Purpose <p>Cancer care requires coordination across several clinical and supportive care specialties. Patients often need multidisciplinary teams to receive guideline-supported care; however, little is known about patients’ perceptions of care team selection and coordination, particularly in the context of a rural hub-and-spoke health-care system.</p> Methods <p>In this qualitative study, we conducted semi-structured interviews with patients regarding breast, lung, or colorectal cancer who received treatment at a large, rural academic health system. The cancer multi-team systems (cMTS) framework guided interview coding and analysis.</p> Results <p>We conducted interviews with 11 breast, 11 lung, and 12 colorectal cancer patients. The mean participant age was 66 (range: 34–85); 56% were female, and 41% lived in a rural area. Half (<i>n</i> = 17) received care only at the central hub location, with most remaining participants (<i>n</i> = 13) receiving care across both hub-and-spoke facilities. Results include two main themes: 1) patient preferences, including past experience, interpersonal factors, and practical issues, drove patient care team and facility selection; and 2) patient experiences with providers influenced perceptions of team-based care and teaming processes. We did not discern differences between participants whose care teams were colocated at the hub hospital compared with those spanning hub-and-spoke. We used the cMTS framework to illustrate the inputs and processes most relevant to this study population’s decisions and perceptions regarding care delivery.</p> Conclusion <p>Findings contribute to our understanding of patient preferences related to care team selection. These factors could be important in shaping future development of multidisciplinary cancer care teams.</p>