Medical office acquisitions in 2026, by the numbers

The rebound, by the numbers

Medical outpatient buildings spent the last two years becoming the asset class other sectors get compared against. Cushman & Wakefield's MOB capital markets outlook counts more than $14 billion of MOB investment in 2025, up 34 percent year over year, with $8.2 billion closing in Q4 2025 alone, one of the strongest quarters in a decade. Portfolio trades did much of the lifting, with nearly $7 billion in portfolio deals closing during the year.

The momentum carried into 2026. CBRE's Q1 2026 medical outpatient figures show quarterly volume of $2.9 billion, up 78 percent year over year and 15 percent above the five-year Q1 average.

Pricing followed volume. CBRE's average MOB cap rate fell to 6.9 percent in Q1 2026, down 13 basis points year over year and below 7 percent for the first time since Q3 2024. Cushman & Wakefield separately measured 20 to 40 basis points of compression in late 2025. Two providers, two methodologies, one direction.

The two trades that frame the market

The defining transaction of the cycle is Welltower's $7.2 billion sale of its outpatient medical portfolio to Remedy Medical Properties and Kayne Anderson Real Estate: 296 properties, roughly 18 million square feet across 34 states, 94 percent occupied at announcement. The deal closes in tranches through mid-2026, with an initial $2 billion tranche first, and it makes the buyer partnership the largest outpatient medical owner in the country at 52.4 million square feet across roughly 1,104 properties. Welltower keeps a preferred equity position while it concentrates on seniors housing.

The second trade is smaller but more useful for underwriting. Healthpeak announced $925 million of transaction activity in January 2026, including roughly $325 million of outpatient medical dispositions in Q4 2025 covering about 834,000 square feet of fully stabilized properties. CEO Scott Brinker put the pricing at low-6 percent cap rates, and the company flagged another $700 million or more of outpatient sales and recapitalizations in negotiation.

One seller exiting at scale, one seller trimming stabilized assets to fund life science, and buyers absorbing both. For an acquisitions team, the message is that the bid for stabilized outpatient medical is deep enough that public REITs are treating it as a source of cheap capital.

Backing NOI out of the Healthpeak sale

The Healthpeak disposition is the rare data point that lets a deal team reverse-engineer institutional pricing with public numbers. Run it.

1. Price per square foot: $325 million divided by 834,000 square feet is roughly $390 per square foot.

1. Implied NOI: at low-6 percent cap rates, call the band 6.1 to 6.3 percent, implied NOI is $19.8 million to $20.5 million on the package.

1. NOI per square foot: that works out to $23.75 to $24.55 per square foot.

Now set that against CBRE's Q1 2026 averages: a $310 per square foot average sale price and a record $25.40 average asking rent. The Healthpeak package traded about 25 percent above the national average price per foot, on NOI per foot that sits just under the national average asking rent. That is what "fully stabilized, institutional quality" costs in this market: you pay up on the per-foot basis, and the yield premium over the 6.9 percent average disappears.

The exercise generalizes. When a broker quotes you $390 per foot on a stabilized MOB, multiply by the cap rate the market clears at and you have the NOI per foot the price assumes. If the in-place rent roll cannot support that number after real operating expenses, the asking price is carrying lease-up or mark-to-market assumptions someone should have to defend in writing.

Why the fundamentals support the pricing

Operating fundamentals back up the capital markets story. The sector keeps printing numbers traditional office cannot match, per CBRE's Q1 2026 figures: a record $25.40 average asking rent, up 1.6 percent year over year, 511,000 square feet of positive net absorption marking a fourth consecutive positive quarter, and an average sale price of $310 per square foot, 55 percent above the $200 average for traditional office.

Returns data tells the same story over longer horizons. Cushman & Wakefield puts MOB income returns at 5.6 percent in Q4 2025, ahead of major property indices, with ten-year MOB returns of 6 percent against 4.9 percent for the NCREIF index.

Then there is supply. CBRE counts 2.9 million square feet under construction across the 59 markets it tracks. The Welltower portfolio alone is six times that. Demand for outpatient care grows on demographics, construction is thin, and existing product is consolidating into fewer, larger hands. Scarcity is doing real work in these cap rates.

What it means for buyers in 2026

The buyer pool splits by check size, and the two halves face different problems.

Portfolio-scale buyers are competing against specialist platforms with operational depth. Remedy took over property management and leasing across the Welltower portfolio and added 170 Welltower employees in the process. A financial buyer without that machinery cannot underwrite the same expense line.

Small and mid-size teams face a different game: one-off and small-portfolio deals sourced from health systems, retiring physician-owners, developers, and REITs pruning their edges, at the 6.9 percent average rather than the low-6s trophy pricing. That market rewards preparation over scale. The team that already knows which health system is consolidating clinics in its target metro, and has the tenant, lease, and reimbursement questions mapped before the OM arrives, wins deals the bigger capital never sees.

Cushman & Wakefield's 2026 outlook expects lower interest rates, ample dry powder, and stabilizing valuations to keep the transaction environment strong. Translated for a deal team: more competition on every marketed process, and more reason to have your pipeline organized before volume picks up further.

Running an MOB acquisitions pipeline

Medical office deals carry diligence weight that generic trackers handle badly. Beyond the standard title, survey, environmental, and physical work, an MOB file accumulates tenant credit reviews on health systems and physician groups, lease abstracts with reimbursement-sensitive terms, compliance documentation, and parking ratio verification. Teams run each deal in a deal workspace so that file set, the task list, and the key dates live in one place per deal instead of across inboxes.

Stage discipline matters more when volume rises. A pipeline board with days-in-stage visible shows which of your eight live deals has sat in DD without movement for three weeks. And because MOB debt terms vary meaningfully by lender familiarity with the asset class, teams track quotes side by side with financing tools rather than in a forwarded-email chain.

We wrote a fuller brief on how medical office investors structure deal management. Teams comparing healthcare-adjacent sectors should also read the senior housing acquisitions brief, where record capital is chasing a different demand curve.

The 2026 setup

Volume is rising off a strong 2025 base, cap rates are through 7 percent and tightening, supply is thin, and the biggest owner in the sector just changed. For acquisition teams, 2026 medical office is a market that rewards being organized: the assets are stable, the processes are competitive, and the spread between winning and losing a deal is usually preparation, not capital.