After Three Collapsed Mergers, Sanford CEO Shares Why Fourth Time’s a Charm [Video]

Sanford Health, the nation’s largest rural health system, kicked off the new year by becoming even larger.

On January 1, Sioux Falls, South Dakota-based Sanford completed a merger with Marshfield, Wisconsin-based Marshfield Clinic Health System. The combined system—operating as Sanford Health—includes 56 hospitals and more than 270 clinics.

Two factors make this integration particularly intriguing.

Sanford, for one, has been working to find a partner for years. Three merger attempts with three entities have fallen through since 2019. Reasons vary, including misalignments on organizational culture, unexpected leadership shakeups and opposition from local stakeholders.

The combination also comes as both public and private entities sound the alarm on health care mergers. Multiple health systems have abandoned merger and acquisition plans in recent years following FTC interference—but only about 1 percent of hospital mergers are flagged by the government agency, according to an April 2024 studyfrom the University of Chicago, Harvard University, Yale University and the University of Wisconsin-Madison. …