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Thanks for listening. Now here's the episode.
This is Laura Dedo with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Bill Gassen,
president and c e o of Sanford Health. Bill,
it's a pleasure to have you on the podcast today.
Thank you. It's a pleasure to be here.
Now, I know we have a lot to talk about.
There's so many exciting things happening at Sanford and really is just such a
important time in healthcare right now, and especially rural healthcare.
But before we dive into my questions,
can you tell us a little bit more about yourself and your background?
Yeah, gladly. Uh, and again, thanks for the opportunity, uh,
really appreciate the,
the chance to spend a few minutes with you talking about matters of, uh,
significance and importance, uh, for Sanford Health. But, uh, as you referenced,
I think across the country right now, as we find ourselves at, uh,
significant inflection point within healthcare and, uh,
as the President of Sanford Health, the largest, uh,
rural health system in the country, uh, my promise,
my commitment to those who I have the privilege of serving in this organization
has the opportunity to serve, uh,
is that we are committed each and every day to ensure that one zip code does not
limit the level of care that they receive. Um, as you know,
well, uh,
based on our prior conversations and what you hear from our colleagues around
the country,
that those individuals who live in rural America face some really unique
challenges. Uh, we know that there's, uh, a need for, uh,
physicians in these communities. We know that they deal with limited resources,
uh, that oftentimes, uh, un unfortunately,
they experience a higher rate of poverty and food insecurity as well as chronic
disease. And so we really see it at Stanford Health, uh,
as our calling and our unique privilege to be able to serve, uh, those living,
uh, here in the upper Midwest, especially those living in rural America.
And this, uh, mission is, is really personal to me. Uh,
I had the privilege of growing up, uh, in a home where my mother spent, uh,
more than four decades, uh, serving as an inpatient rn. And so I, uh,
had the opportunity to see my mother,
like so many of the talented caregivers who we have, uh,
serving at Sanford Health and around the country that, you know,
they're the caregivers, uh, on the front lines,
taking care of our patients every day.
And they're also the caregivers on the front lines at home, uh, caring for, uh,
and helping to provide for their families.
And so I am always been grateful for that experience with, uh, in my home.
Uh, and then very similarly, uh, my father was very mission driven, uh,
following his 24 year, uh, career in the United States Air Force. Uh,
he then was integral in starting, uh, what is today South Dakota's, uh,
largest hunger relief organization feeding South Dakota. Uh, and so seeing him,
uh, standing in the gap with his team each and every day, uh,
helping to try and, uh, address those food insecurity issues that we have.
And many of those communities that suffered most significantly are some of our
most rural communities in this part of the country. And, uh, then of course, uh,
blessed, uh, my wife of now nearly 20 years, uh, when she's not, uh,
keeping me in line. And our five children, uh,
serves as a physician's assistant, uh, with the, uh, veterans, uh,
administration.
And so she's been working at the VA Medical Center now for getting close to
almost 20 years as well. And so, uh, I counted a real privilege, uh,
to have grown up in a home and to live in a home today where, uh, my family,
uh, you know, has, has sought the calling, uh, to be able to meet people, uh,
both from a healthcare perspective, uh, as well as those basic needs of, uh,
food insecurity and working to address those each and every day. Uh,
so I've seen firsthand what it means to address those barriers, uh,
to access, uh,
to help address some of those challenges from a health disparities perspective.
And, uh, you know, again, as I, as I referenced before,
and we will always say it is a, it is a privilege,
it's an honor to be able to serve at an organization that has that as its
mission. And so at Sanford Health, uh, we believe very strongly,
uh, in that mission.
We believe at this organization that we really stand in the gap, uh,
making sure that individuals in this part of the country across the
250,000 square miles that we have the privilege of serving in that we believe
that, but for Sanford Health, but for the talented caregivers,
the incredible dedicated teammates that we have, uh, but for them,
individuals in this part of the country wouldn't have access to care and not
just care, but world class care. And so, uh, I'm excited to be able to do that.
Uh,
I'm excited to be a part of a talented team that serves today 1.5 million
patients, over 200,000, uh, health plan members, uh, here in a,
in a special part of the country.
Well, that's amazing to hear,
and really such an inspirational story of all the different, uh,
family members you have around you focused on healthcare and healthcare
delivery. And I know that coming together of,
of services and being able to serve, um, the community, um,
with social determinants of health and all those kinds of things have really,
um, in the last several years,
more and more integrated into the mission of health systems and healthcare
organizations. And so it seems like, you know, you just have such a fascinating,
unique perspective, um, based on your family and your upbringing, and now,
you know, continue to,
to bring that into your role as the president and c e o of a major health
system.
