← Becker’s Healthcare Podcast
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- [00:02]
A
This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you in Chicago.
- [00:32]
B
This is Madeline Ashley with Becker CFO and Revenue Cycle Podcast, and I'm excited to be joined today by Nick Olson, Executive Vice President and CFO of Sanford Health. Nick, it's great to have you back on with me.
- [00:44]
A
Yeah, thanks for having me. Appreciate it.
- [00:46]
B
Yeah, I'm really excited to dive into the convo, but before we do, do you mind sharing just a little bit about yourself and Sanford Health with our listeners who might not have caught one of our previous discussions?
- [00:57]
A
I have the privilege of serving as the Executive Vice President and Chief Financial Officer at Sanford Health, the largest rural health system in the United States, headquartered in Sioux Falls, South Dakota. My background includes leadership roles both within Samford Health and also outside the organization, both of which have shaped my perspective and the lens through which I look through in my current role. I'm really focused on financial stewardship of our organization to ensure both near term, but more importantly long term sustainability while also enabling reinvestment into the communities that we are so privileged to serve. Stanford Health serves more than 2 million patients and approximately 430,000 health plan members across 320,000 square miles, a region that is 99% rural with over 12 billion in annual revenue. Our integrated nonprofit health system includes 57 hospitals, approximately 290 clinic locations, 150 senior living locations, around 4000 physicians and advanced practice providers, more than 1100 active clinical trials and studies, and over 55,000 employees. Nearly 2 thirds of our patients come from those rural communities that I touched on across the upper Midwest. 70% of our residents served through Good Samaritan and approximately 2/3 of our Sanford Health Plan members also live in rural communities. Further, many of these counties that we serve are federally designated provider shortage areas, which makes access to preventative and specialty care even more challenging. But all that said, these realities really shape everything that we do. They drive our commitment to eliminate barriers, improve outcomes, and deliver high quality care no matter where our patients live.
- [02:50]
B
I really appreciate you sharing that and you know, it sounds like Sanford Health definitely stays busy. You guys are a wonderful organization, so I truly appreciate you Sharing now, Nick, I know again, we've talked many times and I feel like there's always something going on in healthcare. It is never a dull industry. So I would love to hear, as we're entering 2026, some of the financial trends or shifts that you're keeping a close eye on, particularly maybe even around the rural healthcare side of things right now and why you're watching these trends.
- [03:20]
A
Yeah, as we enter 2026, certainly there's a lot that's top of mind for me, but really the one thing that I am most focused on heading into this new year is really this continued acceleration towards value based care and the opportunity that it creates to improve outcomes, to lower the total cost of care and really to build healthier communities for our patients, for our members and for our residents. There's certainly growing recognition across the industry that aligning care delivery, aligning coverage and the financing with which that coverage is provided, all of which is essential to delivering long term value. And here at Sanford Health, value based care is a strategic priority for us. We're establishing a value based care committee to strengthen the system wide alignments. And really this committee is going to be focused on four key areas. The first of which is going to be aligning incentives between providers, between payers and between the patients through contracting. The second of which will be through enabling technology and data analytic tools. The third of which is going to be supporting care model transitions. And the fourth and final area is going to be strengthening core health plan operations as a fully integrated system with a health plan. We believe that Sanford Health is really uniquely positioned to lead this transformation. And integration really allows us to align incentives across the care delivery and coverage, improve that care coordination and the efficiency and focus on that total cost of care that I mentioned. And at the end of the day, if done right, which we believe we will do this correctly, lowering the total cost of care can be a win win. Healthcare can become more affordable for our patients, which we know are top of mind for each of our patients in our communities. But we can also remove cost from the system, making us more sustainable long term. Really for those reasons, the shift towards that lowering of the total cost of care via value based care arrangements is one of the things that's certainly top of mind for me as we begin 2026.
- [05:27]
B
Yeah, that's such an important thing to keep an eye on as well. I would also be curious to hear, you know, here at Becker's we've done a lot of coverage just in terms of the rural health funding. I was curious if you had any thoughts there right now, I do believe all 50 states of course got the funds. You know, how that's being distributed is, there's some question marks. So how are you following this right now?
- [05:49]
A
Yeah, I know it's as we look at 20, 26, you know, one of the other things that's certainly top of mind for me is just, you know, the areas that we think about as we continue to evolve and to grow and one of those areas, amongst other things, is the Rural Health Transformation Program that you touched on. It's, it's really a significant opportunity really in the history of healthcare to accelerate progress in rural healthcare, which is really what we're all about. As I mentioned, our significant rural presence here in the upper Midwest. And you know, I think our 300,000 square mile rural footprint, fully integrated care delivery model and proven record of innovation really uniquely positions us to partner with CMS to transform what the future of rural healthcare can look like. And we've built and scaled certain capabilities across virtual care, across value based care. We've invested a lot into workforce developments, into digital and infrastructure and delivering, you know, improvements and access outcomes and affordability for rural, rural communities. And you know, maybe just by way of a couple of examples, you know, and the way of virtual care infrastructure, we've delivered more than 1 million virtual visits across nearly 80 specialties, supported certainly by our new virtual care center and hub and spoke model. You know, this approach certainly helps extend that specialty care gap that I touched on. It allows us to extend our clinical trials and you know, from a workforce development perspective, we have one of the most extensive rural workforce programs in the country, inclusive of graduate medical education, mobile simulation and academic and community partnerships that strengthen pipelines for the critical clinical roles that we're looking to fill. And so really, as we think about that infrastructure that we have, kind of in light of this new rural health transformation program, we see a big opportunity to accelerate what is already working. Right? These are not net new things, these are already working. But certainly we look to expand those programs to address the barriers that we've touched on around workforce shortages, interoperability, fragmentation. And so really, ultimately this program aligns directly with our mission and we're certainly excited about the opportunity that it presents for us.
