Medical Concierges, Telehealth, Experience Define Healthcare Real Estate’s Brand-New World

Around the country, the ways consumers choose to access healthcare is undergoing a seismic shift. And those changes are affecting the locations health providers choose, the space they need and the ways they want to build it.

Patients across all demographics are leaning toward easily accessible, convenient healthcare systems and starting to warm to things like telehealth and digital offerings. Meanwhile, advances in technology are happening at a rapid clip, changing the way healthcare providers now practice medicine and casting uncertainty on how it will be done in the future.

“We really don’t know what these buildings are going to be and look like 10 years from now,” Gilbane Building Co. Vice President Peter Mulcahey said at Bisnow’s National Healthcare East event Wednesday.

“I think, if we all sat here 10 years ago and said, ‘Most of the medicine we want to deliver is through iPad interface and we only want to do critical services within four walls’ …. the reality hadn’t quite set in, otherwise we would have been prepared for where we are right now.”

Medical facility designers could be forgiven for their lack of foresight: The iPad was only announced eight years ago, and back then there were broad questions about whether Steve Jobs’ latest invention had any practical use at all.

As healthcare delivery evolves and more outpatient facilities are developed, Mulcahey said, there needs to be a focus on making sure structures are built to allow for flexibility down the road.

That may mean including more square footage in new or redesigned buildings, he said, to make way for repurposing as needed.

Others said changes to the way hospital services are provided are looming. Just as retail has morphed from physical stores to online, developments in technology will increasingly take healthcare into people’s homes.

“For those whose livelihoods depend on bricks-and-mortar of hospitals, sorry to disappoint you, but the hospital room of the future is likely to be the bedrooms of people across the country,” Partners Continuing Care and Spaulding Rehabilitation Network President David Storto said. “Imagine, for those of you who remember, [1970s TV doctor] Marcus Welby with all the technology that is available today.”

Panelists said treating patients remotely is fast becoming a key element to healthcare. Children’s National Health System in D.C. has been working in telemedicine for two decades, for example, and New York-Presbyterian is one of the largest telehealth providers in the country, according to Chief Strategy Officer Emme Deland.

Still, Deland said, even though telehealth is crucial to supporting patients, the healthcare industry needs to start preparing inpatient facilities for the aging population.

“We’ve done an analysis of what is going to happen over the next 10 years,” Deland told the audience. “If you take into consideration the technology and the population … We will see a slight decrease in the number of discharges, but we will see an increase in the number of patient days because people will be sicker and hospitalized. So we do need to have our inpatient facility [and] we do need to figure out our additional intensive care space.”

These changes are all playing out in healthcare providers’ search for locations, and the type of space they choose.

“You are seeing [a] greater number of practitioners in one space, more one-stop shops, so providing many services under one roof,” said broker Paul Wexler, the head of the Wexler Healthcare Properties Team at Corcoran, who added easy-to-access locations are in high demand.

He and his team recently arranged for a 17K SF outpatient center to go into a former movie theater at 1210 Second Ave. and for a 5K SF obstetrician and gynecologist clinic at 260 East 62nd St., he said.

“As much as retailers are trying to create that experience … healthcare providers are recognizing the same need to create the same experience,” he said. “Everything from the fast and efficient way they move people through the office to the overall experience of checking in and out.”

Mount Sinai Health Real Estate Division Vice President Tom Ahn agreed that type of one-stop shopping option — where you can see a primary care doctor, have blood drawn and get an MRI done in one place — is a major part of his hospital’s expansion.

Earlier this year, Mount Sinai announced a plan to build an 18K SF health center at 55 Hudson Yards, which will serve the companies with offices at the megaproject and the residents who live in the high-end condominiums and rentals there. Ahn said that location will be unique in that it will be a “concierge” health service, which is a path many providers are now taking.

Ultimately, he said, it is about standing out to patients and consumers.

“If we are not convenient and in a good location, providing all those services, we aren’t going to be competitive,” he said. “So that’s an important piece of our strategy, and that’s an important part of a lot of institutions’ strategy right now.”

While carving out that strategy, both in terms of location and service, in the shifting healthcare environment is imperative, panelists said patients will still seek out doctors and practitioners they feel they can trust.

“So [healthcare] is going to be less physical and more digital … A 25-year-old should be using 90% of his healthcare digitally… [for a] 45-year-old that will change, a 65-year-old will use 50% digital,” CityMD CEO Dr. Richard Park said. “AI, technology, that’s all important and needed. But humanity — that is the missing piece of healthcare.”

 

Source:  Bisnow

Fidelis To Develop Five-Story, 100,000 SF Facility For SCL/Saint Joseph In Denver

Fidelis Healthcare Partners, a new healthcare real estate venture established by the same leaders who previously built the successful Trammell Crow Company/CBRE Healthcare Services and Development business, has announced its first project.

Fidelis Healthcare Partners has recently finalized an agreement to develop the five-story, 100,000-square-foot Saint Joseph Medical Office Pavilion on the Uptown Denver campus of Saint Joseph Hospital.

Saint Joseph is one of the leading medical campuses in SCL Health, a non-profit, faith-based health system with 11 hospitals in three states. Saint Joseph Hospital’s new $650 million, 375-bed acute care facility opened in late 2014. The campus was rated one of America’s 50 Best Hospitals by Healthgrades in 2017 and 2018.

The new Saint Joseph Medical Office Pavilion will be located on a prominent 1-acre site on the campus at the intersection of Park Avenue, Ogden Street and 18th Avenue. Three floors will be dedicated to Class A medical office space; the ground floor will house convenience retail and restaurant uses; and the rooftop will offer wellness/fitness and entertainment options. The project also includes ground-level, covered parking for physicians and an adjacent parking lot that will offer free parking for patients, visitors and tenant employees.

