As the healthcare sector evolves to meet changing demands, real estate M&A remain key in shaping healthcare delivery. The healthcare real estate (HCRE) sector encompasses Medical Outpatient Buildings (MOBs), Outpatient Surgery Centers (OSCs), life sciences buildings and other general healthcare real estate subsectors. According to data captured in the LevinPro HC database, there were 273 HCRE deals announced in the United States during 2025 (including 231 MOB deals, 27 OSC deals, 10 life sciences building deals and seven other healthcare real estate deals). Activity in 2025 represents a slight dip from 278 deals in 2024, but shows continued strength from the 242 in 2023, underscoring a sector ripe with opportunities for both investors and healthcare providers looking to leverage real estate for better service integration and patient access.
In 2025, certain states stood out as particularly active in HCRE M&A, with activity driven by population growth and regional healthcare demands.
2025 Healthcare Real Estate M&A Activity by State and Region:
| Region | Deal Totals Per State* |
| Northeast | Connecticut (4 deals), Massachusetts (7), New Jersey (6), New York (8), Pennsylvania (12), Rhode Island (1). |
| Southwest | Arizona (17 deals), New Mexico (1), Oklahoma (4), Texas (25). |
| West | California (20), Colorado (7), Idaho (1), Nevada (3), Oregon (3), Utah (1), Washington (3). |
| Southeast | Alabama (6 deals), Arkansas (5), Florida (28), Georgia (17), Kentucky (1), Louisiana (3), Maryland (3), Mississippi (1), North Carolina (15), South Carolina (6), Tennessee (9), Virginia (10), Washington, D.C. (1). |
| Midwest | Illinois (15 deals), Indiana (3), Iowa (3), Kansas (2), Michigan (3), Minnesota (7), Missouri (4), Ohio (13), Wisconsin (5). |
*States with no deal announcements were not included
MOBs have been the focal point of numerous transactions, especially in states experiencing significant population growth. In 2025, MOBs accounted for about 85% of all U.S.-based HCRE deals, totaling 231. Florida and Texas were the most active states in this subsector, with 28 and 25 deals respectively. These states are becoming healthcare hubs, driven by demographic booms.
According to the U.S. Census Bureau, Texas added 391,243 residents from 2024 to 2025, a 1.2% growth rate, while Florida saw an increase of 196,680 people, with a 0.8% growth rate, both surpassing the national average of 0.5%. This population growth has intensified the need for additional healthcare facilities, particularly in high-growth urban areas and underserved rural regions.
Private equity firms and real estate investment trusts (REITs) played a significant role in shaping the HCRE landscape. In terms of M&A activity, real estate investment firms were the most active acquirer type with 119 deals, accounting for approximately 44% of all U.S.-based HCRE transactions. Private equity firms followed, participating in 36 deals, which made up about 13% of the market. Real estate investment trusts were involved in 28 deals, representing around 10% of transactions.
The largest HCRE deal by purchase price in 2025 was Remedy Medical Properties’ and Kayne Anderson Real Estate’s acquisition of a Welltower MOB portfolio comprising approximately 18 million square feet across 296 properties in 34 states. According to Welltower, the transaction will total $7.2 billion and will be completed in tranches through mid-2026, with the first tranche selling for $2 billion.
Regulatory and policy considerations influenced transaction activity, particularly in states with Certificate of Need (CON) laws, which require healthcare providers to prove the necessity of new or expanded facilities. In markets such as New York and Illinois, HCRE M&A was driven by existing providers expanding within these frameworks. Rural healthcare consolidation continued in the Midwest and West, with transactions aimed at modernizing infrastructure and addressing provider shortages.
While the HCRE M&A space presented many opportunities, it also faced headwinds like persistent interest rate pressures, which slowed deals for smaller operators without ample capital, favoring larger firms. Higher borrowing costs limited acquisitions by independent groups, while inflation in construction materials and healthcare labor shortages delayed closings and raised expenses in a competitive market.
So far in 2026 (as of March 13), there have been 63 HCRE deals, with the MOB sector dominating at 55 deals. The most active states are Texas (eight deals), California (six), Florida (five), Arizona (four), New Jersey (four) and North Carolina (four). The largest HCRE deal by purchase price so far in 2026 is Celltrion’s acquisition of Eli Lilly‘s 1.6-million-square-foot biopharmaceutical production facility in Branchburg, New Jersey, for $330 million. The deal was announced on January 2.
As the HCRE sector moves forward, its ability to navigate economic volatility and adapt to shifting patient preferences (such as the rising emphasis on telehealth-integrated spaces and sustainable building practices) will be crucial. With early 2026 indicators pointing to sustained momentum, particularly in MOBs and life sciences, stakeholders can anticipate a landscape where innovative financing models and cross-sector partnerships emerge to bridge gaps in access and efficiency. Ultimately, this evolution promises not only financial returns for investors but also improved community health outcomes, positioning HCRE as a cornerstone of a more agile and inclusive U.S. healthcare system.
