By Cheryl Carron, Contributing Writer

As healthcare industry leaders navigate persistent challenges around policy changes, patient access and affordability, it is increasingly vital that providers understand the critical role of real estate in elevating patient experience and driving market share. 

JLL’s 2025 Patient Consumer Survey illuminates the fundamental reshaping of the way patients choose and access care. Consumers’ heightened demand for convenience and mounting concerns over coverage are looming large for health systems, who are in turn feeling an unprecedented level of financial pressure. To compete, organizations must turn their real estate from a cost center into a competitive advantage. 

Insurance fallout  

Recent policy changes under H.R.1. are exerting pressure on healthcare consumers and providers alike, with projections indicating that up to 14 million people could lose insurance over the next decade. JLL’s research found that cost and access to insurance coverage weigh heavily on patients’ healthcare decisions: 

• Nearly one-quarter — 23 percent — of respondents did not receive in-person medical care in the last year. 
• Sixteen percent of those respondents said they did not seek care because they could not afford it. 
• Two-thirds of respondents without health insurance did not receive in-person care within the past year. 

The survey also found that 56 percent of Medicaid patients and 40 percent of Medicare recipients, along with 38 percent of those covered through an employer or a union, reported concerns over losing healthcare coverage in the coming year. Lack of insurance and prohibitively high costs for care might result in a significant portion of the population forgoing preventative screenings or facing a lack of coverage in the event of a medical emergency. 

Coverage losses also create problems for health systems. Uninsured patients still need care, and those who have deferred preventive care tend to experience worse health outcomes and present in worse shape when they do seek care. As providers charge higher rates to offset losses from public plans and those who are uninsured, insurance premiums are likely to increase. 

Related Content: Outpatient Growth and the Future of Healthcare Real Estate

Coverage gaps also pose significant challenges for health systems. Uninsured patients continue to require medical attention, while those who have postponed preventive care typically face deteriorating health conditions and arrive in more critical states when they eventually seek treatment. As healthcare providers raise rates to compensate for revenue shortfalls from public programs and uninsured populations, insurance premiums likely will rise accordingly. 

Geographic considerations  

Geographic location can be just as critical to patient outcomes as insurance coverage, according to JLL’s research. In fact, the location and proximity of a healthcare provider is a major factor in where patients choose to receive care. The survey reveals significant disparities in how convenient it is for respondents in different areas to access healthcare facilities. 

For example, despite urban areas’ higher provider density, urban patients were less likely than suburban patients to rate their care locations as convenient, likely due to factors including traffic, parking and navigation challenges. 

JLL’s research also found that at least one-third of patients living in rural communities said they had to travel 30 or more minutes for inpatient care, outpatient surgery, and specialist care. Meanwhile, 28 percent of patients in suburban areas can reach healthcare providers within 10 minutes. Rural healthcare providers and safety-net hospitals are facing disproportionate challenges due to policy shifts and changes in patient volumes driven by care avoidance. 

Technology and patient decisions 

JLL’s survey highlighted other key considerations for healthcare consumers when making decisions about where to receive care, including perceived quality of healthcare facilities and their use of technology. The quality of a facility is most likely to affect choices for acute care, such as inpatient care or surgery, urgent care and emergency care. In these settings, prioritizing the visual environment and conveniences like waiting room Wi-Fi might help providers attract and retain patients. 

Technology significantly influences patient healthcare choices. More than one-half of JLL survey respondents — 51 percent — said they would prefer providers offering technological conveniences such as online scheduling and patient portals. 

Patients are increasingly adopting telehealth services. Survey findings show that 67 percent of telehealth appointments effectively addressed patient needs without requiring subsequent in-person visits, while 73 percent of telehealth users reported satisfaction with this care delivery approach. But patients in rural areas show lower adoption rates for telehealth services compared to those in urban and suburban areas. 

With real estate representing up to 20 percent of operating budgets for most health systems, strategically evaluating real estate portfolios is an important component of balancing care access with operational costs. Healthcare leaders should look for opportunities to address a variety of current challenges through real estate strategy, including: 

• reducing real estate costs and expanding their footprint for high-value services to address decreasing revenue 
• prioritizing convenience and navigation in facilities to improve patient care and experiences 
• leveraging technology, including AI, to enable more efficient use of facilities 
• adopting a hospitality mindset and incorporating features to improve overall experience for patients and staff. 

Changes to healthcare policy and patients’ priorities are creating an increasingly complex operating environment for hospitals and health systems. By first gaining insight into utilization patterns and patients’ attitudes and preferences and then aligning and implementing an effective real estate strategy, healthcare leaders can drive market share, achieve financial sustainability and provide better patient experiences. 

Cheryl Carron is chief operating officer of work dynamics Americas and president of JLL’s Healthcare Division.