Healthcare is on the move—literally. Procedures once performed in hospitals are now happening in outpatient clinics down the street. Lab tests, imaging, physical therapy, even surgeries—more of it is being delivered in medical office buildings (MOBs) and ambulatory surgery centers (ASCs), and less inside large, centralized hospitals.

This shift toward decentralized care isn’t just about patient preference—it’s about strategy, economics, and evolving standards of care. As the healthcare system adapts to new technologies, changing demographics, and tighter margins, the real estate that supports care delivery is evolving too.

For practice owners, investors, and developers, understanding what’s driving this movement isn’t just helpful—it’s essential.

Decentralization Defined: What’s Changing?

Traditionally, most care was centered in large, hospital-based settings. But in 2025, the healthcare landscape looks different. MOBs and ASCs are taking center stage. In fact, the term “medical office” is giving way to the more comprehensive “medical outpatient building,” reflecting the shift in how we think about care delivery.

According to JLL’s latest U.S. Medical Outpatient Building Perspective, the healthcare system is being reshaped by several key forces: technology, reimbursement structures, aging demographics, and shifting consumer preferences. The result? Demand for outpatient facilities is rising fast, and the implications for healthcare real estate are significant

Technology Is Changing Where Care Happens

Innovations in medical technology are doing more than improving patient outcomes—they’re transforming where care can be delivered. Procedures that once required an inpatient hospital stay can now be performed safely in outpatient settings.

Minimally invasive surgical techniques, mobile diagnostics, and advanced telehealth platforms are allowing physicians to offer more services closer to where patients live and work. Even specialties like oncology are shifting out of large centralized hospitals. Thanks to early detection tools and targeted therapies, smaller neighborhood-based clinics and outpatient surgical centers can now support cancer care, imaging, and follow-up treatment with greater convenience and lower overhead.

This isn’t just a shift in location—it’s a shift in mindset. Care is becoming more flexible, more accessible, and more integrated into daily life.

Cost Efficiency Is Fueling the Shift

At a time when healthcare providers are facing rising labor costs and tighter margins, decentralized care offers a much-needed financial release valve.

Outpatient facilities—especially ambulatory surgery centers (ASCs)—allow providers to reduce costs by eliminating the overhead associated with hospital-based care. For example, a joint replacement performed in an ASC typically costs 30–50% less than in a traditional hospital outpatient department. That translates to savings for providers, insurers, and patients alike.

This cost efficiency is helping to expand access, especially as more procedures migrate to outpatient settings. For health systems and private practices, investing in medical office buildings (MOBs) and ASCs has become a strategic move to capture revenue and streamline operations without sacrificing care quality.

Patients Want Convenient, Local Care

Beyond the financials, there’s a very human driver behind the rise of decentralized care: patients want it.

People are tired of navigating massive hospital campuses and waiting weeks—or even months—for appointments. Outpatient facilities offer a different experience. They’re often located closer to home, have shorter wait times, and provide an environment that feels less clinical and more community-based.

This preference is shaping real estate demand. Medical office buildings located off traditional hospital campuses—especially in suburban areas—are seeing growing occupancy. These facilities are easier to access and more aligned with the expectations of today’s healthcare consumers, who value proximity and convenience.

Reimbursement Models Are Catching Up

Healthcare providers don’t just follow patient demand—they follow the money. And increasingly, reimbursement models are supporting outpatient care.

Public and private payers have adjusted how and where they reimburse providers, creating strong financial incentives for procedures to move out of the hospital and into ASCs and MOBs. Medicare, for example, has expanded its list of approved outpatient procedures and increased payment rates for ASC-based care.

This realignment encourages providers to rethink their footprint, expand into outpatient spaces, and prioritize locations that support more efficient, lower-cost models of care. It’s a win for everyone involved—patients, providers, and the broader healthcare system.

An Aging Population Is Driving Demand

Demographic shifts are another powerful force behind the rise of decentralized care. The U.S. population is aging rapidly, with the number of adults over 80 expected to surge in the next decade. These older adults require more medical attention—but they also want to receive it in familiar, accessible settings.

Outpatient care models are uniquely suited to meet those needs. ASCs and MOBs offer targeted services like orthopedics, cardiology, and rehab in a setting that’s easier for aging patients to navigate. New developments are also springing up in fast-growing metro areas to keep up with rising demand.

In cities across the country—especially in the South and Sunbelt regions—healthcare systems and investors are working to expand outpatient infrastructure where population growth is strongest. These communities are setting the pace for the next generation of care delivery.

A Strong Market for Investors and Operators

The growth in decentralized care isn’t just a trend—it’s shifting the fundamentals of healthcare real estate.

Unlike traditional office spaces, medical office buildings have remained resilient post-pandemic. Occupancy rates are rising, and rent growth in the sector has outperformed many other commercial real estate categories. That’s creating strong tailwinds for investors, especially those focused on long-term, stable returns.

Medical properties tied to strong health systems or reputable provider groups are in high demand, and transaction volume in key markets has remained healthy. Even in a cautious lending environment, capital is flowing toward outpatient-focused assets with solid lease terms and strong operational performance.

But Development Still Comes with Challenges

While demand for outpatient care is rising, building the infrastructure to support it isn’t always easy.

Construction costs continue to climb, and skilled labor shortages remain a concern in many regions. At the same time, healthcare systems must carefully manage tight budgets while planning for growth. Real estate typically accounts for a significant share of their overhead, so every square foot must serve a clear purpose.

As a result, many providers are renovating existing buildings, consolidating services into shared spaces, or partnering with developers to create facilities that maximize efficiency and minimize waste. Creative planning is essential—especially as care models evolve.

Looking Ahead: What This Means for You

For healthcare providers, decentralized care offers more than convenience—it offers opportunity. Outpatient-focused spaces are easier to scale, more adaptable to specialty care, and preferred by the communities they serve.

For investors, the fundamentals of the market are strong. With demand on the rise, well-located MOBs and ASCs remain a resilient investment class, offering predictable income and long-term growth potential.

And for communities, the payoff is real. More care options. Less travel. Better outcomes.

The Center of Care Is Moving Outward

Hospitals still play a vital role—but they’re no longer the only hub. In 2025 and beyond, the real center of care is spreading outward, into neighborhoods, retail corridors, and suburban developments.

If you’re planning to open a medical practice or expand your portfolio, understanding the forces behind decentralized care isn’t optional—it’s strategic.

Looking to navigate this shift with confidence? Whether you’re exploring new locations, evaluating lease opportunities, or planning your next outpatient facility, Healthcare Realty Group is here to help you align strategy with growth.