The hub-and-spoke success of ambulatory care: Expanding reach with the help of digital tools

By Nancy Wright, VP Digital Platforms

In a search for better margins, staffing solutions, and more expedited and efficient care, ambulatory services have become a popular focus for hospital systems. Ambulatory care is emerging as one of the most effective levers for health systems to improve margins, alleviate inpatient capacity constraints and expand access—without the capital burden of traditional hospital growth.¹

According to McKinsey and Company, while some areas of healthcare have a murky financial future, ambulatory care may be primed for growth due to site-of-care and at-home care trends.¹ This reflects an aging population that may be less able to travel far for exams, scheduled follow-ups, and other treatments.

But as more systems look to supplement their operations with ambulatory care offerings, there are practical ways to make these investments as effective as possible. Let’s explore some of the factors that organizations should consider in this structural and industry shift.

An extension of the hub

One of the best ways to look at the organization is through a hub-and-spoke model. This means that while the main hospital campus is the system's epicenter, all care centers are connected to it, linking data and protocols in an effort to provide the best possible care.

If protocols and data are all connected across the system using digital tools like integrated scheduling, imaging interoperability, and real-time specialist collaboration, it ultimately helps accomplish the two key goals of most ambulatory centers. First, you can expand your footprint far beyond where most people might typically travel to get care, potentially bringing in more patients and revenue.

Next, it can help bring return-on-investment with the help of technology and remote care capabilities. Shifting appropriate procedures to lower-cost ambulatory settings can help systems reduce cost per case while increasing procedural throughput and freeing inpatient capacity for higher-acuity, higher-margin care.

Getting creative with scheduling

Because ambulatory care centers are more nimble, there are many possibilities when it comes to how you leverage them to support the entire system. The equipment is typically more mobile and can be swapped out to account for different patient needs within the same system.

In light of that, to take pressure off the larger system, one helpful tactic is to group similar procedures and funnel them to different ambulatory care centers. For example, at a care center, you could organize imaging such that one day you’re doing all knee scans. The next day is shoulders, the next is cataracts and so on.

By offloading those procedures to a secondary care center as appropriate, you can help pursue the goal of optimizing care while still gathering valuable information from patients that can then dictate where they go next.

Digital tools help make this possible because specialists can remotely view scans, to be able to ask the technologist for a different image or angle or provide specific feedback on next steps. This can help decrease rescans or additional visits by the patient.

Mammograms are another excellent example of the opportunities available for connected ambulatory care centers. For these scheduled, routine scans, ambulatory care centers can be the perfect environment for them. By investing in mobile units, you can have a full 12-month schedule for patients that meets a common, scalable care need and essentially outsources appropriate procedures it to your ambulatory care centers.

The flexibility of at-home care

Beyond the reconfiguring of procedures, check-ups and routine visits like mammograms and prostate exams, the rise of at-home and telehealth care should be factored into your growth strategy. If you’re serving a wide geographic area, at-home care can work as a strategy in tandem with the patients’ more local ambulatory care centers.

Post-op follow-ups can be more flexible now as people don’t have to travel so far and they can either have an initial post-op check-up at the ambulatory care center or engage in a fully telehealth appointment to determine the need for an in-person evaluation at the main hospital campus.

Leveraging the digital tools available while using ambulatory care centers as a bridge provides a great deal of flexibility that can help you to ease the burden on different care areas within your hospital system as a whole.

Putting it in action

To bring this vision to life, there are certainly “big picture” considerations like digital connectivity and enterprise-wide workflows, but there are also more specific things to address. For example, you will likely need either additional training to relocate some of these procedures to ambulatory centers or have traveling technologists to staff the different procedures at those facilities.

Compliance and organized governance are also key considerations, as your connected care centers must manage data and imaging appropriately. Without strong governance, health systems risk creating fragmented patient experiences, inconsistent clinical protocols and data silos across sites. Centralized oversight and interoperable systems are an essential tool to help avoid these pitfalls.

Sustainable growth

Expansion of care or geographic footprint can come with the risk of compromised care quality or a lack of organization. However, telehealth and digital tools that assist with scheduling, imaging and more, can help create a path where ambulatory care centers can thrive in a hub and spoke model. They can be the first touch point for routine check-ups or exams, or they can be the “path home” for patients who need frequent post-op appointments.

Health systems that deliberately design and operationalize a hub-and-spoke ambulatory strategy—supported by interoperable technology and disciplined workflows—can be better positioned to scale access, protect margins and compete in an increasingly decentralized care landscape.

¹ Neha Patel, Shubham Singhal, "What to expect in US healthcare in 2026 and beyond," McKinsey & Company, last modified January 12, 2026, https://www.mckinsey.com/industries/healthcare/our-insights/what-to-expect-in-us-healthcare.