Development
Healthcare Real Estate Development
When the data says grow, we build. Montecito develops ground-up, build-to-suit medical office buildings and ambulatory surgery centers where your patients are already going, structured as a partnership your physicians can invest in, with up to 100% of the project cost funded.
What We Hear
“We Know We Need to Expand. We Don’t Know Where, and We Can’t Fund It.”
Expansion decisions are some of the most expensive decisions a practice or health system makes, and most are still made on outdated demographic studies and intuition. Montecito starts every project with a North Star Growth Assessment including: the physician deficit by specialty and ZIP code, where patients leave the market for care, the medical office square footage the market can support, and the professional-fee revenue that footprint generates at your contracted rates.
Then we build exactly what that analysis supports, where it supports it, and fund it.
What We Build
Every development project requires a lease backed by a dominate physician group or leading health system.
| Specs | Typical project |
|---|---|
| Type | Ground-up, build-to-suit; MOB and/or ASC |
| Size | 10,000–100,000 SF, Class A |
| Markets | Primary, secondary, and tertiary markets, nationwide |
| Structure | Joint venture with the tenant; tenant and physician investment of 0–49% |
| Funding | Up to 100% of project costs |
| Site selection | Powered by Atlas and the North Star Growth Assessment |
Build-to-Suit Medical Office Construction, From Site Selection to Opening Day
Step 01
Identify Sites Aligned With Your Service-Line Strategy
AI-driven site selection and market analysis: growth corridors, drive times, healthcare deserts, and competitive scores for existing buildings.
Step 02
Structure Capital for Speed and Long-Term Control
Project funding of up to 100% of costs through our diverse funds or relationships with national lenders and global capital partners.
Step 03
Align Ownership Terms Up Front
A joint venture in which the tenant and its physicians can invest up to 49% of equity needed into the new entity, with the Provider Real Estate Partnership.
Step 04
Montecito Handles It All
Pre-construction entitlements, due diligence, compliance, design, and space planning around your clinical model.
Step 05
Coordinate Vendors and Timelines
We can do as little or as much as you need; construction oversight, vendor coordination, budgeting, and cost control, with relationships across top architecture, engineering, and construction partners.
Step 06
Deliver a Facility on Time and on Budget
We can do a takeout upon completion or stay on as landlord and asset manager. Plus with our unique SmartMOB tracking platform we can drive facility utilization and ROI from the first month.
Ambulatory Surgery Center Development
Higher-acuity procedures are moving from hospital campuses into outpatient settings, and the practices that own the site of service capture the growth. Montecito develops ambulatory surgery centers for physician groups and health systems, as stand-alone projects or combined with a medical office building, with the same joint-venture structure and physician investment option. We do not develop stand-alone surgery centers without a practice partner.
Development in Practice
An Orthopedic Group, a 15-Physician Deficit, and a Building Sited for Patient Capture From Day One
For an orthopedic practice group in a high-growth suburban market, Atlas identified a current deficit of nearly 13 orthopedic providers, forecast to approach 15, representing more than $51 million in addressable revenue. The group’s own referral data showed a substantial share of referrals from its primary service area being captured by competitors in adjacent geographies, not because of clinical preference but because of facility access and drive time. Montecito applied the group’s own payer contract rates to the procedure-level demand in the target area, and the practice committed to expansion backed by data. Montecito then structured a build-to-suit development directly with the practice, sited to intercept those referrals.
Developing With Montecito
For Developers
Lead developer, co-developer, or capital-placement partner; joint venture or takeout at certificate of occupancy; capital at scale and speed.
Development Questions Physician Groups and Health Systems Ask
Related
Atlas
The intelligence behind every site decision.
Physician Co-Investment
Ownership in the building you help create.
Build Where the Data Says.
Bring us your vision for expansion. We’ll provide build-to-suit services with access to trillions of data points about local medical markets and competition to guide your growth strategy.
Our Trusted Partners
Long-term relationships with leading physician groups across 40 states.
