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Maximizing ROI: Health System Finance, Real Estate, Population Health, Value-Based Care, Clinical Integration, CON

Capital constraints, CON laws, and the shift to ambulatory care are reshaping value-based delivery. Leaders must hit the trinity of clinical outcomes, operational throughput, and financial performance while preserving ratings and liquidity. One question we’re hearing: How should our health system balance ambulatory expansion with acute-care investment to maximize capital efficiency and population health impact? As healthcare-exclusive strategists since 1989—validated by our acquisition by Duke Realty—we integrate operations, population health, and capital planning to turn strategy into execution. Bremner leads strategic portfolio optimization that repositions underutilized space, frees trapped capital, and improves access—linking ROIC to care models and system goals. What follows is a CFO-ready, fiduciary playbook you can take to the board. Health system leaders are confronting a trilemma: protect margins, expand access, and modernize facilities under value-based care and persistent capital constraints. The fastest ROI increasingly comes from repositioning underutilized space, right-sizing ambulatory networks, and embedding digital into the care model. As a healthcare-exclusive platform since 1989—validated by our acquisition by Duke Realty—and a partner to national health systems on $100M+ on and off-campus developments, Bremner translates strategy into measurable [...]

2025-10-03T15:05:19+00:00October 1st, 2025|Blog|0 Comments

Health System Finance, Healthcare Real Estate Investment for Value-Based, Population Health, Clinical Integration, CON

Capital constraints, CON scrutiny, and the ambulatory shift are colliding with rapid value-based care adoption. Boards now expect real estate to advance clinical outcomes, operational throughput, and financial performance—measured in HEDIS/STARs, first-contact resolution, and risk-adjusted ROI. How should our health system balance ambulatory expansion with acute care investment while maximizing capital efficiency? Bremner Healthcare Real Estate—healthcare-exclusive since 1989 and validated by acquisition by Duke Realty—builds population health footprints and clinically integrated hubs through strategic portfolio optimization, aligning location, capital structure, and care models to reduce leakage and PMPM. We act as healthcare real estate strategists embedded in operations and capital planning, not brokers of square feet. Healthcare real estate strategy is now inseparable from value-based performance. Boards are asking how location, capital structure, and care models translate directly into HEDIS improvement, leakage reduction, and PMPM savings. Bremner’s healthcare-exclusive focus since 1989, institutional validation via acquisition by Duke Realty, and track record of $3.2B+ on-campus and off-campus developments and national health system partnerships demonstrate a proven method for execution. The sections that follow connect population health, clinical integration, finance levers, and compliance into [...]

2025-10-01T14:05:24+00:00September 16th, 2025|Blog|0 Comments

Clinical Integration, Health System Finance, Population Health, VBC, CON Strategy, Healthcare Real Estate Investment

Capital constraints, Certificate of Need scrutiny, and the accelerating shift to ambulatory, value-based care are forcing health systems to rewire networks for population health. The bar is triple: clinical integration, operational throughput, and financial resilience. Executive prompt: How should our health system balance ambulatory expansion with acute care investment to optimize capital efficiency and strategic portfolio performance? Bremner Healthcare Real Estate is a healthcare-exclusive strategist and developer, translating care models into access, cost, and growth—since 1989 and validated by the Duke Realty acquisition. We align service lines, finance, and market execution, treating real estate as the operating system for integration and site-of-care shift. From JV ASCs to $100M+ campuses, we build board-ready, rating-agency-transparent plans that advance population health while protecting the balance sheet. Health systems are retooling their portfolios to support clinical integration, value-based care, and margin resiliency. Real estate is the operating system for these ambitions, translating strategy into daily workflows and patient access. The right facilities plan improves network integrity, protects the balance sheet, and accelerates growth in the settings patients prefer. With decades as a healthcare-exclusive partner since 1989—validated [...]

2025-09-01T14:12:25+00:00September 1st, 2025|Blog|Comments Off on Clinical Integration, Health System Finance, Population Health, VBC, CON Strategy, Healthcare Real Estate Investment

Planning Exit Strategies That Preserve Value in Health System Real Estate Holdings

Capital constraints, CON timelines, and the shift to ambulatory, value‑based care are tightening the window for health systems to realign their real estate. The mandate is triple‑aim: protect clinical integration and population health access, keep operations seamless, and improve capital efficiency. Executive prompt: How should our health system balance ambulatory expansion with acute care investment? Bremner Healthcare Real Estate—healthcare‑exclusive since 1989 and validated by our acquisition by Duke Realty—advises beyond transactions. We integrate service-line strategy, regulatory timing, and balance‑sheet goals to turn exits into strategic portfolio optimization, not one‑off sales. With national health system partnerships and $3.4B+ on campus and off campus developments, we bring fiduciary rigor and operating fluency to structure sale‑leasebacks, JVs, and recapitalizations that preserve provider control and unlock growth. Health systems are exiting owned real estate to unlock capital, reduce risk, and accelerate value-based care—not to chase one-time gains. The most successful exits align directly to population health strategy, operational continuity, and balance-sheet resilience while preserving provider control. With healthcare cycles tightening, a disciplined approach to objectives, segmentation, structure, regulatory timing, and clinical integration is essential. Bremner Healthcare [...]

