MARSHFIELD, Wis. (WSAW) – Recovery has been swift for the legacy medical provider, Marshfield Clinic. Its choice in a merger with Sanford Health System has revived the system to the point where it has been able to share its renewed health with the community.
“The new brand campaign is here for all, here for good. And it’s not just a tagline, but it really resonates nicely with not only where we’ve been as an organization, but where we’re headed,” smiled Dr. Brian Hoerneman, President & CEO of the Marshfield Clinic Region of Sanford Health.
A health system on life support
For several years following the COVID-19 pandemic, Marshfield Clinic faced severe financial challenges. It caused programs and whole departments to close, dissolve, or be reorganized. Benefits and pay cuts alongside numerous rounds of layoffs caused uncertainty for staff and patients. Its leader announced her exit soon after.
The health system put an emergency medicine doctor in charge, Dr. Hoerneman, as it continued to navigate that crisis. The Marshfield native has been with the more-than-a-century-old health system for the last 22 years. To this day, he continues to get some rounds in emergency medicine and has previously held a variety of leadership roles.
The revival
Hoerneman told 7 Investigates that Marshfield Clinic’s revival has come from examining its operations.
“Over the last two plus years, we’ve basically looked at every facet in the organization you could think of to make sure we’re being as effective and as efficient as we can be.”
That includes fixing issues with properly billing patients so they get paid for their services, something that was previously a problem.
They also continued searching for a partner after their previous merger plans with Essentia ultimately ended at the beginning of 2024. Internal communication noted the partnership would not have added to Marshfield Clinic’s resources or financial strategy.
Later that year, Marshfield Clinic and Sanford Health jointly announced plans to merge. Sanford Health promised to invest $500 million in capital improvements over the first five years of the merger, along with converting Marshfield Clinic’s electronic medical record and billing system to Epic. That conversion is expected to be complete by the end of 2027.
By the beginning of 2026, the formal merger was completed, turning Marshfield Clinic into a region of Sanford Health. In a matter of a year under the new combined system, it improved its financials by about $166 million from 2024 to 2025. Ratings agencies, Fitch and S&P improved Marshfield Clinic’s borrowing grades back into the As.
“The financial turnaround over the last two years has been nothing short of remarkable,” Hoerneman said.
Road to recovery
Since the merger, Hoerneman said there have been about 1,500 positions added to the Marshfield Clinic region; about 20% of those filled are previous Marshfield Clinic employees.
“That’s been terrific, not only to see them come back, but then also that kind of jump-starts them because they’ve got that familiarity with the organization.”
He said they are working hard to keep them. As the integration of the health systems continues, leadership is working to keep employees informed. That includes an open forum town hall for employees on a quarterly basis at the system level that allows employees to ask any questions they have. As well as an internal communications page that keeps staff and providers informed of the direction the system is heading.
“Then at the departmental level, holding those department meetings, being able to cascade that information down. ‘OK, this is what’s going on in the system. Here’s what it means for our practice. Here’s the steps we’re going to be able to take,’” Hoerneman explained. “So, I’ve been very intentional about that and making sure that those changes are understood and that if there’s (sic) concerns, that those departments get to work through that and understand, ‘OK, this is changing. How does this impact what we’re doing on a day-to-day basis? What can we do to make sure this works well for our practices and our patients?’”
In addition, they are working harder to recognize employees for their hard work.
“One of the partnerships that we have with Sanford Health — they have a long track record of great recognition programs for providers and employees to recognize the great work that they do every day.”
They are ensuring they keep up with the market pay ranges and provide regular raises.
They are also working to promote from within through training their own people. Its nurse residency program is one example. Newly graduated nurses spend a year in the residency program, which includes a mix of bookwork, real-world experiences, and networking with fellow nurses.
“It can be a hard transition coming right out of school to taking care of patients and being more independent. So, that’s been a terrific program; we’re just rolling that out here now.”
Hoerneman explained that the program already existed in other Sanford Health regions. In those programs, he said the nurse retention rate in the first year has been more than 90%.
For their graduate medical programs, he said about 30-40% of the residents who train with Marshfield Clinic stay with the system. Another 70%, he continued, stay within the region even if they do not remain with Marshfield Clinic.
Adding services
As part of the 1,500 new positions, at least 32 are primary care providers. They come at a time when the NewsChannel 7 viewing area is rated as needing at least 19. It is a problem nationwide, with Wisconsin expected to be short about 1,000 providers by 2030.
“Some of the communities before — not only us, but other health systems in the area — were really having a hard time getting patients in to see a primary care provider. So, that’s been great to reduce that amount of time.”
Hoerneman added that the wait times for patients to get an appointment with a primary care provider have been reduced by half, which has set new highs for the patient experience. Not only that, it helps ensure financial sustainability for the health system.
“Part of that is being able to get in to see the provider and do that in a timely fashion,” he explained. “And then all the communication that we do up front, all the communication with our care teams. And then all the way through to making sure when a patient leaves the visit that they understand if they’ve got any obligation from a financial standpoint. So, being able to have all that tied together, we’ve made great progress on that, all those in the last couple of years.”
In addition, while Marshfield Clinic previously dissolved the telehealth department as it was previously structured, it is now expanding. Hoerneman described that they are looking to create access points for patients in their rural geography. The Marshfield Clinic region is participating in Sanford Health’s $350 million virtual care initiative.
