Image by THỌ VƯƠNG HỒNG from PixabayHealth systems are reassessing and expanding their ambulatory care strategies in response to shifting patient expectations, workforce challenges and increasing financial pressures.
That’s according to a new report from the Center for Connected Medicine (CCM) at UPMC Enterprises and KLAS Research.
The report details how midsize to large integrated health systems in the U.S. are developing their strategies, focusing on scalable care models in high-growth or underserved markets. Key areas of interest include multispecialty clinics, ambulatory surgery centers (ASCs) and virtual care platforms.
KLAS Researchers conducted phone interviews with C-suite leaders, senior directors and other executives from 25 health systems — most with more than 1,000 beds — in May and June of 2025 to understand the direction of their ambulatory strategies.
They uncovered that oversight of ambulatory care is increasingly being centralized, with executive-level leaders often responsible, according to those interviewed. Most respondents indicated that their strategy is guided by leaders with systemwide visibility and decision-making authority across clinical programs.
This shift toward centralization highlights the expanding importance of ambulatory care in overall strategic planning, researchers surmised.
Regarding staffing concerns, most leaders surveyed indicated that their health systems have dedicated clinical staff for ambulatory locations, especially for critical roles such as primary care, nursing and support staff.
Although most ambulatory teams are assigned to specific sites and do not switch between inpatient and outpatient duties, some respondents mentioned that their systems use float pools or flexible staffing strategies, allowing clinicians to move between clinics based on demand.
Growth in high-demand markets
Most leaders interviewed said they are focusing on markets and service lines that are most strategically important or have the highest patient demand, as highlighted in the report. While some still aim to expand their geographic reach, they are doing so with more caution and discipline.
Investment priorities include services like primary care, cardiology, oncology, orthopedics and gastrointestinal care. Primary care is vital to most systems and serves as the key driver for patient engagement and subsequent treatment.
Several health systems are increasing investment in these areas, not only to achieve financial benefits but also to ensure equitable access for all patients, researchers noted. In markets where private providers restrict services for public insurance beneficiaries, such as those on Medicare or Medicaid, or for individuals with complex needs, health systems are responding by creating their own integrated services.
Many health systems are shifting surgical procedures from inpatient hospitals to ASCs. This change is especially common in systems with specialized outpatient surgery centers and rising demand for surgeries, as noted in the report.
Most interviewed health systems are shifting toward outpatient surgery, although their progress varies based on factors like capacity, service complexity and financial incentives.
Those with established outpatient programs focus on freestanding centers, which they believe offer better scheduling and higher throughput. Others face challenges such as limited ASC availability or uncertainties about filling inpatient operating room slots.
Overall, most systems see the transition to ASCs as essential for achieving long-term cost savings and improving patient access.
