Changing hands: How investors are repositioning in the U.S. healthcare sector
- Medical outpatient building (MOB) capital flows have shifted dramatically over the past five years. In 2021, net acquisitions for REITs were at their highest, surpassing $2.3 billion, while private investors offloaded nearly $4.1 billion in capital.
- By 2025, these dynamics shifted entirely. REITs offloaded over $2.5 billion in capital, while private investors posted $613 million in net acquisitions, a 115% swing toward private capital and a 209.5% pullback for REITs.
- REITs entered 2025 with elevated leverage after the rising interest rates of 2021–2024, pushing many into selling mode and driving the sharp drop in their capital flows since 2021.
- In summary, REITs are deleveraging and private capital is stepping in as the primary buyer, creating a more negotiation-driven investment environment where strategy, capital alignment, and asset quality matter more than ever for healthcare real estate clients.
