorities for 2026, the transformation of rural healthcare, integration after recent mergers, and lessons learned from a year of significant organizational growth.

Key Discussion Points & Insights

1. About Sanford Health and Its Rural Mission [00:46–02:49]

• Sanford is the largest rural health system in the nation, serving over 2 million patients, with significant reach in federally designated provider shortage areas.
• Emphasis on long-term financial stewardship, sustainability, and reinvestment into rural communities.
• Notable stats: 57 hospitals, 290 clinics, 150 senior living centers, 4,000 physicians/APPs, 1,100 clinical trials, 55,000 employees, $12B annual revenue.
• Quote – Nick Olson [01:33]:
  “Nearly two thirds of our patients come from those rural communities that I touched on across the upper Midwest... many of these counties that we serve are federally designated provider shortage areas, which makes access to preventative and specialty care even more challenging.”

2. Financial Trends and Value-Based Care Focus [03:19–05:26]

• The top priority for 2026 is accelerating the shift towards value-based care to improve outcomes, lower costs, and build healthier communities.
• Formation of a system-wide value-based care committee with four key focuses:
  1. Aligning incentives between providers, payers, and patients through contracting.
  2. Enabling technology and data analytics.
  3. Supporting care model transitions.
  4. Strengthening core health plan operations.
• Belief in the power of integration—having the health plan, care delivery, and coverage under one umbrella.
• Quote – Nick Olson [04:44]:
  “At the end of the day, if done right... lowering the total cost of care can be a win-win. Healthcare can become more affordable for our patients... We can also remove cost from the system, making us more sustainable long term.“

3. Rural Health Transformation Program & Funding [05:48–08:22]

• Sanford is closely following and participating in the Rural Health Transformation Program—a historic opportunity for rural healthcare improvement.
• Their virtual care infrastructure supports over 1 million virtual visits in nearly 80 specialties, closing regional specialty care gaps.
• Robust workforce development initiatives: graduate medical education, mobile simulation, academic partnerships.
• The program enables Sanford to expand already successful strategies: virtual care, workforce programs, tackling workforce shortages, interoperability, and fragmentation.
• Quote – Nick Olson [07:23]:
  “We see a big opportunity to accelerate what is already working. Right? These are not net new things, these are already working... this program aligns directly with our mission and we’re certainly excited about the opportunity that it presents.”

4. Smart Growth and Recent Integrations [08:45–11:48]

• Two primary opportunities for smart growth in 2026:
  • Deepening care integration and expanding capacity in existing communities.
  • Strategic partnerships with mission-driven organizations.
• Recent major moves:
  • Merger with Marshfield Clinic Health System (2025).
  • Expansion into Rapid City, SD; combination with Prairie Lakes Health System; acquisition of Lewis Drug—all in 2025.
• Focused on integrating new organizations to leverage strengths, expand access, invest in legacy communities, and deliver value across both care and coverage.
• Emphasis on partnerships that support access, quality, and sustainability—not just growth for growth’s sake.
• Quote – Nick Olson [10:33]:
  “Our strategy is rooted in meeting community needs... every combination in our history has been focused on expanding specialty care, enhancing quality and bolstering provider recruitments to ensure that long-term sustainability.”

5. Lessons from a Year of Growth [12:29–14:28]

• Biggest takeaway from 2025: The critical importance of cultural alignment during integration and change.
  • When teams are culturally aligned, integration is smoother, decisions are clearer, and change is embraced.
• Embracing challenges—workforce constraints, access gaps, economic changes—as drivers for innovation and new partnerships.
• A “purpose and optimism” mindset is anchored in meeting access, quality, and financial sustainability demands for Sanford’s communities.
• Quote – Nick Olson [13:12]:
  “Alignment around mission, around vision and values and expectations is extremely critical... when teams are culturally aligned, this integration can move faster, buy-in to change can become easier, and decisions become more clear, and that change that is certainly always present becomes embraced and not a challenge.”

Memorable Moments & Quotes

• On Value-Based Care's Potential [04:44]:
  “Lowering the total cost of care can be a win-win... Healthcare can become more affordable for our patients... we can also remove cost from the system, making us more sustainable long term.” — Nick Olson

• On the Rural Health Transformation Program [07:23]:
  “We see a big opportunity to accelerate what is already working... this program aligns directly with our mission and we’re certainly excited about the opportunity that it presents.” — Nick Olson

• On Cultural Alignment During Integration [13:12]:
  “As operational and financial integration begins to take place. We've found that when teams are culturally aligned, this integration can move faster, buy-in to change can become easier, and decisions become more clear, and that change that is certainly always present becomes embraced and not a challenge.” — Nick Olson

Timestamps for Key Segments

• Background & Sanford Mission: [00:46–02:49]
• Financial Trends & Value-Based Care: [03:19–05:26]
• Rural Health Transformation & Funding: [05:48–08:22]
• Smart Growth & Integration: [08:45–11:48]
• Approach to Future Partnerships: [11:48–12:29]
• Lessons from 2025: [12:29–14:28]

Tone and Style

Nick Olson speaks with a strategic, optimistic, and mission-driven focus, underscoring Sanford’s commitment to rural healthcare, integration, and sustainably advancing patient outcomes. The conversation is forward-looking, practical, and grounded in serving community needs.