Posts

Hospitals Buying Real Estate, Revamping Clinical Space For Innovation Hubs

In February, Pittsburgh-based Allegheny Health Network held a ribbon-cutting in Bellevue, Pennsylvania, to unveil a home for one of its newest ventures—AlphaLab Health, which the system hopes will spur innovation and improvements to community health.

The 10,000-square-foot innovation hub, a partnership with Pittsburgh-based startup incubator Innovation Works, is housed in a former hospital owned by AHN. It will serve as the home base for startups participating in AlphaLab Health, AHN’s healthcare and life sciences startup accelerator launched in fall 2020.

“It’s a demonstration of what you can do to repurpose these assets that are aged but have great bones,” said Dr. Jeff Cohen, AHN’s chief physician executive for community health and innovation.

The space gives AlphaLab Health startups access to wet and dry labs to develop products, as well as office space and areas to collaborate and meet with other startups. The startups also receive early-stage funding and opportunities to connect with clinicians and test products at AHN.

The project has involved more than two years and $5 million, including renovations and investments in startups and programing—of which AHN and its parent Highmark Health contributed $2 million.

“Accelerators and other innovation centers became more popular during the COVID-19 pandemic,” said Pam Arlotto, president and CEO of healthcare consultancy Maestro Strategies.

While hospitals have been setting up innovation programs for years, the efforts took on a new focus as the healthcare industry eyed consumerism and pushed to create new care models that engage patients at home and outside of the hospital. They’re expensive projects, usually involving investments in real estate and hiring staff to run the programs.

“Hospitals starting innovation centers have done everything from revamping old clinical or administrative space to building new facilities to house innovation programs,” said Rob Lowe, CEO of Wellspring, a software company that sells products for innovation and research and development programs. “It depends what type of work the hospital needs to do or the form of the incubator itself. Some hospitals create accelerators to identify startups worth partnering with or venture capital arms that invest. Some, like AHN’s, are partially funded through local government as part of economic development efforts. Almost in all cases of these hospitals that we work with around the U.S., we see dedicated space.”

A Hospital Makeover

The vision for AlphaLab Health started in 2019. Cohen, then president of the system’s Allegheny General Hospital, wanted to embark on a community health project. He requested that the health system let him start an accelerator at a nearby facility that Allegheny General was responsible for—a 240,000-square-foot facility about 6 miles away in Bellevue, which closed its inpatient units and emergency department in 2010.

The hospital, formerly AGH Suburban, had transitioned into a nursing facility, but that closed in 2019. AHN continues to operate an urgent care center and outpatient clinics at the facility. It required significant renovations to become AlphaLab Health.

The facility’s intensive-care units were transformed into lab space, patient rooms turned into office space, and waiting rooms became conference space. Startups aren’t charged rent while participating in the accelerator but can choose to continue to rent office space from AlphaLab Health after the six-month program comes to an end.

Cohen is curious whether this model, should it prove successful, could be used in other regions. He said many hospital closures have left vacant facilities in poor areas. In rural areas alone, more than 181 hospitals have closed nationwide since 2005, according to the North Carolina Rural Health Research Program.

But initiatives like AlphaLab Health could help turn around that blight by creating jobs in underserved areas, lifting community health and improving medical care with new innovations. Jobs could serve to decrease the cost of care, since research has suggested employment is a social determinant of health.

To renovate the former hospital, AlphaLab Health raised funds from government, philanthropy and AHN’s parent company Highmark Health. The funding included a grant from the Pennsylvania Department of Community and Economic Development, which will reimburse $500,000 in construction costs from its Redevelopment Assistance Capital Program. More than 181 hospitalshave closed since 2005 in rural areas alone, according to the North Carolina Rural Health Research Program.

Each startup also receives up to $100,000 in funding—half of which is provided by AHN, and the other half from Innovation Works. AlphaLab Health retains 2% equity. AlphaLab Health accepted its first class of seven startups in 2020, six startups in 2021 and received more than 100 applicants each year.

AlphaLab Health is tracking a few metrics to gauge success, including follow-on funding that startups receive after the accelerator. Already, five of the first 13 startups have raised an estimated $10 million in additional funding, Cohen said. Six companies have started tests of their products and five have hired at least one new local full-time employee.

“We’ve been very early, but so far we’re very pleased with the direction of where this is going,” Cohen said.

Spinning Off Innovation

Milwaukee-based Froedtert and the Medical College of Wisconsin launched Inception Health, a program that develops innovations and evaluates digital tools in the market, seven years ago. It’s a separate company owned by Froedtert and MCW, housed in a 10,000-square-foot office space in the health system’s North Hills Health Center.

