Ascension, Tenet and HCA Healthcare may be some of the biggest names in health system ASC strategy, but they’re not the only ones betting on outpatient growth.
Across the country, more hospitals and systems are expanding ambulatory footprints through new centers, partnerships and joint ventures. In a 2025 VMG Health survey of health system executives, outpatient surgery ranked as the top service line for joint venture partnerships, with more than 60% of respondents naming ASCs as a primary growth interest.
Here’s a breakdown of 10 health systems’ ASC strategies:
AdventHealth
Altamonte Springs, Fla.-based AdventHealth has a well-developed ambulatory strategy focused on strengthening care across the full continuum and expanding its ASC footprint. President and CEO David Banks told Becker’s the system is investing in ambulatory offerings beyond acute care, including wellness and prevention.
“At AdventHealth, our growth strategy is focused on strengthening how we care for people across the full continuum, not just in acute care but also through wellness, prevention and other key points in a person’s health journey,” Mr. Banks said. “We’re deepening our presence in both established and expanding markets by investing in ambulatory care offerings through our primary health division, which includes primary care, home health, virtual care and hospice.”
AdventHealth is also expanding its ASC reach through partnerships and acquisitions. In 2022, it partnered with United Surgical Partners International to open a surgery center in Orlando, Fla. In July, the 90-physician, Winter Haven, Fla.-based Bond Clinic joined AdventHealth, bringing multiple care sites into the system.
The system has also earned national recognition for quality at one of its ASCs. AdventHealth Surgery Center Innovation Tower in Orlando, was recently named one of 37 ASCs recognized by The Leapfrog Group for excellence in quality and patient safety.
Baylor Scott & White Health
Dallas-based Baylor Scott & White Health is expanding its ASC footprint through joint-ownership partnerships and new facility development in fast-growing Texas markets. In December, the system partnered with Brentwood, Tenn.-based Surgery Partners to jointly own the 16-bed Physicians Centre Hospital in Bryan, Texas. Baylor Scott & White, Surgery Partners and the facility’s physicians will share ownership.
“We are committed to offering our patients access to exceptional care close to where they live and work,” Jason Jennings, president of Baylor Scott & White–College Station Region, said in a December news release. “This partnership allows us to further enhance our services and deliver a seamless experience for our community as it continues to grow.”
The system is also adding new ambulatory capacity. In June, Baylor Scott & White opened a new ASC in College Station, Texas, which is expected to accommodate more than 100 additional patients per month. Over the past five years, the system has seen a 30% increase in patients visiting its hospitals and clinics.
Beyond ASCs, Baylor Scott & White is targeting growth in rapidly expanding communities. In July, the system opened Baylor Scott & White Medical Center–Frisco (Texas) at PGA Parkway, located within 24 miles of three of the fastest-growing cities with populations over 20,000.
Bon Secours Mercy Health
Cincinnati-based Bon Secours Mercy Health is scaling its ASC strategy through an expanded partnership with Raleigh, N.C.-based Compass Surgical Partners, with plans to develop more than 30 ASCs. The two organizations initially announced their outpatient surgery expansion partnership in May 2023.
The first ASC under the partnership opened in January 2024. Springfield (Ohio) Regional Outpatient Surgery Center marked the first facility launched through the collaboration. In late 2025, Compass Surgical Partners, Bon Secours Mercy Health and Aligned Cardio also launched the Short Pump Cardiovascular Ambulatory Surgery Center in Henrico, Va. The 8,000-square-foot facility offers procedures including diagnostic heart catheterization, coronary interventions, peripheral interventions, and pacemaker and automatic implantable cardioverter defibrillator implantations.
Bon Secours Mercy Health plans to build ASCs across its footprint and expand into new states. The system said it intends to develop ASCs in all states where it currently operates — Kentucky, Ohio, South Carolina, Virginia, Maryland, New York and Florida — and is also eyeing entry into new markets, including North Carolina.
