Transactions involving medical office and outpatient buildings are exploding, with both health systems and private equity firms getting in on the action.
There were nearly 300 MOB deals across the top 50 U.S. metro areas in the fourth quarter of 2025, marking the most activity in more than three years, according to a recent analysis by commercial real estate group Avison Young.
The 284 transactions represented a 78.6% increase year over year and a 110.4% jump quarter over quarter. In the fourth quarter of 2025, medical outpatient building occupancy was over 92%, compared to about 80% occupancy of U.S. offices, signifying the demand for MOBs.
That increasing trend has spilled over into the first few months of 2026, with a number of nine-figure deals. Some of the largest transactions include a newly built MOB being purchased for $340 million by a California county, a real estate investment trust acquiring an outpatient portfolio for $260 million and an investment firm paying more than $100 million for five ASC and healthcare properties.
According to a recent report from real estate company JLL, the aging U.S. population is driving demand for outpatient services, as eight out of the top 10 growth areas for patient volumes are in the outpatient space.
Health systems are jumping at the opportunity to grow their outpatient lines. In 2025, health systems accounted for nearly half of medical leasing, with an emphasis on large, multispecialty clinics, JLL’s report found.
On top of operating out of existing space, systems are also looking to build their own facilities. In April alone, Fort Lauderdale, Fla.-based Broward Health broke ground on a 127,000-square-foot center; Morgantown, W.Va.-based WVU Medicine announced an investment of $25.5 million into a new MOB; and South Bend, Ind.-based Beacon Health System opened a new $21.7 million outpatient facility.
As outpatient real estate grows more expensive and competitive, independent ASCs and physician groups may find themselves not just competing on quality and cost of care, but on location and access in ways they haven’t had to before.
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