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Regionalization and 'Retail-ization': Boston Healthcare Moves Away From City To Get Closer To Patients

As Boston’s healthcare industry builds for the future, abandoning the traditional urban core model in favor of a system of suburban regionalization and “retail-ization” for easier patient access is at the forefront of local healthcare development. 

Exterior of the Life Time Center, which was originally the Atrium Mall in Chestnut Hill, Mass.

“It’s really all about outpatient right now,” said David Storto, president of Partners Continuing Care and Spaulding Rehabilitation Network. “We can’t keep up with the demand we have for outpatient services.” 

Spaulding has 25 outpatient sites ranging from 3K to 14K SF across eastern Massachusetts outside its hospital-based activities, Storto said at Bisnow’s State of Boston Healthcare event Tuesday. His organization recognizes healthcare is moving more into the community, and he said it is able to care for people who are sicker at home in new ways, thanks to advances in technology permitting remote monitoring of patients. 

“The goal is to have people where they want to be, which is normally home instead of the hospital,” Storto said. “Unless it’s Spaulding in Charlestown, and in that case, they don’t want to leave because they think of it like a resort.”

David Storto at Bisnow's State of Boston Healthcare event

Wendy Gettleman, vice president of facilities management and real estate at Dana-Farber Cancer Institute, said the repetitive nature of visits for cancer treatment makes it important for her hospital to have locations in the suburbs where patients live and work. She has previously said she expects Dana-Farber to announce the opening of more treatment centers in the suburbs in the next 12 months. 

“I think for large systems, we have been in a hub-and-spoke model for a long time,” said Lisa Hagerty, senior vice president of real estate planning and development at Boston Children’s Hospital. “But as the system itself has shifted to more accountable care, regionalization has been on the rise.”

Lisa Hagerty and Wendy Gettleman at Bisnow's State of Boston Healthcare event

The shift to easier community and patient access in healthcare has led to what developers are calling the retail-ization of segments of the industry.

“I was talking to a leading provider of urgent care facilities about where they look to locate, and they said they are usually fighting over space with Qdoba,” said Patrick Murphy, vice president of real estate and business development at real estate consulting firm GeniSys. 

Urgent care facilities have become a bigger part of New England’s healthcare equation and are one of several shifts in the industry to smaller, off-site facilities to be closer to patients and their homes. Murphy said the health centers look to have synergy feeding tertiary care providers and community hospitals along with providing their own primary care specialties. This usually works best with foot traffic in a suburban retail atmosphere, meaning the great bones that work for retail are equally as important for medical care. 

Wendy Gettleman and Patrick Murphy at Bisnow's State of Boston Healthcare event

Sometimes the two share such similar philosophies and location goals that converting one into the other is a logical evolution. Chestnut Hill’s Atrium Mall was a glitzy suburban mecca for shoppers when it first opened in 1989, but spent its final years with occupancy under 20% until finally closing in 2014. It has since been converted by Needham developer The Bulfinch Cos. into the 286K SF Life Time Center, a development devoted to health and wellness anchored by a Life Time Fitness gym.

Lisa Nickerson and Frank Nelson at Bisnow's State of Boston Healthcare event

Newmark Grubb Knight Frank executive managing director Frank Nelson points to Nashville’s 100 Oaks Mall, which was renovated in 2008 to house medical clinics and administrative offices for Vanderbilt University Medical Center, as the national model for retail-to-healthcare conversion. 

“It’s a national icon just like Life Time center will be our icon,” Nelson said.