'Our patients come first:' Why Sanford Health could drop Wellmark coverage. Sioux Falls Argus Leader Oct. 28, 2026 Updated Oct. 29, 2026, 7:02 a.m. CT * Sanford Health has issued a notice to terminate its contract with Wellmark Blue Cross and Blue Shield, effective July 1, 2027. * The dispute centers on Sanford's objection to Wellmark retaining broad authority to unilaterally change contract terms affecting patient care and reimbursement. * For now, patients' coverage and scheduled appointments are not affected, as Sanford remains in Wellmark's network. Sanford Health has moved to end its commercial insurance contract with Wellmark Blue Cross and Blue Shield, effective July 1 unless the two organizations can resolve a dispute over contract terms affecting patient care and reimbursement. A Sanford Health press release published Monday stated that a notice of termination was issued to Wellmark, following months of negotiations between the health system and insurer. At the center of the dispute is how much authority Wellmark has to alter contract provisions after an agreement is signed. Sanford contends Wellmark wants to retain broad authority to change terms affecting how patients receive care and how Sanford is reimbursed. "Sanford Health believes patients deserve healthcare agreements that ensure stability, certainty and protect access to care within their communities, and Wellmark has been unwilling to compromise on its demands for exclusive control of decisions affecting patient care," Sanford stated in a press release. How does this affect patients? For now, Sanford remains in Wellmark's network, and patients' coverage, scheduled appointments, procedures and treatments are not immediately affected, according to the Sanford press release. The negotiations primarily affect Wellmark members and potentially BlueCare patients who receive care at Sanford facilities in South Dakota and Iowa. Lewis Drug pharmacies and Good Samaritan Society long-term locations, both of which are under the Sanford Health system, are not affected. The health care system emphasized in its release that predictable reimbursement and contract terms are particularly important in rural communities, where hospitals and clinics rely on long-term planning to maintain staff, facilities, emergency care and specialty services. The organization continued, stating in the release that uncertainty over payment and contract terms can complicate investments in staff and services and potentially make it more difficult to keep specialty and other care close to home. "Patients in rural communities should not have to travel farther or wait longer to receive care because of decisions made by an insurance company," Joshua Crabtree, M.D., chief physician at Sanford Health stated. "Also, patients should not have to choose between affordable health insurance and access to trusted local healthcare providers. Both matter." Crabtree also noted that health insurance should keep care affordable while ensuring patients can access trusted providers and services when and where they need them. If the organizations do not reach an agreement, Sanford would become out of network for affected Wellmark plans beginning July 1, affecting about 130,000, previous reporting from the Rapid City Journal stated. Patients could still receive care at Sanford, but coverage and out-of-pocket costs would depend on their individual Wellmark plans. Why Sanford is pushing back. According to Sanford's press release, "Wellmark has a history of exercising broad control to change terms in a way that materially affects providers, patient care and agreed upon reimbursement." "This power that they're demanding is not new," Sanford Chief Financial Officer Nick Olson stated. "However, as we approach the expiration of our existing contract with them on June 30, 2027, what we've learned in our existing contract is that they are willing to execute on that power and unilaterally change those key terms of the contract... It has become clear to us we cannot give them that sole authority to continue to be able to change those terms after we sign the contract, and without our consent." Sanford's experience with its other commercial insurers has generally operated differently, "through negotiation and mutual agreement when substantive contract changes are proposed," the health system's release stated. The organization also stated that it wants a new agreement that provides stable reimbursement, preserves local health care services and requires significant contract changes to be agreed upon by both organizations "rather than implemented by one party alone." "Our patients come first. Decisions affecting access to care and the future of local healthcare services must be mutually negotiated, not dictated by Wellmark," Olson stated in Sanford's announcement. "We cannot accept a contract that gives an insurance company the power to change the terms on its own, with consequences for the care our patients and communities depend on." And to answer the question as to whether Sanford's true intention is to steer patients toward its own health plan, as some have