The recent RealShare Medical Office Buildings conference included a discussion of ambulatory strategies by several healthcare executives.

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PHOENIX-Most healthcare providers would agree that establishing an “ambulatory strategy” is a top priority as they strive to reduce costs, improve access to care and compete more effectively. Embarking on such endeavors has become quite important, perhaps instrumental, in the era of the Patient Protection and Affordable Care Act, known as “Obamacare.” Under the law, the Centers for Medicaid and Medicare Services (CMS) is mandated to create a national network of Accountable Care Organizations in which doctors and hospitals share responsibility for the success of the care that patients receive.

Using an ambulatory strategy in which more and more healthcare services are delivered in outpatient settings in neighborhoods away from the hospital is considered a good way to achieve success with an ACO.

A good example can be found in the greater Phoenix area, where one of the country’s largest not-for-profit health systems, Banner Health, is transforming itself from a traditional hospital company and into “a full-service healthcare provider that really is focused on clinical quality,” according to Craig Jensen, system director.

At the latest RealShare Medical Office Buildings Conference, Jensen explained that the health system has established an ACO model called the Banner Health Network, which includes all of the system’s affiliated physicians, 13 acute-care hospitals and other services.

Real estate, namely the establishment of community health centers throughout the Phoenix area, is a key part of the strategy. In late 2012 Banner broke ground on four health centers in four separate cities in the East Valley of Greater Phoenix: Chandler, Gilbert, Mesa and Queen Creek. The total cost is a reported $45.2 million.

Three additional ambulatory centers are planned for the West Valley, in Verrado/Buckeye, Surprise and Goodyear, as well as in Loveland, CO. By the end of July of this year, Banner will have eight new community health centers, according to Jensen, “and we’re not done by any means.”

While the centers will be somewhat small upon opening, each is designed to be expandable to 90,000 square feet. In expanding its geographic coverage, Jensen says Banner works with Buxton, a market analytics firm, to receive detailed demographic and psychographic data to understand patients, analyze locations and optimize services. The analysis helps the health system identify geographic areas most likely to support its strategy of bringing services to where they are needed most.

Banner is targeting growth communities, particularly in outlying areas, Jensen says. There are many reasons for that, including the fact that those areas tend to be underserved and there is less competition. Entering a new market is easier to do in outlying areas than in markets where competitors are already established, he noted.

“The mantra we’re using is, ‘Think like a retailer,’ ” Jensen says.

In that vein, Banner’s community health centers will all have the same design, look and feel. “This is a branding exercise,” he notes. “We’re willing to spend a little more money to create that brand image.” The architect for the centers is HMC Architects and the general contractor is Kitchell.

John Mugford is the Editor of Healthcare Real Estate Insights, the nation’s first and only publication totally dedicated to covering news and trends in healthcare real estate development, financing and investment. For more information, please visit