The Top Healthcare Architecture Firms in Raleigh

Between January and May 2026, our team contracted an independent research firm, which compiled a dataset of 18 healthcare architecture firms with active operations in the Raleigh–Durham metro area. We evaluated each firm against the following weighted criteria:

• Healthcare Project Experience (30%) – Depth and breadth of completed hospital, cancer center, emergency department, research, and specialty healthcare projects
• Raleigh/NC Market Presence (20%) – Active local office and documented North Carolina project history
• Integrated Services — A/E/P + Interior Design (20%) – Whether the firm delivers architecture, engineering, planning, and interior design under one roof
• Evidence-Based Design Commitment (15%) – Published research, EDAC-certified staff, Center for Health Design recognition, and data-driven design methodology
• National Industry Rankings (15%) – Placement on BD+C Giants 400, Modern Healthcare, AIA awards, and comparable industry benchmarks

We then rank-ordered all firms using a weighted scoring system applied to each factor. The table below shows the top performers; in-depth reviews follow for each firm.

The Top Healthcare Architecture Firms in Raleigh in 2026

In the table below, we break down how Raleigh’s leading healthcare architecture firms compare across all five factors.

1. BSA, for Integrated Healthcare + Research Design

BSA is a 100% employee-owned architecture, engineering, interior design, and planning firm founded in Indianapolis. The firm operates a Raleigh studio at 510 Glenwood Avenue, making it a genuinely embedded partner in the Triangle’s healthcare and academic research market.

BSA’s local project portfolio is among the deepest of any firm on this list: completed work includes the UNC Health Rex Cancer Care, the WakeMed Cary Hospital Patient Tower Vertical Expansion, a stand-alone emergency department for WakeMed in Wendell, and the Wake Tech Perry Family Simulation Hospital at Wake Technical Community College in Raleigh.

What separates BSA from most competitors is its truly integrated delivery model. Architecture, MEP engineering, interior design, planning, and commissioning all operate under one roof, removing the coordination friction that arises when hospitals or developers engage multiple separate firms. BSA’s design process is data-driven and research-led: the firm earned a Gold Touchstone Award from the Center for Health Design for its evidence-based design process on the UNC Health Rex Cancer Center, and was ranked #8 among Top Architecture Firms in the Modern Healthcare Construction & Design Survey.

• Location: Indianapolis, IN (Raleigh Studio: 510 Glenwood Ave, Suite 321, Raleigh, NC 27603)
• Average Review Score: 4.7/5.0
• Services Offered: Architecture, MEP Engineering, Interior Design, Planning, Commissioning, Sustainability

2. Flad Architects, for Healthcare + Health Sciences Facilities

Flad Architects is a national planning and design firm founded in Madison, Wisconsin, in 1927. Today, the firm operates from ten offices across the United States, including a Raleigh studio at 555 Fayetteville Street, placing it directly within the Triangle’s growing healthcare and research corridor.

Flad specializes in three closely linked sectors: healthcare, higher education, and science and technology. In North Carolina, the firm has been active in the academic health sciences market, including work at NC State University. At the national level, Flad’s healthcare portfolio spans major academic medical centers, hospital expansions, specialty care clinics, and advanced research facilities.

Flad’s value proposition for Raleigh healthcare clients centers on research-informed design and deep technical expertise in complex facility types, particularly laboratory-integrated clinical buildings and health sciences education environments that are increasingly common in the Triangle’s academic medical ecosystem.

• Location: Madison, WI (Raleigh Studio: 555 Fayetteville St, Suite 400, Raleigh, NC 27601)
• Average Review Score: 4.0/5.0
• Services Offered: Architecture, Planning, Interior Design, Science & Technology Facility Design

3. Gresham Smith, for Full-Service Southeast Healthcare A/E

Gresham Smith was founded in Nashville, where healthcare remains the firm’s founding and largest practice area. In the Carolinas, Gresham Smith operates from a Charlotte studio and has delivered significant projects for regional health systems, including the Novant Health Forsyth Medical Center Critical Care Tower Renovation and Expansion in Winston-Salem, NC.

