How healthcare expansion is moving care beyond hospitals

Key points:

• • Healthcare is shifting beyond hospitals toward outpatient, home-based, and virtual care.
• • Financial pressures and patient preferences are accelerating more flexible, accessible care models.
• • Providers are expanding services and partnerships to meet growing, aging population needs.

April 2026 — Healthcare expansion is moving care beyond hospitals, with providers scaling outpatient sites, home-based services, and virtual care. Across North Carolina and nationally, systems are rethinking how patients access care, aiming to reduce barriers and meet people where they live.

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Financial pressures and changing care patterns drive this transition. Recent findings from the Kaufman Hall National Hospital Flash Report show hospital expenses remain elevated in early 2026 while revenues are constrained. Softer inpatient volumes and steady lengths of stay suggest care is being redistributed across settings. A growing share of procedures is moving into outpatient and ambulatory environments, with activity projected to increase by about 9% between 2023 and 2028, outpacing hospital outpatient departments and expanding the sector’s scale in the coming years.

Over the next decade, the U.S. healthcare system is expected to place greater emphasis on prevention, personalized care, digital-first access, and services delivered across a wider range of settings. Findings from PwC indicate that nearly 70% of consumers already use health technology monthly, with younger generations more likely to rely on virtual visits, home-based care, and retail clinics. Interest in AI-assisted diagnosis and unified care platforms continues to rise, supporting more flexible, consumer-driven access models. Providers and payers are building out virtual, home-based, and hybrid options, integrating care more directly into patients’ daily lives.

Invest: Raleigh Durham spoke with healthcare leaders across the region to understand how systems, providers, and insurers are expanding access beyond traditional facilities.

James Day, General Manager & Market Growth Leader, Carolinas, Cigna:

The Drive to 2025 investments in virtual tools and resources are strong both in Cigna and the marketplace. We enhanced our telehealth services through our acquisition of MDLIVE in 2021, which became our anchor provider for services such as alignment to a PCP. Our members have access to a full suite of virtual care options including dermatology, behavioral and urgent care. 

We are also redefining how the virtual space interacts with our members. Anytime you log into Cigna resources, it recommends a virtual and in-person option. We have virtual behavioral health, where we have seen huge advancements and growth in popularity. There is a stigma around behavioral healthcare, and many individuals are not comfortable going into a physical office. Virtual services are a gateway for individuals to access behavioral healthcare when they need it. The average American with a behavioral health condition waits 10 years to access behavioral care. When they make the decision to talk to someone, we ensure we get them in front of an individual as quickly as possible. Our Fast Access Network provides behavioral resources and care within a matter of days, as opposed to weeks. Some individuals don’t need to sit in front of a provider; they just need coaching. Adolescent behavioral health is one of the key areas of focus where we see growth. We partner with over 16 different behavioral health vendors and guide members through their journey to find the help that is best for them. This flexibility and ingenuity are mission critical for our members. We are the only healthcare provider that has 24/7/365 live customer service.

Brad Dilday, Executive Director, Springmoor Life Care Retirement Community:

As a campus, we’re essentially at capacity. Apartments fill quickly, and we have a pretty expansive waitlist. Part of our role is continuing to deliver the quality and consistency that residents expect, while maintaining the standard that keeps demand strong.

At the same time, we recognize needs outside our campus. The data and the demographics tell the story. The baby boomer population is coming, and the question becomes whether the region is prepared for that influx. We know our campus alone can’t be the full answer.

That’s why we’ve started expanding into external home care. Springmoor created a home care department over ten years ago to provide services to residents on campus, and in 2024, we expanded the department to provide home care services out in the community. Over the next couple of years, we want to grow that. It’s one way we can help people who want to stay at home, or who aren’t in a position to move to a CCRC but still need support.

We’re also looking at how we use existing space on campus to support aging in place. We have supportive living apartments, and we’re exploring ways to offer different services so residents can bring home care into their apartment and stay in their home throughout changing needs, rather than automatically moving to the next level of care.

As Raleigh grows, I see our role expanding beyond our walls. We’ll keep doing what we do well on campus, but we also want to be a partner to the broader community as needs increase with the rising geriatric population.

Alisha Hutchens, President, Novant Health’s acute care facilities in the Triad Region/Novant Health Forsyth Medical Center/Novant Health Medical Park Hospital:

Our industry must continue shifting care beyond the hospital and expanding access through more affordable outpatient services, ambulatory surgery centers, and virtual care options.

That growth also creates a ripple effect in job creation and economic impact across our communities. A recent study found that Novant Health generated an estimated $18.2 billion of economic activity in North and South Carolina, up from $9 billion in 2018. We are investing in our people, patients, and communities. More than 40,000 team members benefited from over $300 million in pay increases and bonuses in 2025, and we continue investing in training and career development.

Patients remain at the center of every decision we make. In 2025, the Novant Health Cancer Institute became the first in the nation to introduce RapidARC Dynamic, a next-generation radiation therapy. Here in the Triad, Novant Health Forsyth Medical Center and the Novant Health Derrick L. Davis Cancer Institute became the first in the Carolinas to offer histotripsy, a noninvasive treatment for liver cancer.

Rural health is another critical focus. We recently opened an outpatient wellness and education facility in Davidson County near Novant Health Thomasville Medical Center, expanding access to preventive care and specialty services while helping patients manage conditions earlier and avoid unnecessary hospitalizations.

Acute care hospitals will always play a vital role, but we are diversifying our strategy to better meet patients’ needs and turn today’s challenges into opportunities.

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