For example, a patient near Park Falls who does not have a reliable or strong internet connection at their own home can conduct telehealth appointments with a specialist in Marshfield from the Marshfield Medical Center – Park Falls.
“They can get things jump-started. And if that leads to a procedure later, we can address that in person, but be able to do a lot of that work, a lot of those visits remotely,” Hoerneman explained.
He said specialties that this has worked well in include behavioral health, as well as some inpatient areas inside critical access hospitals and emergency departments. For example, those needing to see an infectious disease consultant while an inpatient at a facility that does not have one on site could see one remotely without having to be transferred out of their home community.
“It’s been part of nonprofit health care is making sure that we’re being as creative as possible to meet that need of the community.”
In addition, within the last six months, Marshfield Clinic opened a new hospital in Wisconsin Rapids and Park Falls, reopened its Cattails Cottage and expanded eligibility for those who can stay, created a new partnership with Veteran Affairs to improve access for veterans, and now offers enhanced mammography screening. Marshfield Clinic has also updated its equipment, like new CT scanners, MRI scanners, and other infrastructure.
“Things like new chillers on the building, not very glamorous, but very necessary for patient care,” Hoerneman added.
They have also upgraded their cybersecurity system following a data breach last year and as new cyber threats continue to emerge.
Program changes that remain
There were cuts and reorganization efforts over the past few years that 7 Investigates reported, which remain today.
SANE
One of the first big changes in 2022 was consolidating the Sexual Assault Nurse Examiner program from both the Marshfield and Weston hospitals, to solely operating out of Marshfield Medical Center – Weston. That remains in 2026. Hoerneman explained through follow-up questions via email that all programs are continuously evaluated, which includes SANE. He noted it is a centralized location for patients, meaning less travel, particularly for those coming from the north.
“Being centralized, that team of highly specialized nurses has been able to develop and then maintain their expertise, being there for patients after a traumatic event. It’s a great model of providing expert care in a sustainable manner in our rural geography.”
After 7 Investigates broke the news of that change in 2022, HealthFirst Network announced it would bring those services back to the Marshfield area.
BBS
Marshfield Clinic has long been the lone resource in the U.S. for families and patients with a rare medical condition, Bardet-Biedl Syndrome. When the program’s coordinator was laid off, families made their concerns known.
At the time, Marshfield Clinic moved the coordination of the BBS program under the direction of a nurse who was coordinating the special needs clinic for the past several years and provides support at the child development center. Today, Hoerneman said the support, treatment, and research continue, leading to new discoveries.
“In 2026 we have 4, four-day clinics where BBS patients from across the country come to Marshfield to meet with providers and staff, and BBS families gather for social activities and interaction. These clinics are a critical to their ongoing care,” Hoerneman answered in a follow-up email. “Our BBS researchers have multiple papers published annually about their work as we try to learn more about the causes and treatments for this rare disease.”
Rural health challenges
While Marshfield Clinic’s financial future is increasingly stable, providing care in a rural geography remains challenging. Vast distances, smaller populations, older demographics with higher care needs, and difficulties recruiting and retaining medical staff in smaller communities are among the difficulties. In addition, medical systems everywhere operate in complex financial structures that often include a mix of governmental, private, and independent payers.
“I think there are a few things as certain as knowing that next year things are going to cost more,” Hoerneman stated. “Supplies are going to be costing more. Medications are going to be costing more. Cost of our workforce will cost more. And at the same time, we’re also confident that there’ll be more challenges on the reimbursement end. And so this is not something that’s new in health care; it’s something over the years we’ve gotten pretty familiar with, and we’ll have to continue to be creative on how we address that and serve communities the best we can.”
Asking about the dynamic between both providing care to patients while also often insuring the same patients through its insurance arm, Security Health Plan, Hoerneman said he believes it is the right model for health care.
“That continuity of coverage is critical for the continuity of care,” he explained. “As long as patients continue to have that ability to afford their health insurance, be able to have access, be able to see their doctor, and not have financial barriers, then they are more consistent in keeping up with their health care maintenance. It leads to better outcomes for their patients, less chronic illness.”
He said it leads to an incentive to keep patients as healthy as possible and prevent chronic illness where possible.
Maternal care continues to be a challenge facing rural health care systems, too. It is one Hoerneman said their team is meeting about constantly.
The challenge lies in the costs to provide care for expectant mothers, both in terms of resources and financials. It is a service that is required 24 hours a day, seven days a week. In order to provide that care, there needs to be shifts of nurses staffed, at least three providers who can deliver a baby to ensure that 24/7 coverage, as well as anesthesiologists and pediatricians available when they are needed. Those providers can be available and have no birthing mothers come for days or weeks, depending on the area.
“It’s not an easy issue. And it’s one that, unfortunately, we’re seeing struggles across the country right now,” Hoerneman said. “It’s one that we’re working– our teams are working on, on a nearly daily basis.”
He said investing back into communities and providing necessary care is what they are working to do despite the challenges facing health care, particularly rural health care.
“I think that’s the message that we’d like to make sure is out there, is (for) people (to) understand that we are here for all, here for good,” Hoerneman concluded. “Now that we’ve worked over the last couple (of) years, that partnership with Sanford Health has really provided fantastic sustainability for us to be able to provide these services for years to come.”
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