Articles and Blogs

Health systems and physician groups largely held back on mergers and acquisitions in 2025 due to inflation, high labor costs, reimbursement uncertainty and new state laws targeting private equity. In 2026, deal activity is expected to increase as policy uncertainty clears up and health systems align with physicians to grow their ambulatory networks. PE... READ MORE

We hope everyone enjoyed some time off over the holidays. As we reflect on 2025 and head into the new year, we spent some time mapping out our hospital real estate predictions for 2026. We believe it will be a mixed bag for hospitals and health systems around the country. Most hospital systems will... READ MORE

Revista published a pair of interesting blog posts: (1) the amount of general hospital space under construction in Q3 of 2025 has continued a multi-year climb that started in 2022; and (2) noting that the least expensive MOB rents (bottom 10th percentile) have grown at just 1.3%/yr since 2018, while moderately priced properties (50th... READ MORE

As we head into the holidays, we want to thank you for being a valued reader of our Weekly Hospital Real Estate Briefing. We hope you are able to enjoy time with friends and family in the days ahead. To provide you with a few timely topics to consider over the holidays, we’ve compiled... READ MORE

Fitch Ratings’ 2026 outlook for the nonprofit hospital sector was “neutral,” and forecasts median operating margins between 1-2%, while noting largely healthy volume trends and strong balance sheets. It expects a roughly equal number of ratings downgrades and upgrades among its portfolio, and noted that the industry is still investing in patient tower and... READ MORE

In 2025, we worked on a number of significant land transactions where hospitals acquired land for new hospital campus projects. From our perspective, it seemed like an increase in land transactions when compared to previous years. Here are 10 observations based on our work on these transactions: Resource Race – Hospital systems were aggressive... READ MORE

According to a recent EY report commissioned by the AHA, nonprofit hospitals provide over $149B in annual community benefits, as compared with $13.2B in forgone federal income tax revenue. Even when factoring in state and local exemptions ($54B per year), community benefits were three times higher than total forgone taxes. The largest share of benefits is... READ MORE

Legislators in several states are considering certificate of need (CON) reform over the next year. According to a recent article, legislators in Alabama, North Carolina and Tennessee are considering a complete repeal of their CON laws. Ascension Saint Thomas announced more than $537M in capital investments to improve medical facilities across Middle Tennessee. The... READ MORE

The longest government shutdown in American history ended Nov. 12. As part of the resolution to fund the government, Medicare telehealth and acute hospital care at home programs were extended through Jan. 30. The fate of ACA enhanced premium tax credits will be debated by Congress in December. PwC, ULI, and Revista released an... READ MORE

On October 9 and 10, our Firm hosted The Real Deal Summit in Scottsdale, Arizona. It was a conference focused on growth and strategy trends in the hospital and health system industry. We had a great turnout of hospital and health care executives, in-house counsel and leaders from across the country. Here are our... READ MORE