Healthcare construction nationwide is booming, with about $97 billion in projects for new hospitals, expansions and off-campus clinics and medical offices currently underway, according to Revista.
The Annapolis-based company, which began tracking medical construction in 2014, said 1,340 projects started in the past year or remain in the planning stages.
See table below for the Top 50 projects
"Providers are watching and everyone is asking why this sector is such a good investment," said Revista Principal Hilda Flower Martin. "It's proven to be more stable. Tenants tend to stay in the building. Physician practices normally don't want to move."
Providers use Revista's database to see what the competition is doing. Revista maps property locations, ownership information, demographic details and keeps an inventory of available space.
"They can go in and assess the landscape and it gives them a good jumping point of where they should be buying or building," Flower Martin said. "They can look at comparable sales in areas and see who's there and what it's going to cost."
Though most hospital projects are renovations, Revista is tracking 150 new hospital construction projects across the U.S. that feature a complete hospital replacement or a brand new building.
The top five projects are valued at over a billion.
Topping the list at $2 billion is the Tisch Hospital expansion in New York, the flagship acute care facility for NYU Langone Medical Center, totaling 800,000 square feet.
Next is the $1.5 billion construction of a new hospital tower at the Hospital of the University of Pennsylvania in Philadelphia.
Loma Linda University Medical Center in California is replacing its main medical campus for $1.2 billion, the most expensive of its construction to date in a string of projects.
At $1.1 billion, Lucile Packard Children's Hospital at Stanford, Palo Alto, California, ties for the fourth most expensive current project. The expansion will add an estimated 521,000 square feet to the existing 300,000 square-foot hospital.
In Aurora, Colorado, the VA Hospital, Fitzsimmons campus, is replacing its campus, at a cost of $1.1 billion, though The Washington Post earlier this year put the price tag at $1.7 billion. It is among four VA medical center projects – the others are in Las Vegas, Orlando and New Orleans, that are behind schedule and over budget, according to the published report.
California and Texas lead the country in healthcare real estate construction, Flower Martin said.
California currently has $11.8 billion in projects. Much of this is due to the California Seismic Safety Act mandating hospitals meet structural guidelines to withstand a major earthquake. The deadline is 2030.
A hospital evaluation, completed in 2001, showed that 40 percent of California's hospitals were vulnerable to collapse in an earthquake, according to the Office of Statewide Health Planning and Development.
"All of these hospitals have to meet certain standards," Flower Martin said. "They're so expensive to renovate to these standards they just rebuild."
Construction in California also costs more. The price is estimated at $2 million per bed, compared to $1.7 million for the rest of the U.S., she said.
Texas has $7.7 billion in projects in the works, and that state has no requirement for a certificate of need prior to a new facility being built, according to Flower Martin. In Texas, the market is working strictly on supply and demand and is seeing a growth in facilities such as Memorial Hermann that has two hospitals in the state under construction.
In Louisiana, two big projects are underway that were deemed necessary after Hurricane Katrina devastated the New Orleans area 10 years ago. One is the Southeast Louisiana Veterans Replacement Hospital in New Orleans that was supposed to open in 2014, but now has a target date of 2016. At a cost of $995 million, it's ranked sixth on Revista's list of most expensive projects.
Revista's top 10 cities for medical construction, including surrounding regions, are, in order: Atlanta, Boston, Chicago, Dallas-Fort Worth, Houston, Los Angeles, Miami -Fort Lauderdale, New York and Newark, Philadelphia, and Washington, D.C.
Flower Martin said the uptick in medical construction is driven by several factors, including the need for off-campus buildings, such as urgent care facilities.
"Look across what hospitals are building as far as ambulatory space, there's a movement to go out into the community and away from the campus," she said.
Another is that more people are seeing a doctor, she said.
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The number of people who have gotten health insurance through the Affordable Care Act marketplace, government, their employer or on their own has risen by 15.3 million people in the past two years, according to Flower Martin.
Revista translates these numbers into square feet. In 2013, for every insured person, there was 4.8 square feet of medical office space; today, that's 4.58 square feet. An additional 62 million square feet would be needed to fill the gap, she said.
There's also an elderly population demographic that's rising. Statistics show that 66 percent of those 65 or older see a doctor three or more times a year, compared to 26 percent of those in the 18 to 24 age group, she said.
