Healthcare organizations continually face pressure to manage expenses and improve operating margins while meeting the growing demands of the communities they serve. Traditionally, those demands are driven by community growth, demographic shifts, anticipated census increases, and/or changing service line complexity in various markets or regions. In addition to these top-line metrics, health care organizations must also consider the need to harden facilities against natural disasters and cybersecurity threats, improve energy efficiency, reduce carbon emissions and reimagine the role of the facility itself. And in today’s economic and political climate, CMS reimbursement uncertainty adds a layer of complexity when considering strategic investment opportunities.

Through it all, the existing infrastructure continues to age. In 2017, the American Society for Healthcare Engineering (ASHE) reported that “the median average age of plant (AoP) for U.S. hospitals in 2015 ranged from 10.78 to 11.48 (depending on publishing source), compared to 9.8 to 9.96 years in 2004, and 8.6 in 1994. This increase in median average AoP ...indicates that hospitals, in general, have struggled to raise the capital needed to keep their facilities up to date.” (ASHE Monograph, State of U.S. Health Care Facility Infrastructure). In 2025, both the American Hospital Association (AHA) and Becker’s Hospital Review have published data suggesting that the current average AoP for hospitals in the U.S. could be as high as 13.2 years, increasing an additional 18% in only 8 years.

We are not making the necessary progress. With 25+ years of underinvestment in our critical health care infrastructure behind us, it is imperative that we take intentional steps to redefine the Return on Investment (ROI) of infrastructure investment. Our legacy as healthcare facility leaders depends on the actions we take now. Let's get started!

When innovation meets investment, we can redefine the BUSINESS VALUE of our critical health care infrastructure!

Aging health care infrastructure and decades of underinvestment demand a new approach to evaluating capital decisions.

A long history of under-invesment in our critical healthcare infrastructure suggests that the traditional ROI, NPV and Payback methods often fail to capture the value of emerging technologies that impact multiple departments and create new revenue or efficiency gains. We can do better.

Please contact us if you have high levels of deferred maintenance and are struggling to create, develop, or optimize your infrastructure investment planning!

Whether you are looking for a conference keynote speaker, or searching for continuing education content, you have come to the right place.

The introduction of new technologies is changing the landscape of healthcare facility operations. Whether AI or related technologies, or revised operational guidelines such as the ASHE/ASHRAE Guideline 43, we are entering a new era of strategic asset management and investment.

Please contact us to learn more about infrastructure investment advocacy and to schedule an educational session for your upcoming conference!