“The office was previously used for outpatient ambulatory services but was revamped to be a classic innovation space,” said Cathy Jacobson, Froedtert’s president and CEO. “The team needed dedicated meeting areas, since it’s often bringing in external partners and vendors. It couldn’t just be a conference room buried within a hospital. Inception Health was set up as a limited-liability corporation owned and funded by Froedtert so that innovative ideas wouldn’t have to compete for resources with the traditional health system.”

Inception Health’s projects must align with challenges and goals outlined in Froedtert’s strategic plan, such as patient access, consumer experience and population health. The company’s board is made up of C-suite executives from Froedtert and chaired by Jacobson. Inception Health’s annual budget has increased over the years, from roughly $2.5 million in 2015 to $10 million.

“The board evaluates return on investment across the portfolio rather than for individual projects, according to Jacobson. “That factors in care quality and consumer access improvements. We want the ability to experiment and fail.”

Inception Health doesn’t sell services to other health systems. It does have one hospital that pays to be a partner, which means it’s able to deploy tools that Inception Health has developed and assessed. Inception Health is working to onboard another hospital partner.

“Froedtert is still fine-tuning how to design innovations with full-scale deployment in mind, beyond the initial pilot or experiment,” Jacobson said.

While Inception Health’s charter is to develop innovations, it doesn’t implement them. That’s handled by Froedtert’s operations team. Once an innovation is developed, Froedtert’s team will work with Inception Health to pilot the new product or process at the health system. But Jacobson said leadership has realized they need to build up that implementation capacity and dedicate more staff to scaling an innovation across the health system after a successful pilot, similar to how IT workers home in on EHR work during a go-live or upgrade.

“You always staff an EHR implementation,” Jacobson said. “We weren’t doing it with the same rigor with Inception.”

Creating a business plan with next steps for after product development and piloting technology is critical for a successful innovation center, said Ash Shehata, national sector leader for healthcare and life sciences at consulting firm KPMG. That could include how to scale it across the health system for an internal return on investment, as well as considering whether to commercialize the intellectual property and sell to peers.

“Without that business plan, it’s easy to get stuck in a prototype phase,” Jacobson said.

A Pandemic Shift

Cedars-Sinai in Los Angeles has run a startup accelerator since 2016 to connect with early-stage companies.

“The Cedars-Sinai Accelerator provides an entry point for the health system’s work with startups,” said Jim Laur, vice president of technology transfer and business affairs at the system.

It’s a three-month program in which startups work with hospital staffers who have identified problems to develop possible pilots. Cedars-Sinai has hosted seven accelerator cohorts with about eight to 10 startups in each.

“Usually, each class has at least two or three startups that end up launching a pilot and subsequently providing services to the health system,” Laur said.

The accelerator is hosted in the Cedars-Sinai Innovation Space, a two-story, 10,000-square-foot building across the street from Cedars-Sinai Medical Center. Being across the street was important for the accelerator, making it easy for startup founders to walk to the hospital to talk with staff and see workflows in action.

“We thought it would be good to have a space that’s on its own for a specific purpose … while still being just across the street,”  Laur said. “People can still connect really easily.”

It’s a repurposed building that was originally a retail space, which meant Cedars-Sinai had to do some minimal renovations, like taking out the store counters and putting in conference rooms.

“The goal for the Cedars-Sinai Accelerator is to bring solutions to clinicians and business leaders at the hospital,” Laur said. “It’s not expected to drive a financial return for the health system.”

Laur’s team has found ways to measure the accelerator’s performance and whether it’s succeeding in identifying high-impact startups. The team tracks the number of employees that a startup has before and after the program, to see whether the company has grown. They also track funding the company raises after the program.

Cedars-Sinai took a break from using the innovation space during the COVID-19 pandemic, when the accelerator shifted to a virtual model. During that time, the building was used to create supplies like hand sanitizer and face shields during shortages.

Moving forward, the accelerator plans to take some lessons from the pandemic. Leaders are looking to maintain a virtual option for startups that may not be able to relocate, only bringing them to Los Angeles for a portion of the program focused on things that are hard to replicate remotely, like walking through the hospital floors. It will continue to offer educational sessions virtually, which leaders hope will create opportunities for entrepreneurs with families or other responsibilities that make it challenging to move for three months.

“We’re able to now accommodate a broader range of individual circumstances,” Laur said. “It’s really been an exciting refresh for the program.”

