Sanford Health’s latest expansion is pushing the Sioux Falls, S.D.-based system into a new phase of growth: one that increasingly blends its deep rural footprint with a major urban presence.
On Sept. 1, Sanford acquired North Memorial Health, a two-hospital system headquartered in Robbinsdale, Minn.. The transaction grew Sanford to 60 hospitals and created a new Twin Cities care delivery region for the health system. The combined system now serves about 2.5 million patients across the Upper Midwest, with roughly 61,000 employees, 310 clinic locations, 145 senior care communities and 4,950 physicians and advanced practice providers.
Bill Gassen, president and CEO of Sanford, sees the partnership as a natural extension of the nonprofit system’s strategy. He spoke to Becker’s about how Sanford plans to connect rural and urban care, what it has learned from integrating Marshfield (Wis.) Clinic Health System, why Minnesota remains central to its growth strategy and how he expects multistate health systems to evolve over the next five years.
Question: North Memorial Health gives Sanford a major foothold in the Twin Cities while Sanford already has a strong rural presence. How do you see that urban-rural combination changing the system’s strategy?
Bill Gassen: This doesn’t change our strategy; it builds on it. We have always focused on understanding what each community needs, keeping care local and supporting our local teams with the resources and capabilities of our integrated system.
Our partnership with North Memorial Health creates a first-of-its-kind, fully integrated rural-urban health system in Minnesota and puts us in an even stronger position to serve patients and communities across the state.
Sanford Health has decades of experience serving rural communities and delivering care across a broad geography. North Memorial brings deep experience serving diverse urban and suburban communities, with expertise in trauma, emergency care and EMS services.
Bringing those strengths together creates new opportunities to improve how care is delivered across Minnesota — extending the reach of specialty care through outreach and virtual care, strengthening care coordination across communities and giving clinicians more opportunities to share expertise and learn from one another.
We are committed to creating a simpler, more seamless experience for patients. Health care can be incredibly difficult to navigate. As one integrated system, we can make it easier for patients to get to the right care at the right time, as close to home as possible.
Q. Minnesota is attracting major health systems, including Sanford Health and Sutter Health. What is it about Minnesota’s healthcare market that makes it especially attractive for large-scale expansion right now?
BG: Sanford has deep roots in Minnesota. We’ve cared for Minnesotans for decades and have made significant long-term investments to expand access and strengthen care in communities across the western third of the state.
Minnesota has a long history of leadership in health care. There’s a strong spirit of innovation and collaboration here, along with talented clinicians, community leaders and organizations who care deeply about the future of the state. Those are qualities that have always made Minnesota an important part of Sanford.
Bemidji is a great example. When Sanford and North Country Health Services came together in 2011, we committed to investing $75 million over 10 years. Since then, we’ve invested more than $170 million in facilities, technology, our workforce and expanded services across northern Minnesota. Today, we serve about 176,000 people across 14,000 square miles in that region, where distance, an aging population and growing health care needs make access especially important.
One of our early investments was establishing interventional cardiology in Bemidji. Before that care was available locally, a patient experiencing a heart attack faced a four-hour round trip to Fargo. Today, Bemidji has three cath labs and a heart and vascular center that has helped reduce cardiovascular mortality in the region by a third. We’ve also expanded cancer care through the Joe Lueken Cancer Center and opened Minnesota’s first pediatric EmPATH unit, bringing behavioral health crisis care closer to children and families.
Our partnership with North is the next opportunity to build on our longstanding commitment to Minnesota. We’ve committed more than $600 million to strengthen and expand care in the Twin Cities, including investments to modernize Robbinsdale Hospital and support its role as a Level I trauma center, and to expand Maple Grove Hospital and enhance emergency, inpatient, surgical and specialty care to meet the needs of one of Minnesota’s fastest-growing communities. Maple Grove is also home to the state’s largest birth center, serving families from across the region.
We believe deeply in the future of Minnesota and see tremendous opportunity to continue investing in the people, communities and care that will shape the state for generations to come.
Q. As Sanford continues to grow — now a 60-hospital system spanning multiple states — what are the biggest challenges you face as CEO in leading such a large organization while integrating new hospitals and maintaining consistency across the system?
BG: The biggest challenge — and opportunity — is doing the hard work of truly integrating our organizations. Closing a partnership really puts us at the starting line. That’s when the work begins to thoughtfully bring our people, processes, expertise and capabilities together so we can operate as one integrated organization and realize the full value of our partnership for our patients, people and communities.
Sanford has a dedicated Integration Management Office that brings structure, experience and discipline to this work and reflects how important we believe it is to get integration right. We also view integration as a two-way opportunity. We listen to understand what our new colleagues do exceptionally well, what we can learn from one another and how bringing our strengths together can make the entire organization better.
We’ve seen what that approach can accomplish with Marshfield Clinic Health System. In the first year following our merger, we reduced physician turnover by more than half, from 22% to 10.5%, and achieved a $166 million financial improvement. Since coming together, we’ve recruited more primary care providers than at any point in Marshfield’s history and added psychiatrists, OB/GYNs, surgeons and other specialists who are critical to rural communities. We’re also sharing physicians across markets through outreach, virtual care and surgical support, helping expand access while making better use of the clinical expertise across our system.
As we grow, strong local leadership remains central to our model, supported by the expertise and resources of our integrated system. Ultimately, success means becoming stronger together — creating more opportunities for our people, strengthening care for our patients and helping the communities we serve thrive for generations to come.
Q. Looking ahead five years, how do you see the hospital landscape evolving as more health systems become multi-state operators, cross-market mergers become more prominent and large regional systems continue to expand?
BG: I think we will continue to see more partnerships as health systems look for new ways to strengthen care, meet evolving health care needs and invest in their communities.
Strategic size and scale can create opportunities that are difficult to achieve independently. For Sanford, this has allowed us to make investments that benefit patients across our entire footprint — including building a graduate medical education pipeline that will soon train more than 500 residents and fellows each year, with about 40% staying to practice at Sanford; providing patients in rural communities access to specialty care through our virtual care network spanning 80 specialties; and bringing clinical trials and innovative treatments closer to patients who previously may have had to travel hundreds of miles to access them.
I also think we’ll see greater focus on making healthcare easier for patients to navigate. We have to continue asking where the friction points are and how we can remove them, whether that’s making it easier to schedule an appointment, connecting patients to the right specialist or coordinating care across different settings. The more integrated we become, the more we can simplify that journey so patients can spend less time navigating health care and more time focused on getting and staying well.
We’ll also see more collaboration across traditional boundaries between rural and urban providers, health systems and independent hospitals, and care delivery and health plans. Our integrated care and coverage model allows us to look across the entire patient journey, identify needs earlier and invest in prevention and care management in ways that can improve outcomes while reducing the overall cost of care.
Ultimately, the opportunity is to translate those capabilities into something meaningful for the people and communities we serve: better access, better outcomes and more affordable care.