Uh, absolutely. I mean, I, uh, as I stated, you know, just discount myself,
very, very fortunate to have been, uh,
exposed to and given the perspectives that I have, uh,
throughout my life growing up, uh, and then now having that continue, uh,
as my wife Jill and I have the opportunity and the privilege to raise our
children as well. And so, uh, to be a part of, uh,
a family that, uh, is sort of a mission verse oriented family,
and then have an opportunity to be able to serve and live that out, uh, in my,
uh, professional career, uh, I think is, is pretty special.
That's amazing. And, you know, from your vantage point, I,
I can imagine you get to, um,
really see a lot of the great things that are going on within the community as
well as within Sanford Health. What are some of your top priorities right now,
especially given, um, you know, where things are headed in healthcare,
some of the different challenges in, in macroeconomic trends,
what are your top priorities as you think about being able to continue to serve
the community and continue to provide great care?
Yeah, you know, Laura, that's, you bring up a good point. Uh, again,
one of the other special aspects of being able to serve at an organization like
Sanford Health, that is a, uh,
5 0 1 C three community-based not-for-profit.
We have not only the unique obligation to be able to provide and extend
world-class care to every one of our patients in these communities, uh,
but because of the nature of our organization's,
what we do and what our missions are, we do find ourselves, you know,
really at the forefront of all of the community opportunities and challenges.
And so, uh,
it provides us with a very unique opportunity across the 300 communities where
Sanford Health is present today to really partner, uh,
with government organizations, other not-for-profits,
other business leaders to see, you know,
there are certain things that we believe we can address, uh,
very uniquely from a healthcare perspective,
but there are so many of the other challenges and opportunities in these
communities that we need to partner with, whether it's, again,
addressing food insecurity,
whether it's working with schools to make sure that we're providing the best
possible environment to see that, uh,
our young ones are educated and provided opportunities that they need to be
successful. And so we can't do it all ourselves.
We need to have incredible partners to do that. And again,
I think that's one of the special parts of the calling, uh,
for those of us who have the opportunity to serve and not-for-profit healthcare.
Uh, and at the same time, uh, these are large,
complex organizations that, uh, are addressing large,
complex challenges.
And so when you think about our priorities right now from a healthcare delivery
perspective, it really is, uh,
like many across the country that one of those top priorities for us is
workforce. And, uh, as we know and has been widely publicized,
we've seen a lot of challenges from a workforce perspective. Uh,
and it really starts and ends with this,
that for anybody at any point in time in history to be able to serve in
healthcare, you have to really see it as a calling. Uh,
'cause it's difficult intellectually,
it's very difficult physically in many instances.
And it's absolutely taxing from an emotional perspective that's always been
there. Uh, and I believe it always will be, uh, as we continue to add,
uh, to the, to the work that we do,
the innovations that are out there as we continue to augment our workforce
through, uh, advancements in technology and digital, at the end of the day,
there's still always just gonna be a very personal, a very people intensive, uh,
quotient to what we do in healthcare. And again,
I think that makes it rewarding, but also makes it very challenging.
And so when we look across, uh, the workforce today, uh,
we know that there's, uh,
there's a deficit when it comes to the number of individuals who are there based
on the rising needs. We've seen the forecast. We know that in the years to come,
uh, they'll forecast, uh,
as much of a hundred and twenty four, a hundred twenty 5,000, uh,
physicians that will be a, a delta, uh,
that needs to be reached between where we're at, uh,
now and where we'll need to be in the future.
And some of the ways that we're looking to address that at Sanford Health, uh,
is a little bit of a grow our own. Uh,
we have been very fortunate through the incredible philanthropy, uh,
from our namesake and benefactor, Mr. Sanford, uh,
to be able to stand up and to fully fund, uh,
15 graduate medical education programs.
We know from our experience to date that where those individuals, uh, do, uh,
come to for the residencies where they train at for their fellowships,
oftentimes ends up being where they're staying.
And so the privilege of training these individuals,
we see close to 40% of them end up staying with us.
And we see that as a unique opportunity to not only build out,
to train the workforce in the future, uh,
but then also to be able to bring in exposed, uh, those talented physicians to,
uh, our organization and then uniquely the patients, uh,
who we have the opportunity to be able to serve.
And so that's one of the ways that we're addressing, uh,
some of that workforce gap we're doing very similar when it comes to, uh,
you know, nurse training programs, uh,
working to both with governmental and non-governmental organizations,
working with our colleges and universities to be able to train that workforce
for the future. But importantly,
we believe that it's not just how do we throw more bodies at these challenges
that we really have to think differently about the work that we do. Uh,
at Sanford Health will we say,
often what we do will never change standing in the gap,
providing world-class care for our patients, that will never change.
How we do that is changing, and it must change as we go forward.