The pandemic’s push toward more remote and hybrid work could lead to more innovation centers, KPMG’s Shehata suggested. As organizations downsize office space where back-office employees used to work, that space will need a new purpose.

“Health systems need to reconsider what they want to do with it,” Laur said. “They could offload it to reap the savings or transform it into something new.”

Building From The Ground Up

Peoria, Illinois-based OSF HealthCare has operated a 168,000-square-foot innovation center, dubbed the Jump Trading Simulation and Education Center, since 2013.

“It was new construction,” said Dr. John Vozenilek, vice president and chief medical officer for innovation and digital health at OSF HealthCare.

Jump Simulation, which cost an estimated $55 million to build, is attached to the system’s St. Francis Medical Center in Peoria The building was funded through a $25 million donation from trading firm Jump Trading, as well as private donors and OSF HealthCare. It’s a partnership with the University of Illinois College of Medicine at Peoria.

The building’s first two floors comprise simulation spaces, including an operating theater, inpatient and outpatient settings, and a home environment with an ambulance used for medical training, The floors above are innovation spaces, where teams of engineers and clinicians design and build solutions—and then test them in the simulation spaces below. The innovation spaces house seven labs focused on research and development for topics like children’s healthcare, data science and informatics, and advanced imaging and modeling, among others.

OSF HealthCare’s Jump Simulation innovation hub houses a simulated operating theater and inpatient and outpatient settings for medical training.

The labs often work with external partners who have expertise in their given focus area, as well as professors and students from nearby universities.

“The labs almost serve as a beacon, letting outside experts know that this is an area OSF HealthCare is investing in and is interested in expanding,according to Vozenilek. “That’s really accelerated our whole process. For the model to be successful, the work in the lab can’t just stay there. It has to be translated back into hospital operations or patient care,’OSF leadership monitors the labs’ progress based on whether they’re producing new ideas and the extent to which those ideas are getting disseminated into the hospital and throughout the industry.

“The vision behind Jump Simulation is to improve outcomes and cut costs through innovative training, as well as finding better ways to perform clinical care,said Dr. Lisa Barker, chief medical director at the Jump Simulation center. “To demonstrate the value of Jump Simulation’s work to health system leadership, the team often measures ROI based on cost avoidance. That includes figuring out how programs at the center contribute to reductions in medical errors and complications or creating efficiencies when onboarding new medical professionals. Not only do we have a qualitative impact, but we can have a tangible benefit as well.”

 

Source: Modern Healthcare

Lucky’s Market Site In Florida Up For Grabs For Medical Or Grocery Space

Reports that Lucky’s Market is shutting down almost all of its Florida grocery stores leaves the one under construction in Cape Coral in limbo.

Of the 12 existing Lucky’s Markets in Florida, only the one in Melbourne will remain operational, the Sun-Sentinel reported. Employees at the two Lucky’s Market locations in Naples were told their stores are closing.

The Lucky’s Market construction site in Cape Coral, which took more than a decade to assemble by local developer Dan Creighton, is not quite half-finished.

Creighton, who was traveling with limited phone and internet access, released a statement through Priority Marketing: “As representatives for SB-VETS-1 LLC, which serves as the landlord of this property, we are not privy to Lucky’s Market’s next steps at this point and have no additional information beyond what has already been shared publicly We are hopeful the next tenant for this site will be another excellent fit for the Cape Coral community.”

Work on the Lucky’s Market in Cape Coral has halted as the grocery chain is backing out of Florida. The building was to be completed by June but is now in limbo off Veterans Parkway and Santa Barbara Boulevard. (PHOTO CREDIT: David Dorsey)

Walls are already up on what was planned to be the 30,000-square-foot Lucky’s at the southeast corner of Veterans Parkway and Santa Barbara Boulevard. The store shell is flanked by a still-under-construction Wawa gas station and convenience store, Aspen Dental, other businesses and a new and open Burger King that are accessible from Santa Barbara.

Creighton celebrated the groundbreaking in September with city dignitaries on hand. He said then the construction would be targeted for completion by June of this year.

This marks the second time in two years a major chain has announced plans to open a grocery in Cape Coral only to back out. Fresh Market announced plans to build a store in Coralwood Mall. It backed out and Aldi has taken its place there. And now Lucky’s Market remains in limbo.

