Uncertainty and high risk are kryptonite to any investment community, and the healthcare real estate sector has seen a heavy dose of both since the beginning of the Great Recession.
From the economic crash of 2008-09, to the enactment of Obamacare in 2010, to the feds’ latest experiment—Ryancare, Republicare, Trumpcare, whatever you want to call it—no other major business sector has dealt with the level of chaos that healthcare owners, developers, providers, and consumers have faced.
Even as Speaker Paul Ryan’s Obamacare replacement died on the vine in Congress, President Trump and the GOP have no plans to walk away from their promise to repeal and replace the Affordable Care Act.
So, with a long road of political and financial uncertainty ahead for the healthcare sector, what does this mean for the nonresidential construction industry’s third-largest sector ($41 billion in annual construction spending)?
In the days and weeks following Trump’s historic victory, the consensus among healthcare sector analysts and AEC professionals was that the repeal and replace efforts would cause healthcare owners and developers to pump the brakes on major real estate construction and renovation plans in the pipeline. This, of course, was the case during the early days of the ACA, when many healthcare organizations halted construction projects until they could fully understand the implications of the law, especially the reimbursement structure.
More recent projections paint a slightly more positive picture for the healthcare construction market, at least in the near-term. In its latest healthcare real estate investment update, released last month (http://tinyurl.com/CBREhc17), CBRE Healthcare reported that healthcare providers “appear to be moving along with their strategy”—including their real estate plans—despite the turmoil in Washington, D.C.
“The ACA was a wake-up call for healthcare providers,” the report states. “In the last several years, healthcare providers have focused on ways to deliver care more efficiently and capture a greater market share to further their economies of scale. For developers, this means more outpatient facilities and a push to expand into new markets.”
Other real estate experts are not as upbeat. John Burns Real Estate Consulting, a respected housing market analyst based in Irvine, Calif., released a 68-page white paper last month (http://tinyurl.com/JBRChc17) that identifies healthcare as one of three major industries (the others being technology and automotive) that are “overheated and will likely be shedding jobs sometime soon.”
The most alarming indicator cited by JBRC: the sector’s rapid accumulation of debt—308% since 2009. This rate of growth far outpaces industry job and GDP growth, a circumstance that, historically, has triggered industry downturns.
Related Stories
| Sep 15, 2014
Ranked: Top international AEC firms [2014 Giants 300 Report]
Parsons Brinckerhoff, Gensler, and Jacobs top BD+C's rankings of U.S.-based design and construction firms with the most revenue from international projects, as reported in the 2014 Giants 300 Report.
| Sep 15, 2014
Perkins+Will unveils design for Ghana's largest hospital
The new hospital will be home to numerous hospital services including public health, accident and emergency, imaging, obstetrics, gynecology, dental, surgical, intensive care and administration.
| Sep 9, 2014
Using Facebook to transform workplace design
As part of our ongoing studies of how building design influences human behavior in today’s social media-driven world, HOK’s workplace strategists had an idea: Leverage the power of social media to collect data about how people feel about their workplaces and the type of spaces they need to succeed.
| Sep 7, 2014
Ranked: Top state government sector AEC firms [2014 Giants 300 Report]
PCL Construction, Stantec, and AECOM head BD+C's rankings of the nation's largest state government design and construction firms, as reported in the 2014 Giants 300 Report.
| Sep 7, 2014
Hybrid healthcare: Revamping inefficient inpatient units to revenue-producing outpatient care
It's happening at community hospitals all over America: leadership teams are looking for ways to maintain margins by managing underutilized and non-revenue producing space. GS&P's David Magner explores nontraditional healthcare models.
| Sep 7, 2014
Behind the scenes of integrated project delivery — successful tools and applications
The underlying variables and tools used to manage collaboration between teams is ultimately the driving for success with IPD, writes CBRE Healthcare's Megan Donham.
| Sep 4, 2014
Hospital CEOs, architects sound off on state of healthcare design
Healthcare construction will continue to feel the effects of radical changes in the delivery of care, according to healthcare leaders attending the annual Summer Leadership Summit of the American College of Healthcare Architects and the AIA Academy of Architecture for Health.
| Sep 3, 2014
Ranked: Top local government sector AEC firms [2014 Giants 300 Report]
STV, HOK, and Turner top BD+C's rankings of the nation's largest local government design and construction firms, as reported in the 2014 Giants 300 Report.
| Sep 3, 2014
New designation launched to streamline LEED review process
The LEED Proven Provider designation is designed to minimize the need for additional work during the project review process.
| Sep 2, 2014
Ranked: Top green building sector AEC firms [2014 Giants 300 Report]
AECOM, Gensler, and Turner top BD+C's rankings of the nation's largest green design and construction firms.
