The Top Ambulatory Care Architecture Firms of 2026

From January through May 2026, our team contracted an independent research firm to analyze more than 40 ambulatory care architecture firms operating across the United States, narrowing the dataset to the eight firms whose portfolios, service models, and healthcare specialization most consistently met our weighted benchmark criteria. Each firm was scored using the following factors:

• Integrated Service Delivery, A/E/I/P (30%) – Whether the firm offers architecture, engineering, planning, and interior design under a single roof, eliminating the coordination overhead of multi-vendor delivery
• Ambulatory Portfolio Depth (25%) – The volume, complexity, and variety of ambulatory care facilities in each firm’s completed project record, including ASCs, MOBs, outpatient cancer centers, urgent care clinics, and comprehensive ambulatory campuses
• Healthcare-Sector Exclusivity (20%) – The degree to which each firm’s practice is concentrated in healthcare versus distributed across commercial, residential, or civic sectors
• Average Client Review Score (10%) – Aggregated employer and client satisfaction scores from Glassdoor and publicly available industry reviews, used as a proxy for delivery quality and client experience
• Years of Practice Experience (10%) – Longevity in the healthcare design market, weighted to recognize established firms with multi-decade ambulatory care track records
• Price Range (5%) – Relative fee positioning, used to flag significant cost-accessibility differences across firms

We rank-ordered firms by weighted score. The table below shows the top six performers; in-depth summaries for each follow.

The Top Ambulatory Care Architecture Firms of 2026

In the table below, we break down the six top-ranked ambulatory care architecture firms across all six comparison factors.

1. BSA, for Full-Service Integrated Ambulatory Design

BSA is a national, integrated design firm headquartered in Indianapolis, Indiana, serving healthcare, higher education, and research clients across the U.S. Founded in 1975, BSA operates eight studios and delivers architecture, engineering, interior design, and planning under one roof — a model that supports its strength in ambulatory care, from ASCs and outpatient cancer centers to medical office buildings and urgent care clinics.

What sets BSA apart is the depth of integration: rather than coordinating with outside engineers or interior design subconsultants, its licensed engineers, designers, and planners work as one team from day one. In ambulatory care, where surgical suite HVAC requirements, clinical workflow, and healing-environment design must align precisely, in-house coordination cuts design iteration and change-order risk. BSA is also the only firm in this ranking represented across all five ambulatory specialization categories — ASC, MOB, outpatient cancer center, urgent care, and comprehensive ambulatory care — making it the broadest-scope integrated option for health systems.

• Location: Indianapolis, IN (eight studios nationwide)
• Year Founded: 1975
• Average Review Score: 4.4/5 (Glassdoor)
• Services Offered: Architecture, Engineering, Interior Design, Planning

2. CannonDesign, for Community Health and MOB Design

CannonDesign is a global architecture, engineering, and planning firm with roots dating to 1945, headquartered in New York City. CannonDesign operates through a “Living-Centered Design” philosophy that emphasizes the long-term wellbeing of users and communities, applied across healthcare, education, and science sectors. The firm’s healthcare practice has produced a significant body of ambulatory work, with particular strength in community health centers, medical office buildings, and outpatient facilities for regional and academic health systems.

CannonDesign’s ambulatory portfolio is bolstered by in-house engineering capacity, which gives project teams better coordination between architectural layouts and MEP systems than firms relying entirely on external subconsultants. The firm does not offer interior design as a fully integrated in-house discipline at the depth of BSA or Gresham Smith, meaning some projects engage interior design subconsultants for finishes and furniture specification. CannonDesign’s national footprint and experience with complex health system clients make it a credible option for large ambulatory expansion programs, particularly in community health and MOB-centered programs where healthcare access equity is a design driver.

• Location: New York, NY (offices nationwide)
• Year Founded: 1945
• Average Review Score: 4.1/5 (Glassdoor)
• Services Offered: Architecture, Engineering, Planning, Strategy

3. SmithGroup, for Evidence-Based Interdisciplinary Outpatient Design

SmithGroup’s healthcare practice is built on an evidence-based design foundation, with deep experience in complex science and research environments that translates directly into ambulatory care programs requiring precision in clinical workflow, infection control, and technical systems. The firm’s ambulatory portfolio includes interdisciplinary outpatient clinics, ASCs, and specialty care facilities for academic medical centers and research-driven health systems.

SmithGroup’s strength is its research-forward culture and its capacity to handle technically demanding healthcare programs where design decisions must be grounded in clinical evidence and peer-reviewed literature. Its integrated architecture and engineering delivery covers most ambulatory MEP requirements without external coordination. The firm’s healthcare focus is genuine but not exclusive: SmithGroup also maintains robust science, workplace, and higher education practices, meaning healthcare competes for internal resources alongside other sector groups. For health systems that prioritize a pure-play or near-exclusive healthcare firm, that multi-sector model is worth weighing in the firm selection process.

