Outpatient care is becoming the norm across specialties as patient preferences, CMS coverage and the demand for cost-savings drive a shift away from inpatient care models.
From standalone ASCs to system-owned medical office buildings, hospitals, health systems and independent groups alike are scrambling to acquire and develop physical space to meet the growing need for outpatient care.
According to a March 24 report by real estate services firm JLL, current development trends are pacing behind the demand for services, with about 93% of current MOB space nationwide being occupied.
ASCs are commanding the highest rent increases of any outpatient facility type, with rents climbing more than 8% even as leases surged 145% between 2022 and 2025, according to another recent report from real estate company CBRE.
These trends point to growing competition across the U.S., with new facility developments, mergers and acquisitions being concentrated in several states:
1. Florida: Heightened demand for MOB facilities has been documented particularly in the Sun Belt, according to the JLL report. Demand for services is outpacing existing outpatient space in the state, heating up competition between providers. Orlando, for example, is projected to see a 16.4% increase in outpatient visits through 2029, but construction of the necessary sites is projected to grow by only 3.8%. Becker’s has also reported on at least five new ASC developments in Florida in 2026 alone.
2. California: Becker’s has reported on at least four new ASC developments in the state so far in 2026, with a broad geographic range. Big healthcare systems are responsible for about 57% of the healthcare real estate under construction, according to JLL, a trend reflected in California’s outpatient development. Both Oakland-based Kaiser Permanente and Sacramento-based Sutter Health have moved forward with new ASC and MOB developments in 2026.
3. New York: New York has the most new ASC developments of any state reported on by Becker’s in 2026, with seven new developments. The JLL report flagged New York City — specifically Manhattan — as the only market where construction is outpacing visit growth, at 9.6% 8.4%, respectively.
4. Michigan: Michigan has seen three new ASC developments in 2026, as reported by Becker’s, the fourth-most of any state in the nation and the most among all states in the Midwest. Michigan lawmakers are weighing legislation that would eliminate hospital outpatient facility fees and loosen certificate-of-need requirements for imaging services, which could spark more outpatient competition.
The state is also seeing heightened development by its academic centers. University of Michigan Health-Sparrow Ionia is building a 31,000-square-foot ambulatory clinic next to its hospital campus as well as a $60 million standalone ASC in Lansing, pointing to an expanding health system-outpatient footprint.
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