Planning Healthcare Facilities That Drive Growth
Creating Resilient, Future-Ready Spaces to Transform Care Delivery
Rising costs. Shifting care models. Uncertain margins. Healthcare leaders face a new set of challenges that demand more than incremental changes to facility planning. Across the country, health systems are rethinking how, where, and when to invest in infrastructure—moving away from a project-by-project mindset and toward long-term, outcomes-based capital strategies.
Pressures Reshaping Healthcare Capital Strategy
For decades, healthcare capital planning was largely reactive: adding beds when demand spiked, renovating outdated spaces, or expanding service lines to capture market share. That approach no longer works. Today’s environment requires deliberate, forward-looking strategy because:
- Margins are shrinking. Between 2024 and 2025, the national median health system margin fell a full percentage point to under 1% (Strata). With operating costs rising faster than reimbursements, every investment must deliver measurable value.
- Costs are unpredictable. Inflation, workforce shortages, and supply chain disruptions have driven up project costs and made long-term forecasting far more difficult.
- Policy changes create uncertainty. Shifts in federal healthcare policy affect reimbursement models, capital funding, and compliance requirements—forcing systems to plan amid ongoing uncertainty and a potential 14.2M increase in uninsured people over the next 10 years (Advisory Board).
- Care delivery is shifting. Patient demand continues to shift away from inpatient settings, creating new facility and technology needs. Estimates project nearly $50B in hospital volumes could shift to the outpatient setting (Advisory Board).
Stay Ahead of Market Shifts
Mortenson's quarterly Cost Index provides healthcare leaders with the latest data on construction costs, supply chain trends, and labor impact—helping you make informed capital decisions with confidence.
A Shift: Resilient, Outcomes-Based Planning
Forward-looking organizations are adopting capital strategies to prioritize long-term resilience over short-term fixes. Instead of evaluating projects in isolation, leaders are asking:
- How will this investment strengthen the system’s ability to adapt to future change?
- Can this facility remain flexible as care models evolve?
- In what ways can capital dollars drive both clinical excellence and financial resilience?
This shift requires a holistic view of facilities—not just as physical assets, but as strategic enablers of growth, efficiency, and improved patient outcomes. So, whether you’re expanding or optimizing your space, it’s critical to consider how your facilities strategies will help you achieve your goals.
At the 2025 Mortenson Healthcare Leaders Summit, system leaders, spanning across the nation, ranked their top strategic priorities, providing insight into how organizations are putting the concept of facilities as strategic assets into practice. In order of importance, some examples include:
- Master Planning & Forecasting: Integrating market analysis and data-driven decision-making to design flexible facilities—like convertible rooms and system-wide investments—that anticipate future needs and align leadership around a unified strategy.
- Service Line Strategy: Realigning and expanding clinical service lines, with a focus on behavioral health and partnerships to optimize resources.
- AI & Infrastructure Planning: Applying AI and analytics to improve facility design and operations, with an emphasis on overcoming data standardization challenges.
- Revenue Models: Developing financial strategies, such as expanding ambulatory surgery centers and exploring payment models for sustainable efficiency.
The alignment between these priorities and national trends demonstrates that facilities are central to delivering results. By integrating capital planning, service line optimization, and infrastructure investments, organizations are not just building spaces-they are shaping the flexibility, efficiency, and financial resilience needed to meet evolving care demands.
Resilient capital strategy means measuring success not just in square footage or cost per bed, but in how well those investments position organizations for long-term clinical and financial strength. In the Chicago metro area, some systems are introducing multi-year capital performance dashboards, while others are using project-level ROI reviews to ensure investments continue delivering intended outcomes.
Candace Small
Senior Design Phase Manager, Mortenson Chicago
Across the country, system leaders are adapting to address these challenges through more integrated, future-focused capital strategies. One of the largest nonprofit health systems in the U.S., with whom Mortenson partners on capital and planning initiatives, is undertaking a radically holistic master planning effort after decades of operating within a joint venture. With multiple hospitals located just miles apart, leaders are redefining their identity and service distribution—planning not only for today’s needs but for population growth and evolving care models through 2040 and beyond. Their approach includes aligning campus footprints with future service line priorities, building capacity for specialized care, and accelerating expansion following major partnership shifts. By bringing outsourced services 90 back in-house and designing flexible spaces that can support both inpatient and ambulatory growth, they’re establishing a resilient capital framework that supports long-term adaptability, clinical excellence, and financial strength.
Key Actions for System Leaders Like You
In 2026 and beyond, the most successful health systems will be those that:
- Plan for adaptability, not just expansion. Facilities must flex to support new models of care.
- Connect capital to mission. Investments should be measured by outcomes—clinical, operational, and community impact.
- Balance bold moves with risk resilience. Smart planning means building in room for uncertainty with the right expert, early.
The Bottom Line
Healthcare infrastructure decisions are no longer just about bricks and mortar. They are about resilience, adaptability, and impact. By rethinking capital strategy, leaders can build facilities that not only meet today’s demands but also prepare their organizations for whatever the future brings.