Ambulatory Shift Forces Rethink of Perioperative Strategy

The shift of surgical care from hospital operating rooms to ambulatory settings has moved from forecast to reality, and it is changing how health systems plan surgical growth, according to Becker's Hospital Review.

CMS and commercial payers continue to steer procedures into lower-cost outpatient sites and ambulatory surgery centers. That pressure is forcing perioperative leaders to rethink assumptions built around inpatient volume. Instead of adding hospital OR capacity, systems must decide where cases should be performed, how to staff across multiple settings, and how to keep surgeons aligned as work moves outside the main hospital.

In practice, growth increasingly depends on building or partnering on ambulatory surgery capacity rather than expanding traditional operating rooms. Physician alignment becomes central, since surgeons often have a say in where they operate and may have ownership stakes in outpatient facilities. Leaders who cling to inpatient-first models risk losing volume, revenue, and physician loyalty to competitors that adapt faster to the new payment and site-of-care reality.