Cancer Centers a Growth Area for Hospitals, Investors

By 2030, the incidence of cancer in the United States will increase to 45 percent; by 2050, that rate will hit 50 percent. Americans born today have a 40 percent chance of developing the disease and one in three will be diagnosed by age 65.

The healthcare industry is well aware of what some experts are calling the “slow motion” cancer epidemic, and with the demand for oncology care expected to skyrocket 36 percent over the next decade alone, most healthcare systems are scrambling to add cancer care services to their repertoire, either by building new cancer centers on existing hospital campuses or expanding treatment facilities.

“Three of our recent major new medical campus projects have included separate cancer centers and one of our long-term not-for-profit clients is in the planning stages for a new cancer center on their main medical campus,” said John Kemper, CEO of hospital facilities service firm KLMK Group.

The projects include Firelands Regional Medical Center in Sandusky, Ohio; Atrium Medical Center in Middletown, Ohio; Children’s Medical Center in Dallas; and South Jersey Regional Medical Center in Vineland, N.J. In addition, Upper Chesapeake Health in Bel Air, Md. is in the early design phase of a new cancer center and Duke Medicine in Durham, N.C. has a $220 million cancer center under construction.

“We have observed an increase in cancer center construction in both the for-profit and not-for-profit sectors,” he said. “In the past four years, we have worked with clients on five major cancer center projects. We see this particular market sector growing in the future.”

We won’t know how healthcare reform will affect either sector until reforms are deployed but for now, oncology-related construction is booming in both sectors, Kemper said.

Cancer treatment delivery is undergoing a “sea change,” said Scot Latimer, a healthcare facility planning expert who in January joined investment firm Jones Lang LaSalle’s Capital Asset Strategy segment – a growing part of the company’s National Healthcare Solutions Group that provides services to the healthcare industry ranging from program management, strategic consulting, financial strategy, advisory services and facilities and property management. JLL is known for its financial advising and real estate management, and in 2010 was ranked as the number two-hospital management firm in the U.S.

“The future of cancer care is in the integrated hospital setting,” rather than in the standalone cancer centers that have seen an increase in construction over the last three years, Latimer said. “Most commercial hospitals are trying to integrate specific services that favor providing cancer treatment and providing for co-morbid specialty needs and social services to treat the whole patient.”

JLL recently partnered with Detroit-based Beaumont Hospitals to service an 8.5 million-square-foot hospital facilities and medical real estate portfolio. To gain momentum for this hospital, JLL was said to have the best dividend stocks and share tips, presenting them to investors in order to gain more capital for their new investment. By the same token, investing in healthcare is often thought to be enticing. After all, everyone needs medical care at some point in their lives and almost everyone uses health services of some kind. When it comes to investing in what you know, health stocks, which can range from hospitals to pharmaceutical and insurance companies, certainly qualify. Moreover, thanks to developments in financial technology like apps and online trading platforms, investing in the healthcare industry has never been easier. In developed countries like Germany, healthcare is often valued as a secure investment opportunity. Correspondingly, you can discover a few of the most popular trading apps out there by taking a look at this Investment App Vergleich (Investment app comparison) guide.

Jones Lang LaSalle at Beaumont Hospitals, as it is now called, will provide all of Beaumont’s healthcare facility services including facility management, construction program management, utility operations, energy and sustainability services, property management, biomedical equipment maintenance and service management, lease administration, portfolio strategy and real estate transaction services. The deal involves 5.1 million square feet of acute care hospital space, 1,744-licensed acute care patient beds and 101 owned or leased off-campus patient care or business sites in metro Detroit.

“We do not believe the trend is that cancer centers are replacing traditional hospitals as the number one treatment option,” KLMK’s Kemper said. “Rather, healthcare owners are adjusting their model of care delivery to better meet patient needs. Cancer treatment facilities are being added to supplement the care being provided in the traditional hospital setting.”

