HCA, Ascension Double Down on Outpatient Growth
Major health systems are aggressively expanding their ambulatory footprints in response to market shifts. HCA Healthcare is investing heavily in freestanding and ambulatory imaging sites to defend market share. Likewise, Ascension posted a net profit for the first half of 2026 and is directing new investment toward outpatient services.
- The shift to outpatient settings is significant, with ambulatory centers now handling approximately 40% of all radiology volume. Projections indicate that standard outpatient imaging will grow by 10% and advanced imaging by nearly 14% over the next decade, with PET, ultrasound, and CT scans seeing the most substantial increases. - This trend is heavily influenced by payers and employers steering patients toward lower-cost freestanding centers. While hospitals still account for 41.5% of outpatient imaging claims nationally, states like Florida, Arizona, and Colorado show much higher penetration of freestanding imaging facilities. - Consolidation among outpatient providers is accelerating, with large operators like RadNet and SimonMed pursuing aggressive acquisition strategies, often backed by private equity. This trend is leading to larger, multi-site practices, which in turn drives the need for unified IT systems and creates opportunities for radiologists to subspecialize. - The mobile medical imaging market is projected to grow at a compound annual growth rate of 6.73% between 2025 and 2035. Key players in this space include Siemens Healthineers, GE Healthcare, and Philips Healthcare, alongside service providers like Akumin (formerly Alliance Healthcare Services) and DMS Health Technologies. - Persistent workforce shortages for both radiologists and technologists are a critical challenge, with vacancy rates for CT technologists reaching an all-time high of 19.4%. This is forcing departments to adopt new coverage models, such as using teleradiology for overflow and after-hours reads, and to invest in technology to improve efficiency. - Declining reimbursement rates continue to pressure providers. The proposed 2025 Medicare Physician Fee Schedule includes a 2.8% cut to the conversion factor, which follows years of reductions and compels imaging centers to focus heavily on operational efficiency and cost reduction to maintain profitability. - Artificial intelligence is rapidly becoming a standard tool in radiology to enhance efficiency and diagnostic accuracy. As of early 2026, the FDA has approved over 1,000 AI-powered tools for clinical imaging, with applications ranging from workflow triage and automated report generation to flagging suspicious findings in mammograms and CT scans.
