Primary Care Space Loses Its Luster Within The MOB Marketplace
Healthcare developers considering building primary care space may be hearing a voice in their heads, one that gives them pause: “If you build it, they may not come.”
That’s because patients increasingly are choosing at-home settings for noncomplex care, making primary care space a less desirable part of the medical office building mix, according to medical developers speaking at the Bisnow's Charlotte Healthcare Conference.
“Healthcare has become a consumer-driven product,” said Mike Orlando, vice president of Realty Trust Group.
The healthcare industry has long pushed to provide more in-home care but has only made incremental progress toward that goal in the last couple of years. However, annual spending for at-home care is expected to rapidly accelerate from $155B in 2025 to nearly $321B by 2035, according to a report from healthcare consulting firm Nova One Advisor.
A wider pool of providers will be focusing on at-home care in the future, said Sarah Mueller, national director of healthcare for the Beck Group. This presents a challenge for developers of medical office buildings.
“If care is really going to start to get pushed more into the home as much as can be done, what does that mean for the built environment?” she asked at the event, held March 31 at The Union at West Station.
As primary care becomes more decentralized, MOB space is being reshaped or developed into facilities focused on intensive or specialized care.
“The way it changes the built environment is it increases the complexity of patients that are going to be [there],” said Bennett Thompson, vice president of real estate for Atrium Health.
Given the consumer preference for care close to home, healthcare providers are choosing to open satellite or outpatient offices in neighborhood settings.
“Patients are more comfortable heading to their neighborhood location, if it's primary care or something that can be done off campus,” said Ben Barr, managing partner for Woodside Health. “So they don’t have to head to a big parking garage and walk through a whole big hospital.”
When choosing a location for these local facilities, Orlando said accessibility, visibility and convenience are key. He noted that prime locations might be an inline strip center or a grocery-anchored shopping center. These sorts of locations are also good spots for urgent care centers.
“Is it on the way to and from school and work? Can I get in easily? Those are all factors,” he said.
This pull away from primary care space comes at a time when new MOB space, in general, can be hard to come by. This isn’t because of a lack of demand.
From a national standpoint, demand for medical outpatient offices is high. In the state of North Carolina, for example, there are 199 outpatient clinics that employ more than 28,000 workers and earn more than $5B in revenue each year. The MOB market occupancy rate was record-setting in Charlotte, above 93%, according to a November 2025 PwC report on trends in commercial real estate.
However, the expenses of constructing new medical space is becoming prohibitive. The fit-out cost for medical outpatient facilities has reached $412 per SF, according to a February JLL guide on MOBs.
This makes existing MOB space a sought-after commodity. Investment in MOB space, driven largely by sales, rose 35% year-over-year in 2025 to $12.6B, according to CBRE. The Southeast led the way in investment dollars in MOB in Q4 2025, specifically, with $1.6B spent on such space in the region.
Overall, Charlotte has emerged as a med-tech innovation hub, with work currently underway on the $1.5B The Pearl district, a 26-acre development anchored by the Wake Forest University School of Medicine and backed by Atrium Health and Wexford Science & Technology.
