Ken Holmen leads a $2B health system with 12,000 employees across rural Minnesota. After 30 years as an anesthesiologist, he's now managing 70% government revenue growing at 2-3% while costs climb 5-7% annually. That 4-5% gap compounds every year.

This conversation covers the shift from clinician to CEO, why technology hasn't bent the cost curve despite massive investment, what AI is actually doing in imaging and diagnostics, and how Minnesota's collaborative health culture produces different outcomes. We also get into rural workforce strategies, group purchasing leverage, and the structural math every health system CEO is navigating.

If you're leading through structural headwinds, managing stakeholders with opposing interests, or building long-term infrastructure in short-term policy cycles—this one's for you.

Key Takeaways:

• Why clinician CEOs have an edge (and why it doesn't guarantee success)

• The high-tech vs. high-touch paradox: Epic delivered features, not savings

• AI in production: DAX Copilot smart rooms, imaging inference, diagnostic algorithms

• The "Cadillac problem": patients demanding care that isn't best practice

• US vs. nationalized systems: different cost buckets, different outcomes

• Minnesota's secret: collaboration + public health investment

Chapters:

00:00 Intro & rural roots

01:05 Small-town hurdles & "bumper bowling" mentors

03:23 Path to CentraCare: becoming CEO

05:00 Do clinician-CEOs have an edge?

07:42 Leading the "parts & the whole" of an integrated system

09:34 Scale vs. personal care; today's healthcare headwinds

10:50 Rural labor & demographics: the double whammy

12:41 Building the pipeline: colleges, training, staying local

13:35 Beyond the hospital: community health & rural economy

14:58 North Star: "Making rural life healthier"15:59 Minnesota outcomes, collaboration & "Minnesota nice"

17:48 Fighting complacency: change management & urgency

18:33 Has tech delivered? EHRs, vaccines, robotics

19:15 High-tech vs. high-touch—and why costs haven't fallen

20:37 AI examples: imaging, labs & EHR inference

21:25 Smart rooms & DAX co-pilots in clinic

22:08 Consumer demand vs. best practice (the "Cadillac" problem)

25:16 Comparing systems: U.S. vs. nationalized care

26:37 Panda Health & CAPTIS: buying tech and "stuff" better

27:30 5-10 year outlook: workforce first

29:52 How the CEO role changed: ambiguity & discernment

31:05 Career advice for future clinicians & administrators

32:23 Wrap-up & takeaways

Guest:

Dr. Kenneth Holmen: President & CEO, CentraCare

LinkedIn: https://www.linkedin.com/in/ken-holmen-26149a10/

About CEO Tradecraft:

Real operator stories. No coaching, no hype, no media-trained narratives. Jason Radisson (founder-CEO of Movo, operator behind five unicorns across three continents) talks with CEOs and senior leaders about decisions under pressure, scaling teams, and navigating power, performance, and politics. The plays that actually matter—the ones that rarely get talked about or passed down.

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