The healthcare landscape is shifting in ways that are starting to show up both inside clinical settings and across the real estate decisions that support them. Costs are rising, care delivery is changing, and patients are asking for more flexibility and convenience. Together, these forces are creating a moment where organizations are rethinking not just how they operate, but where and how they invest.

The five statistics below help frame the trends shaping the months ahead and what they could mean as we move toward 2026.

Provider margins continue to tighten

Analysis shows that provider EBITDA as a share of total health spending declined by roughly 200 basis points between 2019 and 2024. Projections suggest it may fall another 100 basis points by 2027 without meaningful intervention. This steady compression is forcing organizations to take a closer look at the performance of every facet of their business.

For real estate, that often means taking stock of the size, mix, and purpose of existing portfolios. Many systems are exploring more flexible formats, smaller and more efficient footprints, and the adaptive reuse of existing buildings rather than pursuing capital-intensive ground-up projects. As financial pressure increases, the appetite for real estate strategies that reduce long-term commitments is only growing.

Health spending is growing faster than the overall economy

Current projections indicate that national health expenditures will outpace GDP growth by roughly 1.2% per year over the next five years. The trend is not new, but the gap is widening, and it is creating ripple effects for providers, payors and patients. As costs rise, organizations are prioritizing operational efficiency and technology enabled models that can help ease the burden. Real estate planning is following suit. Locations and layouts that support efficient workflows, smoother patient movement and reduced square footage are becoming more important. The question is not how much space a system can acquire, but how well that space supports care delivery.

Workforce pressures are shaping operational and facility decisions

A recent survey found that more than half of healthcare workers in the United States are considering leaving their jobs within the next year. Burnout, high workloads, and declining job satisfaction continue to challenge organizations nationwide.

These pressures influence more than staffing strategies. They also affect decisions about when and how to expand, how much space is needed, and which functions can be redesigned to reduce administrative burden. Facilities that support streamlined workflows, flexible staffing zones, and a better day-to-day experience for employees are becoming an increasingly important part of retention and recruitment.

Outpatient and ambulatory care are expanding at a steady pace

Outpatient care has been outpacing inpatient care for years, and that trend is accelerating. Procedure volume in ambulatory surgery centers is projected to grow by roughly 9% between 2023 and 2028 as more care moves closer to where people live.

This shift is influencing real estate strategy in a meaningful way. Providers are leaning toward smaller, service-specific locations that offer easier access, lower operating costs, and a better patient experience. Traditional hospital campuses remain essential, but the center of gravity is shifting outward into community-based sites that support convenience and more predictable operating environments.

Patients are expecting a more connected and proactive care experience

The 2025 PwC US Healthcare Consumer Insights Survey shows just how much the next generation of patients is reshaping expectations for care. Gen Z, the first fully digital native cohort, is already changing how providers think about both operations and facility design. According to the survey, 79% of Gen Z use health technology such as wearables, telehealth, or online prescription tools on a monthly basis, a far higher rate than older generations. Many are also more willing to use AI-assisted tools and new care navigation technologies to guide decisions.

These behaviors signal a shift toward care models that blend digital access with strategically located in person sites. As patients expect more seamless coordination, faster access, and the ability to handle routine steps online, organizations are rethinking how their facilities support hybrid care delivery. Clinics that integrate virtual care workflows, provide flexible layouts for team based care, and reduce friction for patients moving between digital and physical touchpoints will be better positioned to meet rising expectations and build long term loyalty.

Looking ahead

What emerges from these statistics is a picture of an industry that is moving toward more flexible, cost aware and patient oriented models. Real estate strategies that support those goals will help organizations stay competitive as the pace of change accelerates. The coming year will reward teams that plan proactively and build space that can adapt as care delivery continues to evolve.