Kemper explained that while the cancer centers that many integrated hospitals are building are physically separate from the main hospital structures, they are still part of the integrated model that is allowing hospitals to adjust their care delivery model and supplement the oncology care already available in the hospital.

“More cancer centers are beginning to offer post-treatment options – exercise classes and activities, yoga, massage therapy, counseling and mind-body studios are becoming more common as medical facilities extend the traditional boundaries of healthcare,” Kemper said. “It allows them to maintain relationships with the patients, as well as to meet patient demands for more complementary and alternative approaches to wellness.”

Kemper also noted that separate oncology facilities allow patients to better navigate their treatment while still benefitting from expanded care options.

“A free-standing facility offers a more intimate, comfortable atmosphere for the patient as opposed to a large sterile hospital,” he said. “It is more convenient for the patient to access this type of service from a smaller facility than from a large, sometimes confusing hospital.”

An unexpected driver lies behind the trend toward integrated hospital oncology care – healthcare reform and its changes to reimbursement schemes and treatment delivery.

“As people anticipate reform, they anticipate the winners will be those who can integrate a continuum of care,” said Latimer. “Future reimbursement makes it tougher for them because reimbursement will be reduced in physician-owned and investor-owned places. A lot of freestanding cancer treatment centers are selling to hospitals,” and consequently, “there will be fewer specialty hospitals,” he said.

Despite the trend toward the integrated hospital care model, not all integrated hospitals will win once healthcare reforms come online. Experts predict some of them will be forced to shut down or merge with stronger hospital systems to successfully operate under the new rules.

Last year, Standard & Poor’s’ U.S. not-for-profit healthcare analysts predicted that while the nonprofit care sector will remain stable in the near term, the next four to six years will likely result in consolidations for nonprofit providers who, among other things, are unable to integrate healthcare reforms into their operations, particularly changes to reimbursement schemes and the care delivery system.

The care delivery reforms emphasize standardized care – wherein physicians treat patients according to protocols designed by determining which treatment strategies work most successfully and consistently on the greatest number of patients in order to raise the quality care while reducing expenses. In order to incent doctors to treat patients according to the standard protocol for their particular condition, standardized care reforms will require that all Medicare reimbursements be tied to “quality metrics,” meaning that doctors who do not treat patients according to protocol, or who do follow protocol but get a poor outcome, will not be reimbursed for that care. Many private insurers are introducing similar incentive programs.

For now, the picture looks rosy for for-profit hospitals and healthcare facilities. Investor-owned firms now own 19 percent of hospitals, up from 14 percent in 2004, and that trend didn’t slow down in 2010, a year rife with for-profit takeovers of nonprofit healthcare systems. The top ten hospitals M&As of 2010 were valued at about $3.8 billion and experts predict that trend will accelerate this year.

But whether for-profits will remain profitable once healthcare reforms are introduced is another story. Studies show that for-profit hospitals and healthcare facilities in the U.S. are more expensive, have higher mortality rates, and provide lower-quality care than their nonprofit counterparts. On average, for-profit hospitals cost Medicare 18 percent more than do non-profits, and death rates are 2 percent higher. For-profit renal dialysis centers, two-thirds of which are privately owned, have a 20 percent higher death rate, though their costs are equivalent to non-profit clinics. No data exists on for-profit cancer centers. From this data, it may be summarised that non-profit could be more beneficial to the healthcare system, however, they do struggle to find funds. There is the usda qualifying map that non-profits can look at to see if they are eligible for a loan in their area to help them serve their communities without being taken over by for-profit companies.

“We do not know, definitively, what accounts for for-profit hospital’s higher death rates,” said Harvard Medical School professor Dr. Stephani Woolhandler. “However, relative to private, nonprofit hospitals, for-profits spend less on nursing and more on ancillary costs.”

If for-profit hospitals consistently register negative patient outcomes and churn out higher bills, it is unclear whether Medicare and private insurers will continue to reimburse them.