And so we're doing a lot of work right now in trying to figure out different
ways that we can change the workflows, modify how we do the work that we do,
so that one, we can pull some of the redundancy,
we can pull some of the mundane tasks out of the work that we do,
which should in turn make it a more rewarding career for the individuals who
decide to serve in that capacity. And then at the same time,
we can drive up our efficiency and then help close the gap as it relates to some
of the delta that we have from a workforce perspective. Uh, and of course,
with all the advancements that we're seeing right now from a technological
perspective,
we believe that that will help us continue to close that gap going forward. Uh,
we won't be replacing our people.
We hope that what we're actually gonna be able to do is help make the work that
they do more rewarding, more efficient. And at the end of the day,
the most important thing is that we will help to increase access,
help to improve quality for each and every one of the patients who we have the
opportunity to serve and do that in a way that's more financially sustainable.
Got it. That's, you know, fascinating to hear. And,
and thank you so much for laying out, um, that plan for us, because essentially,
you know,
the issues you're talking about are certainly issues for health systems across
the country, whether it's looking at the workforce challenges or, um,
trying to make sure that, you know,
you're serving people who have not traditionally had access to care for a
variety of reasons. And so it's inspiring to see that, you know,
you've been able to create some of those partnerships and,
and programs that are really making a big difference.
How do you see Stanford Health growing and evolving over the next two to three
years or so?
Uh, it's a great question. You know,
one of the things that we're very resolute about here at the organization is
that as we continue to evolve and change, and as the, uh,
healthcare ecosystem continues to change and mature around us,
what will never change for our organization is that strategic aspiration that
we want to, uh, stand, uh,
in the gap continue to be that premier rural health system in the United States.
And from our standpoint, what that means, again, as we've talked about today,
it's really that focus and that commitment of making sure we do everything we
can to add the capabilities to, uh, augment the organization that we have today,
to ensure that we're extending that world-class life-saving care to every
individual regardless of where they live.
Whether it's some of your most densely populated urban communities,
or whether it's some of the most, uh, sparsely populated, uh,
rural communities that we have the opportunity to serve.
One of the ways that we believe that we're going to continue to evolve and
change as an organization and be able to achieve that necessary goal of
improving access, right, improving quality, and making sure that we, uh,
drive to that financial sustainability is really by the addition of virtual
care for our organization and extending that out beyond what it's been today.
Uh, we, again, have had a unique privilege, uh,
because of our benefactor and namesake, uh,
that we have a $350 million philanthropic investment that's been made all
focused on the advancement through digital and virtual, uh,
care for each one of our patients. And so right now, uh, and over the last year,
we've continued to build out more of that infrastructure.
We'll continue to do that in the future.
We have that we'll be opening up in late 24, a virtual care center.
There will be sort of a ni a central nervous system from which we'll extend out,
uh,
that virtual care that we'll provide that will allow us to extend specialty and
subspecialty care into some of our most rural communities. And that,
in addition to that, it's also gonna serve as an innovation center.
That's where we will train, that's where we'll work, uh, to make sure that the,
uh,
healthcare genera or that the healthcare providers of the next generation will
have had exposure to and had deep training and understanding how to extend that
virtual care into, uh, the homes, uh, into smaller,
uh, you know, clinics into smaller medical centers to make sure, again,
that we're extending out and spreading across, uh, the whole, uh,
breadth of the organization.
That type of deep specialty care that we believe is critically important. Uh,
we wanna make sure that all that we have to offer is something that we're able
to extend into each and every one of the communities that we serve.
That's fantastic to hear, and certainly, you know, inspiring that, um,
you're able to have that type of capability with the virtual care center,
uh, to really breed innovation within the organization, uh,
as well as reach and connect with patients, and especially on,
on the rural setting.
I can imagine having those virtual capabilities is helpful. Um,
from your perspective, obviously the care providers, you know, having them,
um, be able to transition to virtual is one thing,
but when you're working in extending into the community,
has there been a pretty good reception to, um,
the virtual technology side of it? Or, or you have, you had to, um, you know,
educate patients and really get buy-in, I guess, for lack of a better word, um,
for this type of transition to be able to do more virtual care?
Yeah, that's a great question. Uh, you know, it's, it's one of the, uh,
I'll call it silver linings, which I'm always careful to state, uh,
given all the challenges and the, uh,
horrible difficulties that this country and this world suffered having come
through the pandemic. Uh, but having had to go through that experience that, uh,
we've seen not only from a healthcare perspective, but you know,
really across almost all sectors of our economy, uh, and our society,
a greater openness to engaging and interacting, whether it be commerce,
whether it be healthcare, whether it be just those, uh, familial relationships,
uh, through virtual. And that is something that's helped us in that front. Uh,
also I think there's can be sometimes a misnomer a little bit too about those
living in rural America that perhaps there's not a, a,
a receptivity or an openness to, uh, you know,
digital transformation to virtual interaction,
but because of the nature of where they live, uh,
not just from a healthcare perspective, uh,
but we do find that a lot of these communities are,
are not only open to embracing it now,
but they've already been embracing it through a variety of different ways. Uh,
we've seen, especially here in America's heartland,
the way that technology has made significant changes in our agricultural
business, uh, the way in which we, uh, engage not only from,
I'll say sort of a, a domestic perspective, but also internationally as well.
