Capturing Value From Health-Care Collaborations

In the wake of the pandemic, collaboration within and among organizations has become increasingly important—if not necessary.

While turbulent times forged new partnerships across all sectors, some of these preserved and further strengthened their key competencies. Chestnut Funds and Anchor Health Properties’ newly launched Chestnut Healthcare Fund II stands as an example of what can be achieved through perseverance and the successful identification of off-market opportunities. Chestnut Healthcare Fund I was launched in 2015 and raised a total of $50 million, which included the acquisition of 52 assets through direct or joint venture transactions.

In an interview with Commercial Property Executive, Anchor Health Properties Chief Investment Officer James Schmid and CEO Ben Ochs, alongside Chestnut Funds CEO Steen Watson, elaborate on their partnerships and how Chestnut Healthcare Fund I’s success fueled their drive to initiate its successor.

CPE: Tell us more about Chestnut Healthcare Fund II. How does the investment vehicle differ from its predecessor, Chestnut Healthcare Fund I?

James Schmid: The new fund is a follow-up to its successful predecessor, which was our initial health-care real estate acquisition fund. The first fund raised just under $50 million in equity, and we have recently completed placement of these funds. The new fund will continue the investment strategy of medical office acquisitions—primarily core and core-plus assets in major U.S. markets—both through direct ownership and through joint venture investments with institutional equity capital.

CPE: Elaborate on the partnerships you’ve created since you launched Fund I.

Ben Ochs: The initial fund has invested across multiple joint venture acquisitions with both The Carlyle Group and Harrison Street Real Estate. Each of these partnerships continues to expand.

CPE: What kind of assets are you targeting and why?

James Schmid: Core and core-plus medical office acquisitions in major markets continue to be the broadest area of focus. These assets continue to offer attractive risk-adjusted returns and ample debt market liquidity to provide leverage and enhance returns. The Anchor platform has acquired over 50 percent of its recent investments in an off-market fashion, allowing for the continued volume of investment opportunities despite increased investor appetite for sector investments.

CPE: What are the markets you are targeting through Chestnut Healthcare Fund II and why?

Steen Watson: The target market focus generally overlaps with the largest 30 U.S. markets, though we have had particular success building scale in markets such as Boston, New York, Philadelphia, Washington, D.C./Baltimore, Charlotte, N.C., Atlanta, Nashville, Tenn., Denver, San Diego and Seattle.

CPE:Tell us more about the factors and conditions that stimulate growth in the aforementioned areas.

Steen Watson: We carefully evaluate factors such as local demand for health-care services, local population trends, local health-care insurance trends, constraints of supply of new facilities, needs of local health-care systems and medical tenancy, and local and state health-care regulations to make informed decisions about investing in a given market and for a given target asset.

CPE: What are the major changes the medical office sector has seen since the onset of the pandemic?

James Schmid: Perhaps the biggest change was the one that didn’t happen. Health systems and their patients continued to need medical office space to handle patient health-care needs. While elective surgeries—typically the highest margin contributor to medical groups and health systems—generally shut down for 90 to 120 days at the beginning of the pandemic, they quickly reopened and regained previous—and backlogged—case volumes.

While telemedicine became a tool for health-care practitioners in certain circumstances, it did not serve as a replacement for physical space to handle true clinical and acuity needs of patients. Going forward, we see telemedicine as a complement to medical office space for lower-acuity and administrative functions, as opposed to a replacement for said space.

CPE: How do you see the sector going forward?

Ben Ochs: An aging U.S. population will continue to drive demand for additional health-care services in the years to come. Health systems will continue to push to capture market share through expansion into strong demographic locations and through the use of modern, efficient outpatient facilities.

Dedicated facilities for inpatient rehabilitation, behavioral health, memory care and substance abuse should continue to be in demand, fueling opportunities for additional development.

 

Source: Commercial Property Executive

After 121 Hospital Sales Over 6 Years, CHS Doubles Down On ASC, Outpatient Growth

Franklin, Tenn.-based Community Health Systems has sold 121 hospitals over the last six years and is nearing the end of a multiyear divestiture plan, and at the same time, the system has invested heavily into the outpatient space, the Nashville Post reported Feb. 19.

Over the same time period, CHS has spent nearly $440 million in developing three ASCs and three freestanding outpatient-based emergency departments, with more in the pipeline.

 “The system pivoted to the outpatient space because the centers are less capital-intensive,” said  Community Health Systems CEO Tim Hingtgen. “We continue our emphasis on the development of service lines, thereby further increasing our acuity levels on the inpatient side. And our investments on the outpatient side are designed to expand entry points into our networks, providing more convenient out-of-hospital care environments that satisfy evolving consumer expectations about the availability and accessibility of healthcare services.”

CHS still operates 85 hospitals in 16 states.

 

Source: Becker’s ASC Review

Medical Office Building Construction Remains Strong In Starts And Completions

Although many healthcare real estate (HRE) professionals correctly predicted that medical office building (MOB) sales would remain strong during the COVID-19 pandemic, they did express some concern that construction numbers would fall as providers would be forced to focus on myriad other concerns than moving into new buildings.

But that hasn’t been the case so far.

“Medical office construction has remained very strong throughout COVID, both in terms of starts and completions,” said Hilda Flower Martin, a principal with the HRE research and data firm, during a Jan. 26 Revista webcast. “Completions slowed a little bit towards the end of the year (2020), but starts remain pretty much in line (with past years), as there was about 20.9 million square feet of MOB space started as of the fourth quarter (Q4) of 2020 on a trailing 12-month basis (TTM). The MOB projects being built are typically well pre-leased and continue to get larger.”

 

Source: HREI