HAL market report on outpatient healthcare real estate: Transaction volume more than doubled in 2025

The investment market for nursing and healthcare properties continued its recovery course in 2025. In total, a transaction volume of around 1.2 billion euros was registered. This corresponds to an increase of 23 percent compared to the previous year's result of 973 million euros. In addition to established segments such as nursing homes, other areas of social infrastructure are increasingly becoming the focus of institutional investors, including outpatient healthcare properties in particular. They benefit from stable structural fundamentals, such as demographic development and the growing importance of outpatient medical care.

Within the asset class of care and healthcare properties, outpatient healthcare properties developed particularly dynamically. The transaction volume for 2025 adds up to around 200 million euros, after about 91 million euros were registered in 2024. This corresponds to an increase of 120 percent. For 2026, the market experts at CBRE expect a further increase to more than 300 million euros. The prime yield has been stable at 4.6 percent since 2024 and a further sideways movement is expected.

Transaction activity continues to be strongly influenced by individual deals, often with a volume of up to 50 million euros. On the buyer side, institutional investors from abroad are increasingly appearing, especially open-ended real estate funds and special funds as well as private capital. On the seller side, portfolio holders and project developers who bring newly developed or modernised properties to the market are particularly active. In addition to the top 7 locations, B, C and D cities with solid fundamentals also offer attractive investment opportunities. Of the 2.1 billion euros invested in the market for outpatient healthcare real estate since 2016, around two-thirds are accounted for by locations outside Germany's seven largest cities.

"The outpatient care system will further increase the demand for modern outpatient care structures. Medical centers and health centers are increasingly taking on central functions in outpatient medical care and offer investors stable, long-term cash flows," says Dr. Jan Linsin, Head of Research Germany at CBRE. "Asset management is becoming increasingly important for long-term success in this segment as well. Accordingly, investors are checking the micro-location, the construction quality of the facilities and the creditworthiness of the tenants more and more intensively."

The updated and expanded analysis by Rebmann Research in cooperation with Hauck Aufhäuser Lampe shows that there are 4,336 outpatient healthcare properties in Germany. Compared to the previous year's evaluation with 3,441 locations identified, the higher figure is primarily based on an expanded data basis and a broader definition of health-related tenants. Medical supply stores, hearing aid acousticians and opticians were also included in the new evaluation.

The study defines outpatient healthcare properties as locations where at least five medical or health-related facilities are bundled, such as doctors' practices, therapy providers, pharmacies or outpatient care services. "Based on the increased number of potentially investable outpatient healthcare properties to around 4,330 properties and the analysis results from our HAL database on the average purchase price, we can derive a potential market volume of more than EUR 37 billion for the asset class," says Patrick Brinker, Head of Real Estate Investment Management at Hauck Aufhäuser Lampe.

The regional distribution of outpatient healthcare properties in Germany shows clear differences between the individual federal states and regions. A relatively dense network of such objects can be found mainly in eastern German states. Mecklenburg-Western Pomerania has one of the highest densities with 122 outpatient healthcare properties and around 13,335 inhabitants per location, followed by Saxony with 259 locations and about 15,790 inhabitants per location. The city-states also show a high concentration: Hamburg has 209 outpatient healthcare properties, which corresponds to a density of around 9,238 inhabitants per location, while Berlin has 334 locations and around 11,324 inhabitants per location. In large states such as Bavaria (677 locations), Baden-Württemberg (461) or North Rhine-Westphalia (825), greater concentrations are particularly evident in urban centres, while rural regions still have few outpatient healthcare properties in some cases. These so-called "green meadows" therefore offer development potential for cities, municipalities, project developers and investors for new supply locations.

"As a specialist in investments in outpatient healthcare real estate, we see that the structural changes in the healthcare sector are opening up long-term opportunities in the field of outpatient care. There is still great potential for development, especially in medium-sized cities and rural regions," explains Brinker.

In the outpatient healthcare sector, the credit ratings of many tenant groups are in the particularly stable range. Doctors in private practice or medical care centres benefit from consistently high demand as well as predictable income from the statutory health insurance system (GKV). Practices and medical care centers have an average probability of failure of about 0.26 percent. Other typical tenants such as dentists (0.46%), pharmacies (0.55) or physiotherapy practices (0.50%) also have a very good credit rating. In comparison, the probability of default is significantly higher for tenants from the inpatient sector: nursing homes reach an average of around 1.17 percent, retirement and disabled homes about 1.37 percent and hospitals about 1.52 percent.

"The data thus confirm a generally high stability of outpatient healthcare properties, also in terms of tenant creditworthiness, and underline their attractiveness as an investment segment. Many medical facilities benefit from predictable revenues from the healthcare system and have correspondingly low default risks," says Felix Rotaru, Director Healthcare at Hauck Aufhäuser Lampe.

The structural changes in the health care system will be further accelerated by the amendment to the hospital reform now passed in the Bundestag. The aim of the reform is to make the hospital landscape more efficient and to organise medical services more across sectors. The health policy principle of "outpatient before inpatient" remains central. Already today, around 97% of all treatment cases are in the outpatient sector, but the inpatient sector still accounts for a significantly higher share of the total benefit expenditure of the statutory health insurance (GKV). "This cost-disadvantageous development for the healthcare system is to be reduced by the outpatient potential, and in the long term this will also increase the need for suitable real estate infrastructure for outpatient care, for example in the form of medical centres, health centres or other specialised outpatient treatment centres," says Rotaru.

In the course of the reform, a transformation fund for the modernisation of hospital structures was also adopted, which is to provide more than 50 billion euros for the restructuring of the hospital landscape between 2026 and 2035. Part of the funds could also be used for the restructuring of sites into cross-sectoral utilities. This opens up new perspectives for the real estate industry: In particular, intersectoral healthcare properties with a diversified tenant mix of outpatient and inpatient self-sufficient service providers could play a central role in the transformation of care structures in the future and create new investment opportunities for specialised healthcare investors.

The increasing importance of outpatient healthcare real estate is also reflected in the investment activities of Hauck Aufhäuser Lampe. Through the special real estate fund "HAL Social Infrastructure Germany II", Real Estate Investment Management invests specifically in core and core+ properties for outpatient healthcare. The equity fund is aimed in particular at institutional investors such as banks and insurance companies and is aiming for a target volume of EUR 200 to 250 million.

Most recently, HAL REIM acquired a medical and health centre in Landshut, Bavaria, with around 3,118 square metres of rental space and a diversified tenant base from various medical disciplines. The property complements the fund's growing portfolio and exemplifies the demand for modern outpatient care locations.

https://www.hal-privatbank.com/real-estate-investment-management/marktreport-ambulante-gesundheitsimmobilien