For a typical 50,000–100,000 square-foot medical office building (MOB), plan for 18–30 months from initial concept to opening, with the biggest variables being delivery method, Authority Having Jurisdiction (AHJ) reviews, and specialty scope such as imaging or an ambulatory surgery center (ASC). Why it matters Time drives return on invested capital. At a 5% cost of capital, each month of delay on a $50 million project translates to roughly $208,000 in carrying cost before a single patient is seen—capital that could otherwise support clinical growth or workforce initiatives. In today’s environment of higher borrowing costs and competitive ambulatory expansion, compressing the schedule without compromising quality directly improves ROI and speeds access to care. Market dynamics also favor timely delivery. In fast-growing regions such as Nashville and Middle Tennessee, physician alignment, outpatient market share, and site control move quickly; a slow real estate timeline can force program compromises or lost opportunities. The goal is realism—anchoring milestones to evidence-based benchmarks—so executives can align clinical, capital, and operational decisions with confidence. How it works The end-to-end MOB timeline typically includes: strategic alignment and programming; site [...]

In most U.S. markets, plan for roughly 24–36 months from concept to opening for a 50,000–150,000 SF medical outpatient building (MOB), spanning preplanning and entitlements (6–9 months), design and procurement (8–12 months), construction (12–18 months), and commissioning and occupancy (1–3 months), with variation driven by AHJ review, delivery model, and long-lead materials. Why it matters Time-to-market directly affects revenue capture, physician alignment, and capital efficiency. Each month of delay defers clinic volumes, imaging throughput, and downstream referrals—eroding the project’s net present value. Elevated interest rates also increase carry costs during development, putting a premium on disciplined schedules and early risk mitigation. The Federal Reserve’s H.15 data underscores how rate environments shape the cost of capital, which compounds across multi-year projects. A realistic, front-loaded schedule protects ROI by sequencing entitlements, design, procurement, and construction in a way that prevents idle time. It also clarifies when to activate physician recruitment, equipment purchasing, and payer notifications so clinical and operational go-live align with substantial completion. In Middle Tennessee, for example, differences between Nashville Metro and suburban jurisdictions can materially affect preconstruction timeline assumptions. How it [...]

How do you decide where to build your next ambulatory care facility? Use a data-driven, stepwise process that aligns service-line strategy with market demand, regulatory constraints, capital costs, and delivery timelines—validated by clear financial thresholds, site criteria and service line analytics for any given location. Why it matters Ambulatory care has been steadily gaining share as procedures migrate out of the hospital, putting a premium on the right locations for access, payer mix, and growth. National healthcare real estate analyses show resilient demand for outpatient space and continued expansion of physician-aligned facilities, making poor siting decisions costly and hard to unwind. Independent market evidence indicates that systems capturing outpatient shifts earlier tend to defend referral channels and reduce leakage, improving downstream contribution margins in acute settings. JLL Healthcare Real Estate Outlook At the same time, the cost of capital remains elevated compared to the pre-2022 era, so every project must clear stricter hurdle rates and timing risks. The Federal Reserve’s target federal funds rate reached 5.25%–5.50% in 2023, and rate conditions continue to influence borrowing costs and discount rates used in real [...]