For academic health systems, the imperative to expand ambulatory care networks is clear. With inpatient only volumes declining and outpatient procedure volumes projected to grow by approximately 10% in the next five years, extending your brand’s clinical excellence beyond campus boundaries is essential for maintaining your brand’s market position and patient connections.
Yet understanding the need for ambulatory expansion and developing an effective strategy to pursue it are two distinctly different challenges. Many academic institutions already know they need to prioritize ambulatory care. But they struggle with where to begin, including how to align diverse stakeholder interests and define a strategy that balances clinical considerations, patient needs, faculty concerns, financial realities, and competitive positioning.
The high degree of complexity involved in increasing your ambulatory footprint calls for a comprehensive expansion strategy. Here’s what you need to know to get started.
What’s included in an ambulatory expansion strategy?
A comprehensive ambulatory expansion strategy blends market analysis, service planning, faculty and staff availability, and facility development into one cohesive roadmap.
For academic health systems specifically, an expansion strategy identifies how to extend your distinctive brand of clinical excellence into community settings while maintaining seamless integration with your main campus.
In addition, it defines the geographic distribution of outpatient services, the optimal mix of specialties for each location, and how these facilities will connect patients back to specialized campus resources when needed.
A well-crafted strategy addresses both defensive positioning against competitors and proactive growth opportunities in expanding markets. Most importantly, it creates a phased approach to development that aligns with financial realities while maximizing the value of your academic brand in outpatient settings.
The ultimate goal is to create an integrated network that delivers the right care to the right patients in the right places.
How to develop a smart ambulatory expansion strategy
1. Take stock of your current ambulatory care network
Before mapping the future of your academic system’s ambulatory network, you must first take stock of your existing portfolio. Many institutions, particularly those that have grown through piecemeal mergers and acquisitions, lack a centralized, comprehensive understanding of their existing outpatient assets.
A thorough assessment of the following factors will reveal immediate strategic opportunities:
- The geographic distribution of current facilities, including market coverage gaps and/or redundancies and the degree to which existing site locations are convenient and accessible for patients
- The mix of services offered within and across facilities, including gaps, redundancies, and consolidation opportunities
- Facility conditions and lease terms
Let’s take a closer look at the kinds of insights that arise from reviewing facility conditions and lease terms.
Outdated facilities with poor layouts often create inefficiencies and diminish both patient and provider experiences. These aging buildings — which are sometimes hastily leased to establish market presence — may struggle to attract younger physicians who expect contemporary environments with integrated technology and efficient workflows.
At the same time, forthcoming lease expirations provide natural decision points for your expansion strategy. For example, if you have multiple locations clustered near each other with short-term leases, consolidation should be a key consideration as you build your strategy.
A thoughtful consolidation approach might combine three outdated leased spaces into one modern, purpose-built center that is optimally located near retail destinations. This informed strategy enhances patient access, supports physician recruitment, and optimizes financial performance.
As this example demonstrates, the details of your existing ambulatory care portfolio are the foundation from which all strategic decisions follow. Without a clear picture of your current network, you stand to inadvertently create duplication or miss critical opportunities.
2. Assemble a cross-functional team (and consider a strategic partner)
Developing an effective expansion strategy requires input from multiple stakeholders within your institution.
The administrative team holds ultimate accountability for strategy and planning. However, physician leadership is equally critical. The chief medical officer and leaders of major physician groups must participate in strategy development from the beginning. It’s essential that you gain faculty buy-in to ensure your ambulatory expansion strategy can succeed.
Additionally, facility management and real estate specialists — whether at the healthcare system or university level — bring valuable perspective on location opportunities, facility conditions, and future growth potential.
Finally, consider working with an experienced strategic partner like NexCore to facilitate this complex process. Academic health systems face unique challenges when developing expansion strategies. They must balance faculty interests, administrative priorities, and financial realities while staying true to their academic mission.
A third-party facilitator brings objectivity to discussions where stakeholders naturally advocate for their individual interests. CFOs focus on financial sustainability, while clinical leaders prioritize patient volumes and care quality and real estate specialists emphasize location opportunities. Bringing in the voice of patients is critical along with more retail-oriented metrics and expertise. Without expert facilitation, these competing viewpoints can lead to decision paralysis or suboptimal compromises.
An external partner with focused healthcare development expertise brings valuable perspective from hundreds of similar projects, identifying patterns and opportunities that might not be apparent to internal teams. They can guide complex stakeholder groups through structured decision-making processes, ensuring all perspectives are heard while maintaining forward momentum. This facilitation ultimately produces a cohesive strategy that serves the institution’s broader mission rather than any single department’s priorities.
3. Build your expansion strategy
Next, you’ll work as a team to define your expansion strategy and document it in a formal ambulatory network plan. As part of this process, you should:
- Define targeted service areas based on demographic data and trends
- Analyze retail trade patterns to establish where your presence can most effectively serve patient populations
- Examine physician supply and demand throughout your region
- Assess competitive positions
- Identify consolidation opportunities within your existing network
Once you’ve established a clear plan, the focus shifts to service planning. In this critical step, you define the operational heart of your ambulatory strategy by determining which services belong where. For academic institutions, this means objectively weighing which services should remain rooted on your main campus and which ones should shift to an ambulatory setting.
Selecting an appropriate service mix, both within individual locations and across your network, is crucial. The right service complement has the power to increase patient convenience, optimize referral flows, enhance provider collaboration, and maximize reimbursement rates.
This process includes forecasting volume projections for each specialty and developing detailed business plans that validate each location’s sustainability. You should also consider how to strategically backfill the spaces that will become available on campus as designated services move to ambulatory settings.
The result is a clear roadmap for which services should be prioritized in your ambulatory settings versus maintained on your main campus.
Special considerations for academic systems
There are several factors that are unique to academic institutions and which deserve special attention:
- Brand Extension: Your ambulatory centers should embody the same clinical and experiential standards that distinguish your flagship institution. By extending your academic brand into community settings, you differentiate from non-academic competitors while maintaining your reputation for excellence.
- Referral Integration: Design your network to support seamless patient flow between ambulatory sites and your main campus. Focus on creating frictionless transitions as patients move between settings, ensuring coordinated care throughout your system.
- Clinical Synergies: Position your ambulatory services to complement your academic center’s specialized resources. This strategic alignment creates natural referral patterns for complex cases requiring the advanced care that can only be accessed on your main campus.
- Talent Attraction: Modern ambulatory environments with integrated technology and efficient workflows significantly enhance physician recruitment and retention — a critical advantage as competition for clinical talent intensifies.
- Market Reach: In addition to demographic trends, consider your institution’s connections and reputation in surrounding areas. For instance, you might prioritize site locations in areas with higher concentrations of alumni and other populations predisposed to select your brand.
The defensive imperative: why the time to begin planning your expansion is now
As healthcare continues the march toward ambulatory care, the race for outpatient market share is on. Academic institutions that successfully bridge campus excellence with community convenience stand to gain significant competitive advantage, defending market share and maintaining connections across the full spectrum of care.
When considering your ambulatory expansion strategy, remember that inaction poses its own risks. Developing an ambulatory network requires significant runway. Meanwhile, community health systems and physician groups continue to develop modern outpatient facilities at a steady clip. The time for thoughtful, strategic action is now.
Setting an effective strategy is the first step on the journey to expanding your ambulatory care network. It begins with understanding your current position, engaging the right stakeholders, and creating a balanced approach that benefits patients, providers, and your institution. The outcome is a sophisticated and actionable roadmap that enables you to deliver the right care in the right location — maximizing both clinical outcomes and financial performance.