Many trends affect healthcare real estate. More decentralized treatment structures have shifted focus from medical office buildings to medical outpatient buildings. Telemedicine and so-called medtail are ways to deliver medical help outside of traditional structures.

Colliers has pointed out in a new report one that might come less to mind: payment automation and outsourcing. That can mean almost anything from "digital-first patient-facing payments system for bill pay," a shift from paper-based systems to computerized processing; or third parties that can handle insurance submissions.

What all of these have in common is the potential to reduce the need for people — who can be hard to find in a tight labor market — and filing cabinets. Less space needed means less investment in real estate.