The medical office building (MOB) market continues to demonstrate resilience as healthcare delivery evolves, tenant expectations shift, and capital markets adapt. To understand the dynamics shaping today’s MOB landscape, I sat down with my colleague Marianne Skorupski, Director of National Office Research at Colliers.

In my role leading Agency Leasing, I work closely with multiple service lines to anticipate trends and guide clients through complex leasing decisions. Marianne brings a data-driven perspective, and this Q&A highlights the insights we’re seeing across vacancy, rents, tenant behavior, and emerging opportunities.

Matt: Based on your research, what are the current trends in medical office leasing regarding vacancy, rental rates, and tenant demand?

Marianne: MOBs remain one of the most stable segments in commercial real estate (CRE) due to consistent healthcare demand and the continued shift toward outpatient care. Their performance is supported by long-term leases, needs-based patient utilization, and high tenant retention, all of which contribute to superior risk-adjusted returns compared with many traditional CRE asset classes. Health systems and physician groups are strategically improving their locations, modernizing clinical space, consolidating into larger or newer facilities, and expanding in high-growth suburban and Smile State markets, reinforcing strong leasing fundamentals for well-located MOBs.

Steadily lowering vacancy rates reflect strong healthcare demand, limited new supply, and favorable long-term demographic trends. As a result, the MOB vacancy has remained lower and more stable than traditional office space from 2018 to 2025.

On a cumulative basis since the pandemic, demand has exceeded new supply by 4.7 million SF, confirming that post-pandemic absorption strength extends across the broader Top 100 markets.

Growth has also been robust in the top 100 U.S. markets. Average rents were $21.86/SF in 2018, rising steadily to $25.79/SF in 2025, approximately 18% growth. Several interconnected forces are driving a steady rise in medical office rents.

Matt: How are shifts in healthcare delivery and provider needs impacting MOB leasing patterns and lease structures?

Marianne: Several factors are driving change:

• Outpatient and ambulatory care growth is redefining site selection strategies and prompting expansion in high-growth suburban and “Smile State” markets.
• Digital health and AI adoption require modernized power and IT infrastructure to avoid delays in patient care.
• Workforce shortages and operational pressures are influencing location and design decisions, as providers balance patient and employee needs.
• Consolidation, M&A, and strategic partnerships can create expansion opportunities, while overlapping services sometimes lead to closures.
• Real estate optimization and portfolio management are now central; health systems are aligning footprints with outpatient growth, repurposing inpatient space, and optimizing operations to reduce costs.
• Rising costs and capital constraints are shaping disciplined investment decisions, efficiency initiatives, and partnerships.

Overall, these shifts are prompting more strategic site selection and lease structures that support operational flexibility.

Matt: What metrics or data points should landlords and investors focus on in today’s MOB market?

Marianne: Investment trends reflect a disciplined but constructive market. While transaction volume has softened due to higher interest rates, investor appetite remains strong for high-quality assets and operators with scale, specialized clinical capabilities, or strong regional density.

Capital is increasingly flowing toward on-campus and near-campus medical office buildings, outpatient surgery centers, and real estate linked to high-acuity services. Investors and their capital partners have shown significant demand for healthcare real estate. Many have formed new joint ventures through new acquisitions or portfolio recapitalizations and have dry powder ready to deploy. The general stability of healthcare tenancy, buoyed by long-term demand drivers, continues to make healthcare real estate a sought-after asset class, with capital-market demand currently outpacing supply.

Matt: Looking ahead, where do you see the greatest opportunities for innovation in medical office leasing?

Marianne: Although the ultimate level of success is yet to be determined, there is a growing trend among property owners to convert traditional office buildings into medical outpatient facilities. Given the significant challenges of constructing new properties in today’s environment, these conversions may offer valuable opportunities for health systems and providers seeking to address unmet needs. While this trend is not yet widespread, positive outcomes in local markets can drive growth in otherwise stable regions.

In closing
Our conversation highlights that the MOB market remains strong, even as it adjusts to healthcare delivery shifts, rising costs, and evolving tenant needs. Vacancy rates are low, rents are rising, and investors continue to seek high-quality, well-located assets. The greatest opportunities will come from strategic site selection, portfolio optimization, and creative solutions like adaptive reuse of existing office space. Staying ahead of these trends will position landlords, investors, and tenants to succeed in this dynamic segment of healthcare real estate.