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Healthcare Insights

Healthcare facility construction activity by state

Hospital and healthcare construction projects expand and improve facilities to better serve patients and the healthcare providers who work there. And new healthcare facilities help increase services and capabilities in the local communities.

How is healthcare construction activity tracked?

In the Definitive Healthcare HospitalView product, we collect certificates of need (CONs) and requests for proposals (RFPs) from federal, state, local, and healthcare system websites. The “new hospitals/units/services” and “hospital/facility relocation/renovation” CON categories and “construction - new building/relocation/design” RFP category track new hospital buildings, hospital construction projects and healthcare facility renovations to inform the market on planned projects.

What is a healthcare certificate of need?

Certificates of need (CONs) are legal documents required by the District of Columbia and many states for the approval of capital expenditures and projects. The goal of CON programs is to help reduce healthcare spending by ensuring new expenses fit the community and the healthcare system’s needs.

Definitive Healthcare collects CONs by monitoring the websites of the 36 states/federal jurisdictions with participating programs and makes the information available in our HospitalView product.

What is a healthcare request for proposal?

Requests for proposals (RFPs) are documents that announce and outline the specifics of a project that a hospital or healthcare system plans to undertake. These formal requests solicit bids from suppliers and contractors to complete the proposed project.

The Definitive Healthcare HospitalView product tracks federal healthcare RFPs from the System for Award Management website and collects non-federal RFPs by monitoring state, local, and healthcare entity websites for RFPs and purchasing requests.

The “new hospitals/units/services” and “hospital/facility relocation/renovation” CON categories and “construction - new building/relocation/design” RFP category track new hospital buildings, hospital construction projects, and healthcare facility renovations to inform the market on planned projects.

How many healthcare construction CONs and RFPs are there each year?

In 2024 through October, we collected more than 1,700 healthcare construction CONs and RFPs. This list below ranks states by their total number of construction-related CONs and RFPs so far this year.

Number of healthcare construction CONs and RFPs by state

RankStateNumber of RFPs and CONs in 2024 YTDExplore dataset
1New York355Explore
2District of Columbia164Explore
3Maryland87Explore
4Texas79Explore
5California76Explore
6Michigan56Explore
7Illinois52Explore
8Virginia51Explore
9Washington49Explore
10North Carolina46Explore
11South Carolina43Explore
12Florida41Explore
13Connecticut40Explore
14Kentucky39Explore
15Massachusetts39Explore
16Ohio38Explore
17Indiana34Explore
18Missouri33Explore
19Oregon31Explore
20Pennsylvania28Explore
21Mississippi25Explore
22Oklahoma22Explore
23Nevada21Explore
24Georgia20Explore
25Wyoming19Explore
26Alabama17Explore
27Iowa17Explore
28Kansas17Explore
29Arizona15Explore
30New Jersey15Explore
31Hawaii14Explore
32Utah14Explore
33Louisiana13Explore
34Tennessee13Explore
35Arkansas11Explore
36Colorado10Explore
37Minnesota10Explore
38Wisconsin10Explore
39Montana9Explore
40New Mexico8Explore
41South Dakota8Explore
42West Virginia8Explore
43Idaho7Explore
44Nebraska7Explore
45Delaware6Explore
46Rhode Island5Explore
47North Dakota4Explore
48New Hampshire4Explore
49Alaska1Explore
50Maine1Explore

Fig. 1 Data is from the Definitive Healthcare HospitalView product through October 2024. The RFP categories encompass Construction - New Buildings, Renovations, and Design. The CON categories include Hospital/Facility Relocation, Hospital/Facility Renovation, and New Hospital/Unit.

Which states have the most healthcare construction activity?

New York had the most construction CONs and RFPs in 2024 YTD, with 355. The state’s CON requirements, large population, and number of healthcare facilities likely contribute to this number. The District of Columbia had 164 construction-related CONs and RFPs while Maryland had 87.

What are the trends for healthcare construction?

Looking at the annual number of healthcare construction CONs and RFPs reveals some notable trends. In 2022, we saw a peak with 2,493 construction RFPs—the highest in the last decade—indicating a surge in construction interest, likely fueled by post-pandemic recovery efforts and growing healthcare demands.

The number of construction CONs has fluctuated over the years, particularly as many states have opted to phase out their CON programs. Our data shows that CONs peaked at 1,024 in 2015 but gradually declined to just 207 in 2022. This decrease suggests that, even with rising construction activity, the regulatory landscape has changed, resulting in fewer projects needing a CON. In 2019, for example, Florida immediately eliminated several CON requirements but phased out hospital CONs two years later.

Although 2023 experienced a dip in both RFPs and CONs compared to 2022, the overall figures from the past decade still reflect a robust demand for healthcare construction. Learn how you can capitalize on the current demand for healthcare construction and win more healthcare RFPs with our comprehensive guide.

Construction-related RFP and CON activity, 2014-2024

YearNumber of RFPsNumber of CONsTotal number of CONs and RFPsExplore dataset
20141,3107552,065Explore
20151,5461,0242,570Explore
20161,6948352,529Explore
20171,7416602,401Explore
20181,8584172,275Explore
20191,4656112,076Explore
20201,6545392,193Explore
20211,7305552,285Explore
20222,4932072,700Explore
20231,9212122,133Explore
2024 YTD1,4312351,666Explore

Fig 2 Data is from the Definitive Healthcare HospitalView product through October 2024. The RFP categories encompass Construction - New Buildings, Renovations, and Design. The CON categories include Hospital/Facility Relocation, Hospital/Facility Renovation, and New Hospital/Unit.

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