JLL Notes Role of Real Estate in Healthcare

CHICAGO -- Mounting insurance-coverage anxieties and convenience demands are forcing health systems to transform their real estate from cost centers into competitive advantages, according to JLL’s 2025 Patient Consumer Survey.

The survey found that insurance coverage continues to dominate healthcare decision-making as sweeping policy changes threaten to create a perfect storm of financial pressures while fundamentally reshaping how patients choose and access care.

The survey found that two-thirds of respondents without health insurance did not receive in-person care in the past year, and patients have significant anxiety over losing healthcare coverage; 56% of Medicaid and 40% of Medicare recipients, along with 38% of those covered through an employer or a union, reported concerns over losing healthcare coverage in the coming year.

“Health insurance coverage losses have widespread economic impacts, upending patient finances while simultaneously strangling health system revenues through reduced volumes and surging uncompensated care costs,” said Matt Coursen, U.S. Healthcare Lead, Leasing Advisory. “When patients defer preventive treatment due to coverage fears, they inevitably return sicker and require far more expensive emergency interventions. For providers, strategic location decisions can mean the difference between financial sustainability and organizational survival.”

“While insurance coverage remains the primary gatekeeper to healthcare access, our research reveals striking geographic disparities that make convenience and proximity even more critical for patient outcomes,” said Cheryl Carron, COO of Work Dynamics Americas and President of the Healthcare Division at JLL. “When rural patients must travel more than half an hour for essential care while suburban patients enjoy easier access times, we see how real estate strategy directly determines who can receive timely treatment. Health systems serving diverse geographic markets must strategically position facilities to optimize both operational efficiency and patient outcomes, creating a competitive advantage that extends far beyond basic operational considerations.”

Location strategy drives market share
Among those with insurance coverage, location/proximity was a decisive factor, ranking second across all care types and creating new imperatives for healthcare real estate strategy as organizations fight for market share in an increasingly competitive landscape. Convenience and easy access to the facility also correlate with a more positive patient care experience.

Hospital footprints are expanding dramatically as a result, with square footage completed in the last twelve months surging 34% from Q1 2023 to Q2 2025. This reflects the growing importance of proximity and convenience in healthcare delivery, especially as patients increasingly prioritize location when selecting providers.

“The convenience factor means more than proximity since the goal is removing every possible friction point in the patient journey,” said Kari Beets, Senior Manager, Industries Research, JLL Healthcare. “Our research reveals significant gaps that directly impact patient experience; those who rated their providers highly were much more likely to report easy parking access at 87% versus just 58% for dissatisfied patients, and simple navigation to their destination at 91% versus 62%. These seemingly small operational details are major competitive differentiators that can make or break patient loyalty.”

Location strategy also proves increasingly critical for capturing market share, particularly for urgent and emergency care services where patients have more provider options. From 2023 to 2025, urgent care utilization increased by 240 basis points to 27% of patients having an urgent care visit within the last year, with nearly 83% of users rating their urgent care location as convenient.

Hospitality mindset required
Facility quality emerged as a critical decision factor, particularly for acute care settings where patients most need confidence in their care environment. More than half of patients considering inpatient care ranked facility quality among their top five selection criteria, the highest percentage across all care types.

First impressions create lasting impact on patient satisfaction, with service quality, wait times and waiting area comfort showing the largest satisfaction gaps between promoters and detractors. While patients spend relatively little time in waiting areas for surgical care, the quality of the space disproportionately influences their overall experience and likelihood to recommend the provider.

“Healthcare real estate strategy must evolve beyond traditional metrics to embrace a hospitality mindset,” said Dan Squiers, Executive Vice President, Healthcare Lead, JLL Project and Development Services. “Health systems that prioritize convenience factors – from Wi-Fi quality in waiting rooms to what patients see when they first walk through the door – will better attract and retain patients.”

Real estate represents 15 to 20% of operating budgets for most health systems. The survey identifies key opportunities for healthcare providers to leverage real estate strategy in addressing challenges. As potential coverage losses threaten revenue streams, strategic portfolio evaluation becomes essential for balancing care access with operational costs while expanding higher-margin services.

The nationally representative survey was conducted from June 18-26, 2025, among 4,061 U.S. residents across urban (31%), suburban (48%) and rural (22%) communities, providing comprehensive insights into patient preferences and healthcare utilization patterns.

For more, go to jll.com.