Building With Heart: Colorado Healthcare Outlook For 2026

Healthcare design and construction across Colorado is entering a new phase — one defined by cost volatility, workforce shortages, evolving reimbursement models, and increasing operational complexity.

These forces shaped the conversation at Building with Heart: Colorado’s Healthcare Outlook 2026, a February panel presented by Society for Marketing Professional Services Colorado (SMPS Colorado) and Colorado Association of Healthcare Engineers & Directors (CAHED).

Before a sold-out audience, healthcare operators, commercial real estate leaders, and A/E/C professionals gathered to examine where the market is heading — and how project teams must evolve alongside it.

Moderated by Conor Ryan, director of business development at Layton Construction, the panel featured:

• Mike Chihoski, UCHealth vice president of facilities, design & construction
• Meredith Wardwell, CommonSpirit Health National Real Estate Team system director
• Jim Hartmann, Nexcore Group executive vice president of real estate development
• David Nelson, AdventHealth executive director of construction and facilities

Cost Certainty Is Reshaping Project Delivery

Escalating construction costs and persistent market uncertainty are accelerating the industry’s move away from traditional delivery models in favor of more collaborative, cost-controlled approaches.

“Anything is better than Design-Bid-Build,” Chihoski remarked — reflecting a broader consensus that integrated models are better suited to today’s environment.

Panelists pointed to the growing adoption of Target Value Delivery, Integrated Project Delivery (IPD), Design-Assist, LEAN methodologies, and real-time estimating. Early contractor and trade partner engagement, transparent cost modeling, and shared-risk frameworks are no longer optional — they are essential to maintaining project feasibility in a tightening capital landscape.

For owners and developers, the mandate is clear: bring the right partners to the table earlier, align expectations from day one, and build teams equipped to navigate uncertainty together.

Capital Strategy And Outpatient Expansion

As reimbursement reform and federal healthcare policy re-enter national debate, healthcare systems are recalibrating how and where they deploy capital.

Outpatient expansion continues to dominate real estate strategy, driven by patient convenience, lower-cost care delivery, and decentralized care models. However, systems are applying heightened scrutiny to every capital decision.

UCHealth shared that it has more than 30 active land-banking transactions across Colorado, each aligned with short-, mid-, or long-term strategic plans. Nexcore Group and AdventHealth emphasized rigorous feasibility studies, due diligence, and master planning efforts designed to “future-proof” investments before capital is committed. CommonSpirit Health echoed that sentiment, noting the organization is doubling down on planning and long-range strategy.

The message to the commercial real estate community: healthcare systems are still investing — but with disciplined focus on long-term operational sustainability.

Workforce Pressures Extend Beyond Construction

Labor challenges emerged as a central theme — not only within construction, but across healthcare operations. Panelists acknowledged a clear imbalance: demand for new facilities exceeds the available workforce of designers, builders, clinicians, and operators required to support them. This strain is reshaping project timelines, intensifying pressure on Planning, Design & Construction teams, and influencing how projects are phased and prioritized.

Yet the operational implications may be even more significant.

“The easiest part of the job is building the hospital,” said David Nelson of AdventHealth. “The real work begins after. There is no ‘soft’ opening — from day one, people are walking through the doors needing lifesaving care.”

For A/E/C teams, that reality reframes success. Healthcare facilities must perform at full capacity immediately upon opening, making activation planning, staffing coordination, and operational readiness just as critical as physical construction.

Designing For Wellness — Without Overdesigning

An audience question addressed another growing concern: with rising staff burnout and workforce shortages, are facilities being designed to support employee wellness?

Panelists agreed that staff respite and mental health considerations are increasingly integrated into design conversations. However, financial constraints require careful balance. Break rooms and respite areas must function as true recovery spaces — not simply overflow work areas. At the same time, owners cautioned against unnecessary complexity.

“Design to fit our needs first — not to win the design award,” one panelist advised.

Healthcare systems are seeking right-sized, operationally efficient solutions that prioritize long-term performance over aesthetics alone.

What Owners Expect From Design & Construction Partners

When asked what differentiates strong project partners, panelists were candid: expertise and transparency matter.

“You are hired to be a subject matter expert,” one panelist emphasized.

The most valuable teams provide informed guidance, respectfully challenge assumptions, and maintain discipline around cost and scope. Transparency, operational understanding, and long-term thinking were repeatedly cited as defining characteristics of trusted partners.

About SMPS Colorado

Founded in 1983, SMPS Colorado is the largest chapter nationwide of the Society for Marketing Professional Services, representing more than 300 members. Its membership includes firm principals, business development leaders, and marketing professionals focused on relationship-building and revenue generation within the A/E/C industry. As a not-for-profit association, SMPS Colorado is dedicated to helping members develop the skills and connections necessary to win business. The chapter hosts programming throughout Denver, Fort Collins, and Colorado Springs, including monthly luncheons and professional development forums.

About CAHED

The Colorado Association of Healthcare Engineers & Directors (CAHED) is a nonprofit organization committed to advancing healthcare facilities management across the state. CAHED brings together healthcare facility leaders, engineers, construction professionals, and industry partners to foster education, collaboration, and innovation within the built healthcare environment. Through educational programs, conferences, and partnerships — including alignment with ASHE — CAHED promotes best practices in healthcare design, construction, and operations.

Source: Mile High CRE