A. Joseph Marshall
Coldwell Banker Commercial
Commercial Real Estate Advisor
Savannah, Ga
912-790-6999
With only a few exceptions, the mood was decidedly up at Thursday’s Healthcare Real Estate Conference in Chicago. The investors, brokers, tenants, developers and managers who met at the University Club came to hear about strategies and trends in development, management and capital for medical properties ranging from medical office buildings (MOBs) to large healthcare campuses to retail outpatient facilities.
Superficially, the first indicator from 2012 was a drop in medical facility construction starts. Usually, when a sector sees a drop in national groundbreaking, it's kind of tough to read the tea leaves as anything other than a negative.
That wasn't the diagnosis at the conference.
On a panel including Shawn Janus of Jones Lang LaSalle's Healthcare practice, the drop in starts was likened to a deception associated with long-term factors finally clearing up. "We saw a decrease due to the capital markets still rebounding, and a SCOTUS ruling on ACA, then an election," said Janus. "With all that behind us we're going to see greater activity. On the acute care side, that has dropped off. Community hospital starts has slowed down. But we're going to see high-acuity activity driven into the outpatient environment.
- Acute care: more or less means large hospitals.
- High acuity: medical interventions for seriously ill people. Typically conducted on inpatients, that is people who stay over night. But the general trend in medicine and the incentives are to take some higher acuity patients and treat them not in hospitals, but in specialized outpatient settings. One classical example of this trend is the dialysis clinic. There was a time that dialysis for kidney patients was conducted primarily inside a hospital: that has changed in a great many places today.
- Outpatient: a patient not hospitalized overnight.
Read the rest of the article by clicking the link at the top of the page.What he's describing is a trend - several trends, in medical payments, technology and facilities management- that will cause an explosion in non-hospital medical facility utilitization for outpatients. Strip mall spaces, office renovations, all manner of off-campus medical facilities are going to form the demand nationally going forward. Consider it a retailization of medicine.
"Cap rates are close to their historic lows for most property classes. At the same time, other commercial real estate fundamentals are still weak. This apparent disconnect- low cap rates and weak fundamentals- has prompted some observers to question the Federal Reserve's low interest rate policy. The concern is that low rates may be boosting commercial real estate prices excessively."But on the surface things look great! So let's focus on arguments that the market is nuanced, complex, dynamic, etc...