Historically, hospitals sink about 45% of all spending into some sort of real estate cost, whether it’s maintenance, new development or upgrades, she says. Also, hospitals are having to get creative on new designs, as patients want easier access through medical facilities, and also demand private rooms for all patient stays.

The past few years has seen hospitals take on these challenges, Scarborough says, but now the movement is providing better services is across the board, requiring health care systems that don’t want to raise patient costs to find more and more efficiencies in running their buildings. “You’re looking at everything to do with infrastructure, energy systems, better project management, technology and more,” she says.

For example, JLL took on earlier this year the management of about eight million square feet for the William Beaumont system in the Detroit suburbs. “The company was able to find ways to reduce costs by about $30 million in four years, and we’ve started doing that. We’ve already launched an energy demand management system that has saved more than $300,000,” Scarborough says.