Healthcare delivery is transforming rapidly and the shift to outpatient care is driving demand for medical office buildings (MOBs) across high-growth metros and the Sun Belt, according to a JLL analysis. Limited new, purpose-built supply has pushed occupancy higher, as health systems adopt retail-style access strategies to serve expanding populations.
Policy changes are reinforcing this trend. The 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System, finalized by the Centers for Medicare and Medicaid Services, provides incentives that support ambulatory access, further strengthening the viability of MOB investment.
Meanwhile, the unwinding of Medicaid coverage, which removed more than 25 million people from eligibility by late 2024, has increased the risk of bad debt for health systems. JLL advises that location strategies now must integrate payer mix analytics and eligibility churn data to identify durable patient populations and minimize financial exposure.
Cybersecurity has emerged as a critical consideration. Following the 2024 Change Healthcare attack, nearly all hospitals faced operational disruption, prompting widespread upgrades to IT infrastructure. Facilities now require dual fiber entries, generator interfaces and enhanced connectivity when selecting sites or negotiating leases.
Sustainability mandates are also shaping lease and design decisions. Hospitals are being guided toward zero operational carbon by 2030, with requirements for electrification readiness, energy metering and low-carbon tenant improvements. Regional regulations, including California seismic standards and New York City's Local Law 97, further influence planning and lease specifications.
Outpatient platforms are increasingly supporting complex procedures, demanding infrastructure such as procedure-ready exam pods, imaging power loads, negative pressure rooms and behavioral health spaces. MOB occupancy continues to rise as providers expand psychiatric access and address emergency department boarding pressures.
JLL also highlights innovative real estate strategies that can help organizations manage capital while scaling access. Flexible leasing, sale-leaseback arrangements and adaptive reuse of office or retail space allow health systems to preserve cash, accelerate market entry and maintain portfolio agility amid uncertain market conditions.
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