The architecture and design of hospitals and medical space is evolving with changes to the delivery and venue of healthcare. Hospital beds take up valuable space, but reimbursement remains critically important to both the hospital and the patient as most patients pay only 20 percent of the bill when they leave the hospital and become an outpatient.

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At a recent Interface Healthcare Conference, healthcare architects and space designers reported that the need for healthcare beds in many hospitals has been reduced due to advances in surgical technologies and the shift to managing more of the rehabilitation process at home. Many patients are instead opting to undergo procedures at one of the growing number of ambulatory surgery centers (ASCs). At an ASC, costs can be significantly lower, particularly for elective procedures, and patients can avoid an overnight hospital stay.

So, what do we do if that trend continues?

Shift to New Services

Some conference panelists suggested converting beds for rehab instead of building a new wing – or perhaps using them as inpatient psychiatric beds, a category of service that needs to be expanded in most markets.

Go Small

An alternative to ASCs that are popping up are micro-hospitals. These are ambulatory care facilities that have a small number of beds and allow providers to bill for hospital services. Since outpatient services are billed at lower rates, 20 to 40 beds in a micro-hospital would allow the provider to bill at the higher rate. These new medical facilities will become more common in rural areas where there is a strong community need.

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Center Communities around Health

Another new plan being tested is a community anchored by a hospital. In the past, any ambulatory center that had a rehab arm was considered a wellness center. Today, outside of the fitness sector, we’re seeing more non-traditional healthcare business partnering with healthcare providers to produce new wellness centers. There’s a great synergy because biometric information can be combined with a fitness center. Envision a mix of residential, business and play environments centered around health with easy access to a hospital, research center, and perhaps a tennis center or swimming pool.

Don’t Just Treat Illness; Make Places That Keep Us Well

Such health communities may be the answer to several issues. Statistics say that 75 percent of our medical care goes to treat obesity and related health issues. Designs that strategically situate homes, schools and wellness centers can sync more easily to manage health and well-being. As much as 80 percent of health outcomes are related to non-acute care factors: access to transportation systems, healthful foods, physical activity, and green space; it’s a shift toward a health district, which provides integrated, healthy place-making, efficient circulation, open space, a connection to nature, and efficient uses of space that encourage more active lifestyles. And it’s also a way to allow people to age in place. Creating healthy places where people want to be is more about health maintenance than health repair.

As we learn how to focus on disease prevention and monitoring our own wellness, expect a growing interface between the public market and a healthier lifestyle.

Beth (CCIM, LEED AP) is a healthcare real estate advisor to health systems with a specialty in the sale of investment properties including hospitals, surgery centers and medical office buildings. She was a former pilot, professional pianist, and dance instructor who co-owned a 25-thousand acre ranch in Wyoming before flipping Texas real estate to fund her early brokerage career.