WASHINGTON, DC—In late March, the US Supreme Court began hearings on arguments over whether or not the health-care law passed in 2010 is constitutional. The three-day marathon of arguments and counter arguments will then be followed by the Supreme Court's decision, expected sometime in June.

That could go a number of ways. It could affirm the law and its constitutionality. Or, it could decide that the mandate for individuals to buy health insurance—the heart of this very complex piece of legislation—is unconstitutional and strike that down, leaving the rest of the legislation intact. But there's a third choice as well: the Court could find that the individual mandate is unconstitutional and, because it's so closely linked to the rest of the legislation, strike it all down.

It's an open question whether or not the Court will strike down the individual mandate. But even if it does, one participant in the space says it doesn't matter—at least in terms of healthcare real estate investment.

"Economics drives the shape of healthcare real estate now, not this legislation," says Jeffrey H. Cooper, executive managing director of Savills US and an attorney specializing in medical office property investment. "And that won't be impacted, no matter what the Supreme Court decides."

Granted, a period of uncertainty (depending on how significant any changes are made by the Court) will no doubt follow the decision. But the roadmap in the larger picture is clear: reimbursement with or without the mandate is on the decline, and that will continue whether or not individuals are required to buy health insurance, Cooper says. "For healthcare real estate, that means a growth in outpatient or ambulatory facilities."

He isn't alone in this conclusion. Todd Lillibridge, president and CEO of Lillibridge Healthcare Services, and Rasesh Thakkar, senior managing director of the Tavistock Group, both predicted the healthcare industry would be investing more in outpatient services.

Cooper points in particular to the tremendous downward pressure on reimbursement levels in both private-sector insurance and by the government as the main driver. "If a procedure can be done on an outpatient basis, it will be," he says.

By the same token, if the individual mandate is upheld, Cooper doesn't think it would lead to an even greater demand for medical office buildings or outpatient facilities. "Look to Massachusetts and Mitt Romney's healthcare plan," says Cooper. "Providers there will tell you that an individual mandate has made no difference in terms of forcing providers to offer more healthcare. What it has done is change the reimbursement structure."