The big shift that everyone involved in healthcare and healthcare real estate (HRE) has been talking about for years upon years has finally taken place, at least on the real estate side of the equation.

Last year 77 medical office projects started that will be over 100,000 square feet when completed. That's quite an uptick over previous years when we averaged less than 50.

So much of the conversation in the industry right now is about placing medical services out into the community to be more convenient and cost effective for patients. But what is that community going to look like in 10 years? 20 years? Flexibility becomes the name of the game.

After a slow start to the year, medical office building (MOB) sales have picked up in the second and third quarters (Q2 and Q3), providing a very strong possibility that the final 2019 volume will top $10 billion for the fifth straight year.

There are currently about 600 medical office projects under way across the country. More than 15 percent of those projects include orthopedics. Why do so many projects include this specialty?

The country’s healthcare-focused REITs have always been, and are likely to continue to be, an important investor group in the medical office building (MOB) acquisitions sector.

While MOB transaction activity might have cooled somewhat and MOB construction remains steady, deliveries of hospital projects have been on a spike. Based on projects that have either opened or are scheduled to open by the end of the year, we will be adding roughly 35 million square feet to inventory in 2019.

Medical Office (MOB) transaction volume has slowed during the past year. Within the top 50 metros Revista recorded $7.14B worth of MOB trades from 3Q18 to 2Q19

In recent weeks we've seen significant volatility in the stock market along with increasing fears of a recession. After all, this is now the longest market expansion in history. It can't continue forever, right? MOBs have long been considered somewhat insulated from market shifts - but what does the data say?

2019 MOB deal volume continues the cooling trend after coming off historical highs in 2017. While total volume may be down, a theme continues - private investors represent the greatest percentage of acquisitions.