Continuing focus on high medical office sales activity might lead one to wonder where all this activity is occurring. In 2017, more than 25% of sales volume was represented in only 5 metro areas. Who's leading the pack?

Transaction volumes have been steadily rising for the past few years. Revista began tracking property transactions in 2014 and volumes in that year were $8.9B for MOBs

2017 will have broken many records in terms of sales transaction activity in healthcare real estate, but it won’t in terms of new construction. Revista data is showing 3 consecutive years with a decrease in starts which is now also affecting total deliveries. Only 16.3M square feet was delivered in 2017, 15% less than the previous year's total of 19.3M.

The table below shows the median price per square foot (PPSF) for medical office buildings (MOBs) that have a surgery center and do not have a surgery center and the resulting premium.

The medical real estate sector is seeing increasing levels of transaction activity, particularly across hospital real estate and medical office buildings

Well, the time certainly seems right to sell in 2017, as capitalization (cap) rates – the estimated first-year return on an investment – have reached all-time lows. Many high-quality portfolios and single MOBs with credit-rated tenants are trading at cap rates of 6 percent and below, some right around or even under 5 percent.

...although roughly 25% of inventory is investor owned nationally, the stats vary widely by metro. Some areas are predominantly owned by healthcare providers while other areas have a significant portion, sometimes majority, of the real estate owned by a third party - whether that be a REIT, institutional fund or private investor.

The portfolio includes several class A assets such as the Harker Heights Medical Pavilion which is 100% leased and on the campus of Seton Medical Center Harker Heights.

The Big Three healthcare REITs – HCP, Welltower and Ventas –remained disciplined with acquisitions while non-listed REIT fundraising has limited their supply of new investment capital.

In the medical office building (MOB) space, large portfolio sales involving publicly traded companies usually grab most of the headlines. Recent blockbuster deals include Physicians Realty Trust’s (NYSE: DOC) $700 million acquisition of more than 50 MOBs from Catholic Health Initiatives in 2016 and Healthcare Trust of America’s (NYSE: HTA) $2.25 billion purchase of more than 70 medical office properties from Duke Realty Corp. (NYSE: DRE) in recent months.