Medical Office Building Investors Will Be Chasing Deals In 2020

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As we prepare to swing into the new year, the outlook for the medical office sector is good…largely.

Underpinning the market, as it always has, is the continual aging of the population and the increased medical services that come along with it.

But, despite this sure-bet demand, the sector is not without its challenges, as Al Pontius, SVP and national director of Marcus & Millichap’s Office and Industrial divisions, makes clear. Those concerns arise as a result of the massive industry trend toward consolidation and the move on the part of many formerly independent care providers to saddle up with national care brands.

The firm’s second-half Medical Office Buildings Report defines the growth of the merger movement:

“Hospital and health-system merger activity continues to transform the medical office sector, driving a reduction in physician-owned practices in recent years. In 2012, nearly half of locations were physician-owned practices, but in 2018, just 31 percent were owned by doctors.”

And therein lie the concerns for the existing stock of medical office buildings (MOB).

“There’s a lot of older-vintage product that’s not located where the health systems want to be,” says Pontius. “Some assets may not accommodate the desired configuration of services that the major health systems see as appropriate, modern enough or technologically supportive enough. Consequently, there are a number of buildings that will under-perform relative to newer properties in the sector as well as other asset classes.”

But while there might be assets that sit on the sidelines as healthcare needs grow, few investors, be they institutional or private, are doing the same.

“The consolidation has supported investor sentiment as major providers create efficiencies and broaden service coverage,” says the report. “A sizable pipeline of new space and major expansions by high-credit tenants will sustain elevated investment activity through the end of this year.”

 

Source: GlobeSt.

What A Future Medical Waiting Room Will Look Like

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With healthcare spending forecast to grow by $2 trillion within the next 10 years, transformational technology coupled with a busy younger generation and aging population means that healthcare real estate spaces will undergo a dramatic makeover.

“Your doctor’s office, for example, may soon resemble your neighborhood bookstore or coffee shop instead go your typical “doc in a box” office. Spaces will be more dynamic mainly because of technology,” says David Wilson, Vice President of Real Estate Development, Ryan Companies, US, Inc.

Overall, there will be a lot more open spaces, more windows, less closed doors, more charging stations, tablets and kiosk registrations, Wilson tells GlobeSt.com. The physician’s waiting room will now help keep the patient calm and informed about the latest in healthcare news, and boost the patient’s sense of well-being.

“Waiting rooms and reception areas will face heightened traffic and will respond by creating a more customer-friendly experience. Competition over these new patients will naturally increase as well and so amenities like technology-friendly waiting room furniture, and a “Starbucks-type” look will become more and more important,” says Wilson. “Patients will be able to settle down at a table and access their electronic medical forms or peruse the latest research on wellness and medications.”

Some medical practices will also start offering 30-minute sessions focused on stress management techniques, yoga, acid reflux, youth sports injuries, etc. All sessions will be led by skilled in-house medical professionals.

“Consumer expectations are constantly changing and healthcare, as well as its real estate spaces, will have to change to fulfill the needs of the Gen X, Gen Y and millennial populations,” says Wilson. “Companies such as CVS and Kaiser Permanente have developed health hubs where both convenience and care intersect for the overall care of the patient. If we think healthcare is convenient now, just wait a few more years and it’ll be even more convenient and at your fingertips. Everyone is so busy now and has no time for long office waits. Convenience will be a bigger factor than it even is now.”

 

Source: GlobeSt.

Wellness Is Critical In Healthcare Investment

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Wellness is the biggest trend rocking the healthcare investment market today. It has become essential to bending the cost curve down, according to healthcare investor and developer Meridian’s John Pollock, and players in the product type should focus on wellness as a means of managing population health.

“Wellness is critical to help bend the cost curve down. Providers and payors have to embrace this mindset and focus on managing the health of the population,” Pollock, CEO of Meridian, tells GlobeSt.com in a recent interview about market trends. “I recently caught up with Ken Gorman, Founder and CEO of Power Wellness. It is clear that focusing on population health vis-a-vi wellness centers is trend that should continue and aligns with Meridian’s mission to help ‘bend the cost curve.’”

Wellness centers have evolved tremendously, and insurance companies are catching on the importance of these services.

“These centers have evolved over the years from small retail-based outlets that were referral only to what Ken calls “Gen 3 Wellness Centers” serve upwards of 6,000 community members and integrated into clinical care pathways,” says Pollock. “Payors are finally realizing that wellness is less expensive than treating chronic conditions and should be reimbursable under Medicare Advantage, most Accountable Care Organization and/or risk-based contracts.”

This is an important trend for both experienced and new players to not. The healthcare market has seen substantial increase in the capital players.

“There has been a lot of entrants into the healthcare real estate space over the past few years, particularly in the value-add space, and it is disconcerting,” says Pollock. “Often new operators don’t truly understand the dynamics of medical office and are at risk because the space is nuanced, users are very particular, and the correct tenant ecosystem is critical to an asset’s success.”

This has also pushed healthcare operators into outlying markets, and as a result, healthcare is expanding in nearly every metro across the country.

“With so much competition in the primary markets, some of my colleagues are seeing opportunities in secondary and tertiary markets where yields can be 100-150 bps higher than in primary markets for similar lease terms and credit profiles,” says Pollock. “At Meridian, for our investment business, we continue to focus on primary markets and look for the opportunities that others don’t see. We believe our unique lens allows us to see opportunities that leverage our core competencies that include entitlement prowess, a seasoned project management bench, intense asset management and access to flexible capital.”

 

Source: GlobeSt.