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Construction & Design

Healthcare’s master builders debate impact of Obamacare, technology

A standing-room only crowd gathered on June 4 at the Healthcare Master Builders forum to hear experts discuss how the sweeping changes in healthcare delivery as well as technological advances are resulting in new development and construction paradigms in the healthcare industry.

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Hosted by Zetlin & De Chiara LLP, The New York Building Congress, The American Council of Engineering Companies of New York, The Steven L. Newman Real Estate Institute and Real Estate Weekly, the program offered insight into the strategic visions and planning challenges of some the Tri-State area’s most prestigious hospitals and healthcare systems and the critical role that the design, development and construction industries play in supporting these institutions.

Zetlin & De Chiara Partner Loryn Riggiola introduced the program noting, “The healthcare industry is changing, and its changes are going to impact the way we design, build and maintain our healthcare institutions today and in the future.”

Riggiola outlined market factors that were driving forces of change, specifically:
• The demands of educated healthcare consumers who can choose from a range of hospitals and treatment options and are pushing for more specialized health centers which is leading hospitals to invest in more ambulatory and outpatient care facilities.

• New financial demands, such as the 30 million new Americans with health insurance due to the Affordable Care Act and the pressure to keep costs down, are forcing hospitals to seek new financing options to achieve growth such as selling bonds, mergers and exploring public private partnerships (P3s).

• Healthcare organizations continue to seek consolidation whether horizontally (hospital –hospital), vertically (hospital-diagnostic center-wellness center) or cross-sector (health plan provider-clinical services).

• Technology issues in the healthcare industry include mobile health, maintaining state-of-the-art clinical care as well as electronic healthcare data and privacy which all impact infrastructure and facilities planning and design.

Next, Zetlin & De Chiara Partner Lina Telese described a number of construction trends that are taking hold in the healthcare industry as a result of market demands, including:
• Adoption of fixed price contract models (e.g. Design-build, Integrated Project Delivery) over traditional Design-bid-Build models

• The necessity of Building Information Modeling (BIM) for all construction projects as well as ongoing facilities management

• A focus on sustainable construction and environmental responsibility

• The emergence of the converged network to service the multi-tiered technology needs of healthcare providers

• Flexible design and construction to accommodate changing needs is the new standard in the healthcare sector.

Following the introduction, four healthcare leaders outlined their institutions’ strategies in light of the shifting industry landscape.

Gary Acord, Vice President of Design + Construction at Memorial Sloan Kettering Cancer Center (MSKCC), discussed MSKCC’s growth plan, focusing on consolidation of existing spaces and the expansion of ambulatory care centers as opposed to in-patient care or pure research facilities.

The ambulatory and outpatient centers will be in strategic locations around the Tri-State area according to Acord who said that regional growth is “the future.”

He also discussed the critical importance of extensive resiliency and disaster preparedness measures like those being integrated into the design and construction of MSKCC’s Manhattan development on the East River in response to events like Hurricane Sandy.

Thomas Ahn, Vice President of Real Estate Services at Mount Sinai Hospital, outlined Mt. Sinai’s vision for creating a regional network of comprehensive ambulatory care practices that would offer a “one-stop-shop” for low cost, high-quality care.

Patrick J. Burke, III AIA, Assistant Vice President of Capital Project Management at Columbia University Medical Center, detailed the hospital’s efforts to consolidate disparate practices and create new unified, sustainable and cutting-edge care centers while balancing ongoing capital needs for upgrades and maintenance throughout their existing properties.

And Sharon Greenberger, Senior Vice President of Facilities and Construction at New York Presbyterian Hospital, provided an overview of the unique challenges facing the hospital when considering space needs, particularly because the average age of its existing facilities is 70 years old.

The third segment of the program was a roundtable discussion moderated by Michael De Chiara, Senior Partner of Zetlin & De Chiara LLP.

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