Medical office building sales are on pace for a record-breaking year, according to the latest research from JLL.
JLL reported that in the first half of 2017, the country saw nearly $5.5 billion in medical office building sales. How big is that number? It’s nearly the total volume of medical office building sales recorded in 2012 through 2014 in the United States.
The biggest sale in the first half of the year was HTA’s $2.2 billion acquisition of the Duke Realty healthcare portfolio this June. There are other major sales in the pipeline, though, with JLL predicting that 2017 medical office building sales will shatter the 2015 record of $9 billion.
The best news? The market has not been slow to respond to the increased demand for medical office properties. JLL said that developers have been quick to create new medical supply, pointing to the large developer-built portfolios offered by companies such as Duke Realty and Meadows & Ohly.
JLL only predicts good things for this segment going forward. Saying that new capital from investors seeking high yields will only provide a greater boost for this segment of the commercial real estate industry.
/wp-content/uploads/2020/08/florida-medical-space-logo.png00ADMIN/wp-content/uploads/2020/08/florida-medical-space-logo.pngADMIN2017-09-07 02:38:572017-09-07 02:38:57Medical Office Building Sales On Record Pace
Industrial REIT Duke Realty has completed its $2.8 billion sale of 72 medical office buildings to Healthcare Trust of America as it ramps up its bulk-space strategy.
“I am happy to announce that we have substantially completed the previously announced sale of our medical office business, generating $2.45 billion in proceeds to date, with the remaining properties expected to close during the third quarter,” said Duke CEO Jim Connor in a second quarter results statement.
Duke used some of the sale proceeds to pay down its debts and placed $796 million in escrow to finance future acquisitions and development, according to Mark Denien, Duke’s chief financial officer.
/wp-content/uploads/2020/08/florida-medical-space-logo.png00ADMIN/wp-content/uploads/2020/08/florida-medical-space-logo.pngADMIN2017-09-04 09:09:182017-09-04 09:09:18Duke Realty Closes $2.8B Sale Of 72-Building Medical Office Package
While Miami has made a science of marketing its world-class beaches, hotels and retail locations, promoting Miami as a medical destination for tourists has a different set of rules. Local health centers and the convention and visitors bureau are finding new ways to market Miami as a global health care destination.
Medical Tourism is a unique brand of tourism because it’s not always appropriate to use the same advertising channels, said Rolando Aedo, executive vice president and chief marketing officer at the Greater Miami Convention & Visitors Bureau.
“When people call our 800-number, we don’t tell them about medical procedures they can have done, but we have collateral materials in different languages if people request that information, and we refer them to the professionals,” Mr. Aedo said.
Though the bureau doesn’t actively advertise Miami’s hospitals, it promotes Miami as a medical destination by hosting meetings and conventions.
“When people come for medical care, their families stay at our hotels. They eat, drink and shop here, so it impacts our industry even though it doesn’t seem like it would,” Mr. Aedo said.
The bureau has dedicated staff charged with bringing more visitors and tourists to Miami and attracting people for meetings and conventions, Mr. Aedo said.
“The future is very bright for medical meetings in Miami,” he said. “Our health care excellence, our geography and the remodel of the Miami Beach Convention Center provide great opportunities to bring people here.”
The convention center is to open next September, and the American Health Information Management Association, a medical tech conference, is to be the first held.
The bureau sends staff to the World Medical Tourism Conference each year and runs miamihealthcare.org, a website dedicated to medical tourism, with visitor information on places to see, where to stay, things to do, events, special offers and a trip planning feature.
Baptist Health has the same approach as the bureau when it comes to promoting Baptist internationally:
“We proactively sponsor medical conferences, bring in speakers and interact with medical schools in the region,” said Mario Mendez, corporate vice president and chief medical officer at Baptist Health.
Medical tourism growth in Miami is largely organic, Dr. Mendez said:
“Baptist has been growing its footprint here for about 20 years by expanding and acquiring private hospitals. We have world-renowned centers of excellence in orthopedics, cardiovascular medicine and cancer treatment.”
It was natural for Miami to promote itself as a medical destination because of its location and medical infrastructure.
“Miami is the port of the Americas. It’s close to home, there are no language barriers and similar cultural influences” for many of the patients traveling to Miami for care, Dr. Mendez said.
While medical marketing is less conspicuous than travel brochures, Miami’s health centers still believe the heat plays a role in attracting patients.
