Download - Colliers Medical Office-Update
![Page 1: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/1.jpg)
Medical Office Update (US)
Andrea Cross, National Office Research Manager | USA
John Wadsworth, National Director Healthcare Properties
March, 2014
![Page 2: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/2.jpg)
2
About the 2014 Medical Office Outlook Report
Colliers’ first-ever national medical office report
Collaboration between Colliers Healthcare Services Group (CHSG),
U.S. Research team and local market researchers
Report supports CHSG’s activities by establishing Colliers as a thought
leader in the MOB space
Features healthcare industry overview, key healthcare real estate
trends and investment market outlook
![Page 3: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/3.jpg)
About the 2014 Medical Office Outlook Report
Features detailed market-level statistics for 39 U.S. markets
Key differentiator from reports produced by our competitors
More markets to be added in future iterations of the report
3
![Page 4: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/4.jpg)
What Are the Key Drivers of the MOB Market?#1: Aging Baby Boomer Population
4
![Page 5: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/5.jpg)
What Are the Key Drivers of the MOB Market?#1: Aging Baby Boomer Population
5
![Page 6: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/6.jpg)
What Are the Key Drivers of the MOB Market?#1: Aging Baby Boomer Population
6
Annual number of physician office visits 70% higher among
65-74 year-olds than 45-64 year-olds.
![Page 7: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/7.jpg)
What Are the Key Drivers of the MOB Market?#2: Affordable Care Act (ACA)
7
U.S. healthcare costs highest in the world by a large margin
Goal of ACA: insure more people while achieving lower-cost,
more successful outcomes
![Page 8: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/8.jpg)
What Are the Key Drivers of the MOB Market?#2: Affordable Care Act (ACA)
8
Electronic Health Records (EHR) requirements being phased in to
improve provider coordination
![Page 9: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/9.jpg)
Healthcare Industry Employment Trends
9
Outpatient, home health care employment driving overall healthcare
employment.
![Page 10: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/10.jpg)
Healthcare Industry Growth Widespread Across
Geographies
10
Large, in-place older populations supporting healthcare demand in
Northeast and Midwest.
![Page 11: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/11.jpg)
Healthcare Industry Growth Widespread Across
Geographies
11
Above-average population growth driving healthcare demand in
South and West.
![Page 12: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/12.jpg)
What Do These Trends Mean for MOBs?
12
MOB vacancy rate remarkably stable despite uncertainty caused by ACA.
![Page 13: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/13.jpg)
What Do These Trends Mean for MOBs?
13
Construction activity down significantly in recent years.
![Page 14: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/14.jpg)
Retail Space Conversions
Sources: ULI, Kaiser Permanente
![Page 15: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/15.jpg)
Open Layouts
Sources: ULI, Davis Partnership/Align Healthcare
![Page 16: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/16.jpg)
MOB Performance by Market
16
Small, southeastern markets top the list: strong demand, little new supply
Overbuilt Sunbelt markets starting to recover
![Page 17: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/17.jpg)
MOB Investment Surging
17
Q4 2013 MOB investment totaled $2.47 bil., approaching Q4 2006 peak,
cap rates trending down.
![Page 18: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/18.jpg)
Cap Rates Trending Down
18
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
Q1'06
Q3'06
Q1'07
Q3'07
Q1'08
Q3'08
Q1'09
Q3'09
Q1'10
Q3'10
Q1'11
Q3'11
Q1'12
Q3'12
Q1'13
Q3'13
Medical CBD Suburban
Note: Latest data as of Q4 2013
Source: Real Capital Analytics
![Page 19: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/19.jpg)
Links
CHSG: http://www.colliers.com/en-us/us/healthcareservices
US Research: http://www.colliers.com/en-US/US/insights
MOB Report: http://www.colliers.com/us/medical-1H
Contact Info
Andrea CrossNational Office Research Manager | USA
Direct: 415.288.7892
Email: [email protected]
CI_AndreaCross
19
![Page 20: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/20.jpg)
20
Colliers InternationalHealthcare Services Group
Specialized Real Estate Solutions
Presented by:
John Wadsworth
National Director
An Introduction to…
![Page 21: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/21.jpg)
Colliers Healthcare Services Group (CHSG) Overview
Formed in 2005, “Organically Grown”
76 members in US 34 markets, London and Hong Kong
Service Offerings:
Brokerage
Property Management
Valuation & Appraisal
Project Management
Market Research
Strategy & Consulting
$1B in Gross Transactions 2013
Key Differentiator: CHSG is Healthcare Real Estate Solutions Provider:
“If you are in the healthcare real estate business,
by default you are in the healthcare business”
![Page 22: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/22.jpg)
Patient Protection and Affordable Care Act, aka “Obamacare”…
22
![Page 23: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/23.jpg)
ACA Impacts on the Healthcare Industry,
Resulting Trends:
March 2010 present: Major shift in US healthcare delivery system
Fee for service fee for quality
Healthcare “consumer“ driven
Lower payments (reimbursements) from the Feds & Insurance
Companies
New pressure on Hospitals/Providers to:
Cut cost / Improve quality
Coordinate care for better outcomes
Preserve margins via savings (vs. more revenue)
Mandate for efficiency = Massive healthcare industry consolidation
23
![Page 24: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/24.jpg)
Hospital Mergers and Acquisitions
5,000 hospitals in the US
2012: $143B in healthcare M&A
2013, topped 100 mergers
US Physician Consolidation
2000: 682,470 physicians in the US / 57% independent
2013: 792,594 physicians / 36% independent 24
![Page 25: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/25.jpg)
25
Shift in Tenant Profile
Flexibility
In-patient to out-patient: higher acuity care moved to the MOB setting
Hospital driven monetization
Repurpose of non-medical assets to medical facilities
Regulatory Compliance
ACA Impact on Healthcare Real Estate, Resulting Trends:
![Page 26: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/26.jpg)
Challenge
170,000 SF, 176-bed “dark” acute-care hospital
1970’s construction / compliance with CA seismic
standards
Find a new hospital operator to re-use the facility vs.
redevelop
Healthcare Reform
Strategy
Determine feasibility / cost of re-use of existing
building
Position as re-opportunity to comply with HC Reform
Perform need/gap analysis for full “continuum of care”
Roadshow presentation to prospects
Success Story Century City Hospital, Century City, CA
![Page 27: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/27.jpg)
Success Story Century City Hospital, Century City, CA
Results
Secured a provider with a need to develop an
“acute-rehab” facility
Building re-purposed / modernized to comply with
licensing req’s
Partnership between UCLA, Cedars Sinai and
Select Medical
Executed 17 year, $80M lease
![Page 28: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/28.jpg)
50 acres / 1.2M SF
Full continuum of healthcare to be developed
CHSG awarded assignment in 2013 to market, lease and sell
Current Project Canyon Springs Healthcare Center
28
![Page 29: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/29.jpg)
How can you partner withColliers Healthcare Services Group?
Step #1 – know that CHSG exists, is “healthy” and expanding!
Leverage CHSG platform to pursue HC – “b/c you don’t understand it, don’t
ignore it”
Expand service offerings (beyond brokerage) to existing healthcare client
Collaborate!
29
![Page 30: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/30.jpg)
30
“We take our job seriously…”
![Page 31: Colliers Medical Office-Update](https://reader033.vdocuments.us/reader033/viewer/2022060109/5555de03d8b42a711f8b50d1/html5/thumbnails/31.jpg)
Medical Office Update (US)
Andrea Cross, National Office Research Manager | USA
John Wadsworth, National Director Healthcare Properties
March, 2014