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Bellinzona Castello Medical Center: Less of a hospital, more quality

01 July 2026

Curated by Editorial Team

With the opening of the Centromedico Bellinzona Castello, Swiss Medical Network is bringing an outpatient care model to the Sopraceneri region that addresses the most pressing challenges facing the Swiss healthcare system: premium containment, allocative efficiency, and local care.

Bellinzona Castello Medical Center: ua new center in an ancient city

Just steps from the UNESCO World Heritage castles of Bellinzona, the Centromedico Bellinzona Castello was inaugurated in a completely renovated 2.500-square-meter building, scheduled to open in 2025. This multidisciplinary healthcare facility brings together orthopedic, ophthalmological, radiological, and physiotherapy expertise under one roof. The Center is an expression of Swiss Medical Network, one of the two largest private hospital groups in Switzerland, present with 21 hospitals and clinics in 16 cantons.

The facility houses Ars Medica Bellinzona, the outpatient clinic of the Ars Medica Clinic in Gravesano, specializing in orthopedics and outpatient orthopedic surgery. The ground floor features two operating rooms dedicated exclusively to outpatient procedures, the first of their kind in the Sopraceneri region. The second floor houses specialist medical offices and a radiology department, while the third floor houses a physiotherapy center overlooking the castles. The facility is shared with Swiss Visio Bellinzona, the first Ticino branch of the group's ophthalmology and ophthalmic surgery network, which offers medical and surgical treatments for all eye conditions, including laser refractive surgery.

Swiss Visio Network management emphasizes that patients are no longer forced to travel dozens of kilometers for outpatient surgery: the facility is closer to the citizen, eliminating the need for hospitalization, which is more expensive and more demanding for both the patient and the system.

Outpatient before inpatient: a silent revolution

The opening of the center is part of a profound transformation of the Swiss healthcare system, whose guiding principle has become "outpatient before inpatient": any procedure that can be performed on an outpatient basis, without compromising patient safety, must be performed that way. The Federal Council introduced a list of groups of procedures in 2019 that compulsory insurance reimburses only if performed on an outpatient basis, barring justified exceptions. This list has grown from six groups in 2019 to 18 at the beginning of 2023 and is expected to grow further.

The striking data is the European comparison: Switzerland currently performs only about 20% of eligible surgical cases on an outpatient basis, compared to 60% in Nordic countries and a European average of around 50%. This difference is not accidental: it is the result of distorted structural incentives that for decades have favored hospitalization over outpatient care.

The funding issue: why outpatient care cost more in premiums

Until now, a paradoxical asymmetry has existed in Swiss healthcare financing. For inpatient treatments, the cantons cover at least 55% of the costs, while health insurers cover a maximum of 45%. For outpatient treatments, however, the costs fall entirely on compulsory insurance, and therefore on the premiums citizens pay each month.

The result is somewhat paradoxical: despite being clinically less complex and less costly in absolute terms, an outpatient procedure generates additional burdens for premium payers compared to a hospital stay. This mechanism has for years created the wrong incentives: hospital facilities geared toward inpatient care, delays in transferring patients to more appropriate and cost-effective care, and ongoing pressure on health insurance premiums. The average monthly premium in Switzerland reached 393 francs in 2026, with structural increases year over year.

The EFAS (Uniform Financing of Outpatient and Inpatient Services) reform, approved by the Swiss electorate on November 24, 2024, with 53,3% of the vote, is intended to correct this distortion. Starting January 1, 2028, all outpatient and inpatient healthcare services, and, from 2032, long-term care, will be financed according to a single distribution: the cantons will contribute at least 26,9% and health insurers will contribute at most 73,1%. The goal is to eliminate false incentives, promote appropriate care, avoid unnecessary hospitalizations, and stabilize premiums.

Integrated care: the systemic response

The new Bellinzona center is more than just a surgical facility: it's an integrated care hub based on a seamless care model: the same patient undergoing orthopedic surgery in the operating room on the ground floor will find a follow-up specialist appointment on the second floor, and rehabilitation physiotherapy on the third. Furthermore, access to diagnostic imaging is internal. Emergency care has direct access to the operating block. There are no redundant steps or interruptions in the care pathway.

In Ticino, this model is part of a broader network: the Sant'Anna Network, a cantonal integrated care platform that brings together hospitals, specialist centers, and outpatient services in a coordinated ecosystem. The goal is smart dehospitalization: reducing inappropriate hospitalizations not by cutting services, but by building quality alternatives closer to the patient.

Integrated care produces documented effects on three levels. First, they reduce the fragmentation of the treatment pathway, which is often the main cause of inefficiency and clinical errors. Second, they enable proactive management of chronic conditions, avoiding exacerbations and emergency hospitalizations, which place the greatest burden on the system. Third, they lower per-patient costs while maintaining or improving clinical outcomes; this is what is technically called value in healthcare.

Proximity and sustainability: two sides of the same coin

The opening of an outpatient surgery center in the heart of Bellinzona responds to a specific regional need. Until now, the Sopraceneri region (Bellinzona and its surrounding valleys: Blenio, Leventina, and Riviera) lacked a private outpatient surgical facility in the cantonal capital. Residents were forced to travel to Lugano or the public hospital for procedures that could be managed locally, with a lesser impact on the patient's quality of life and overall system costs.

Proximity isn't just a matter of convenience: it's a lever for systemic efficiency. A patient receiving care close to home doesn't miss workdays, doesn't involve family members in travel, and doesn't face the additional costs that often deter preventative care and checkups. In a system that rightly focuses on premium costs, the total cost of the illness for the patient and the community must also be considered.

A concrete response to a systemic challenge

Health insurance premiums are rising because costs are rising. Costs are rising for many reasons: demographic, technological, and pricing. But they're also rising because the system hasn't yet shifted enough care to the most appropriate and efficient settings. A concrete response is the integrated outpatient model, implemented with clinical rigor and intelligent design of spaces and pathways.

The Swiss Medical Network's Bellinzona Castello center is an example of this approach. Two specialized operating rooms, integrated specialists, in-house diagnostics, and integrated physiotherapy: not a clinic that reduces costs by cutting services, but a facility that reduces costs by improving care. It's a distinction worth highlighting in a public debate where savings and quality are often presented as opposites.