Medical Real Estate Advisory

U.S. Medical Outpatient Real Estate Quarterly Briefing

Second Quarter 2026 | United States | Information available through September 11, 2026

Executive Summary

Transaction volume and sector mix: U.S. medical outpatient building investment reached $2.7 billion in Q2 2026, up 24% year over year and 11% above the five-year Q2 average, bringing trailing-four-quarter volume to approximately $14.4 billion. First-half investment volume totaled roughly $6.7 billion, up 21% from the prior year, with portfolio sales more than doubling and single-asset volume rising 42%. Investor demand remained concentrated in medical office buildings, ambulatory surgery centers and outpatient facilities aligned with established health systems and specialty physician groups.

Cap rates and geography: Average U.S. MOB cap rates were approximately 7.10% in Q2, essentially stable year over year, while average transaction pricing reached $307 per square foot—57% above traditional office pricing. The headline average masks significant differentiation based on tenant credit, lease term, asset quality and health-system affiliation, with institutional-quality assets continuing to command premium valuations. Investor preference remains strongest in high-growth markets, particularly the Sun Belt; Dallas/Fort Worth, Phoenix and Atlanta again ranked among investors’ preferred healthcare real estate markets for 2026.

Buyer composition and capital flows: Capital appetite for healthcare real estate remains broad across private capital, institutional investors and healthcare REITs. CBRE’s 2026 investor survey found that 77% of respondents expect to be net buyers of MOB assets, versus only 12% expecting to be net sellers, while approximately $16 billion of equity capital is estimated to be allocated to healthcare real estate during 2026. Private capital has become increasingly aggressive, while institutional investors and REITs continue to target larger, stabilized properties and portfolios with health-system alignment, long lease duration and strong operating fundamentals.

Operating fundamentals and supply: Medical outpatient fundamentals remained among the strongest in commercial real estate during Q2. Average asking rents increased to a record $25.46 per square foot, up 1.3% year over year, while the sector recorded 1.18 million square feet of positive net absorption, its fifth consecutive quarter of positive demand. Vacancy remained approximately 9.8%, and just 2.7 million square feet was under construction across the 59 markets tracked by CBRE. Limited new supply, elevated replacement costs and the continued shift of healthcare delivery toward outpatient settings are supporting tenant retention and rent growth despite a higher-for-longer cost of capital environment.