The bread-and-butter medical office building (MOB) deal continues to entail the sale of a single building for a price of less $20 million, often quite a bit less. Such deals, of course, do not typically satisfy the appetites of the sector’s largest investors, including private equity funds, the larger publicly traded REITs, and institutions, as well as foreign capital. Such investors prefer deals that provide immediate scale instead of having to accumulate a portfolio by making smaller, one-building acquisitions.

Houston is the number one metro in terms of square feet of hospital space under construction. As of the end of 2017, Houston had roughly 4.2 million square feet of hospital space under way – about a million square feet ahead of the runner up, New York.

Prior to the start of 2018, several members of the Editorial Advisory Board (EAB) of Healthcare Real Estate Insights™ predicted that the sector would see some transactions in which health systems would buy medical office buildings (MOBs) that they are leasing from third-party owners.

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?

Doctor visits will increase 217.6% faster than the population in Los Angeles, Orange, Riverside, San Bernardino, and San Diego Counties. That’s according to an analysis prepared for the California Hospital, Outpatient Facilities & Medical Office Building Summit in Downtown Los Angeles on December 13.

...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.

Revista has posted the Mid -2017 Top 50 Metro Rankings Report for Medical Real Estate to its subscriber portal.

The Revista MOB Sector Fundamentals Report represents approximately 150M SF of data reported by major owners of medical office properties. Data are provided quarterly encompassing a portfolio as well as on a same store, year over year basis.

In 2013, there were 271.6 million insured and 1.3B square feet of MOB space in the US..

We often show in our reports and presentations the metros that have the most MOB construction activity. Frequently this ends up being the usual suspects - New York, Chicago, Los Angeles etc. and this is simply because these are the largest overall markets so they will tend to have more space being built. To broaden the spectrum, let’s take a look at metros that are the most active in comparison to their existing inventory.