Top Health Systems Show Slight Decline in Medical Construction Spending for 2018

 In Medical Construction, New Construction, Projects over 1 Billion

The top 10 leading U.S. health systems account for more than $20.4 billion of current and upcoming medical construction, according to a recent analysis from BuildCentral, down approximately 5% from 2017. 

Behind the numbers

One potential reason for the slight decrease in spending by top systems is the continuing focus on renovation work and new outpatient facilities rather than costlier, ground-up expansions. Compared to this time last year, BuildCentral reports a 26% increase in the number of newly planned and active renovation projects industry wide, with new construction and expansions up 8.5% in the same time frame.

Compared to this time last year, BuildCentral reports a 26% increase in the number of newly planned and active renovation projects industry wide, with new construction and expansions up 8.5% in the same time frame. Click To Tweet

Investments in outpatient care continue to grow

Investments in outpatient care and ambulatory surgery centers continued a three-year, reported growth trend with an 18.5% increase in projects from 2017. Health Facilities Management Magazine and The American Society for Health Care Engineering (ASHE) showed similar findings in its 2018 Hospital Construction Survey, with respondents continually reporting a focus on renovations, along with ambulatory and outpatient care. 

Only Scripps Health broke $2 billion in active construction value and remained the active construction leader, compared to three additional health systems in 2017, with its $2 billion Scripps Memorial Hospital replacement in La Jolla, California. Last year’s leaders Sutter Health and the New York Presbyterian Healthcare System no longer even rank in the top 10 of spending, having respectively completed around $2.6 billion and $1.8 billion in construction the past year. The University of Maryland and Indiana University health systems also left the top 10 in spending this year, along with Providence Saint Joseph Health. 

Investment leaders

Leading the top 10’s new additions for 2018 is University of California Health with its $1.5 billion, planned replacement hospital for UC San Francisco. Other health systems with major planned projects include the University of Pittsburgh Medical Center (UPMC) with nearly $1.8 billion worth of projects in combined estimated value, and Mount Sinai Health with $1.5 billion in combined projects, both new additions to the list in 2018. 

Other shifts on the 2018’s top 10 list include the new arrival of the Mayo Clinic Health System with $1.7 billion in planned and active projects, and the Inova Health System with $1.5 billion in planned and active projects. 

Top 10 Health Systems Rankings 

The top 10 health systems ranked by combined active and planned construction value are: 

Top Health Systems  Value (in millions) 
University of California Health  $2,715 
Scripps Health  $2,578 
HCA Healthcare  $2,416 
Kaiser Permanente  $2,243 
University of Pittsburgh Medical Center (UPMC)  $1,920 
Mount Sinai Health System  $1,866 
University of Pennsylvania Health System  $1,851 
Mayo Clinic Health System  $1,745 
Virtua Health  $1,584 
Inova Health System  $1,551 

The analysis is based on BuildCentral’s proprietary medical construction market research tools available via and  as of 11.15.2018.  BuildCentral, headquartered in Chicago, compiles comprehensive construction intelligence on all major U.S. medical construction projects as well as multifamily, hospitality/lodging and CRE construction. Publisher and analyst data licenses available.


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Andrew Struska
Andrew has been at BuildCentral since 2011 and oversees the Medical Research arm of BuildCentral. Andrew has his Bachelor's Degree in Journalism from Michigan State University and obtained his Master's Degree in Health Communication from Northwestern University.
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