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The Medical Office Market Has Reset

Medical Office Building, Pasadena, TX
  • by Coy Davidson | March 8, 2026

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What the 2025 Medical Office (MOB) Transaction Data Is Actually Telling Us

Revista has just released its most recent (Q4-2025) U.S National Transaction report for Healthcare Real Estate.

Key Takeaways:
 
Overall Market (Full Year 2025, $2.5M+ trades)
 
  • 1,403 properties traded totaling $21.5B across 75.7M SF
  • MOBs dominated with 1,033 properties and $13.3B in volume
  • Grand total average cap rate: 6.8%
 

Aggregate Table – Past 12 Months (1/1/2025 to 12/31/2025) $2.5M Trades and Higher

US medical real estate transaction report

Medical Office Highlights

  • Annual MOB volume of $8.7B–$9.4B per quarter in 2025 — a meaningful pullback from the 2021–2022 peak of $25–30B annually
  • Average price per SF nationally: $373, with New York ($478) and Phoenix ($505) commanding premiums; Houston came in at $421/SF with a 5.8% cap rate — notably the tightest cap rate of any major metro listed
  • Cap rates have stabilized in the 6.5–7.3% range on a TTM basis, up significantly from the sub-5% lows of 2021–2022

Buyer/Seller Dynamics

  • Investors/Private dominated buying activity (80%+ of volume in 2025)
  • Remedy Medical Properties was the most active buyer (186 properties, $4.3B), followed by IRA Capital and Montecito Medical
  • Welltower was the top seller ($4.1B), followed by Healthcare Realty Trust ($1.1B)
  • Health systems were net sellers, continuing a long-running portfolio monetization trend

Cap Rate Trends

  • On-campus MOBs: ~6.5% median; off-campus: ~6.7%
  • Portfolio deals trade tighter (~6.4%) vs. single-property (~7.2%)
MOB CAP Rate Trends: Portfolio vs, Single Property

Houston/Healthcare Real Estate:

“Houston recorded $269M in MOB volume with an unusually tight 5.8% average cap rate, suggesting strong investor demand and pricing pressure.”
 
Houston’s 5.8% cap rates (on $269M of 2025 MOB volume) reflect genuine pricing power driven by robust population growth (one the fastest among major markets), healthcare created 10k+ jobs (45% of 2026 projected growth), and the Texas Medical Center ecosystem fuels massive on- and off-campus expansion (e.g., MD Anderson Sugar Land, TMC Helix Park, Methodist/Memorial Hermann projects).
 
Net absorption hit 667k SF with vacancy tightening to 10.9%—demand is outpacing even the #1 national construction pipeline. These fundamentals are defensive and long-term (population + aging demographics + outpatient shift), so the premium pricing is expected to hold for well-located, credit-tenanted assets into 2026–2027.
US metro MOB Stats

Data Source: Revista

Frequently Asked Questions

FAQ: Is the current market environment favorable for new investors given the seller activity from health systems?
Absolutely. Health systems have been consistent net sellers to unlock capital for their core operations, creating a steady supply of quality assets. Private investors captured over 80% of 2025 volume, with active players like Remedy Medical Properties ($4.3B in acquisitions) leading the way. This dynamic increases liquidity and opportunities for new capital to enter through direct purchases or partnerships. The sector remains defensive with resilient fundamentals—strong occupancy and growing outpatient demand—making it appealing for long-term, income-focused portfolios compared to more volatile traditional office properties.

FAQ: Why is Houston delivering the tightest MOB cap rates (5.8%) among major U.S. metros, and is this sustainable?

A lot of this comes down to pure momentum. Houston is one the fastest population growth major metros in the country—and healthcare is the engine behind it, creating over 10,000 jobs. Between the massive expansions at TMC Helix Park and new satellite projects from MD Anderson and Methodist, the Texas Medical Center ecosystem is pushing demand well beyond its main campus. The numbers tell a clear story: even with the busiest construction pipeline in the U.S., we’re still seeing vacancy tighten to 10.9% because people are snapping up space faster than we can build it. Between a growing, aging population and the shift toward outpatient care, these are long-term wins. If you’re looking at well-located assets with solid tenants, expect that premium pricing to stick around well into 2027.


  

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