<p>The politically driven shift of surgical services to outpatient care represents a profound structural transformation of healthcare delivery. It offers opportunities for patient-centered and resource-efficient treatment, but at the same time entails significant risks for established care structures and existing quality assurance mechanisms. Quality and patient safety depend not on the site of service provision or overnight stay, but on the reliable integration of the entire treatment pathway. Certified care networks, particularly in oncology, have proven to be an effective instrument for ensuring structural, process, and outcome quality. A primarily catalogue-driven shift to outpatient care without structural integration risks fragmenting these achievements. This article advocates for a network-based approach to outpatient care that incorporates certified structures and outlines the necessary health policy framework conditions. Key elements include robust structural prerequisites, systematic risk stratification, and reliable complication management; certification is positioned as a best-practice reference rather than a mandatory requirement.</p>