With the Affordable Care Act adding 16.4 million new patients to the healthcare system, providers have realized they can’t be all things to all people, says Pacific Medical Buildings SVP Jake Rohe, who is among the expert panelists presenting at Bisnow's San Diego Healthcare Leadership and Life Sciences Forum on Sept. 28.

“Providers are racing to develop clinical networks that meet payer, employer and consumer preference criteria, establishing deep clinical scopes over expansive geographic regions," says Jake (snapped here with wife Mary at the Kaaboo music festival in Del Mar).

Faced with caring for large, diverse patient populations, providers are locating primary care services in neighborhoods close to the people they serve, Jake says. He notes a significant number of these patients have multiple chronic health conditions that require a variety of healthcare services. “It’s unrealistic for one provider to meet all of these patients’ needs, so providers with different expertise are forming clinical affiliations with other providers around gaps in patient care."

Pictured below is the three-building ambulatory care complex for Hoag Health Center Irvine, which PMB recently completed. It offers all types of healthcare services under one roof.

Jake says academic medical centers traditionally lack the ability to provide primary care in a cost-effective manner, so they are teaming up with primary care providers through affiliations, partnerships or outright mergers. These relationships provide academic partners with acute care referrals, he says, and these networks function as well-coordinated, comprehensive delivery models to provide a seamless patient experience, which benefits both patients and providers. Academic medical centers, such as UCSD, also are tapping into this clinical system to train medical residents.

These changes in the healthcare delivery system are evolving new healthcare real estate product types, Jake tells us. The three most common types of projects: a 15k to 25k SF primary care clinic with basic imaging services; a 60k to 80k SF primary care facility with additional diagnostic services, such as comprehensive imaging, urgent care, pharmacy, lab and specialty care; and an ambulatory destination center concept, ranging from 120k SF to 250k SF. This final facility type provides everything found in a traditional hospital, except inpatient beds, Jake says.

The 157k SF ambulatory care Hoag Health Center Irvine has three two-story, 50k SF, multi-specialty medical office buildings, which provide all outpatient services under one roof, and a one-story, 7,200 SF retail building occupied by an Urgent Care Center (pictured here).

PMB also is under construction on the nine-story, 250k SF Sutter Van Ness Medical Office Building, pictured below, at the intersection of Van Ness Avenue and Geary Street in San Francisco. This MOB is part of an overall Sutter Health development plan for a medical campus that includes a new 700k SF acute-care hospital. PMB’s project includes a six-level, 383-space subterranean parking structure that will provide parking for both the MOB and hospital.

“There’s also other ancillary models occurring outside these clinical networks,” Jake says, citing micro-hospitals, freestanding emergency centers and other non-traditional patient care facilities, as well as developments that integrate post-acute care and healthcare-focused residential senior living. PMB is finalizing the acquisition of a 2.2-acre site in the greater Seattle area, where it plans to build a 152-unit senior living facility with independent, assisted living and memory care.

“We’re seeing other nontraditional healthcare development opportunities emerge too,” Jake says. He says federal health agencies are pushing providers and payers to provide comprehensive and preventive behavioral and mental health care, creating an opportunity to develop projects that integrate residential product with short- and long-term behavioral health services.

Hear more from Jake and other local healthcare leaders at our San Diego Healthcare Leadership and Life Sciences Forum on Sept. 28, beginning at 7:30am with breakfast and networking at the Westin San Diego Gaslamp Quarter, 910 Broadway Cir, in Downtown.