Healthcare real estate is usually tied to an operating practice or provider, so a sale involves the practice’s employees, referring physicians, patients and payers as well as the property. Buyers underwrite the operator as the credit, which means sharing practice financial information.
Investment Grade represents owners selling medical office buildings, ambulatory surgery centers, dialysis, urgent care, dental, behavioral health, veterinary, imaging and other outpatient healthcare real estate, including portfolios and sale-leasebacks. This page explains when a confidential sale fits and when a public or hybrid process may be better.
Healthcare Property Types We Cover
Each healthcare property type has its own buyers and underwriting:
| Property type | Typical buyer types | What buyers focus on |
|---|---|---|
| Medical office buildings | Healthcare REITs, private equity, health systems, family offices | Tenant mix, health system affiliation, lease terms |
| Ambulatory surgery centers | Healthcare REITs, private equity, health systems | Operator and physician ownership, procedure volume |
| Dialysis | Net lease and healthcare investors, 1031 buyers | Operator credit, lease term |
| Urgent care | Net lease and healthcare investors | Operator credit, site, lease guarantor |
| Dental and veterinary | Practice platforms, healthcare investors, family offices | Practice performance, guarantor, build-out |
| Behavioral health, imaging and infusion | Specialty healthcare investors | Licensing, reimbursement, equipment and build-out |
We provide a property-specific pricing analysis rather than a published cap rate range, because pricing depends on the lease or operating history, credit, market and physical condition. For live asking cap rates on single-tenant net lease properties, see our NNN cap rate data.
Why Healthcare Owners Consider a Confidential Sale
The operator is the tenant
A widely publicized sale can concern employees, referring physicians, patients and recruiters even when nothing operational is changing. A confidential process reduces that risk because fewer people learn of the sale before it closes, though no process can guarantee confidentiality.
Practice financial confidentiality
Buyers of practice-occupied buildings usually need several years of practice financials, payer mix and productivity data. That information should be shared only under a non-disclosure agreement with qualified buyers, whatever the process.
Specialty buyers
Many healthcare buyers are specialists. Direct outreach to them is an important part of any healthcare sale, whether or not the property is also marketed publicly.
When a Public or Hybrid Process May Be Better
Off-market is a distribution choice, not a requirement. A broader process can produce more bidders, and more bidders can mean a higher price. Consider a public or hybrid process when:
- the property is leased to a rated or well-known operator on a long lease and many buyers would compete for it
- maximum price competition matters more than confidentiality
- the operator is comfortable with broad marketing
- an off-market process has not produced an acceptable offer within the agreed window
Our pre-listing analysis compares the likely outcome of an off-market, public or hybrid process for the specific property, so the owner can choose with expected net proceeds, timing and confidentiality in view.
The Healthcare Buyer Landscape
Healthcare real estate buyers include:
- Healthcare REITs. Public REITs focused on medical office and other healthcare property.
- Healthcare-focused private equity. Investors that combine real estate and operating expertise.
- Health systems. May buy property that is strategic to their network and pay more when it is.
- Family offices. Often active in medical office and dental real estate, with long hold periods.
- Practice platforms. Dental, veterinary and specialty platforms that sometimes buy the real estate of practices they acquire.
Healthcare Portfolios
Healthcare portfolios can attract buyers seeking scale and can be simpler to execute than a series of individual sales. They can also sell at a discount if they include weaker assets or are larger than many buyers want. We model portfolio and individual-sale outcomes in the pre-listing analysis so an owner can compare them.
Sale-Leasebacks for Healthcare Owner-Operators
Practice owners who own their building can sell it and lease it back, using the proceeds for a partner buyout, growth, debt reduction or retirement planning while the practice continues in the same location. Healthcare sale-leasebacks often benefit from a confidential process, because a public listing can signal to employees, referring physicians and patients that the owner is raising capital. A broader process can still make sense when wider competition matters more than confidentiality, and public marketing need not disclose protected operating information.
The lease the practice can afford after the sale matters more than the headline price; see our sale-leaseback strategic guide.
The process is covered in Off-Market Sale-Leasebacks for Owner-Operators.
1031 Exchanges
Healthcare real estate is active as both relinquished and replacement property in 1031 exchanges, and healthcare sellers can be matched with 1031 buyers in their identification windows. See Investment Grade 1031 Exchange: The Complete 2026 Guide.
Frequently Asked Questions
What does Investment Grade do in a healthcare transaction?
We represent owners on the real estate: sales, sale-leasebacks, portfolio sales and 1031 exchanges. The sale of an operating practice itself is handled by healthcare investment bankers and practice brokers; we work on the real estate alongside or separately from that transaction.
Can a practice owner sell the building without selling the practice?
Yes. In a sale-leaseback, the practice owner sells the building and signs a long-term lease, often 10 to 20 years or more with renewal options, and keeps operating in the same location.
Will practice financial information be made public?
Not if the process is managed properly. Practice financials should be released only under a non-disclosure agreement to qualified buyers, in an off-market or a broader process. Confidentiality is one of the main reasons many healthcare owners choose a controlled process.
Do healthcare portfolios sell at a premium?
Sometimes. Portfolios can attract buyers seeking scale, but pricing depends on the assets included. Compare the expected outcome with individual sales.
Related Reading
Discuss Your Healthcare Sale
For practice owners, healthcare real estate investors and platforms considering a sale, portfolio sale or sale-leaseback. The pre-listing conversation produces a written analysis of expected pricing, the recommended path (off-market, public or hybrid) and the buyers that would be reached. Conversations are confidential.
Contact Investment Grade, email team@investmentgrade.com or call 312.433.9300 x20.
Investment Grade Income Property, LP is a licensed commercial real estate brokerage. Out-of-state listings are co-listed with licensed brokers in the relevant state through our Broker of Record network. This page is for informational purposes and does not constitute legal, tax or investment advice.
