What to Watch in Medical CRE This Week

Week of October 5 to October 11, 2025

This week will test how fast medical real estate adapts amid seismic policy shifts. With telehealth flexibilities now expired and a federal shutdown in place, the pressure is on.

First, the fallout from the telehealth expiration is going to be front and center. As of October 1, many of the Medicare telehealth waivers enacted during COVID have lapsed, including home-based visits and expanded site allowances. That leaves operators that leaned heavily on virtual care squeezed. Providers can still offer telehealth—but unless Congress steps in, reimbursement will be constrained and retroactive coverage remains uncertain.   The American Telemedicine Association has already called on Congress to restore flexibilities and ensure retroactive payment.   This week, expect to see whether legislative or appropriations vehicles include telehealth rescue language. That’s the signal line for whether hybrid care models hold their value.

Second, the government shutdown will continue to ripple across approvals, survey timelines, and regulatory pathways. While Medicare payments continue, discretionary agency functions are paused or slowed. That means permit reviews, licensing, certificate of need (CON) decisions, and certain grant flows may lag.   For medical real estate deals in the pipeline, that means schedule buffers are table stakes now.

Operator and system moves will also matter. Health systems that have stayed on the sidelines may begin to deploy capital now that reimbursement clarity is under strain and real estate valuations may drift. Look for announcements of clinic openings, acquisitions of outpatient assets, or repositioning efforts—especially in Sunbelt and fast-growing suburban markets, where the outpatient buildout case still holds strength. MOB fundamentals remain resilient, and some markets are still seeing limited supply pressure.   Systems with stronger balance sheets may take advantage of dislocations, accelerating their outpatient footprint. 

Watch also how REITs respond. Investors will be dissecting earnings calls and disclosures for clues on how capital is rebalancing in this environment. Medical Properties Trust continues to be in the spotlight as its landlord role intersects with distressed operators. 

The week ahead may feel like a test of endurance rather than action. But beneath the stress, there will be signals. Which markets hold up when reimbursement compresses? Which operators can flex their model? Who captures opportunistic ground when quieter assets go on market? If you want help interpreting what these signals mean in your target geography, I’d be glad to walk through them with you.

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