2025-08-27T19:10:58+00:00August 27th, 2025|Blog|Comments Off on Planning Exit Strategies That Preserve Value in Health System Real Estate Holdings

Structuring Healthcare-Real-Estate Investment JVs: Health-System Finance, Population Health, Value-based Care, Clinical-Integration, CON Strategy

Capital is tight, CON regimes are unpredictable, and value-based contracts keep shifting care to ambulatory settings. The imperative is clear: expand access and standardize quality while protecting the balance sheet and preserving clinical control—simultaneously advancing clinical, operational, and financial performance through population health, capital efficiency, and strategic portfolio optimization. Executive question: “How should our health system balance ambulatory expansion with acute care investment?” Bremner Healthcare Real Estate is healthcare-exclusive since 1989—our market leadership validated by acquisition by Duke Realty. We’re strategists first, translating care models and capital plans into JV structures, governance, and campuses that perform—not just property transactions. Health systems are turning to real estate joint ventures to expand access, accelerate ambulatory strategies, and protect balance sheets—without compromising clinical control. When designed around population health and value-based outcomes, a JV becomes an operating asset that advances the care model, not just a financing tool. Bremner has been healthcare-exclusive since 1989, with market leadership validated by our acquisition by Duke Realty and programmatic partnerships with national health systems. Our track record includes $3.4B+ on campus developments that tie capital to performance, governance, [...]

2025-08-27T19:07:24+00:00August 25th, 2025|Blog|Comments Off on Structuring Healthcare-Real-Estate Investment JVs: Health-System Finance, Population Health, Value-based Care, Clinical-Integration, CON Strategy

Five Real Estate Questions Healthcare Professionals Should Be Asking

Healthcare real estate is a fast-paced dynamic world; a strong real estate portfolio is critical in empowering systems and physician groups to achieve the “Holy Trinity” of healthcare. Quality of care, convenience, and cost-effectiveness. Outdated spaces, on the other hand, are a drain on all three, and operational and profitability challenges impact your ability to deliver the exceptional standard of care to which you hold yourself. When investigating opportunities, it is essential to ask some tough questions and dig deep into your current assets, as well as your future goals. Here are five healthcare real estate questions (and a bonus “big” question!) to ask as you start the process: Do our existing real estate assets provide our community with a top-rated healthcare experience?  Healthcare providers and systems need to take an unflinching look at their existing portfolio. Is it meeting their needs? More importantly, is it meeting the needs of those they serve? If not, dig deeper: Why? What’s wrong, and how can we fix it?  There are a number of red flags that indicate a portfolio is not conducive to providing [...]

2021-05-20T16:10:47+00:00May 20th, 2021|Blog, News|Comments Off on Five Real Estate Questions Healthcare Professionals Should Be Asking

Strategy, Financing, Development: An Innovative Perspective in Healthcare Real Estate

One of the largest problems within the delivery of healthcare is aging infrastructure and the buildings themselves fail patients and providers alike. Whether they create compliance issues, simply underperform because of lacking space and equipment, or are in the wrong location, they are a real problem that has only been further exposed by the COVID-19 pandemic. Aging infrastructure has made it tough to find enough dedicated facilities in hospitals for COVID-19 care, so many patients flood emergency rooms each day, potentially exacerbating the spread of the virus. COVID-19 has also shown a real demand for additional outpatient facilities to treat affected individuals. The reality is that often new facilities could position entire health systems for better patient care in terms of COVID-19 or the next health pandemic to face people. The Reality of COVID-19 Few responses to the COVID-19 pandemic have been as heroic as those mounted by hospitals and healthcare facilities across the United States. As outbreaks continue to happen, hospitals and health systems have increased testing efforts, worked with what they had to create treatment spaces, and fought to provide [...]

2020-12-15T20:07:54+00:00December 15th, 2020|Blog, News|Comments Off on Strategy, Financing, Development: An Innovative Perspective in Healthcare Real Estate
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