Healthcare in the United States is currently undergoing the greatest paradigm shift in one-half century. Where is it going? How will it be delivered? What will the hospital look like?
1. Hospitals will be used for the highest level of acuity patients. Integrated care will be around the patient with an emphasis on prevention and wellness. Due to less invasive procedures and advancements in research, ultimately, a reduction of hospitalizations will occur. Systems will continue to push further into the suburbia with different models. Specialty areas of medicine will be available within a certain corridors; don’t expect redundancy though.
2. Size is strength. Systems will consolidate in which community hospitals may cease to exist and systems will be vertically integrated. As the differences between for profit and not-for-profit continue to shrink, they may partner or merge, and not-for-profits could lose their tax-exempt status.
3. An oft-used phrase in the healthcare real estate environment is the “patient-centered continuum of care”; this is the cornerstone between treating disease and illness and prevention and wellness. Medical homes and ACO’s are early responses and will jump-start this model.
4. Specialty areas will focus on those practices that have the greatest profitability. These include cancer, heart, orthopedic and neuroscience, and tied into needs of baby boomers.
5. IT is forcing change. Telemedicine, home monitoring systems, point of care testing, EMR, and data management will impact how infrastructure and physical space is designed. In turn, demand for off-campus land for medical use and small scale medical building components will continue to be impacted negatively.
6. Projects within hospitals will have to become more sophisticated and mission critical, thus, the re-purposing of existing facilities will occur. Under the reimbursement rules, patient satisfaction factors into reimbursement rates. We expect facility directors of older property to meet these challenges when new development is not cost effective or physically possible.
7. The industry now expects sustainable practices. LEED, for a short while, was seen as adding an unnecessary additional expense, but “green” and energy efficiency are now coveted for purposes of costs, community and care.
8. Demographics are of huge focus, both for expanding or maintaining qualified staff and for the diverse, aging patient population.
9. As reform is instituted and buildings become a complex authority for the administration of care, medical real estate will develop into a vast submarket within its own parent, commercial real estate. Actively engaged, specialized contractors will compete to provide innovative, yet more cost effective solutions.
During our conference calls, it is apparent healthcare providers are instituting new policies that make them more competitive over the long run, rather than building the landmarks of the past. This is important as budget conscious US lawmakers and corporate heavies want to see their respective burdens lifted.