Latest / Becker’s Healthcare Podcast / Nick Olson, Executive Vice President and CFO of Sanford Health

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Nick Olson, Executive Vice President and CFO of Sanford Health · Becker’s Healthcare Podcast

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This is where health care leadership comes together.
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Becker's sixteenth annual meeting brings more than 3,500
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hospital and health system executives and nearly 800
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speakers to Chicago April.
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This year's event includes keynote conversations with Dallas
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Cowboys legend Troy Aikman and former president George
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w Bush. For the agenda and event details,
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visit beckershospitalreview.com
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and click on the events tab in the
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upper right. We're looking forward to hosting you
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in Chicago.
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This is Madeline Ashley with the Becker CFO
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and Revenue Cycle podcast, and I'm excited to
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be joined today by Nick Olson, executive vice
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president and CFO of Sanford Health. Nick, it's
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great to have you back on with me.
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Yeah. Thanks for having me. Appreciate it.
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Yeah. I'm really excited to dive into the
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convo. But before we do, do you mind
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sharing just a little bit about yourself and
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Sanford Health with our listeners who might not
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have caught one of our previous discussions?
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I have the privilege of serving as the
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executive vice president and chief financial officer at
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Sanford Health, the largest rural health system in
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The United States, headquartered in Sioux Falls, South
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Dakota.
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My background includes leadership roles both within Sanford
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Health and also outside the organization,
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both of which have shaped my perspective and
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the lens through which I look through.
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In my current role, I'm really focused on
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financial stewardship of our organization
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to ensure both near term, but more importantly,
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long term
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sustainability while also
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enabling reinvestment into the communities that we are
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so privileged to serve.
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Sanford Health serves more than 2,000,000 patients and
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approximately 430,000
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health plan members across
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320,000
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square miles, a region that is 99%
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rural.
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With over 12,000,000,000 in annual revenue, our integrated
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nonprofit health system includes
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57 hospitals,
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approximately
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290 clinic locations,
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a 150
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senior living locations,
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around 4,000 physicians and advanced practice providers,
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more than 1,100
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active clinical trials and studies, and over fifty
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five fifty five thousand employees.
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Nearly two thirds of our patients come from
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those rural communities that I touched on across
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the Upper Midwest.
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70% of our residents through, served through Good
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Samaritan,
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and approximately
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two thirds of our Sanford Health Plan members
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also live in rural communities. Further, many of
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these counties that we serve are federally designated
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provider shortage areas,
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which makes access to preventative
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and specialty care even more challenging.
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But all that said, these realities really shape
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everything that we do. They drive our commitment
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to eliminate barriers, improve,
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outcomes, and deliver high quality care no matter
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where our patients live.
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I really appreciate you sharing that. And, you
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know, it sounds like Sanford Health definitely stays
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busy. You guys are a a wonderful organization,
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so I truly appreciate you sharing.
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Now, Nick, I know, again, we've we've talked
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many times, and I feel like there's always
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something going on in health care. It is
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never a a dull industry.
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So I would love to hear, you know,
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as we're entering 2026,
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some of the financial trends or shifts that
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you're keeping a close eye on, particularly maybe
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even around the rural health care side of
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things right now and and why you're you're
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watching these trends.
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Yeah. As we enter 2026,
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certainly, there's a lot that's top of mind
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for me. But, really, the the one thing
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that I am most focused on heading into
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this new year
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is really this continued acceleration
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towards
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value based care and the opportunity that it
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creates to improve outcomes,
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to lower the total cost of care, and
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really to build healthier communities for our patients,
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for our members, and for our residents.
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There's certainly growing
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recognition across the industry that aligning
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care delivery, aligning coverage,
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and the financing with which that coverage is
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provided,
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all of which is essential to delivering long
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term value.
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And here at Sanford Health, value based care
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is a strategic priority for us.
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We're establishing a value based care committee to
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strengthen
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the system wide alignments,
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and, really, this committee is gonna be focused
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on four key areas.
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The first of which is gonna be aligning
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incentives between providers,
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between payers, and between the patients through contracting.
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The second of which will be through enabling
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technology and data analytic tools.
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The third of which is gonna be supporting
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care model transitions,
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and the fourth and final area is gonna
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be strengthening core health plan operations.
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As a fully integrated system
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with a health plan, we believe that Sanford
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Health is really uniquely positioned to lead this
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transformation.