Kevin O’Neil, president and CEO of Fidelis Healthcare Partners, says he’s often optimistic when competing for new development deals but, as a start-up company, he knew it would be a challenge to be selected through a competitive request for proposals (RFP) process.

“We were up against some strong, established national healthcare real estate development firms, as well as local firms – seven final bidders in all,” says Mr. O’Neil. “I think one reason Saint Joseph selected our firm is because we brought a great deal of thoughtfulness and creativity to our development concept.

“For example, we developed a plan for how to build the best, most complete patient experience on a relatively small urban edge site. We also devised a solution for parking that would meet everyone’s needs while being included in the cost of development, yet still ensuring affordable rent for physicians.”

“We’ve also had the opportunity to work with a variety of executives within the system over the years, and through that earned their trust and confidence that we would deliver great outcomes for the hospital and their doctors,” adds Mark C. Allyn, chief investment officer with Fidelis Healthcare Partners.

Mr. Allyn also notes, “In addition, after its substantial investment in the replacement hospital, Saint Joseph was looking for a developer with efficient capital who was willing to assume financial lease-up risk for the new pavilion. We assured Saint Joseph’s leadership that we had the resources in place together with long term efficient capital and remain dedicated to meeting their needs.”

Fidelis Healthcare Partners recently finalized a joint venture (JV) with a new capital partner: a major state retirement fund advised by Bentall Kennedy, a leading investment management firm and a longtime partner in previous ventures with Mr. O’Neil and Mr. Allyn.

“We clearly conveyed to the Saint Joseph leadership that the Fidelis principals are committed to giving our full attention to their deal,” he says. “When you hire our firm, you’re going to get us – hands-on healthcare experience and partner-level involvement all the way through.”

Saint Joseph hospital officials said the medical pavilion, which is scheduled to be completed in the second quarter of 2020, will fill an important need.

“The Saint Joseph campus is strategically located in central Denver, adjacent to the downtown business district, the River North (RiNo) area and many thriving residential areas,” says Jamie Smith, president of Saint Joseph Hospital. “In addition to the new 375-bed Saint Joseph Hospital, the campus has two medical office buildings totaling about 250,000 square feet. However, the campus has proven to be so popular that there’s a waiting list for space, and our existing medical office buildings are 99 percent leased. The new medical pavilion, with a mix of retail and medical office uses, will be a fantastic addition to our campus. The new space will be a key to our continued growth, which ultimately means more services and value for the growing central Denver community.”

The owner of the medical pavilion will be Fidelis Healthcare Strategic Partners, a joint venture between Fidelis and the previously mentioned state pension fund advised by Bentall Kennedy, and the property manager will be Fidelis Healthcare Partners. The entire Fidelis consultant team is Denver-based and headquartered. This includes: architect Boulder Associates, contractor Saunders Construction and healthcare broker CBRE-Denver Healthcare Services.

Fidelis Healthcare Partners is affiliated with Houston-based Fidelis Realty Partners Ltd., a real estate development firm with the biggest retail footprint in the Houston area and more than $3 billion in retail assets across the Southwestern United States. Fidelis Healthcare Partners was launched in September 2017 and finalized its joint venture agreement with Bentall Kennedy in September.

Mr. O’Neil said the retail expertise of Fidelis Realty Partners will be a significant asset for leasing and managing the street-level and rooftop retail space in the new Saint Joseph Medical Office Pavilion.

 

 

Healthcare REITs Signal An Increased Focus On Medical Office

It is earnings season, which means real estate companies are diligently releasing their earnings and analysts are intently scrutinizing said reports. Mizuho REITs analyst Richard Anderson covers healthcare REITs and he noticed a trend among the big 3 companies HCP, Welltower and Ventas in their recent releases: they all are emphasizing strategies involving medical office buildings.

To be sure, MOB is a staple among their holdings but as Anderson tells GlobeSt.com, “it just seemed interesting that each of the three highlighted a very specific strategy aimed at approaching the medical office business to some degree, versus past earnings reports.”

He says that:

  • HCP made mention of its joint venture with Morgan Stanley that’s aimed at investing in medical office as well as a new partnership with HCA to focus on the asset class.
  • Welltower is expected to close about $500 million of MOB transactions in the short term. “Also, they have always talked about using their senior housing portfolio as a quasi hanging carrot for medical office, as a medical office feeder.” The REIT has also brought on board a former Duke Realty executive Keith Knokoli, who has strong credentials in the MOB segment. “You don’t make an investment at that level of executive if you’re not serious about the business.”
  • Ventas is re-igniting its exclusivity arrangement with PMB Real Estate Services. It is a medical office developer that Ventas inherited when it merged with Nationwide Health Properties many years ago, Anderson explains. Ventas just re-upped its exclusivity arrangement with the company for the next ten years, he says.

A Lower Risk Profile

What is strange, he says is that “cap rates on medical office assets that are trading hands are still quite low, but nonetheless REITs are maintaining a fair amount of attention toward the space.” Anderson also points out that medical office assets are known for their stability and relatively lackluster growth while skilled nursing is a higher returning asset class that comes with higher risk.

His tentative takeaway: there is possibly a return to risk-off mentality around the corner for healthcare REITs. “Maybe REITs are becoming buyers of medical offices simply because of their low risk orientation, even though the asset class remains quite expensive.”

 

Source:  GlobeSt.