Throughout Barclay Berdan‘s 12 years as CEO, Arlington-based Texas Health Resources has taken a deliberate approach to growth: identify where North Texas is growing, secure land with good access, add ambulatory services and build hospitals as demand increases. Large-scale consolidation has not been part of that approach.
“Ambulatory services you can put in place relatively quickly,” Mr. Berdan said. “Hospitals take several years to plan and build, so it takes a while to get those things up and running. So that’s the process we use. We go through a prioritization of which of these locations we want to put up first. We’re in a pretty strong financial position, so we’ve been able to invest capital in new location points over the last [several] years.”
Today, Texas Health Resources has more than 30,000 employees and more than 420 access points across North Texas, including hospitals, outpatient facilities, neighborhood care and wellness centers, home health and the Texas Health Resources Physicians Group. The system also holds ownership stakes in roughly 35 ASCs with Optum’s SCA Health and in imaging centers with Envision Imaging.
That growth occurred across a tenure that ends in September, when Winjie Tang Miao takes over as CEO. Texas Health Resources’ board named Ms. Tang Miao president effective April 5, a role created to identify the next CEO, and she has reported to Mr. Berdan since. She has been with the system since 2000 and served as senior executive vice president and COO from 2022. Laura Irvine was named senior executive vice president and chief operating and growth officer in the same announcement, with a focus on enterprise operations, geographic expansion and virtual services.
Mr. Berdan will stay on as a strategic adviser on an as-needed basis for about a year. He has spent four decades at Texas Health Resources, 12 of them as CEO, and is one of the longest-serving health system CEOs in the region.
“I really don’t like the word retirement; it seems kind of final,” he said. “I see it as a transition from one thing, one state, to another. I think the principal difference between the current state and the future state will be that I’ll be a little less busy.”
Mr. Berdan spoke with Becker’s about how the system plans capacity ahead of demand, what keeps culture intact during expansion and why its partnerships have been about capabilities instead of geography.
Capacity planning at Texas Health Resources starts with reading the market. The Dallas-Fort Worth area had about 8.5 million residents in 2025, according to the latest U.S. Census Bureau estimates, and Mr. Berdan said the system does not expect that climb to stop. Leaders pull in data on roads and infrastructure from the North Central Texas Council of Governments, track where growth is already showing up, then divide the region into submarkets and inventory what the system owns in each one.
“There’s sort of a crescent, if you will, that runs from the east side of Dallas County, and goes north over through Collin and Denton [counties], and comes back down onto the west side of Tarrant County, and scooching along a little bit even farther southwest,” he said. “We think 95% of the growth is going to occur in that large market.”
He said Texas Health follows a sequence as it expands into growing areas. The health system secures land with good highway access first, then layers in primary care offices, urgent care, more physician offices and partnered surgery and imaging centers. In a few locations, the system has built neighborhood health and wellness centers that carry all those services plus an emergency room and therapy services. A hospital comes later, once volume justifies it.
In Forney, Texas Health Resources already had physician group offices and an urgent care center and is now building a hospital because of the area’s rapid growth. A strong balance sheet has funded that pace, along with capacity additions at existing hospitals, over the past several years.
Mr. Berdan also credits Texas Health Resources’ culture for the system’s position.
“Culture is really what we consider to be a competitive advantage for us,” he said. “Care is delivered by people to people, so you have to have people really focused.”
Alongside the system’s mission, vision and values sits what Texas Health Resources calls the promise: individuals caring for individuals together. Mr. Berdan said new employees learn it in onboarding. Every month, the system produces a short education piece on one or two promise behaviors, and someone at each unit leads a 10- to 15-minute huddle on what those behaviors look like in daily work. Mr. Berdan rotates that responsibility among his senior leaders in his own monthly staff meeting.
Mr. Berdan said that focus has contributed to high employee retention and low vacancy levels, even as the generational makeup of the workforce has shifted.
Texas Health Resources has also been approached repeatedly by organizations looking to enter the Dallas-Fort Worth market, he noted.
“We’ve had lots of people come and talk to us about whether we’d be interested in them coming into the market or us joining with them,” he said. “We feel like in all those cases so far that those would be dilutive.”
The board has also revisited whether Texas Health Resources should expand beyond North Texas and has consistently directed leadership to remain focused on the region.
The health system has instead pursued partnerships to add specific capabilities. The SCA and Envision Imaging joint ventures came early, before the broader industry push into outpatient. Its clinically integrated network with Dallas-based UT Southwestern covers research, education and quaternary care that Texas Health Resources does not provide itself.
“We did those because the companies we’ve partnered with are better than we are at doing those specific things,” Mr. Berdan said. Of the imaging joint venture, he added: “The first ones I put in place were not next to my hospitals; they were next to my competitors’ hospitals.”
The newest partnership is in physical therapy, with PT Solutions. Texas Health Resources has three sites open and has two more planned, with an eye toward retail physical therapy and outpatient therapies outside its hospital footprint.
“So that’s essentially been our approach to partnerships,” he said. “It’s more really about expanding and strengthening capabilities in the marketplace than it is about gaining ground in geography.”
Asked what he would pass along to other executives, Mr. Berdan pointed to the value of staying long enough to be accountable for one’s own decisions. Twelve years as CEO has meant living with the results of how he led, he said, and in an era of frequent executive movement, leaders should not sell short the chance to grow in one place.
“One of the things I tell some of my younger folks is, don’t be too quick to look to change to the next job. It’s important, I think, to live with the consequences of your decisions,” he said. “And if you leave too early, there’s a tendency to not worry about what’s going to happen three or four years down the road.”
Mr. Berdan said he and Ms. Tang Miao have worked together long enough that the handoff requires little coaching, and he credited the board with a deliberate approach to succession.
“There are challenges ahead, but there have always been challenges ahead,” he said. “So we have a great team, and they will carry forward.”
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