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And integration really allows us to align incentives
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across,
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care delivery and coverage, improve that care coordination,
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and the efficiency and focus on that total
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cost of care that I mentioned.
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And at the end of the day,
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if if done right, which we believe we
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will do this correctly,
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lowering the total cost of care can be
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a win win. Health care can become more
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affordable for our patients, which we know are
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top of mind,
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for each of our patients in our communities,
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but we can also remove cost from the
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system, making us more sustainable
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long term.
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Really, for those reasons,
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the shift towards
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that lowering of the total cost of care
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via value based care arrangements is,
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one of the things that's certainly top of
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mind for me as we begin 2026.
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Yeah. That's such an important thing to to,
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you know, keep an eye on as well.
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I would also be curious to hear,
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you know, here at Becker's, we've done a
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lot of coverage just in terms of the
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rural health funding.
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I was curious if you had any thoughts
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there right now. I I do believe all
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50 states, of course, got the the funds.
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You know, how that's being distributed is there's
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some question marks. So how are you following
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this right now?
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Yeah. I know it's, as we look at,
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2026, you know, one of the other things
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that's,
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certainly top of mind for me is just,
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you know, the areas that we think about
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as we continue to evolve and and to
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grow. And one of those areas,
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amongst other things is the rural health transformation
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program that you touched on.
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It's, it's really a significant opportunity,
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really in the history of health care to
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accelerate progress in in rural health care, which
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is really what we're all about. As I
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mentioned,
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our significant Yeah. Health rural presence here in
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the Upper Midwest. And,
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you know, I think, our our 300,000
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square mile rural footprint,
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fully integrated model and and proven record of
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innovation
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really uniquely positions us to partner with CMS
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to to transform what the future of rural
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health care can look like.
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And,
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Yeah. You know, we've built and scaled certain
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capabilities
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across
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virtual care, across value based care.
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We've invested a lot into workforce development, into
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digital
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infrastructure,
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and delivering, you know, improvements in access outcomes
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and affordability
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for,
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rural
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rural communities.
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And, you know, maybe just by way of
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a couple of examples,
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you know, and and, the way of virtual
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care infrastructure, we've delivered more than 1,000,000
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virtual visits
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across nearly 80 specialties
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supported, certainly by our new virtual care center
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and hub and spoke model.
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You know, this approach, certainly,
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helps extend that specialty care gap that I
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touched on. It allows us to extend our
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clinical trials.
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And, you know, from a workforce development perspective,
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we have one of the most extensive
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rural workforce programs in the country,
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inclusive of graduate
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medical
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education, mobile simulation, and academic and community partnerships
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that strengthen
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pipelines for,
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the critical clinical roles that we're looking to
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fill. And so, really,
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as we think about that infrastructure that we
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have,
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kind of in light of this new rural
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health transformation program, we see a big opportunity
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to accelerate
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what is already working. Right? These are not
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net new things that you're already working.
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But, certainly, you know, we look to expand
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those programs to address the the barriers,
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that that we've touched on around workforce shortages,
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interoperability
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fragmentation.
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And so, really, ultimately, this program aligns directly
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with our mission, and we're certainly
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excited about the opportunity that it presents for
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us.
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Something that can, you know, even further set
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you up for success. So, yeah, that's great
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to hear. I'd like to shift gears a
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little bit and talk about some maybe some
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of the biggest opportunities
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for smart growth that you're seeing, in the
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year ahead. Clearly, you know, as we've also
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covered here at Becker's, the Sanford Health Marshall
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Clinic merger occurred, you know, just a little
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bit over a year ago. So, how are
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things looking there? What what does smart growth
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look like to you this year?
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Yeah. You know, in addition to the the
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rural health transformation program, which we just touched
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on and, we're we're putting a lot of
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emphasis into,
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There's a there's a couple of other areas
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that are top of mind,
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for us.
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The first of which is really the focus
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on continued integration,
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and expanding care in and around the communities
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that we already provide care in. Right? We
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are fortunate, super fortunate to be the provider
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of choice in many of the communities that
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we have a presence,
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and we need to maintain that trust by
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continuing to expand access,
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ensuring there is capacity in our facilities,
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investing in new technology,
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and listening to where our patients need even
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more from us.
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You mentioned the, integration
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with, Marshall Clinic Health System and others. Integration
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remains central to our strategy. We are not
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a holding company. We never will be a
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holding company.