“Speed to market is critical. Each system will need to weigh build, buy or partner options to find the necessary talent and systems. Health systems will also have to determine the best course of action to retain volumes in their networks while — at the same time — identifying opportunities that will increase ambulatory share and attract new physicians,” David Cannady, chief strategy officer of Bon Secours Mercy Health, told Becker’s in 2024.
CommonSpirit Health
Chicago-based CommonSpirit Health is prioritizing ambulatory growth over hospital acquisitions as part of its broader ASC and outpatient strategy. In the first quarter of 2025, the system added eight ambulatory care sites across six states. Over the past two fiscal years, CommonSpirit has added 90 ambulatory sites, including 34 across nine states in 2025.
“At this point, we’re not focused on hospital acquisitions,” CommonSpirit CEO Wright Lassiter III said on an Oct. 1 investor call. “We’re primarily looking at ambulatory growth to meet the needs of our consumers and align with the future of healthcare delivery.”
The system is building a strategic plan centered on expanding its ambulatory footprint while maintaining financial discipline. CFO Daniel Morissette said CommonSpirit is pursuing partnerships and acquisitions selectively, emphasizing that the system is focused on ensuring major expansions remain financially successful.
CommonSpirit is also investing in large-scale outpatient and surgical facilities. In November, CommonSpirit and NexCore Group broke ground on a 92,000-square-foot outpatient clinic and surgical facility in Folsom, Calif. The Folsom Advanced Surgery Center will include five specialized operating rooms, urgent care, imaging, infusion services and a specialty clinic.
In California, the system is focusing on outpatient access expansion to meet shifting demand. CommonSpirit’s California Division already includes 125 ambulatory sites, and CFO Shelly Schorer said the system sees its strongest growth opportunities in expanding outpatient touchpoints as more procedures move out of acute care hospitals.
“There’s still a need for the acute care setting, but we are seeing more and more services and healthcare procedures moving to the outpatient setting and I think we need to expand our ambulatory care footprint,” Ms. Schorer told Becker’s.
Community Health Systems
Franklin, Tenn.-based Community Health Systems shifted more of its focus toward ASCs and outpatient access points in 2025 as it continued restructuring its hospital portfolio. Leaders pointed to a positive financial trajectory, with net operating revenue exceeding $3 billion, year to date. Adjusted EBITDA for the third quarter reached $376 million, up from $347 million in the prior year, with a 12.2% margin.
President and CEO Kavin Hammons said the company is continuing to invest in key service lines, including specialty practice acquisitions in multiple markets. He cited investments tied to robotic surgery programs as part of the system’s push to strengthen higher-growth outpatient capabilities.
At the same time, CHS reported softer outpatient surgery volume, reflecting headwinds in elective demand. Mr. Hammons said outpatient surgeries were down due to “continued pressure on consumer demand for elective procedures” in CHS markets.
The company has divested seven hospitals in 2025 and is continuing its hospital portfolio restructuring into 2026. On the ASC front, Mr. Hammons said CHS is exploring expansion of certain “access points,” with a heavier emphasis on outpatient care.
Ochsner Health
New Orleans-based Ochsner Health is expanding specialty and ambulatory care services as part of a broader strategy to strengthen key clinical programs and grow outpatient access. CEO Pete November told Becker’s the system plans to build out centers of excellence over the next year, including orthopedics, primary care, neuroscience, transplant and cancer care.
“We also see significant potential in the growth of outpatient and ambulatory care, enabling us to deliver high-quality, convenient care closer to where our patients live and work,” said Mr. November. “These efforts are all part of our commitment to innovation and meet the evolving needs of the communities we serve.”
Ochsner is backing the strategy with major outpatient facility investment. In September, the system opened Ochsner Health Center–Bertrand, a 100,000-square-foot outpatient facility in Lafayette, La., representing a nearly $35 million investment. The renovated center includes 75 exam rooms, 15 treatment rooms and four point-of-care testing rooms, and offers services such as internal medicine, orthopedics and sports medicine.
