Although 22nd in rank for population, Charlotte is one of the fastest growing cities in the nation. Over the past 10 years the population has grown almost 60%! In 2010 the population rank was only 33… Affordable housing and lower cost of living paired with rapid economic growth and a hot job market has generated a population magnet.

The year 2018 proved to be healthy one for new medical office building (MOB) construction projects, which is certainly music to the ears of professionals involved in the healthcare real estate sector. The good news comes by way of the third annual Outpatient Healthcare Real Estate (HRE) Development Report released late last week by Revista, a research firm that compiles data for the HRE sector, in conjunction with Healthcare Real Estate Insights (HREI), which provides news and trends in healthcare facility development, financing and investment.

Hospital construction across the US is in the midst of a delivery spike as many projects, both new hospitals and additions, open this year. As of the end of 2018 Philadelphia had the largest under construction hospital pipeline of any metro with 4.4 Million square feet and 14 projects under construction, almost double the square footage of the runner up, Washington DC.

2019 is expected to be a big year in terms of hospital project completions and the Sutter CPMC campus on Van Ness and Geary in San Francisco, opening Saturday, March 2nd, is one of the largest deliveries.

Carmel, Indiana, located in the northern suburbs of Indianapolis, has become a hot target of healthcare providers and associated real estate developers over the past few years. Revista is tracking several in progress and planned medical real estate developments sponsored by difference providers and developers.

Healthcare Real Estate Insights and Revista have partnered to create the healthcare real estate industry's most comprehensive survey of outpatient medical construction activity.

In past metro highlights we’ve talked about growth markets with lots of construction activity, interesting markets with innovative health systems, metros with the highest sales volume, but what about the tightest markets? The ones with the highest rent growth, the most expensive pricing and the lowest vacancy? Flipping through our Metro Rankings report, San Francisco clearly fits the bill.

Over the past year or so there have been many headlines speaking to how hot the medical real estate sector is. You see them pop up in your email or news feed: "Sales volume is at all time highs"..... "New investors are entering the sector right and left"...."Medical Real Estate Hitting Post Recession Peak". At times like this, many investors are getting priced out of the 'cream' offerings that trade and the heavy weight health system construction projects. So it would stand to reason that those interested parties would look elsewhere....and they are.

What do large, institutional MOB investors look for when seeking purchases? For the most part, they prefer larger portfolios in order to add instant scale. They prefer properties occupied by strong, perhaps credit-rated, health systems. And, they want high quality real estate: well-maintained, perhaps newer buildings in good locations.

As REITs pull back on acquisitions and focus more on refining their portfolios, private equity groups have more than taken up the slack. Total healthcare real estate transaction volume may have cooled ever so slightly - but not much - and so far this year, private investor buyers are making up 76% of that total.