Outpatient Real Estate Demand Holds Strong
The boom in outpatient care is keeping demand for medical office buildings robust, with strong tenancy from physician groups. Real estate analysts at Colliers note that Ambulatory Surgery Centers (ASCs) are a particularly dynamic segment. This investor confidence is a key factor enabling health systems to continue shifting procedures and imaging out of hospitals into freestanding facilities.
The shift to outpatient settings is accelerating, with imaging volumes now growing faster in freestanding centers than in the overall radiology market. Projections show outpatient advanced imaging, including CT and PET scans, will grow by nearly 14% over the next decade. This migration is driven by technological advancements allowing for more complex procedures outside the hospital, alongside significant cost and convenience advantages for patients. Payor strategies and CMS reimbursement changes are actively steering procedures toward lower-cost settings. CMS is phasing out the Inpatient-Only (IPO) list, moving 285 procedures off in 2026 alone, giving physicians more discretion to perform surgeries in outpatient facilities. Furthermore, reimbursement updates for 2026 are set to decrease payments for physicians in hospital settings by as much as 11% while increasing it by 7-10% for those in office-based practices, directly incentivizing the move to freestanding clinics. This trend has ignited a surge in healthcare real estate development, with medical office building (MOB) occupancy rates reaching a cyclical high of 92.7% in 2025. The global market for MOBs is projected to grow from roughly $39.8 billion in 2023 to over $62 billion by 2030. Ambulatory Surgery Centers (ASCs) are a particularly hot segment, with revenues expected to climb from $45 billion in 2024 to $57 billion by 2030 as more complex surgeries, like cardiac procedures, shift to this setting. To capture this migrating volume, health systems are aggressively expanding their outpatient imaging footprints through acquisitions, joint ventures, and new constructions. This has led to increased market consolidation, with major players like RadNet, Akumin, and US Radiology Specialists expanding their networks. Mobile imaging providers are also playing a crucial role, offering flexible capacity and new modalities to meet fluctuating patient demand without the need for large capital expenditures. The operational backbone of this outpatient boom is technology, particularly AI, which is being leveraged to enhance workflow efficiency and address staffing shortages. The FDA has recognized this trend, with radiology-related AI tools accounting for nearly 80% of all AI medical device approvals. These AI applications assist in automating routine tasks, prioritizing urgent cases, and improving diagnostic accuracy, allowing strained radiology departments to handle rising imaging volumes. However, the industry faces a persistent radiologist shortage, with attrition rates having increased by 50% since 2020. There are currently around 13 radiologists per 100,000 people in the U.S., a figure insufficient to meet the rising demand, leading to significant burnout. This staffing crisis is a critical challenge for imaging providers and is driving further investment in efficiency-boosting technologies like AI and teleradiology to bridge the gap.