The breadth of Gresham Smith’s integrated capabilities is substantial: architecture, interior design, MEP engineering, planning, experiential design and wayfinding, commissioning, and advisory and consultancy services are all delivered in-house.

The firm employs EDAC-certified staff, publishes ongoing applied research on topics ranging from oncology facility design to AI’s role in healthcare visualization, and has been recognized twice as a Fast Company World’s Most Innovative Company. For health system executives in Raleigh managing large or complex projects, Gresham Smith brings regional proximity via Charlotte alongside nationally scaled healthcare design expertise.

• Location: Nashville, TN (Charlotte Studio serves the Raleigh/NC market)
• Average Review Score: 4.2/5.0
• Services Offered: Architecture, MEP Engineering, Interior Design, Planning, Advisory Services, Experiential Design & Wayfinding, Commissioning

4. Clark Nexsen, for Institutional & Health Sciences Design

Clark Nexsen is part of the JMT family of companies and maintains an active Raleigh office. The firm’s healthcare-adjacent portfolio centers on health sciences education, simulation, and research infrastructure.

Clark Nexsen designed the WTCC Health Sciences Building in Raleigh, the Henderson County Health Sciences Center, and the Health and Human Sciences Building at Western Carolina University. The firm was named the 2017 AIA North Carolina and AIA Triangle Firm of the Year, and has received four AIA North Carolina design awards in a single recognition cycle.

Clark Nexsen is a well-suited partner for health systems, universities, or real estate developers commissioning health sciences education buildings, simulation hospitals, or research-adjacent infrastructure on or near academic medical campuses in the Triangle.

• Location: Virginia Beach, VA (Active Raleigh, NC office)
• Average Review Score: 4.4/5.0
• Services Offered: Architecture, Engineering, Planning, Interior Design

5. O’Brien Atkins, for Interdisciplinary Research Triangle Design

O’Brien Atkins stands as one of the most deeply established architecture and engineering firms native to the Research Triangle Park. The firm holds the distinction of being the inaugural winner of the American Institute of Architects North Carolina Firm of the Year award.

In healthcare-adjacent work, the firm has designed the Wake County Public Health Building in Raleigh and civic and institutional facilities across the Triangle. O’Brien Atkins is a strong candidate for healthcare real estate developers and public health agencies seeking a trusted, locally embedded firm with deep institutional credibility in the Triangle market.

Its familiarity with the region’s stakeholders, government agencies, and campus development environments adds meaningful value for RTP and Wake County-specific projects. That said, O’Brien Atkins’ core specialties lean toward science, technology, academic, and corporate environments rather than acute care or hospital programming.

• Location: Research Triangle Park, NC
• Average Review Score: 3.9/5.0
• Services Offered: Architecture, Electrical Engineering, Planning, Interior Design, Master Planning

6. Little Diversified, for Transdisciplinary Healthcare + Community Design

Little Diversified Architectural Consulting, known simply as Little, was founded in Charlotte and operates a Raleigh-Durham office as part of its six-location national network. The firm carries dedicated practice lines in healthcare, community, retail, and workplace design.

In North Carolina, Little has delivered work for Cape Fear Valley Health System in Fayetteville and VA outpatient facilities, and it maintains an active Raleigh-Durham studio for regional engagements. Little’s healthcare portfolio spans acute care, ambulatory surgery centers, cancer centers, children’s healthcare, and outpatient clinics.

The firm’s approach emphasizes evidence-based design, human-centered process, and empathy-led clinical environments. Services include architecture, interior architecture, MEP engineering, land planning, and facilities planning.

