Colliers’ New Healthcare Lead Discusses Evolving Healthcare Delivery Models

Last month, Colliers International hired Shawn Janus to serve as its National Healthcare Director. Based out of the company’s downtown Chicago office, Janus leads the U.S. Healthcare Services group. Despite the demands of his new role, he made time to chat with Connect Healthcare about evolving healthcare delivery and the way health systems and providers think about real estate today versus 20 years ago.

Janus brought more than 30 years of experience as a commercial real estate executive, and he’s spent the last 20 years focusing exclusively on healthcare real estate with firms including JLL, Caddis Healthcare Real Estate, and Pacific Medical Buildings. Check out his insights about the healthcare real estate market in our latest CRE Q&A.

CONNECT HEALTHCARE: What excites you about healthcare real estate?
JANUS: When it comes to the healthcare industry, it’s constantly changing. This change is driven in large part by the government, both federal and state. While some people think that’s frustrating, I would say it’s a challenge, and challenges present opportunities to provide solutions, which is what I seek out for our clients.

CONNECT HEALTHCARE: What kind of evolution have you seen in the way healthcare is delivered to patients?
JANUS: When I first got into the business, the industry was very inpatient driven. Most procedures were done in the hospitals, even imaging and blood work. Physicians, particularly specialists, were focused on being connected to the hospitals, and not just location-wise. There wasn’t a lot of clinical activity taking place in MOBs.

CONNECT HEALTHCARE: Over the course of your career, what is the single biggest change you’ve seen?
JANUS: The biggest change is how physicians and health systems use MOBs and other facilities such as urgent care clinics, freestanding ERs, and micro-hospitals to deliver care. In fact, I think the term ambulatory care center is more appropriate than MOB because a huge percentage of care delivery has shifted from inpatient to outpatient, and that care is taking place in MOBs.

CONNECT HEALTHCARE: What do you see as the drivers behind the move to outpatient care delivery?
JANUS: Cost is a big driver, of course. It costs more to provide care in an acute care/hospital environment, and health systems are increasingly focused on profitability. Physicians are a driver as well—how closely they are connected to a health system or hospital. And the focus on wellness and prevention is also a huge driver. The entire industry is trying to figure out how to keep people healthy and out of hospitals, which means they’re spending more time in MOBs and clinics.

CONNECT HEALTHCARE: Have patients played a role in this shift to outpatient care or has it been forced on them?
JANUS: Patients have played a huge role. No one likes being in the hospital. Some people absolutely refuse to step foot inside one. In order to care for patients effectively, health systems and providers have evolved and created places that are more convenient and comfortable. The shift in patient expectations is correlated to the shift in consumer expectations. Patients feel more empowered today—they have choices. And health systems feel competitive pressure. It’s always been there, but they’re paying more attention now.

CONNECT HEALTHCARE: Have you seen a significant shift in the way health systems and health providers view real estate?
JANUS: Absolutely. Systems and providers have finally realized that real estate really impacts patient experience. Twenty years ago, real estate wasn’t even on the list of priorities for a health system CEO. Today, if it’s not in the top five, it’s definitely in the top 10. They’ve accepted that real estate is another way to help achieve their mission. The healthcare industry has never lacked data, but they haven’t always known what to do with it. Healthcare providers are looking to real estate professionals to help them interpret their data—overlaying healthcare metrics with demographics so they can make quality decisions.

CONNECT HEALTHCARE: Let’s talk a little bit about the ongoing M&A activity in the healthcare space. How is that impacting health systems and their real estate, as well as patients?
JANUS: Any industry or company that has gone through a wave of M&A is going to have redundancy. Healthcare is no different, but systems are just now starting to work through the real estate side of things. It’s not a fast process, and there are a lot of variables to consider, but eventually, it’s something that must be addressed because it impacts several aspects, from provider retention to patient satisfaction.

For questions, comments or concerns, please contact Jennifer Duell Popovec