Sutter Health
Sacramento, Calif.-based Sutter Health is aggressively expanding its ASC footprint, with plans to nearly double its surgery center count by 2030. The system aims to grow from 36 ASCs to nearly twice that number by the end of the decade. Bradley Heaton, CEO of Sutter’s surgery center division, told Becker’s that ASCs are central to the system’s broader access and affordability strategy.
“The ASCs within our system are a critical part of that work and what we’re trying to accomplish as a health system,” Mr. Heaton said. “[E]ven within Sutter Health, we are continuing to expand our footprint with more ASCs and have comprehensive plans to increase access in the coming years. Our goal is to provide more care for patients seeking high-quality, efficient and affordable healthcare.”
Sutter is backing the strategy with major facility redevelopment and new-build projects. The system plans to convert a 60,000-square-foot office building into an ASC and specialty clinic space. The system also plans to construct a flagship campus in Emeryville, Calif., featuring an ambulatory care complex and a 200-bed medical center.
“Patients increasingly want access to care locally, in an affordable and efficient setting,” he said. “ASCs provide that option for surgical care, allowing us, as a health system, to expand into communities where building a hospital or a more complex facility may not be feasible. ASCs fill that niche, enabling us to reach further into the communities we serve and provide a local option for care.”
One major example is a planned $145 million, 106,000-square-foot medical complex in Folsom, Calif., centered around an ASC. The facility is expected to break ground soon and will house specialty physicians, general surgeons, primary care providers and other clinicians in one location.
However, Sutter’s ambulatory pipeline extends well beyond Folsom. Senior Vice President and COO Mark Sevco told Becker’s the system has “well over $1 billion in ambulatory projects right now,” with 27 projects underway across Northern California. Of those, 19 were slated to open in 2025.
TriHealth
Cincinnati-based TriHealth is expanding its ambulatory footprint by investing in its 13 existing ambulatory care centers and developing a 14th facility over the next year. The system is focused on improving convenient access to comprehensive primary and specialty care, as well as lab and imaging services.
“Our mission is to deliver the right care in the right places in the right way to achieve the right clinical outcomes at the right cost,” Mark Clement, president and CEO of TriHealth, told Becker’s. “We have learned that increasingly the ‘right care in the right place’ is preventative care, early detection and better management of chronic conditions, all provided in the more accessible, convenient and affordable ambulatory setting close to home.”
Trinity Health
Trinity Health New York is prioritizing growth in lower-cost outpatient and ambulatory settings, shifting capital away from hospital-heavy investments. 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. Looking ahead to 2026, Trinity Health New York plans to continue expanding primary care centers, orthopedic centers, ASCs and partnerships while growing outpatient cancer services.
“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.”
Other Trinity regions are also investing heavily in new ASCs. In June, Hartford, Conn.-based Trinity Health of New England opened an ASC in Enfield, Conn., a project six years in the making. The $50 million, two-floor outpatient facility — named the S. Prestley and Helen Blake Ambulatory Care Center after a $10 million donation — includes four operating rooms, two procedure rooms and 20 operative bays.
VCU Health
Richmond, Va.-based VCU Health is expanding its ASC footprint while investing in technology, particularly robotics, to support more outpatient surgical care. The system recently broke ground on a new ASC and medical office building in Chesterfield, Va., which will include four operating rooms and two procedure rooms, Sheldon Barr, president of VCU Community Memorial Hospital, told Becker’s.
The system is also leveraging robotics to expand what can be done safely in outpatient settings. VCU Health has robotic surgical suites across multiple locations, including the Short Pump Ambulatory Surgical Center. The robot at the Short Pump ASC enables certain procedures to be performed safely in an outpatient environment, allowing patients to receive care closer to home.
VCU leaders say reimbursement concerns remain a key barrier for some hospitals considering the ASC model. Bernadette Purser, senior administrator of ambulatory surgery at VCU Health, told Becker’s that some organizations are still hesitant to shift procedures into ASCs out of concern about losing reimbursements.
“There’s still a thought process in some hospitals about not wanting to lose reimbursements,” she said. “That’s one reason there’s sometimes a slow migration to the ASC space.”