• Location: Detroit, MI (21 offices nationwide)
• Year Founded: 1853
• Average Review Score: 4.1/5 (Glassdoor)
• Services Offered: Architecture, Engineering, Interior Design, Planning

4. Array Architects, for Ambulatory Surgery Center Specialists

Array Architects is a King of Prussia, Pennsylvania-based architecture and advisory firm founded in 1982, and the only ambulatory care-exclusive firm in this ranking. Array’s entire practice is concentrated on healthcare, with particular depth in ambulatory surgery center design and medical office building projects, including complex ASC-MOB hybrid facilities where surgical and outpatient clinical programs are co-located. Clients now perform 70–90% of procedures in outpatient settings through advanced laparoscopic and minimally invasive surgery, and Array’s specialization positions it precisely at that clinical inflection point in American healthcare delivery.

Array’s focus produces a level of ambulatory surgery center design expertise that generalist firms — whose healthcare revenue is distributed across acute care hospitals, research buildings, and senior living — cannot replicate with equal depth. The trade-off is scope: Array does not offer full in-house engineering services, which limits its integration advantage on programs with complex MEP requirements. For ASC and MOB programs where deep ambulatory design specialization outweighs the need for full A/E/P/ID integration, Array is the strongest specialized option in this analysis. The firm received the Altro 2025 Design Award for NYC Health+Hospitals’ Outpatient Therapeutic Housing Units.

• Location: King of Prussia, PA (multiple U.S. offices)
• Year Founded: 1982
• Average Review Score: 4.0/5 (Glassdoor)
• Services Offered: Architecture, Interior Design, Advisory and Strategy

5. Gresham Smith, for Outpatient Clinic and MOB Design

Gresham Smith is a Nashville, Tennessee-based architecture, engineering, and interior design firm founded in 1967, with offices across the United States and a portfolio spanning healthcare, transportation, and industrial sectors. Gresham Smith’s healthcare practice is well-established, with consistent recognition from BD+C and particular strength in medical office buildings, outpatient clinics, and adaptive reuse projects — repurposing existing buildings into functional outpatient care environments. The firm’s integrated A/E/ID delivery model covers most ambulatory program requirements without external subconsultants.

Gresham Smith’s ambulatory work is distinguished by its flexibility across project scale. The firm handles both large health system outpatient campuses and smaller community clinic programs, with a MOB and outpatient clinic portfolio that reflects consistent delivery across those scales. Its multi-sector practice — which spans transportation, industrial, and infrastructure — means healthcare competes with other disciplines for leadership attention and talent, a factor that pure-play healthcare firms structurally avoid. For health systems seeking a proven ambulatory partner in the Southeast or mid-South with strong MOB and clinic design credentials, Gresham Smith is a well-established and frequently recommended option.

• Location: Nashville, TN (offices nationwide)
• Year Founded: 1967
• Average Review Score: 4.2/5 (Glassdoor)
• Services Offered: Architecture, Engineering, Interior Design, Planning

6. Stantec, for Community Ambulatory Care Campus Design

Stantec is an international architecture, engineering, planning, and interior design firm founded in 1954 and headquartered in Edmonton, Canada, with extensive U.S. operations. Its U.S. healthcare practice includes a dedicated ambulatory care division focused on community-based outpatient facilities, integrated campus planning, and health system network expansion, with an integrated A/E/P/ID model comparable in breadth to BSA, just at much larger scale.

Stantec’s main edge is its depth in community health and campus planning — its planners can design ambulatory networks spanning multiple facilities and geographies, making it a strong fit for health systems pursuing multi-site expansion. The trade-offs of that scale: project team consistency can vary across offices, and since Stantec also works across environmental, infrastructure, and industrial sectors, healthcare doesn’t carry the same organizational priority it might at a healthcare-focused firm.

• Year Founded: 1954
• Average Review Score: 3.9/5 (Glassdoor)
• Services Offered: Architecture, Engineering, Planning, Interior Design

The Top Ambulatory Care Architecture Firms in the U.S. by Specialization

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

1. The Top Ambulatory Care Architecture Firms in the U.S. for ASC Design

2. The Top Ambulatory Care Architecture Firms in the U.S. for Medical Office Building (MOB) Design

3. The Top Ambulatory Care Architecture Firms in the U.S. for Outpatient Cancer Center Design

For health systems beginning an ambulatory care design search, BSA’s integrated team is available to walk through project-specific requirements and delivery options. Contact BSA.