Commercial real estate firm Northmarq published a Sept. 14, 2026, report warning that outpatient healthcare real estate demand does not automatically convert into facility revenue, even as the U.S. population age 75 and older is projected to grow 54.7% by 2036.
The report, “Outpatient Healthcare Real Estate Outlook and the Role of Accessible Demand,” distinguishes between raw market demand and what it calls “accessible demand.” Bianca Farrington, Northmarq’s content manager; Lanie Beck, senior director of content strategy; and Jeffrey Covington, senior advisor in the firm’s national healthcare group, authored the analysis.
The report ties facility performance to four factors: physician ownership and participation, health system relationships, insurance contracts and operational execution. It cites data showing the share of physicians in private practice fell to 42.2% in 2024, down from 60.1% in 2012, as health systems increasingly own the primary care groups that drive referral patterns. CMS’ 2026 expansion of ASC procedure eligibility adds urgency, the report notes, alongside projections of a U.S. physician shortage of up to 86,000 by 2036.
As a case study, the report highlights a Houston-area surgical hospital that struggled with declining reimbursement and rising costs after the pandemic. A sponsor organized a joint venture among the hospital’s physician owners, a large health system and a specialized operator, each taking a defined role: the health system strengthening payer contracting and referrals, the operator adding purchasing power for staffing, and physicians retaining a financial stake.
The findings signal that healthcare real estate investors must underwrite physician and payer dynamics, not just demographic trends, to gauge facility viability.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
