Sanford Marshfield CEO Dr. Brian Hoerneman: System thriving after merger

Before joining with Sanford Health, the Marshfield Clinic Health System was facing serious financial pressures.

Since the completion of the merger with Sanford Health in January 2025, Marshfield Clinic has seen improved finances and quality metrics. Now a division of Sanford Health, Marshfield Clinic operates 11 hospitals in Wisconsin and Michigan’s upper peninsula. Based in South Dakota, Sanford Health operates 58 hospitals across the upper Midwest.

Dr. Brian Hoerneman, president and CEO of Sanford Health Marshfield, tells Chief Healthcare Executive® that he’s pleased with the strides made since joining Sanford Health.

“For us, it's been a story about strengthening our future, both for our patients and for our communities,” Hoerneman says.

“What we realized from the Marshfield Clinic perspective is, over the last several years, that we needed to find a way to have a sustainable path forward, and that that path where we're not just surviving, that we're thriving,” he says. “And my leadership team and I worked with our board to determine what that path looked like, and that path was going to be most quickly moving forward with a partnership. And so we made that decision to move forward with a partnership with Sanford Health. And it really has been a fantastic decision.”

Hoerneman says he’s encouraged by the success so far, and he’s looking forward to building on that progress.

“We've got a long way to go in a number of different areas, but the partnership has absolutely been additive for us, and we're excited about continuing to move forward,” he says.

• Read more: Sanford Health plans to join with Minnesota health system

Accelerated turnaround

As an emergency physician, Hoerneman is focused on the quality and safety of patient care. He says he’s encouraged by improvements he’s seeing since Marshfield Clinic joined Sanford Health.

The health system has seen fewer falls and fewer patient injuries from falls.

“Working in partnership with Sanford, we've seen improvements in our hospital acquired infections, and reductions in that, great improvements in our sepsis care, top decile performance there, and our ambulatory quality metrics, all of those have gone up. So that's really been terrific,” he says.

From a financial perspective, Marshfield Clinic is seeing the benefits from joining Sanford Health. Marshfield Clinic has seen a $166 million improvement over the last year, Hoerneman says.

He says that he’s pleasantly surprised by the pace of the financial rebound.

“It's accelerated our financial turnaround,” Hoerneman says, calling it a “remarkable improvement in a short amount of time.”

“That was well in excess of what we had expected and exceeded our budget last year,” Hoerneman says. “And we're seeing that sustained going into 2026 so that performance has continued forward, and we're continuing to see the value of the partnership.”

Hoerneman says being part of a larger system has led to efficiencies, and the partnership with Sanford has led to additional expertise in areas such as pharmacy and revenue cycle management.

Sanford Health has committed to investing $500 million into the Marshfield Clinic region over the first five years of the partnership. Hoerneman says that will make a significant impact into the system’s communities and practices.

“We're excited about that, and have some plans on how those are going to be rolled forward,” he says.

• Read more: Sanford Health aims to expand access to care in rural America

Recruiting and retention

With Marshfield Clinic on more stable footing, the system is seeing more success in retaining and recruiting clinicians and other key staff members.

Over the past year, Marshfield Clinic has hired over 1,500 employees, including more than 120 providers, with 32 in primary care, Hoerneman says.

In an encouraging sign, some of those are people returning to the system.

“About 20% of those that had joined us over the last year had worked with us previously, so they've come back to the organization,” Hoerneman says. “They've seen that additional value of the partnership, the stability that's come along with that.”

Hoerneman says the improvement in recruiting and retaining staff has been a welcome development. Many health systems continue to struggle to find and keep good people, and since Marshfield Clinic’s footprint includes swaths of rural communities, that adds to the degree of difficulty.

“Our workforce, our people are absolutely foundational in our ability to deliver care and provide access, and it's just really that simple,” Hoerneman says. “If you don't have the people to be able to give the care at the bedside or in the exam room, it just doesn't happen.”

“It can be more challenging to recruit providers and staff to work in a rural geography,” he says.

Marshfield Clinic has also seen success in recruiting specialty care physicians and surgeons, including those in areas where recruiting is more difficult, such as those in pediatric cardiology, vascular surgery and breast surgery.

“We really have seen some nice success in recruiting and continuing to build on that in ‘26, so that trend has continued from last year into ‘26, but certainly remains an area of focus and where we absolutely need to have those providers to continue the care that we're giving,” he says.

To help reduce some administrative burdens on staff, Marshfield Clinic has rolled out ambient documentation for doctors.

Using AI technology, ambient documentation solutions record and summarize physicians’ conversations with patients, saving doctors time in updating patient records. The technology also allows doctors to have face-to-face conversations with patients, instead of typing into a computer.

“It really does start with culture, and we found that when people feel supported, and when they see that we're delivering really great care, that they stay with us, and then we're able to expand our access. And the ambient listening technology is one of those ways that we're supporting our providers in practice,” Hoerneman says.

Physicians have said the ambient documentation is helping ease their workload. In some cases, doctors who were thinking about leaving the organization changed their mind.

“We've seen a number of instances where we've had resignations that have been rescinded after folks have started using the software,” Hoerneman says.

Coming to fruition

Bill Gassen, president and CEO of Chief Healthcare Executive®, told Chief Healthcare Executive® in an April 2025 interview that he was encouraged by the progress of bringing Marshfield Clinic into the system.

He cited the “cultural alignment” as being key to the success of the consolidation.

“The vision that we had together between Sanford Health and Marshfield Clinic Health System is really starting to come to fruition already,” Gassen said last year.

Hoerneman uses similarly enthusiastic language in working with Gassen, calling him “amazingly personable and genuine.”

“Bill has been consistently fantastic to work with,” Hoerneman says. “His vision for the organization is great. It actually really closely aligned with what we had been doing in the Marshfield Clinic system.”

“So if you think about how we're providing access and providing that world-class care close to home, and how we do that, do that sustainably, Bill's vision for that, for the organization, really resonated with us in the Marshfield Clinic region,” he continues. “And then being able to have his team work with our team, to be able to execute on that, to be able to operationalize that, and see that start to come to fruition, that's really been great. So yeah, we've enjoyed working with Bill a lot.”