GlobeSt.com: What issues do you feel are most affecting healthcare real estate decisions today?
Hoover: Three things:

1. Declining reimbursements. To remain competitive in the marketplace, our clients continue to have to do more with less. As medical services are decanted from high-cost-of-occupancy hospital campuses into outpatient settings, we have unlocked sites and/or buildings, including converting general office buildings to medical office, which has enabled us to provide high-quality space at a lower cost of occupancy to our healthcare clients.
2. Market share. As inpatient admissions have flatlined or declined since the great recession, many of the major hospital systems (Dignity, Tenant Health and HCA) are investing in their outpatient locations, following patients to prevent rivals from scooping them up. Meridian has delivered more outpatient clinics smaller than 50,000 square feet than any other firm in California, and we have boots on the ground in both Northern and Southern California.
3. Physician recruitment. With physicians retiring at an alarming rate and newer physicians favoring systems that offer employment, the real estate teams are challenged with not only making sure they have a great patient experience, but also making sure the physical space and locations are appealing to the physicians.

GlobeSt.com: Where do you see the healthcare real estate industry heading in the next year?
Hoover: In the West Coast markets, I see continued industry consolidation and a turf war in providing locations that are proximate to patients with services that are important to the respective community.

Consumers today want convenient access to medical care, which has led to the “retailization” of healthcare. We are seeing more medical facilities pop up in shopping centers, mixed-use environments, suburban neighborhoods and street corners, and this trend will continue. Millennials, in particular, are less likely to have a relationship with a primary-care physician and want the convenience of an urgent-care center. Their doctor visits tend to be low-risk visits, which helps reduce the overall cost of care. As with any retailer looking to expand, selecting the right location will be critical to the success of a new medical facility.

GlobeSt.com: What else should our readers know about healthcare client services?

Hoover: It is an exciting and challenging time for our industry. Not a week goes by without something grabbing the headlines, from legislative action at the state or federal level that impacts our clients' businesses to new therapies, treatments or drugs that alter outcomes.