Executive Summary 

Healthcare real estate enters 2026 at an inflection point. Elevated borrowing costs, constrained development pipelines, and accelerating outpatient demand are reshaping how healthcare organizations plan growth. At the same time, policy uncertainty and workforce shortages increase the stakes of every real estate decision. This outlook examines the forces redefining healthcare real estate strategy and highlights where disciplined expansion remains viable in a cost-constrained environment.

What to Expect Heading into 2026 

• • Higher Borrowing Costs Persist 
  Healthcare organizations will continue to face “higher for longer” interest rates, keeping the cost of capital elevated and delaying large-scale development decisions. 

• • Projects Stay Cost-Constrained 
  Construction feasibility will remain strained as medical outpatient build costs stay elevated and new development pipelines remain limited. 

• • Outpatient Demand Outpaces Space 
  Outpatient demand will keep rising, while space availability tightens due to high pre-leasing rates and record occupancy. 

• • Rents Remain Under Pressure 
  Rent pressure will persist, especially for newly delivered space, as cost segmentation becomes more pronounced across markets. 

• • Policy Adds Portfolio Volatility 
  Policy and coverage shifts may accelerate outpatient migration, increasing the urgency for efficient, decentralized footprints. 

What to Do About It 

• • Build Flexibility into Growth 
  Prioritize flexible site strategies that support growth without overcommitting capital in an uncertain rate environment. 

• • Accelerate Speed-to-Market 
  Expand outpatient access using renovation, repositioning, and second-generation space to reduce time-to-market risk. 

• • Stress-Test Policy Scenarios 
  Stress-test expansion plans against policy-driven reimbursement risk to avoid overbuilding in fragile utilization scenarios. 

• • Prioritize Underserved Markets 
  Use market-level benchmarking to identify where patient need outpaces provider availability and opportunity is structurally supported. 

How This Report Was Built 

This report synthesizes findings from current U.S. healthcare real estate and healthcare industry research. It also incorporates Audiense market rankings that evaluate U.S. metro areas by service line based on the gap between expected patient demand and provider availability. Together, these inputs provide a forward-looking view of both the market conditions shaping 2026 expansion decisions and the geographic areas where expansion may be most impactful. 

Download the 2026 Outlook

Healthcare organizations face a narrower margin for error as capital constraints and outpatient demand converge. The full 2026 U.S. Healthcare Real Estate Outlook examines where patient need, market conditions, and real estate feasibility align. Complete the form to download the report and access data-driven insights to support more confident expansion decisions in 2026.