Houston’s massive population growth has overwhelmed concerns from the Affordable Care Act, says Methodist Hospital SVP of facilities, real estate and construction Sid Sanders. (Right, with Jacobs’ Yashpal Mehta at yesterday’s event.) Although changing legislation has impacted some behind-the-scenes activities (like reducing operating costs), his huge development pipeline is simply a reaction to demand. The system’s spending $540M to replace a hospital from the 1950s and respond to increased volume at the Main Campus over the last few years. The new 390-bed tower is rendered below.

Methodist also has a 470k SF hospital and 135k SF MOB under construction in The Woodlands (at the same intersection as Texas Children’s and CHI St. Luke’s—242 and I-45), a 109-bed Sugar Land property under construction, and will build out the rest of its Willowbrook Hospital. Its Texas Medical Center West Campus facilities will likely hit capacity in 2017 or 2018, so Sid says it’s in late planning stages for a major expansion there. Sid says the challenge is to always stay a few steps ahead of growth, which often means over-investing in the next move. In the suburbs, that means only purchasing sites with at least 45 acres.