“One does not have to do with the other,” said Gary Tasman, CEO of Cushman & Wakefield in Fort Myers. About a month ago, Kroger backed out of financing Lucky’s Market, which put the store in financial jeopardy. Lucky’s has been looking for a replacement partner,” Tasman said of the chain that began by a husband and wife in Boulder, Colorado. “And it’s my understanding they haven’t been able to find one. That’s why you’re seeing them retreat on their growth. Everything I’ve seen in the Cape justifies the need for additional grocers in Cape Coral based on the growth and sales and all that. But that internal partnership, it just for whatever reason separated out. The financial capacity just wasn’t there to execute it.”

Tasman said he did not know the scenarios surrounding the Cape Coral property and construction site. But he hoped for the best for Creighton, who should be able to find a solution in the long-term for what has been yet another speed bump.

“I don’t know his deal,” Tasman said of Creighton. “I can’t speak to it. But I know Dan Creighton is a very smart, astute businessman. I just have to believe he built certain protections for himself. My hope for Dan is that he is adequately protected. The risk he was willing to take to do that deal was commensurate with the risk that he was willing to take and gain on the upside and protecting him on the downside.”

As for the site’s future, Tasman speculated that another chain like Trader Joe’s or Sprouts could look at the site. Or he could see it as a medical-related space or a big-box store.

“You know, that’s a hard one right now,” Tasman said. “I’m not sure it would be retail. There’s definitely a demand for a grocer in that spot. It could also be medical. I do believe it will be backfilled into something else. If the footprint works for other concepts, frankly I think medical is a great use for it. It’s a great location. I think you’re going to see medical or a big-box retailer.”

 

Source: News-Press

Influx Of Capital Into Medical Real Estate Creating New Competition For Established Players

Growing demand for healthcare services has created a booming market for medical office buildings, bringing a host of new investors into the space and making it more challenging for the sector’s traditional players.

Anchor Health Properties Executive Vice President Katie Jacoby, whose company has been developing medical facilities for over 30 years, said she is seeing a surge of private equity competing for healthcare real estate deals.

“Ten years ago, healthcare was hardly even considered an asset class; now it’s one of the top asset classes,” said Jacoby, who will speak April 11 at Bisnow’s National Healthcare Mid-Atlantic event in D.C. “There is increased competition to purchase properties and to develop properties.”

Flagship Healthcare Properties Executive Vice President Gordon Soderlund, whose firm has been developing medical real estate since the 1980s, is also seeing more private equity firms and REITs making big investments in the healthcare space.

“There’s a lot of competition pursuing development,” Soderlund said. “Our returns on costs are being driven down because there are plenty of players to respond to an RFP … It’s even more competitive on the acquisition side. There’s so much capital chasing medical real estate right now.”

Nationwide transaction volume in healthcare real estate reached a new record in 2017, according to JLL’s 2018 Healthcare Real Estate Outlook, with a significant portion of the growth in the medical office building sector. The JLL report also found the sources of capital investing in medical office buildings are expanding. In 2017, 19% of MOBs were owned by private investors, 11% by REITs and the remaining 70% by healthcare providers, the traditionally dominant owners in the space.

The growing investment in medical real estate comes as the United States’ aging population is creating more demand for healthcare services. The number of people 65 years and older will nearly double by 2050, according to JLL‘s report, and those over 65 spend five times more on annual medical expenses.

“People see it as a stable asset class,” Jacoby said. “Everyone sees it . They have aging parents themselves … They can experience it on their own personal level.”

The types of tenants occupying medical office buildings is also evolving toward more stable operators, giving investors more confidence in the properties.  As recently as five years ago, the most common tenant in an MOB was a physician with a private practice in 3K SF to 5K SF.

“But individual private practices are less common today, with physicians being employed by health systems or forming groups of doctors,” Jacoby said. “A lot of these private doctors are now employed by the health system. If they’re not employed by a health system, consolidations of physician practices into larger conglomerates are allowing them to serve as anchor tenants similar to a health system.”

Soderlund also said he’s seeing physicians being acquired by health systems and consolidating to lease larger blocks of office space, a trend he views as a positive for landlords.

“One day we might be leasing office space to a six-physician practice, and once they’re acquired our lessee is now an investment-graded hospital system,” Soderland said. “From a credit perspective, that’s great. With more large tenants occupying medical office buildings, more investors are interested in buying the properties.

“Hospitals are consolidating, making them stronger, creditworthy tenants,” Jacoby said. “I think that makes it more attractive for other investors that have traditionally invested in other asset classes.”

Jacoby and Soderlund will discuss trends in the medical real estate industry April 11 at Bisnow’s full-day National Healthcare Mid-Atlantic event at the Washington Marriott Georgetown.

 

Source: Bisnow