Here's a sensationalized question: Is the age of the hospital ending?
Spoiler alert: No. Hospitals aren't going away, but the data does indicate that, in recent years, more healthcare services and procedures are happening outside the hospital and in community-based outpatient settings, virtually, or at home.
For patients, this shift offers several benefits, from more convenient locations and shorter wait times to transparent pricing, personalized treatment, and flexible care options.
But decentralized care is more than just a change in real estate. It reflects a broader transformation in how modern healthcare is accessed, delivered, staffed, financed, and supported.
We cover the reasons why this shift is happening, and the impact it may have on the companies that support healthcare, in our latest 2026 Industry Pulse Report. Below, we recap the key findings healthcare leaders should know moving forward.
The market forces contributing to decentralized care
The decentralization of care delivery is the result of several demographic, economic, technological, and regulatory factors coming together. The six trends our report covers are:
- More procedures are happening in outpatient settings
- The aging population and chronic disease are driving demand for specialized care
- Concierge medicine and direct primary care are becoming more popular
- Retail clinics are changing the front door to care
- New technologies are making outpatient sites more viable—and more valuable
- Consumers are expecting more from the care they receive
Each trend illustrates how the healthcare ecosystem is changing. Feel free to jump down to the section that's most relevant to you or read on for a more complete picture.
Trend #1: More procedures are happening in outpatient settings
One of the clearest indicators of decentralized care is the movement of surgical procedures into outpatient settings.
Data from Definitive Healthcare’s Atlas All-Payor Claims dataset reveals that certain procedures, such as joint replacement surgeries, are increasingly being performed in ambulatory surgery centers (ASCs) and hospital outpatient departments. At the same time, the number of those same procedures being performed in hospital inpatient settings is declining year-over-year. For example, the percentage of hip arthroplasty procedures in ASCs increased from about 4% in 2019 to nearly 18% in 2023. The same procedure performed in an inpatient hospital setting saw a decrease from 92% to 34% over the same period.
Advances in clinical technology and surgical techniques are certainly among the reasons why we're seeing this trend, but reimbursement also plays a role. Recently, the Centers for Medicare & Medicaid Services limited which procedures could receive reimbursement. That changed in 2026 as CMS began phasing out the Inpatient-Only list, enabling hundreds of procedures to be performed in appropriate outpatient settings.
As procedure volumes—and patients—migrate across the healthcare landscape, commercial leaders need clear visibility into which service lines are shifting, where demand is growing, and which providers need support expanding their outpatient capabilities.
Trend #2: The aging population and chronic disease are driving demand for specialized care
Decentralized care is also being influenced by the growing need for ongoing, specialized treatment, particularly among adults 65 and older, and chronic disease patients.
Some eye-opening statistics to consider:
- The U.S. Census Bureau projects that by 2034, adults 65+ will outnumber children under 18 for the first time in history.
- The National Council on Aging reports that 93% of older adults have one chronic condition, and 80% have two or more.
- Caring for older adults is expected to account for more than 33% of national healthcare spending.
Fortunately, there are opportunities for healthcare-adjacent companies to help providers address this surge in demand. Specialized care will require specialized practitioners, which staffing and recruiting firms can help fill. Meanwhile, certain aspects of caring for older adults and chronic disease patients can be done through telemedicine, remote patient monitoring (RPM), and virtual programs that will need the expertise of technology and medical equipment companies.
Trend #3: Concierge medicine and direct primary care are becoming more popular
Another contributor to healthcare decentralization is the growing popularity of concierge medicine and direct primary care (DPC) models—for patients who can afford such services.
In concierge medicine, patients typically pay a membership fee for enhanced access to a physician. Under a DPC model, patients pay directly for services without billing insurance. While different, both models are designed around a similar promise: providing patients with more direct access to clinicians, building stronger patient-provider relationships, and reducing barriers to care.
And there's evidence the market is moving to accommodate this demand. Research cited by Harvard Medical School found that concierge medicine and direct primary care practices grew by 83% from 2018 to 2023, while the number of clinicians practicing in those models increased by 78%. Nurse practitioners and physician assistants are also becoming a larger part of the workforce in these settings.
Trend #4: Retail clinics are changing the front door to care
Embedded inside pharmacies, supermarkets, and big-box stores, retail clinics are another clear example of care moving closer to the patient.
Definitive Healthcare data shows that patients primarily use retail clinics for routine, preventive, and low-acuity care. Common diagnoses and services include immunizations, screenings, eye care, counseling, and upper respiratory infections, among others.
Understanding where retail-based care is gaining traction can help healthcare-adjacent companies identify new partnership opportunities. Real estate and construction firms can use market data to inform site selection, while healthcare IT companies can provide solutions for scheduling, patient engagement, and care coordination. As care becomes more fragmented, medical and facility suppliers will also need real-time data to accurately forecast demand and chart new supply delivery routes.
Trend #5: New technologies are making outpatient sites more viable—and more valuable
Decentralized care depends on more than physical access points. Providers also need the infrastructure to deliver care across more settings, both in person and online.
Artificial intelligence, telehealth, and RPM tools (among other solutions) are helping make decentralized care more of a reality. Definitive Healthcare data illustrates how providers and patients are using telehealth to diagnose and treat mental and behavioral health conditions. As mentioned before, clinicians are using RPM technology to manage patients with chronic conditions like diabetes and heart disease. AI adds another layer of opportunity for streamlining clinical and operational workflows. AI can support patient communication, appointment scheduling, ambient documentation, medical imaging analysis, energy management, and much more.
Altogether, these technologies are changing what equipment outpatient facilities need to care for patients. As virtual and hybrid healthcare models spread, there are opportunities for financial consultants and real estate developers to partner with providers and better support their needs. It's a trend we're already seeing happen, as Colliers reported that these entities are driving more investment dollars into outpatient facilities and supporting technology-enabled care.
Trend #6: Consumers are expecting more from the care they receive
Finally, the thread we've been weaving throughout this entire post (and the report) is that patient expectations are changing, and the organizations that support healthcare will need to adapt to help providers and grow their business moving forward.
Consumers increasingly expect healthcare to be easier to access, closer to home, simpler to navigate, more transparent in pricing, and more personalized to their needs. These expectations matter a lot, as shown in a 2025 Tebra survey where 42% of respondents said they would change healthcare providers in order to access convenience features such as online appointment booking and patient portals.
For healthcare-adjacent companies, changing consumer expectations create opportunities to help providers make care easier to access while improving the patient journey. Software and IT companies can support scheduling, digital communication, engagement, and price transparency tools. Staffing firms can help providers build teams that facilitate more responsive care models. Real estate and construction companies can help bring facilities closer to where patients live and work, while suppliers and consultants can address the operational needs behind a more convenient, patient-centered experience.
Read the full report
While a decentralized healthcare landscape makes it easier and more accessible for patients to get treatment, in many ways it will make the operational side of the industry more complex. More outpatient facilities means more decisions need to be made around service line expansion, patient leakage, talent retention, data security, care coordination, and much, much more.
It's because of this complexity that data and analytics will be critical for providers and healthcare-adjacent companies alike. Our insights can help healthcare leaders find answers to critical questions like:
- Where is demand growing?
- What service lines, technologies, or use cases should I prioritize?
- Who are my ideal patients or providers?
- How can I best position myself for success moving forward?
To explore the data behind these trends in more detail, download the full 2026 Industry Pulse Report, which includes considerations for the opportunities and challenges healthcare-adjacent companies are facing today. You can also watch our webinar, "Follow the patient," for more insights into healthcare decentralization.
