Healthcare systems are under constant pressure to improve patient access, protect operating margins, support physician productivity and deploy capital effectively. Yet decisions about healthcare real estate still tend to rely heavily on basic occupancy statistics, leaving out how well each facility actually supports care delivery and organizational performance.
A recent Newmark report, “Beyond Vacancy: A Maturity Model for Measuring Healthcare Space Utilization,” argues that health systems should move beyond vacancy rates and adopt a more comprehensive view of portfolio performance. The firm highlights that facilities, strategy and real estate teams already hold much of the necessary data, but those groups typically operate in silos, which leads to fragmented insights and suboptimal decisions about space.
Newmark proposes a five-level maturity model to help healthcare organizations integrate perspectives and sharpen real estate decision-making. The first level, occupancy status, focuses on whether clinical space is occupied or empty and combines this with square footage and occupancy costs to flag locations that consume resources without directly supporting patient care.
Level two examines square feet per exam room by comparing facilities to internal design standards or external benchmarks. This lens can surface inefficient layouts, oversized support zones and excess circulation space that dilute usable clinical capacity. Level three, static provider occupancy, layers in provider assignments to show how much operational capacity is theoretically supported by a given clinic footprint, based on full-time use of the space.
At level four, dynamic provider occupancy, Newmark recommends incorporating scheduling data for mobile clinicians who divide time among clinics, hospitals, surgery centers, telehealth and administrative duties. This analysis provides a more realistic view of when clinical spaces are truly in use rather than simply assigned on paper.
The fifth level, clinical productivity per square foot, blends real estate information with clinical, operational and financial data. This allows health systems to evaluate which locations deliver appropriate patient care relative to their cost and resource intensity and to distinguish between sites that merely stay busy and those that perform efficiently.
The report also underscores that healthcare real estate choices unfold over longer timelines than many other system functions. Lease renewals often require commitments before future operational requirements are fully known, capital replacement and allocation cycles can extend beyond executive tenures, and development projects take years to bring online.
Newmark stresses that the purpose of a utilization framework is not to maximize activity per square foot at all costs, but to clarify how real estate supports care delivery. With decisions that are expensive and difficult to reverse, the firm argues that health systems need a mature, data-driven view of space utilization before renewing leases, committing capital or expanding portfolios, so leaders can anticipate needs rather than react only to visible inefficiencies.
