April 28, 2021
John B. Mugford

Revista Developer Survey shows strong development numbers; it also ranked the top third-party developers in 2020

While the amount of outpatient facilities started or completed during 2020 fell by about 9.7 percent from the previous year, the number of healthcare real estate projects taking place remains quite healthy. 

According to the fifth annual Outpatient Real Estate Development Report by Revista, the total square footage of outpatient projects “started or completed” in 2020 was 48.15 million. That was down from the 53.3 million square feet of outpatient real estate projects started or completed during 2019, the highest total since Revista started the report in 2016. 

Most of the decline in projects “started or completed” in 2020 came by way of the “projects started” category, where total square footage fell by about 14.6 percent, to 24.6 million square feet of starts in 2020 from 28.8 million square feet in 2019. 

“As one can see from our report, overall starts were slightly down for MOB and outpatient properties in 2020 from 2019,” Mike Hargrave, Revista’s co-founder and principal, tells HREI. “It could be partially pandemic-related, although we feel the pandemic could have more of an effect on 2021 start figures. Also bear in mind, 2019 was a high-water mark for starts, so a slight pullback from those numbers was natural.” 

However, although starts fell in 2020, the year proved to be a good one for third-party HRE development firms. 

That’s because of the total square footage of outpatient projects started or completed, third-party firms led 42 percent of them — or 20 million square feet — meaning health systems and other providers turned to such firms more than ever before to provide their expertise. 

This increased reliance on third-party developers by health systems or other providers seems to be a trend, as a year earlier, in 2019, such firms accounted for 32 percent of all projects started or completed. A year before that, in 2018, third-party developers accounted for 25 percent of the square footage of outpatient projects started or completed.  

“We are noticing that third-party developers are winning a greater share of projects, especially hospital-sponsored, larger, more complex projects,” Mr. Hargrave says. “On these types of projects, hospitals are increasingly open to leasing and realizing the value of working with experienced third-party healthcare real estate developers.” 

As has been the case for each of the past five years, the most recent development survey compiled by Revista ranks the top-rated outpatient medical facility developers from the previous year.  

According to the 2021 report, long-time HRE design-build and development firm Hammes Company, based in Milwaukee, led the way in two categories: Projects “started or completed,” where it was involved in 12 projects with a total of 946,306 square feet of space; and “projects started,” with nine developments totaling 738,806 square feet. 


The runner-up in the projects “started or completed” category was Denver-based NexCore Group LP, a long-time HRE developer that started or completed eight projects with a total of 552,766 square feet. Close behind NexCore in third place was Pensacola, Fla.-based Catalyst Healthcare Real Estate, which completed or started eight projects with a total of 535,754 square feet. 

In the projects “started” category, the runner-up was Washington, D.C.-based National Real Estate Advisors, which started one project with a total of 452,000 square feet. In third place in the category was NexCore, which started four projects with a total of 407,935 square feet. 

The top-ranked firm in the “projects completed” category was Anchor Health Properties, which is based in Media, Pa., and Charlottesville, Va. Anchor completed five projects with a total of 419,866 square feet of space. 

The next top two firms in the “projects completed” category were: Charlotte, N.C.-based Pappas Properties, which completed two projects with a total of 310,349 square feet; and Denver-based Healthpeak Properties Inc. (NYSE: PEAK), a publicly traded real estate investment trust (REIT) that completed four projects with a total of 283,433 square feet. 

According to Mr. Hargrave, Revista gathered data for the report from voluntary surveys provided by 35 companies, as well as information the research firm derived from another 140 companies. 

Mr. Hargrave notes that firms wishing to participate in future surveys should contact him at mike@revistamed.com

For more information and to obtain copies of the 2021 Outpatient HRE Development Report, please visit RevistaMed.com. (Subscription required.)