Although San Antonio’s biggest health care system is in the midst of the largest expansion in its 30-year history, it’s still not enough – even its newest hospital already is operating at full capacity.

Methodist Healthcare is rapidly expanding to meet the increasing demand for patient care across South Texas. Since 2019, the health system has added five hospitals, six ambulatory service centers, eight freestanding emergency rooms, 15 urgent care centers and four imaging centers to its network. And it’s only getting bigger. Plans are already in place to build medical facilities on the South and West sides of San Antonio.

“A lot of our facilities were at capacity, so we’ve gone through this phase of network expansion, acquisition and building to meet the community where they’re growing,” Methodist President and CEO Dan Miller said. It’s also reinvesting in its existing assets to address “capacity restraints, whether that’s parking access or more inpatient beds.”

In 2019, Methodist saw 1.6 million patients. By 2025, that had increased to 2.6 million.

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“We believe that no one should have to leave San Antonio for care, so we’re always thinking about how we can continue to build programming and capability,” Miller said.

The health care system, which was formed in 1995, operates under a 50-50 ownership agreement with Nashville-based HCA Healthcare Inc. and local nonprofit Methodist Healthcare Ministries of South Texas Inc. Its origins date back to the Methodist Hospital, which kick-started the South Texas Medical Center when it opened in 1963. The health care system currently operates 11 hospitals in the San Antonio area.

New hospitals

In 2020, Methodist opened the Stone Oak Rehabilitation Center after acquiring it from Select Rehabilitation. Three years later, the health system expanded farther north into the Hill Country, purchasing Fredericksburg-based Hill Country Memorial. Later that year, it reopened Forest Park Medical Center, which it had acquired earlier, as Methodist Hospital | Landmark in Northwest San Antonio. Last year, Methodist invested $3.45 million to expand Landmark’s emergency department.

“Landmark is on one of the busiest corridors in South Texas, and we saw an opportunity to really build specialty services there,” Miller said.

In October 2024, Methodist acquired another rehabilitation hospital on the Northwest Side of town, rebranding it Methodist Rehabilitation Hospital | Texsan. The next month, the health care provider opened its Westover Hills hospital, a 180,000-square-foot, 54-bed acute care facility on the West Side of San Antonio.

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“Westover Hills is the largest development in our history for a new facility, and it was a culmination of almost a decade of planning, watching the community grow and hearing a lot from the community stakeholders and the medical staff on how much they would like Methodist Healthcare to be out there,” Miller said.

But after only a year in operation, Westover Hills already has reached capacity, spurring Methodist to work on its next phase of growth.

“We’re going to really need to contemplate a faster growth plan, given it ramped up a lot faster than expected,” Miller said.

Reinvestments

Not only is the health care system experiencing its largest expansion, but it’s also committing at least $450 million to improve existing assets, the biggest such reinvestment it’s made.

Last year, Methodist embarked on a $200 million upgrade of its downtown hospital to keep up with growing demand. Methodist Hospital Metropolitan is adding beds and operating rooms with an additional two floors on top of its existing Women’s Pavilion building, while also building a parking garage.

Additionally, Methodist is spending $104 million to add 54 beds at its Stone Oak hospital, bringing the total number of beds to 299, and to expand and upgrade parking, lab space and other sections of the facility. Located in the growing U.S. 281 corridor, the hospital is operating at capacity.

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It also is investing $146 million to add 78 rooms at its Northeast Side hospital and to renovate the kitchen and cafeteria.

“Historically, over the past several years, the Northeast facility has had over 90% occupancy, so expansion is a must,” said Brandon Webb, Methodist’s chief development officer.

Looking ahead

In 2025, Methodist’s board of directors approved $525 million in capital for its upcoming developments.

“Last year was a record year for capital approval by the board, and ’26 should eclipse that,” Miller said.

Part of its development plan includes a new comprehensive medical campus on the South Side of San Antonio. In 2024, Methodist purchased 9 acres at the southwest corner of South Zarzamora Street and the Loop 410 access road, just north of Texas A&M University-San Antonio. It’s an area that has been historically underserved by medical facilities.

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Designed to be similar to its Boerne campus, it will feature emergency services, medical offices and expanded access to specialists in the area. Methodist plans to break ground on the project before the end of the year and open in 2027.

On the West Side of town, Methodist plans to begin construction on another medical campus in March. Dubbed Blue Skies, the project will feature an $8.5 million freestanding emergency department at U.S. 90 and Military Drive West, according to a filing with the Texas Department of Licensing and Regulation. There also will be medical offices on the site.

Alongside its infrastructure expansion, Methodist has been ramping up staffing to keep up with patient demand.

“It’s been an extraordinary year of record hiring for us,” Miller said. “We’ve helped partner with a number of schools, both in the allied health profession and nursing.”

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In 2024, Methodist launched a graduate medical education program, focused on training resident physicians to address workforce shortages in South Texas. Miller said the health care system’s goal is to become the largest provider of medical education opportunities in South Texas with up to 500 residents by 2036.

“There’s a deficit of primary care, and so over the next 10 years, we’re really looking to grow that pipeline of the next generation of providers that are going to be able to care for our communities,” Webb said.

This article originally published at San Antonio’s largest health care system is racing to keep up with growing demand.