Why Your Location Strategy is Your New Clinical Strategy
The healthcare landscape has moved beyond a simple “shift.” We are now in a full-scale migration.
For years, we discussed the gradual movement from inpatient to outpatient care. But as we navigate 2025, that gradual slope has become a steep trajectory. Faced with softening admissions, thin operating margins, and a consumer base that demands the convenience of Amazon-style service, health systems are no longer just looking for more space, they are looking for smarter space.
Real estate is no longer a passive line item on the balance sheet. It is a clinical tool, a recruitment asset, and the primary vehicle for financial success.
Outpatient is No Longer Optional
In 2017, cost transformation was a goal. In 2025, it is a requirement.
In 2025, approximately 80% of surgeries in the United States are performed in outpatient settings, according to data from the ASC Data Group. Projections for the next five years (through 2030) suggest continued growth in the outpatient surgery share, potentially reaching 85-90% while inpatient volumes remain flat or decline.
This isn’t just a clinical preference; it’s an economic necessity. Care delivered in outpatient settings is typically 30% to 60% less expensive than the same care delivered within the four walls of a hospital.
With downward pressure on hospital operating margins for many systems, the strategy is clear: migrate routine care, diagnostics, and even complex surgeries out of the expensive “hub” and into the cost-efficient “spokes.”
The “Retailization” Has Matured
We used to talk about healthcare “learning from retail.” Today, healthcare is retail.
The “Consumer-Patient” of 2025 does not tolerate friction. They expect a “digital front door” that opens seamlessly into a physical location. If they can book a dinner reservation on their phone in 30 seconds, they expect to book an MRI with the same ease and they expect the facility to be just as accessible.
This has driven a massive surge in “Medtail” with medical tenants taking over former retail spaces. These high-visibility, high-access locations are not just about convenience; they are about market share protection. If you aren’t on the corner of Main and Main, your competitor will be.
The ASC Boom: Higher Acuity, Lower Cost
The most significant real estate trend in 2025 is the explosion of the Ambulatory Surgery Center (ASC).
We are witnessing a “acuity shift.” Total joint replacements, cardiac procedures, and advanced spine surgeries are migrating to ASCs at a record pace.
For real estate, this means the technical requirements for outpatient buildings have skyrocketed. We aren’t just looking for exam rooms; we are looking for slab-to-slab heights that can accommodate surgical lights, floors that can support robotic surgery units, and power grids that ensure 100% redundancy.
Data-Driven Site Selection: Beyond “Dots on a Map”
In this high-stakes environment, “gut feeling” site selection is a seven-figure mistake waiting to happen. The process has evolved from simple demographics to complex psychographics. We are no longer just asking, “Where do the patients live?”
We are asking:
- Where does the payer mix most favor?
- What is the drive-time tolerance for an orthopedic consult vs. an oncology visit?
- Where are the “medical voids” in the market that competitors have missed?
The Bottom Line
The ambulatory network of the future is not just a collection of clinics; it is a precisely engineered ecosystem. It includes micro-hospitals, freestanding ERs, ASCs, and multi-specialty hubs, all strategically placed to capture patient volume before it ever reaches the main hospital campus.
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If you are a provider, your real estate strategy is a critical component of your business strategy. In 2025, the right location doesn’t just house your clinical practice, it insures your success.
Need to align your healthcare real estate portfolio with your clinical goals? Contact me to discuss how we can optimize your footprint for the modern healthcare economy.
