20359 Lake Chabot Road

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SAN RAMON, CA—Meridian has beenfocused on healthcare development since early 2000. Its nextprojects in Modesto, Oakland and Castro Valley are close to majorhealthcare providers such as Kaiser facilities and Sutter Eden Medical Centerhospital. John Pollock, CEO of San Ramon-based Meridian, recentlydiscussed trends and elder care in the second of a two-part exclusive.

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GlobeSt.com: What are some of the healthcare developmenttrends you are seeing throughout the Bay Area?

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Pollock: It is an exciting time in healthcare.We have healthcare systems vying for market share while trying tomanage the health of their members. We have a legislativeenvironment that keeps us guessing, and there are major employershere in the Bay Area trying to disrupt the marketplace. There isalso a continued pressure on reimbursement rates, and the need forsystems and providers to drive cost out of the system. These macrotrends are more acute in the Bay Area as a result of the scarcityof both land and available buildings as well as rising costs. Thesystems/providers demand the most efficient and flexible spacepossible to maximize the number of patients that they can see tocombat the lower reimbursements, and to be designed in a way thatcan accommodate future technological advancements. New space thatis more efficient, smaller, more visible and easier for patients toaccess will help to build the case for a new space or the adaptivere-use of an existing building.

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We have several client assignments focused on behavioral healthfacilities. With the significant shortage of available space andthe challenge of getting new outpatient facilities approved eventhough there is an acute need, we have had to thread the needlevery carefully working with the communities, the respectivemunicipalities on zoning and to find the right sites or buildingsthat minimize the impact.

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The recent announcement by Amazon, which recently teamed with JPMorgan and Berkshire Hathaway to figure out a way to change thetrajectory of healthcare for employees, has healthcare insuranceproviders on notice. While it remains to be seen what will happen,they are a formidable group that has the resources to bring aboutsignificant change. It reminds me of the story of how Kaiserstarted when Kaiser Aluminum became frustrated with thethen-current situation around healthcare during the late 1930s and1940s. It was opened to public enrollment in July 1945.

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Closer to home here in the Bay Area, Apple has announced that itis launching medical clinics to deliver the world's best healthcare experience to its employees and their families this spring.The company has advertised for doctors, health coaches anddesigners to create a program to promote healthy behavior. Ianticipate wearables will be part of that plan. It's far cheaper toprevent disease than treat people who are already sick. Healthproblems result in 69 million workers reporting missed days eachyear, reducing economic output by $260 billion per year, accordingto the US Centers for Disease Control and Prevention.

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GlobeSt.com: Is there anything else you would like thereaders to know?

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Pollock: We are also working with new entrantsto the market and recently signed a lease with a PACEProvider/Program for the All-Inclusive Care for the Elderly. ThePACE program can trace its origins back 40 years to Chinatown inSan Francisco. There are approximately 166 programs nationally andthey provide care for the elderly in their respective communities,who would have otherwise had to go to a nursing home. Legislativechanges to the program in 2015 have opened the market to newproviders and the benefits are the care provided, the physicalenvironment for the delivery of care and the fact that on theaverage, care can be provided at 13% reduction from the cost of anursing home. It is the kind of disruption the industry needs.

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Lisa Brown

Lisa Brown is an editor for the south and west regions of GlobeSt.com. She has 25-plus years of real estate experience, with a regional PR role at Grubb & Ellis and a national communications position at MMI. Brown also spent 10 years as executive director at NAIOP San Francisco Bay Area chapter, where she led the organization to achieving its first national award honors and recognition on Capitol Hill. She has written extensively on commercial real estate topics and edited numerous pieces on the subject.