Here is Revista's data on the Top 50 projects currently in progress, ranked by project value:
|Property||Type||Status||Project value||Square feet||New beds||Construction start||Projected open|
|Property||Type||Status||Project value||Square feet||New beds||Construction start||Projected open|
|Hospital Of The University Of Pennsylvania||Hospital||Open||$1,500,000,000||0||700||3/1/2015||3/1/2017|
|Loma Linda University Medical Center||Hospital||Open||$1,200,000,000||0||0||10/1/2015||12/1/2019|
|Lucile Packard Children'S Hospital At Stanford||Hospital||Open||$1,100,000,000||521,000||0||1/14/2015||3/1/2017|
|Va Hospital - Fitzsimons Campus||Hospital||Construction||$1,100,000,000||1,200,000||0||6/1/2010||6/1/2017|
|Southeast Louisiana Veterans Replacement Hospital||Hospital||Construction||$995,000,000||1,600,000||0||12/1/2010||9/1/2016|
|Kaiser Permanente - Central Hospital||Hospital||Construction||$900,000,000||565,000||450||6/2/2014||3/1/2017|
|David H. Koch Center||Medical Office Building||Construction||$895,500,000||568,801||0||8/1/2014||8/1/2018|
|San Francisco General Hospital||Hospital||Construction||$887,400,000||360,000||284||10/29/2009||12/5/2015|
|Louisville Va Medical Center||Hospital||Construction||$880,000,000||0||110||6/1/2016||6/1/2020|
|Inova Fairfax Hospital||Hospital||Open||$850,000,000||876,000||482||6/1/2010||6/1/2016|
|Boston Children's Hospital||Hospital||Open||$850,000,000||445,000||0||8/1/2016||1/2/2000|
|Jacobs Medical Center||Hospital||Construction||$839,000,000||509,500||245||1/3/2012||1/1/2016|
|Alameda County Medical Center||Hospital||Open||$682,000,000||230,000||160||3/1/2010||6/1/2017|
|Largo Regional Medical Center||Hospital||Construction||$655,000,000||711,699||280||6/21/2015||3/1/2017|
|Memorial Hermann Texas Medical Center||Hospital||Open||$650,000,000||1,340,000||160||5/27/2015||3/1/2019|
|Sutter Health California Pacific Medical Center||Hospital||Construction||$600,000,000||215,000||120||10/1/2014||1/1/2019|
|John Peter Smith Hospital expansion||Hospital||Construction||$582,500,000||739,011||157||Unknown||Unknown|
|Maricopa Medical Center||Hospital||Open||$571,000,000||0||0||7/9/2015||1/2/2000|
|Houston Methodist Hospital||Hospital||Open||$540,000,000||470,000||390||7/13/2015||6/1/2017|
|Rehabilitation Institute Of Chicago||Medical Other||Construction||$523,000,000||900,000||242||7/1/2013||1/1/2017|
|Banner - University Medical Center Tucson||Hospital||Open||$500,000,000||689,000||336||3/1/2016||6/1/2019|
|Barnes Jewish Hospital North||Hospital||Construction||$500,000,000||0||0||3/1/2018||1/2/2000|
|Grace Health System Medical Center Lubbock||Hospital||Construction||$500,000,000||350,000||0||3/1/2016||9/1/2017|
|Methodist Hospital Tower||Hospital||Construction||$500,000,000||620,000||200||10/5/2015||1/2/2000|
|Sanford Fargo Medical Center||Hospital||Construction||$494,000,000||1,000,000||384||7/1/2012||9/1/2017|
|Vassar Brothers Medical Center||Hospital||Open||$466,000,000||696,000||294||4/1/2016||2/1/2019|
|Covenant Medical Center||Hospital||Open||$450,000,000||500,000||0||9/1/2016||9/1/2021|
|Jeanne S. Rich Professional Office Building||Medical Office Building||Open||$450,000,000||640,000||305||5/15/2013||1/1/2016|
|Stamford Hospital (Replacement)||Hospital||Open||$450,000,000||640,000||0||5/15/2013||8/1/2016|
|Brigham And Women'S Hospital - Building For The Future||Medical Office Building||Construction||$450,000,000||620,000||0||5/1/2013||12/1/2016|
|Jennie Sealy Hospital||Hospital||Construction||$438,000,000||758,677||310||4/1/2012||6/1/2016|
|Washington Adventist Hospital - White Oak Campus||Hospital||Construction||$434,900,000||0||201||3/14/2016||3/1/2019|
|Northwestern Lake Forest Hospital||Hospital||Open||$426,000,000||470,000||114||10/1/2014||9/1/2017|
|Shands Hospital At The University Of Florida||Hospital||Open||$415,000,000||500,000||216||11/15/2014||3/1/2018|
|St Lukes Regional Medical Center||Hospital||Open||$400,000,000||357,000||0||1/11/2016||1/2/2000|
|Emory University Hospital||Hospital||Open||$400,000,000||456,144||210||2/13/2014||1/1/2017|
|Spartanburg Regional Medical Center||Hospital||Open||$400,000,000||400,000||0||3/1/2018||3/1/2021|
|Baptist Health South Florida Cancer Center||Medical Office Building||Construction||$400,000,000||340,000||0||7/30/2014||4/1/2016|
|Focal Point Saint Anthony Hospital||Hospital||Construction||$400,000,000||450,000||150||1/2/2000||1/2/2000|
|Lexington Medical Center New Patient Tower||Hospital||Open||$400,000,000||550,000||70||4/1/2016||1/2/2000|
|Marin General Hospital||Hospital||Open||$394,000,000||360,000||165||1/1/2016||1/1/2020|
|Coney Island Hospital||Hospital||Open||$390,000,000||0||0||6/26/2016||1/2/2000|
|University Of Nebraska Medical Center||Hospital||Open||$370,000,000||695,000||108||10/14/2013||5/1/2016|
|University Of Iowa Children'S Hospital||Hospital||Construction||$360,200,000||480,000||0||6/21/2013||10/1/2016|
|Seton Medical Center||Hospital||Open||$360,000,000||0||192||2/14/2017||1/1/2020|
|Texas Childrens Hospital||Hospital||Construction||$360,000,000||548,000||48||2/1/2014||6/1/2017|