“No one can beat our incredible weather. If you go to Ohio or Minnesota in the middle of the winter and your flight is canceled, you’ll never go back,” Dr. Mendez said.
When asked about how Baptist Health has an edge in Miami, Dr. Mendez said, “We have one of the most robust international programs in the country, so most of our competitors are not local.”
When patients go to Baptist for medical care, they don’t need to look far to find any specialty, he said: “We cover every specialty available, and only refer out major trauma to the Ryder Trauma Center at Jackson.”
The rise of international health insurance has expanded the scope of medical access and changed how people are paying for care when they travel to Miami.
“When I first started in the business side of health care in the early ’80s, the majority of patients were cash-paying,” Dr. Mendez said. “Today, about 82% of patients are commercially insured with the same plans we have, though some wealthier patients are still self-paying.”
While commercial insurance has allowed more patients to access affordable international care, some executive offerings don’t take insurance. The International Medicine Institute, or the IMI, at the University of Miami’s Miller School of Medicine offers out-of-pocket executive physicals, marketed to companies with new leadership.
“We spend half a day doing a complete workup from top to bottom and provide a full report,” said Marianna Finizio, assistant vice president of the IMI.
Dr. Mendez attributes part of Miami’s medical tourism growth to the University of Miami’s Medical School.
“Though it was a desire of every medical system here, UM ushered in a lot of it in the last 15 years,” he said.
The international program at UM has a synergistic, three-pronged mission to research, educate, and provide clinical care.
The educational and research components help to promote UM as an international destination for patient care, Ms. Finizio said.
The academic mission helps feeds into clinical care because “the physicians who have come through our program have widened our bandwidth as they go into their own specialties and represent us,” Ms. Finizio said.
While the IMI has research and academic goals, clinical care remains a primary focus.
“We’re the only academic medical center in South Florida, so we haven’t been particularly robust in our marketing,” said Eduardo de Marchena, associate dean of international medicine at UM, “but we keep our prices competitive with other institutions and patients keep coming to us because of our relationships in education and research and because our doctors are so well known.”
UM markets patient care just as Baptist Health does: “the most organized form of business development is sending our doctors to local and regional conferences,” Dr. de Marchena said.
As for future plans, the University of Miami is continuing to grow its international patient care by investing “in highly innovative and impactful programs to attract international patients,” said Edward Abraham, dean and CEO of the medical school.
“There are about 7,000 international patients that come here every year,” Dr. Abraham said. “It could be far more if we expand our unique portfolio of clinical services.”
Medical tourism marketing may not be as overt and extravagant as campaigns to promote other Miami attractions, but local health care centers are strategically growing and hosting events to position Miami as a global hub for clinical care.
/wp-content/uploads/2020/08/florida-medical-space-logo.png00ADMIN/wp-content/uploads/2020/08/florida-medical-space-logo.pngADMIN2017-08-30 20:19:322017-08-30 20:19:32Medical Destination Market: The Rules Are Different Here
Health care union 1199SEIU United Healthcare Workers East – Florida, doing business as 1199SEIU Florida, has established a new office at the Miramar Park of Commerce.
It signed for 9,975 square feet of space.
“To represent such an expansive group healthcare workers in South Florida, it’s important for 1199SEIU Florida to have an accessible location in a state-of-the-art facility,” said Sunbeam Properties Vice President Maridee Bell. “Labor unions like 1199SEIU Florida require space that offers functionality and connectivity suitable for serving members locally and across the state.”
Bell and Lauren Pace of Sunbeam Properties, and Ryan Goggins of Colliers International represented the landlord in the deal. Tom Viscount of Butters Realty represented 1199SEIU Florida.
The union represents more than 25,000 health care workers in Florida’s hospitals and nursing home industry.
1199SEIU Florida is a division of 1199SEIU United Healthcare Workers East, one of the largest healthcare union in the nation with more than 400,000 members in Florida, Massachusetts, New York, New Jersey, Washington, D.C. It also has an office in Tampa.
/wp-content/uploads/2020/08/florida-medical-space-logo.png00ADMIN/wp-content/uploads/2020/08/florida-medical-space-logo.pngADMIN2017-08-28 00:17:162017-08-28 00:17:16Major Health Care Union Establishes Office In Miramar
According to a new report from CBRE, the aging U.S. population, pressure for healthcare providers to cut costs and new technologies have boosted demand for medical office properties in recent years.
