BLOGS: Womble Commercial Real Estate

Wednesday, July 31, 2013, 10:35 AM

Medical Office Space and Repurposing (but this time, it’s not what you think)

We’ve covered the repurposing of properties (mainly retail) into healthcare real estate, but we haven’t seen this before – repurposing medical office space into a non-healthcare use.  You can read about this anomaly here:  “Kingston celebrates new city hall, a former medical office building”.

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Friday, July 26, 2013, 10:20 AM

Medical Office Today Talks Timeshares With Girardeau And McDermott

The lure of timesharing a medical office can be a compelling one, but attorneys Jill Girardeau and Gary McDermott talk with Medical Office Today about why it can be a complicated endeavor.

In the article, online here, Girardeau and McDermott explain that while there are certainly advantages to using a timeshare office, such as lower overhead and expanding services, the contract and logistics must be carefully thought out.

"I think the trickiest issue is protecting yourself against violations of kickback laws and the Stark Law,” McDermott said. “What might seem reasonable in a typical landlord-tenant scenario can get you in hot water when medical practices are concerned."

Read more...

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Tuesday, July 23, 2013, 5:59 PM

Healthcare Real Estate, 2013 - How Is It Shaping Up?

With just over half of the year under our belts, it's a good time to look back and evaluate the year thus far.  This can be a valuable exercise – it can help us better understand where we’re headed.  (To look back beyond that, click here for Healthcare Real Estate Insights' review of top trends in healthcare real estate from 2003 to 2012.)

Some predicted that 2013 would be the year that “we become the health care (sic) nation”, with health care being the largest issue that the USA would face in 2013 (Fortune/CNN Money). Although some will not agree with the “largest issue” prediction has been the case, I believe that we can all agree that healthcare and healthcare real estate have been major players in 2013’s economy.

Generally speaking, the reviews thus far this year regarding healthcare real estate have been  overwhelmingly positive, if not outright celebratory, using those terms developers love such as “booming”, “growing”, and “heating up” (see e.g., Construction of Medical Buildings Booming on South Shore (Enterprise News), Demand Accelerates for Medical Office Buildings (NBI Properties), Demand for MOBs Greater Than Ever (GlobeSt.com),  and Construction Booming in Medical Office Building Market (American Medical News)).

Looking back on the first half of 2013, the articles and reports are overwhelming positive.  In making my rounds lately, listening to investors, developers and lenders, their outlook on healthcare real estate is a bit more cautious than much of what I read, but it is still very positive.  And most telling of all?  They are in the game, investing time, money, and effort in healthcare real estate.  In other words, they are looking forward….

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Tuesday, July 16, 2013, 3:03 PM

An Ounce of Prevention (and a Dash of Technology, and a Sprig of Innovative Design)

As evidenced by previous posts, innovation in healthcare is rapid, whether it be in the arena of real estate design, apps, or a focus on wellness and prevention.  Here’s an interesting article about a “prototype medical practice of the future”, which incorporates several areas of healthcare innovation.

MD Revolution Offers Blueprint for “Health Management” Practice
Xconomy
By Bruce V. Bigelow

On the seventh floor of a medical office building near Scripps Memorial Hospital La Jolla, Dr. Samir Damani has established a prototype medical practice of the future.

The suite looks more like a spa than a doctor’s office, with modern art mounted on chalk white walls and white-washed wooden floors that bespeak understated elegance and calm. Subtle lighting illuminates enough MacBooks, iPads, and desktop monitors to stock an Apple store, and the shelves display a host of wireless health devices, including a Digifit heart rate monitor, MyFitnessPal calorie counter, and Fitbit activity tracker.

In a whirlwind tour, Damani explains the suite is both a clinical lab and a medical practice that brings together a variety of health and fitness monitoring technologies. As both a practicing cardiologist and researcher, Damani says he came to The Scripps Research Institute to complete a master’s degree in clinical investigation; he was focusing on genomics and the biomarkers of disease when he saw that cardiovascular disease was reaching epidemic proportions among older Americans. Instead of waiting for patients to develop chronic illnesses—and using medical interventions and pharmaceuticals to treat them (at a projected cost of $500 billion by 2015)—Damani says he realized he should be working to help patients improve their metabolism and cardiovascular fitness.

Damani says he founded MD Revolution to manage patients’ health by using a variety of diagnostics and sensors to track the most important indicators of cardiovascular health, and to integrate good nutrition, exercise, and other healthy practices into a holistic program. “We’re not in the game of creating the sensors and hardware,” Damani says. “What we’re doing is integrating all these different platforms into a dashboard that patients can understand and use. We have to really engage people to change their behavior.”

Integrating data from heart monitors, calorie counters, and other sources into a single platform was no trivial task, and Damani says MD Revolution has invested between $500,000 and $1 million in the effort. Since the company was founded in early 2011, it has raised $2.25 million from doctors and other high net-worth individual investors, according to Camille Saltman, who joined MD Revolution in January as president and chief operating officer. She was previously president of Connect, the nonprofit group that supports technology innovation and entrepreneurship in San Diego.

“Unlike many early stage companies, we have revenues from patients, which has enabled us to reduce our burn rate and lessened the need to raise larger amounts of capital,” Saltman says. In pioneering its clinical practice in La Jolla, Saltman says MD Revolution also was able to keep its costs down by applying software developed for the practice to the design of the software platform.
Damani is set to unveil the new software platform, dubbed RevUp, in a scheduled presentation today at the Digital Health Summit in New York. The company describes RevUp as the first Web-based software platform to aggregate mobile tracking tools, genetic and metabolic assessments, and personalized coaching for employee groups, health systems, and physician practices.

In a statement, MD Revolution says, “The system creates a personalized diet and exercise regime for each individual based on health status and goals.” A team that includes two nurse practitioners, nutritionist, and exercise physiologist track each patient’s progress. Each patient can view their own personal health profile online as well—and those who lapse in their workout routine get a call from the MD Revolution team.

By collecting and monitoring such data, RevUp says it can provide the kind of information that employers need to win discounts on medical benefits and other new incentives that are being offered under the federal Affordable Care Act.

The company asserts that over 90 percent of the patients enrolled at MD Revolution “have experienced statistically significant improvements in resting metabolism, body fat, visceral fat reduction, and improvements in cardiorespiratory fitness.” Damani says the latest scientific research shows these are the most important drivers of chronic cardiovascular diseases.
At MD Revolution, he says, “We have not just built a delivery model. We’ve built a business model for a new paradigm in health care.”

Damani anticipates franchising MD Revolution throughout the country, and tells me, “I see this as a Starbucks model for health care.” But Saltman also says a more practical market may be large companies and health care systems that are self-insured—and therefore keenly interested in reducing their soaring employee health costs.

“With the changes under the Affordable Care Act, it became very cost-effective for physicians to keep their patient population as healthy as possible,” Saltman says. So far, MD Revolution counts 250 individual patients in its pilot practice in San Diego, along such corporate clients as Pharmatek and Sharp Healthcare, the San Diego nonprofit regional health care system with more than 14,000 employees and $2.7 billion in revenue last year.

That seems like a good start, although Damani says, “We expect to have 100,000 patients under management by 2017.”

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