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Following our merger with Marshall Clinic Health System
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in 2025,
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in addition to our expansion,
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in the Rapid City in the Western Part
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of South Dakota,
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our combination with Prairie Lakes Health System in
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Watertown, South Dakota, and the acquisition of Lewis
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drug, all of which occurred in 2025.
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We are continuing the strong focus of integrating
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them into our organization and fully leveraging
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the strengths of an integrated system to deliver
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more patient centered care, ensuring we can invest
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into the communities,
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in the years to come. We're also focusing
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our health plan efforts, in geographic markets where
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we can provide both that care and coverage
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because we found that where we can do
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both of those things is where we can,
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deliver the greatest value for those patients and
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and members.
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And, you know, continuing to invest into our
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legacy communities remains central to our mission and
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our long term strategy.
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Yeah. The other area I see opportunity for
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smart growth
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is through,
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strategic partnerships.
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Our growth strategy is fundamentally about strengthening access,
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improving quality, and doing so in a a
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sustainable way.
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And we are focused on not only inorganic
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growth, but looking to, you know, partner with,
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strategic mission driven organizations.
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We're not focused on growth just for growth's
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sake, but about building a strong foundation for
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the future,
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which we think can enable us to make
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the the necessary investments and whether whatever headwinds
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that, may come at us in the future.
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And so our our strategy is rooted in
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in meeting community needs. Every combination in our
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history,
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has been focused on expanding specialty care, enhancing
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quality,
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and bolstering provider recruitments,
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to ensure that long term sustainability.
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And so, you know, for us, the future
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of health care
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really belongs to organizations
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willing to combine both that purpose and vision,
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recognizing that opportunities and challenges ahead are really
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too big for any one system,
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to tackle alone. So,
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those are a couple of other areas that,
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we're focused on as we look at and
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think about growth in 2026.
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So fair to say that, you know, last
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year was a big year for acquisition and
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partnership, and you're not ruling anything out for
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this year as well in terms of any
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additional partnerships
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or acquisition.
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Yeah. I mean, again, we're gonna focus where
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we're currently at. We've got a lot of
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needs that our patients, and our existing communities
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need for us, so that's gonna be a
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focus area. We've got a lot of intentionality
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around continuing to integrate
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those organizations we merged with in 2025.
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We're gonna focus on the rural health transformation
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program. We're also gonna keep, kind of an
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ear open for other,
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kind of geographically aligned systems that,
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may make sense, and that have cultural alignment
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to Sanford Health.
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And, you know, with with all of the
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great activity that happened with Sanford last year,
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could you share maybe one lesson that you
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took away from 2025
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that you're carrying now into 2020?
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Yeah.
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2025 was a year of of growth for
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Sanford Health, and certainly
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at the top of the list of important
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lessons,
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for 2025 for me,
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again, during the year when we welcome several
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new organizations
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and teams into Sanford Health is the power
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of cultural alignments,
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particularly during these periods of integration and change.
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Alignment around
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mission, around vision and values and expectations is
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extremely critical
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as operational and financial integration begins, to take
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place.
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We've found that when teams are culturally aligned,
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this integration can move faster.
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Buy into change can become easier, and decisions
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become
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more clear.
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And that change that is certainly always present
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becomes embraced and not a challenge.
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And so that that alignment,
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begins to build trust, begins to
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build accountability and momentum across a very complex
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organization.
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And so, you know, another key lesson is
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the importance of viewing challenges as opportunities. You
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know, workforce constraints,
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access gaps,
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evolving economic conditions have created opportunities,
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right, to innovate, to strengthen partnerships, and rethink
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how care is delivered. And so as we
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move into 2026, we're focused on really deepening
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that cultural alignment across our integrated integrated system
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and continuing to approach challenges and complexities
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not as negatives, but as optimism
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and purpose. And so that mindset positions us
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well,
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again, around our focus areas of how can
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we continue to advance access,
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improve quality, and do so in a financially
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sustainable way for both,
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our communities,
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today and into the future.
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Yeah. Some strong, lessons learned there. Thank you
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so much, Nick. And, again, it is always
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such a pleasure having you on the podcast
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and getting to chat with you. Really eager
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to see all the exciting things that Sanford
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Health does this year. So, hopefully, we'll get
14:42
to connect again soon.
14:44
Sounds great. Thanks for having me. I appreciate
14:45
it.