Sanford Health aims to expand access to care in rural America

Sanford Health serves 2.4 million patients annually, and two-thirds of those patients live in rural communities.

Bill Gassen, president and CEO of Sanford Health, says he's looking to expand access to healthcare services across the rural midwest.

Bill Gassen, president and CEO of Sanford Health, says he knows it’s not easy for some rural Americans to get to a doctor, much less a hospital. He acknowledges “the challenges that we're seeing right now in rural America around access, quality, sustainability.”

Based in Sioux Falls, South Dakota, Sanford operates 56 hospitals and more than 280 other healthcare locations across six states in the rural Midwest. Sanford also recently merged with the Marshfield Clinic Health System, a Wisconsin-based organization that also serves a largely rural population.

Gassen says that Sanford is focused on making it easier for its rural communities to get access to care.

“Our efforts right now, both with the integration with Marshfield Clinic as well as across the whole of the organization, is, how do we address those three challenges right now that exist, I believe, more prominently within rural America,” he says.

• Read more: Sanford CEO talks about merger with Marshfield Clinic and opportunities for more growth

In an interview with Chief Healthcare Executive®, Gassen outlines the steps Sanford is taking to expand access to healthcare services in the heartland. He talked about the recent opening of Sanford’s virtual care center, and its expansion of graduate medical education programs to train more physicians.

Investing in technology

Sanford’s service area isn’t exclusively rural, but most of its patients live in smaller communities, Gassen notes. Sanford’s footprint covers South Dakota, North Dakota, Minnesota, Iowa, Wisconsin and Michigan’s upper peninsula.

Gassen acknowledges that his concerns about access mirror those of his colleagues leading hospital systems in cities and suburbs.“I think you'll hear very common talking points out of them that right now, they're also trying to focus on,” Gassen says. “How do we address access to continue that march on improving quality, and how do we do that in a way that is financially sustainable for all the parties involved?”

Sanford is focused on access and building an integrated organization that utilizes all of its capabilities to meet the needs of patients, Gassen says.

The health system is working to make sure that its 4,000 providers at Sanford Health “have what they need to be successful,” he says.

“We believe one of the important tools, if not the most important tool, that they have, is technology. And so we really invested heavily, and will continue to invest more into the future, to make sure that we arm our clinicians with the necessary tools they need to be able to reach their patients,” Gassen says.

Buoyed by a $350 million contribution from Denny Sanford in 2021, Sanford Health has developed a new virtual care center. The center opened in November 2024, and it provides training for clinicians in virtual care and also aims to develop AI-powered tools to improve rural healthcare delivery.

“That virtual care center serves as the epicenter for what is a large, expansive digital footprint that we built out of Sanford Health,” Gassen says. “That allows our clinicians to be able to reach into the smallest of communities, communities where you count the population in hundreds, not thousands or tens or hundreds of thousands, to ensure that they have access to the necessary care.”

Sanford Health now offers virtual care in 78 specialties.

“We believe that's really important by ensuring that more patients get access to more care closer to home,” Gassen says.

Sanford Health looks to continue to build its virtual care capabilities, he says.

“It’s not only going to be a big part going forward, but it's a huge part today, right now,” Gassen says. “I mean, we have providers who are saving patients millions of miles a year in driving, and we know that that not only saves them time, but it also saves them valuable resources by way of finances.”

Those savings cover everything from gasoline to child care, as well as helping patients avoid missing work.

“Removing some of the friction right now from the healthcare system is something that we're committed to doing, and we know that that's going to help us improve access for all of our patients,” Gassen says.

Expanding medical training

Most health systems are struggling with recruiting and retaining clinicians, and rural hospitals can find it particularly difficult to attract and keep talent.

Sanford has been working to expand its ability to train physicians, with the idea that it will be easier to keep those doctors down the road.

“One of the things that we've really tried to do at Sanford Health is understand and appreciate that the workforce has been and always will be critically important,” Gassen says. “And in order to ensure that we have access to world-class physicians both today and into the future, we have to be able to build out that pipeline.”

Sanford has invested in training new physicians and now has 40 graduate medical education programs.

“Through those programs, they're allowing us to train physicians as residents and fellows within our communities where we serve and provide care today, and that is really important,” Gassen says.

“We know that nearly 40% of those individuals will stay where they train,” he explains. “And so if we have the opportunity to train these positions in communities where we're at today, we know that that's going to create an opportunity for us to build, recruit and retain those physicians into the future.”