speculated considering the timing of the Wellmark announcement during open enrollment, Olson states that "it's simply not true." "We don't talk about Sanford Health Plan in any of our communications. You will not see Sanford Health Plan listed on our website as it relates to this communication," Olson told SDPB. "You'll not see that in any press release or news article. So we're certainly not attempting to direct them to us." Wellmark alleges 'Sanford's eyes are elsewhere' A Wellmark press release published Thursday stated that the insurance company has worked with Sanford Health for "many decades" and that it plans to continue negotiations with the health care organization. "Wellmark is committed to making health care better and managing costs for our members. We also believe our members deserve straight answers," the press release stated. "Sanford Health has raised concerns in public about our discussions, but those concerns pull attention away from the real issue. We believe it comes down to how much Sanford Health wants to be paid." Wellmark argued in the press release that Sanford's requested changes could make it more difficult for Wellmark to control costs for its members, and that the insurer proposed terms comparable to agreements it has reached with other South Dakota health care providers. Wellmark also criticized Sanford's recent expansion and investments outside South Dakota in its press release, including Sanford's recent $600 million investment involving North Memorial Health in Minnesota, as well as other mergers and expansions. "It [Sanford] has also spent hundreds of millions in other states expanding beyond South Dakota, including Michigan, Wisconsin and Wyoming," the company stated. "Even within South Dakota, Sanford Health is buying other hospitals and leaving patients with fewer health care options." Continuing to work 'in good faith' Both Wellmark's and Sanford's press releases stated, however, that the two organizations wish to continue discussions, working "in good faith" over the next eight months before the termination takes effect this summer. "Sanford remains committed to reaching a fair, sustainable agreement that protects patients, preserves access to local healthcare services and supports the long-term health of the communities we serve," the organization stated. That commitment includes market-appropriate reimbursement, dependable contract terms and continued access to critical services patients, Sanford's statement read "Our members come first," Wellmark stated in a press release. "South Dakotans deserve quality care from doctors they trust, at a price they can afford. That's why we welcome continued conversation with Sanford Health... So our members can keep receiving the care they need from the providers they know." Vanessa Carlson Bender is the Business and Entertainment Reporter at the Sioux Falls Argus Leader. Reach her at [email protected]. Deal of the Day Recommendations are independently chosen by its editors. Purchases you make through its links may earn The Public Opinion a commission.

Business Record readers name Wellmark Best Health insurer for 30th year. For the 30th consecutive year, Wellmark Blue Cross and Blue Shield has been recognized by Business Record readers as Best Health Insurance Company. This milestone demonstrates Wellmark's ongoing commitment to serving its more than two million members as a leading health insurance company headquartered in Iowa and South Dakota. It comes at a time when employers continue to manage increasing health care costs and employees are seeking clearer, more convenient ways to understand and use their coverage. "Employers face rising health care costs, while employees want benefits that are straightforward and easier to use - and that is exactly where we are focused," said Cory Harris, Wellmark president and CEO. "We use advanced data insights to help employers identify cost trends and understand the needs of their workforce. We're delivering tools that show members what health care will cost before they get it. And we act on member feedback to remove pain points - including handling behind-the-scenes steps so they don't have to. When benefits work this way, Iowa businesses remain competitive, and employees have clear, simple access to their coverage." Additional recent recognitions reflect Wellmark's continued progress toward creating a simpler, more connected experience: * No. 1 (in a tie) in member satisfaction among commercial plans in the Heartland region (JD Power 2026) * CIO 100 Award for technology that improves speed and decision-making * Corporate Insight digital leader for intuitive navigation and usability Wellmark's commitment also extends beyond health benefits. Through The Wellmark Foundation, the company supports initiatives that advance long-term health in Iowa communities, including the expansion of school-centered behavioral health programs in rural Iowa school districts and supporting advanced, hands-on training for rural first responders through Simulation in Motion - Iowa. These efforts support Wellmark's mission of making health care better for everyone.