Health systems across the U.S. invested more capital in ambulatory care in 2025 — a trend several leaders say will accelerate in 2026.
Trinity Health New York, for example, prioritized diversifying revenue streams toward lower-cost sites of care in 2025. The system emphasized new ambulatory clinics and other outpatient sites while deemphasizing capital-intensive hospital investments, according to Steven Hanks, MD, president and CEO of Albany, N.Y.-based St. Peter’s Health Partners and Syracuse, N.Y.-based St. Joseph’s Health.
“That shift from an inpatient focus to an outpatient focus is one that’s been going on for some time, but it really started to take hold in 2025, and I think the timing could not be better,” Dr. Hanks told Becker’s. “H.R. 1, also known as the One Big Beautiful Bill Act, is going to take quite a bit of revenue out of the healthcare system over the next several years. I think all of us are looking at our cost structure and how we maintain the high quality of services and keep them accessible to our communities, and at the same time maintain financial sustainability.”
Looking ahead to 2026, Trinity Health New York is continuing to expand primary care centers, orthopedic centers, ASCs and partnerships to grow outpatient cancer services.
Dover, Del.-based Bayhealth, which operates two hospital campuses and several outpatient centers, also plans to increase ambulatory investments in 2026. One driver is the state’s population growth, President and CEO Terry Murphy told Becker’s.
“At a time when some systems may be retracting on their capital expenditures, we’re using it as an opportunity to continue to grow,” Mr. Murphy said. “So as it relates to outpatient ambulatory practices, ambulatory sites or practitioners, we will be much more active in 2026 to take advantage of the growth in our population.”
Tulsa, Okla.-based Saint Francis Health System is finalizing several hospital capacity projects over the next 18 months, but is now shifting capital toward ambulatory access points, according to President and CEO Cliff Robertson, MD. The system has new clinic locations planned over the next 24 months and is set to take over Carrus Lakeside Hospital in Bristow, Okla., in February. Although the rural hospital has inpatient beds, it functions more like an emergency department and aligns with Saint Francis’ ambulatory strategy, Dr. Robertson told Becker’s.
“We don’t have designs to be multi-state or to acquire hospitals in western Oklahoma,” Dr. Robertson said. “We’re not about that — we’re about improving the health of the populations we serve in eastern Oklahoma.”
He noted that while eastern Oklahoma has sufficient hospital bed capacity, it remains underserved in terms of access to primary care physicians and advanced practice providers.
“We’re doing that both through brick-and-mortar as well as virtual investments,” he said. “We also believe that the best care is care close to home. That’s what’s underpinning our Saint Francis at Home strategy, and that’s also why we are investing in more virtual capabilities.”
At UC San Diego Health, a key focus is improving access for primary and specialty care, CEO Patty Maysent told Becker’s.
“We continue to make investments in our outpatient services, focused on making sure that patients have primary care access close within a 15-minute drive of their home,” Ms. Maysent said. “Access is always a big issue, so we’re watching those scores, and making sure that we’re making improvements.”
As a patient herself, Ms. Maysent said her long-term goal is to simplify the process.
“I just want to be able to get into My Chart and book the appointment that I want,” she said. “We’re not going to get there this year, where I could get into any kind of appointment that I need or want and be able to book it, whether it’s 2 a.m. or 8 p.m. — I don’t have to call, I don’t have to get triaged, I don’t have to go to eight different people — I can just go onto My Chart and get it done. That’s what I would love.”
St. Louis-based Ascension is also betting big on outpatient care. The system is expected to finalize its acquisition of ASC operator AmSurg in early 2026, a deal reportedly valued at about $3.9 billion.
“We truly think this AmSurg partnership will be transformational for our organization,” Amber Sims, executive vice president, chief strategy and growth officer at Ascension, said during a Nov. 3 panel at Becker’s CEO and CFO Roundtable in Chicago. “We really tightened our portfolio and recognized that we have to get ahead in the ambulatory business, because that’s where care is going. It’s where patients want to receive care, where payers want to seek care, and where providers want to provide care.”