The U.S. Census Bureau estimates that the 65+ population will nearly double between 2015 and 2055 to more than 92 million and comprise nearly 23 percent of the country’s total population by that time.
“The steep increase in the 65+ population and anticipated greater need for in-office physician services by this group signals a continued increase in demand for healthcare services and medical office space in the years ahead,” said Andrea Cross, Americas head of office research, CBRE.
The overall U.S. medical office building vacancy rate was 8 percent in Q1 2017, down by nearly 300 basis points from Q1 2010, and significantly below the vacancy rate for the U.S. office market overall (13 percent in Q1 2017). The pace of vacancy rate decrease accelerated in recent quarters due to stronger user demand, likely driven by the aging U.S. population and increase in the ranks of the insured. The national vacancy rate decreased by the same amount during the past nine quarters (140 bps) as during the prior four years, despite a slight increase in new medical office supply during the past few years.
Investment in the U.S. medical office sector increased substantially over the past seven years. Total U.S. investment volume in medical office buildings of at least 10,000 sq. ft. rose from just under $4 billion in 2010 to $10.2 billion in 2016. Moreover, total investment in 2016 exceeded the prior annual peak of $7.3 billion in 2006, further reflecting increased optimism in medical office and not simply improvement from the recession.
The Evolving Healthcare Landscape
Healthcare providers are facing increasing pressure to reduce costs in the face of uncertain reimbursement rates from both Medicare, Medicaid and private insurance companies and improve patient outcomes. Adopting new technologies is one method for improving healthcare outcomes, but the upfront capital required means that costs must either increase or be trimmed elsewhere. Several key ways in which healthcare providers are attempting to reduce costs are by relocating services closer to where patients live, utilizing video technology to meet with patients remotely and moving more patient volume away from hospitals – the highest-cost facilities – and into lower-cost outpatient facilities, including medical office buildings and urgent-care facilities.
“The evolution of medical technologies is boosting demand for newer product with the infrastructure capable of handling cutting-edge devices and systems,” said Jim Hayden, executive managing director, Healthcare, Global Workplace Solutions, CBRE. “Medical office space that helps providers minimize costs and maximize outcomes, including buildings that support collaboration and can accommodate new technologies that help them achieve these goals, will likely remain in favor.”
Leasing Trends
The five markets with the lowest Q1 vacancy rates were Nashville (2.8 percent), New York (3.2 percent), the San Francisco Bay Area (4.2 percent), Louisville (4.9 percent) and Kansas City (5.5 percent). Nashville registered the strongest medical job growth and New York the fifth strongest over the past five years, contributing to their low availability rates.
Overall asking rents for medical office properties have remained relatively flat for the past seven years, ranging between $22 and $23 per sq. ft. per year. This trend reflects sustained demand for healthcare despite the recession, as well as the relative stability of the medical office tenant base. Specifically, the high cost of tenant build-outs, as well as the importance of proximity to a provider’s patient base and ancillary medical services, compels many tenants to remain in place for long periods of time.
Capital Markets Trends
“As investor appetite for healthcare-related real estate has grown, medical office buildings have emerged as the most popular property type within the sector,” said Chris Bodnar, executive vice president, Healthcare, CBRE Capital Markets. “As yields for traditional real estate asset classes have compressed in recent years, new capital sources–including foreign capital–have entered the medical office sector in search of stability to hedge against any potential correction in the global markets.”
Medical office cap rates have consistently decreased from a high of 8.3 percent in mid-2010 to 6.8 percent as of Q1 2017. On a regional basis, average cap rates have been lowest in the West over the past seven years, below the U.S. average by about 60 bps. However, the spread between the highest and the lowest regional cap rates remained relatively tight during this period, as industrywide trends have a similar impact across the various markets.
“Comparatively moderate regional differences are an attractive feature of medical office as an investment class,” said Lee Asher, executive vice president, Healthcare, CBRE Capital Markets. “Because there is demand for healthcare everywhere, investors are generally more willing to look outside the primary markets compared with traditional office investment, and this is apparent in pricing metrics.”
/wp-content/uploads/2020/08/florida-medical-space-logo.png00ADMIN/wp-content/uploads/2020/08/florida-medical-space-logo.pngADMIN2017-08-23 23:07:152017-08-23 23:07:15Demand For Medical Office Buildings Rise As U.S. Population Ages