LOS ANGELES—With the Affordable Care Act well under way and the consolidation of many healthcare organizations, healthcare real estate is experiencing a small revolution. According to Stan Chiu, AIA, LEED AP and principal with HGA Architects and Engineers, owners are also starting to incorporate design trends into healthcare facilities, moving away from the stark white and plain style of the past. To find out more about this changing industry, we sat down with Chiu to discuss the ACA's role in this change, other drivers and which design trends are most popular. Here is what he had to say:

GlobeSt.com: How is the healthcare real estate market in L.A. changing, and what are driving these changes?

Stan Chiu: Consolidation among healthcare organizations is creating partnerships among once-separate specialties practices and providers. Instead of competing with each other, healthcare organizations are creating one vertically integrated system that provides a continuum of care through all healthcare stages. New facilities are built, renovated or repurposed as consolidated healthcare organizations realign their services to meet community needs. Generally, there is a move toward creating satellite facilities and community clinics where people can get care close to their homes. Consolidation also offers new branding opportunities, from the logos and website to signage and architectural detailing to communicate a unified image of healthcare excellence.  

GlobeSt.com: What role has the Affordable Care Act played in this change?

Chiu: The Affordable Care Act is having an impact on reimbursements, cost-containment and healthcare delivery models by emphasizing preventive care and wellness. This is leading to the development of more neighborhood clinics and wellness centers while the construction of large-scale, high-acuity hospitals is slowing down. Many newer neighborhood clinics, in fact, will actually function as community centers offering a range of health, education and outreach services that bring people together.

GlobeSt.com: What are the major design trends for healthcare properties, and how have these changed from past trends?

Chiu: Design is playing a bigger role to engage the community. Rather than the sterile clinic of the past, newer neighborhood clinics are offering architectural amenities such as community meeting rooms, classrooms, nutrition-education kitchens, and public gardens and gathering spaces that draw people in. The more forward-looking facilities are influenced by the retail/hospitality industries, which focus on the customer experience—or in this case, the patient experience.

Likewise, newer clinics are designed to attract and retain top physicians and staff with more attractive and collaborative working spaces that support team-based care. Just as today's corporate office environments focus on natural light, connection to the outdoors, collaborative spaces and operational efficiency, healthcare facilities are designed to create positive workplaces that enable caregivers to deliver better care.

GlobeSt.com: Is development or renovation more popular for healthcare real estate, and why?

Chiu: It is a bit of both. However, there is a growing trend toward converting struggling mid-sized retail malls or empty big-box retail spaces into clinics, which often are in established communities and are integrate with existing public transportation, highways, sidewalks, and parking. The 20,000-square-foot open floor plates coincidence clinics' space and programming needs and prove more cost-effective than building from the ground up. Essentially, this trend is revitalizing underperforming real estate from the Great Recession.

GlobeSt.com: How do you see these trends evolving over the next year?

Chiu: There is a shift from a centralized to decentralized care model that delivers services closer to the home. Through ongoing consolidation that creates vertically integrated healthcare systems, providers are able to offer broader and more targeted community-based services directly or through partnerships. For instance, there is a growing trend in long-term acute-care and skilled-nursing units that move patients out of acute-care hospitals more quickly yet still provide necessary acute-care services more cost-effectively. A hospital is usually the most expensive stop in the healthcare system because of higher infrastructure and code requirements. By keeping patients out of the acute-care hospitals—either through more effective preventive care or more effective post-acute care—we can lower overall healthcare costs.