• Location: Charlotte, NC (Raleigh-Durham office)
• Average Review Score: 4.1/5.0
• Services Offered: Architecture, Interior Design, MEP Engineering, Land Planning, Facilities Planning

7. Apogee Consulting Group, for Federal & VA Healthcare Design

Apogee Consulting Group was founded in Raleigh by Michael Beezley, with additional offices in Charlotte, Las Vegas, Fort Collins, Minneapolis, and Indianapolis. The firm is a certified Service-Disabled Veteran-Owned Small Business (SDVOSB) and has built its reputation on federal healthcare architecture and engineering, particularly facilities for the U.S. Department of Veterans Affairs.

Notable projects include the Durham VA Cancer Center in Durham, NC; the VA Las Vegas Primary Care facility; and VA specialty care, primary care, and rehabilitation buildings across multiple states. Apogee delivers integrated architecture, MEP engineering, telecommunications design, and healthcare planning under one roof.

Apogee is the most locally headquartered firm on this list and a strong choice for healthcare clients with federal procurement requirements or VA-affiliated design needs in the Raleigh-Durham area.

• Location: Raleigh, NC
• Average Review Score: 3.7/5.0
• Services Offered: Architecture, MEP Engineering, Healthcare Planning, Telecommunications Design

The Top Healthcare Architecture Firms in Raleigh by Subcategory

We also broke down the top firms into three subcategories based on specialty.

1. The Top Healthcare Architecture Firms in Raleigh by Hospital & Inpatient Care Design

2. The Top Healthcare Architecture Firms in Raleigh by Health Sciences & Research Facility Design

3. The Top Healthcare Architecture Firms in Raleigh by Ambulatory & Community Health Design

Frequently Asked Questions

What should I look for when choosing a healthcare architecture firm in Raleigh?

The most important factors are local project experience, service integration, and evidence-based design credentials. A firm with an active Raleigh office and a documented portfolio of completed Triangle-area healthcare projects will understand local permitting processes, regional health system relationships, and site-specific constraints. Beyond local presence, prioritize firms that deliver architecture, engineering, planning, and interior design under one roof. Finally, look for third-party validation of design quality: certifications such as EDAC, recognition from the Center for Health Design, and published research are strong signals that a firm applies rigor to clinical performance outcomes, not just aesthetics.

What is evidence-based design, and why does it matter for healthcare projects?

Evidence-based design (EBD) is the practice of making design decisions based on credible research about how the built environment affects patient outcomes, staff performance, and operational efficiency. In a healthcare context, EBD-informed decisions, such as the placement of nurse stations, the use of natural light in patient rooms, and acoustic separation in ICUs, have been shown to reduce patient falls, lower infection rates, decrease staff fatigue, and shorten hospital stays. For health system executives and developers, commissioning a firm with documented EBD methodology reduces clinical risk and strengthens the case for capital investment. The Center for Health Design’s Touchstone Award, held by BSA for the UNC Health Rex Cancer Center, is one of the highest EBD recognitions in the industry.

How can I tell if a healthcare architecture firm is truly integrated vs. just full-service on paper?

A genuinely integrated firm employs architects, engineers, interior designers, and planners as full-time, co-located staff who collaborate from project inception and not subcontractors brought in at defined phases. Key indicators include: a single contract covering all disciplines, shared project management and BIM workflows, and a track record of delivering complex healthcare facilities without outsourcing MEP or structural engineering. Ask prospective firms directly which disciplines are in-house versus contracted, how many licensed engineers are on staff, and whether their interior designers hold NCIDQ or EDAC credentials. Firms like BSA, which offer architecture, MEP engineering, planning, commissioning, and interior design under one roof, represent the highest tier of integration available in the Raleigh market.

Conclusion

Choosing the right healthcare architecture firm in Raleigh requires weighing healthcare project experience, local market presence, integrated service capabilities, evidence-based design commitment, and national industry recognition. BSA stands out as the top-ranked firm for integrated healthcare, higher education, and research design, combining Raleigh-area project experience with a full-service A/E/P + interior design model.

To learn how BSA’s integrated A/E/P + interior design model can serve your next Raleigh-area healthcare project, Contact BSA for a Healthcare Architecture Consultation.