Published on Friday, December 5, 2025
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“It is convenient to the patient customer,” according to rinity Health’s Ross Caulum.
SCOTTSDALE, AZ— The rapid shift toward outpatient care is fundamentally transforming healthcare real estate strategy, according to panelists at GlobeSt.com’s Healthcare conference on Tuesday. What began in the 1990s with regulatory changes to diagnostic imaging has evolved into a comprehensive movement toward ambulatory care, convenience and patient-centered delivery.
During a discussion moderated by Healthcare Real Estate Insights Founder Murray Wolf, Trinity Health’s Ross Caulum explained that the outpatient trend has only accelerated. “It is convenient to the patient customer,” he said.
Ambulatory surgery centers cost less to build and operate, although they generate less revenue than traditional hospital settings. Hospitals, meanwhile, work hard to retain provider-based billing advantages—but regulatory pressure continues to push toward more simplified reimbursement structures.
The real estate considerations behind this shift are equally significant. Caulum emphasized that healthcare delivery must be viewed as a production system. Metrics such as patient visits per exam room now drive facility planning. Hospitals are re-evaluating which services truly require inpatient settings, especially as clinical norms shift away from extended bed rest and toward activity and mobility.
Geography also plays a defining role. While places like Boise are seeing population surges “by the truckload,” aging or shrinking markets—particularly in the Northeast—require different strategies. Facilities must be placed where care will be both accessible and economically viable. “It isn’t so much an investment decision as a care investment,” Caulum said.
“If it’s inconvenient, patients won’t come.”
Trinity’s current development pipeline reflects broad demand for flexible outpatient access points, from primary care offices that act as the “first door” into the system to multispecialty clinics offering comprehensive services under one roof. Projects range from simple lease renewals to ground-up construction, driven by shifting demographics and long-term system planning.
Even as outpatient care expands, technology continues to reshape the landscape. Telehealth use surged during the pandemic, but Caulum cautioned against assuming it is a universal solution. It works well for certain conditions and for patients who prefer digital interactions—but not for everyone.
“It isn’t age-dependent,” he noted. “Some people in their 30s struggle with the basics of a computer.” Ultimately, technology must be deployed in ways that meet each patient’s needs without eroding the personal connection fundamental to healthcare.
As hospitals work toward more efficient, cost-effective delivery models, Caulum stressed that relevance—knowing where and how patients want to receive care—will determine which systems succeed.
“We have to be proactive,” Wolf added, “not reactive.”
Check back with GlobeSt.com for more coverage from the Healthcare conference.