And so as we look ahead to the future, um,
and as we go into these communities and extend that care,
we are seeing that openness and that receptivity when it comes to engaging with
their providers, uh, on that side, uh, from the patient's perspective,
but then also, uh, our providers, uh, we see a great, uh, sort of,
I'll say level of excitement and receptivity when we extend these services into
these communities where, you know,
we find individuals that love the idea of saying that I'm going to be the
community provider. I'm gonna be the advanced practice provider.
I'm gonna be the physician who is able to really satisfy my
desires to live in rural America and raise my family there,
but then also still be able to practice my craft and be able to serve, uh,
and practice medicine in those communities.
But if you're all on your own and you're on an island out there and you don't
have the backing of a health system, that can sometimes be a, a scary situation.
It can also be challenging for individuals to just, uh,
strike that right work-life balance.
But if you know that you've got the backup of an entire system that has, uh,
the very, very fortunate, uh, situation to have nearly 2,800,
uh, providers, uh,
physician and advanced practice providers who are there as your backup, uh,
and to be able to access, uh, at the click of a button,
that really creates a lot of confidence, that creates a lot of continuity.
And at the end of the day, for us,
we know that creates the best outcome for our patients. Uh,
and if we can balance that better outcomes for our patients,
better access for our patients,
and then provide the necessary support for our providers, uh,
we think that we're getting closer, uh,
to being able to hit all those goals that we need to as a health system.
That's amazing to hear, and certainly great that, uh, there's been so much, um,
I guess ability to, uh, receive the, the virtual care and, and, um,
you know, enjoy having that opportunity available. Now, from your perspective,
I'd just love to hear before we wrap up,
what is one change that you or your team has made in the last year or so that's
yielded great results? Yeah.
And I don't know if the right timeframe Laura would say the last year, um,
I'm sure all of us in healthcare feel like we've sort of been dog years right
now and, um,
difficult to sort of distinguish from covid then into the financial challenges
and crises that we saw through 2022 and the start of 23. But I'll say sometime,
uh,
in these last couple of years where I've had the opportunity and the privilege
to serve in this role, perhaps maybe one of the most, uh,
significant things that, uh,
my team and I and the board of trustees at Sanford Health have had the
opportunity and the ability to do was to really stop. Uh,
we found ourselves not only in healthcare, but specifically at Sanford Health,
going back to almost, uh, three years ago now, really at an inflection point,
uh,
as we went through a leadership transition and I and my team had the opportunity
to, uh, step into the roles that we're in today,
it was really that opportunity to,
to stop and pause and look at our organization to say, who are we, uh,
and who do we want to be as we move forward?
And as we had the opportunity to do that and to reset the strategy for this
organization, uh, we had the real privilege, uh,
to be able to stop and say that as we have examined where we've been,
where we've come, and what we do well to this organization, uh,
that was that realization for us and that decision to come together to coalesce
around, uh,
a unified mission and strategy that we were gonna continue our pursuit to be
that premier role health system in the United States. That has been a,
uh, a calling, uh, for this organization.
It's been something that has allowed our organization,
all of our 45,000 incredible team members, caregivers,
to come together as a rally cry to say, this is who we are, this is what we do.
This is the special place that we have, uh, in the healthcare ecosystem.
And, uh, with that sort of clear, uh, clarity for vision, uh,
it's really allowed us to continue to examine the decisions that we make,
the investments that we make to help move us forward.
And so at the end of every decision for us at Sanford Health,
we know that there's a patient, and with that sort of is the, uh,
the table stakes for every conversation that we have now,
we layer on top of that,
that strategic aspiration that all the decisions that we make have to be, uh,
leading us towards the, uh, achievement of that strategy,
which is that we want to be that premier rural health system. Sure. That we're,
again,
continuing to extend world-class care to every single patient who we serve. Um,
and I think that's probably been maybe one of the most significant changes for
us. If you think about over these last couple of years, uh,
that's really provided, I think the necessary clarity to help, uh,
chart the future for this organization.
Be Thank you so much for joining us on the podcast today.
This has been such a fun and interesting conversation,
and I look forward to connecting with you again soon.
Yeah, thank you so much, Laura.
Really appreciate the opportunity to be with you today.
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