- [08:22]
B
Something that can, you know, even further set you up for success. So yeah, that's great to hear. I'd like to shift gears a little bit and talk about some, maybe some of the biggest opportunities for smart growth that you're seeing in the year ahead. Clearly, you know, as We've also covered here at Becker's. The Sanford Health Marshall Clinic merger occurred, know, just a little bit over a year ago. So how are things looking there? What, what does smart growth look like to you this year?
- [08:46]
A
Yeah, you know, in addition to the, the Rural Health Transformation Program which we just touched on and we're, we're putting a lot of emphasis into, there's a, there's a couple of other areas that are top of mind for us. The first of which is really the focus on continued integration and expanding care in and around the communities that we already provide care in. We are fortunate, super fortunate to be the provider of choice in many of the communities that we have a presence. And we need to maintain that trust by continuing to expand access, ensuring there is capacity in our facilities, investing in new technology and listening to where our patients need even more from us. You mentioned the integration with Marshall Clinic Health System and others. Integration remains central to our strategy. We are not a holding company, we never will be a holding company. Following our merger with Marshall Clinic health system in 2025, in addition to our expansion in the Rapid City in the western part of South Dakota, our combination with Prairie Lakes Health System in Watertown, South Dakota and the acquisition of Lewis Drug, all of which occurred in 2025, we are continuing the strong focus of integrating them into our organization and fully leveraging the strengths of an integrated system to deliver more patient centered care, ensuring we can invest into the communities in the years to come. We're also focusing our health plan efforts in geographic markets where we can provide both that care and coverage, because we found that where we can do both of those things is where we can deliver the greatest value for those patients and members. And continuing to invest into our legacy communities remains central to our mission and our long term strategy. Yeah, the other area I see opportunity for smart growth is through strategic partnerships. Our growth strategy is fundamentally about strengthening access, improving quality and doing so in a sustainable way. And we are focused on not only inorganic growth, but looking to, you know, partner with strategic, mission driven organizations. We're not focused on growth just for growth's sake. We're on focusing, but about building a strong foundation for the future, which we think can enable us to make the necessary investments and whatever headwinds that may come at us in the future. And so 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. And so, you know, for us, the future of healthcare really belongs to organizations willing to combine both that purpose and vision, recognizing that opportunities and challenges ahead are really too big for any one system to tackle alone. So those are a couple of other areas that we're focused on as we look at and think about growth in 2026.
- [11:49]
B
So fair to say that, you know, last year was a big year for acquisition and partnership and. And you're not ruling anything out for this year as well in terms of any additional partnerships or acquisition?
- [11:59]
A
Yeah, I mean, again, we're going to focus where we're currently at. We've got a lot of needs that our patients in our existing communities need for us. So that's going to be a focus area. We've got a lot of intentionality around continuing to integrate those organizations we merged with in 2025. We're going to focus on the Rural Health Transformation Program, but we're also going to keep kind of an ear open for other kind of geographically aligned systems that may make sense and that have cultural alignment to Sanford Health.
- [12:29]
B
And, you know, with. With all of the great activity that happened with Stanford last year, could you share maybe one lesson that you took away from 2025 that you're carrying now into 2020?
- [12:40]
A
Yeah, 2025 was a year of growth for Sanford Health, and certainly at the top of the list of important lessons for 2025 for me, again, during a year when we welcomed several new organizations and teams into Stanford Health is the power of cultural alignments, particularly during these periods of integration and change. Alignment around mission, around vision and values and expectations is extremely critical. As operational and financial integration begins to take place. We've found that when teams are culturally aligned, this integration can move faster, buy into change, can become easier, and decisions become more clear, and that change that is certainly always present becomes embraced and not a challenge. And so that alignment begins to build trust, begins to build accountability and momentum across a very complex organization. And so, you know, another key lesson is the importance of viewing challenges as opportunities. You know, workforce constraints, access gaps, evolving economic conditions have created opportunities. Right. To innovate, to strengthen partnerships and rethink how care is delivered. And so, as we move into 2026, we're focused on really deepening that cultural alignment across our integrated, integrated system and continuing to approach challenges and complexities not as negatives, but as optimism and purpose. And so that mindset positions us well again around our focus areas of how can we continue to advance access, improve quality, and do so in a financially sustainable way for both our communities today and into the future.
- [14:28]
B
Yeah, some strong lessons learned there. Thank you so much, Nick. And again, it is always so such a pleasure having you on the podcast and getting to chat with you. I'm really eager to see all the exciting things that Sanford Health does this year, so hopefully we'll get to connect again soon.
- [14:44]
A
Sounds great. Thanks for having me. I appreciate it.