Ground-Up Medical Development Part 2: Where It Actually Makes Sense

Last week we talked about how ground-up medical development is starting to creep back into the conversation. But here’s the truth: it’s not happening everywhere. And it shouldn’t be.

So where does it make sense?

Markets with real population growth.

You need rooftops, not just demand on paper. Texas, Florida, Tennessee, and the Carolinas continue to draw inbound migration and aging demographics—two key ingredients for new builds, especially in behavioral health and senior-focused outpatient care.

Land that doesn’t kill the deal.

Rising construction costs are already a problem. Add overpriced land or heavy site work, and you’re underwater before you ever pour concrete. The best projects right now are on shovel-ready sites that were banked years ago or offered through JV partnerships with health systems or municipalities.

Operators who know what they’re doing.

A ground-up build only works if it’s tied to a scalable operating model. Lenders and equity partners want to see a team that has already proven they can fill and run a facility—not just build one. No one’s gambling on first-timers right now.

The takeaway? Ground-up isn’t back for everyone. But for the right group in the right market with the right playbook—it’s a competitive advantage.

Curious if ground-up fits into your growth strategy? Let’s talk.

📅 Book a 15-minute call

📰 Get our newsletter