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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?

Between 2019 and September 2023, we collected more than 12,900 healthcare construction CONs and RFPs. For the last four calendar years, on average we tracked about 2,670 CONs and RFPs each year.

This list below ranks states by their total number of construction-related CONs and RFPs over the last few years.

Number of healthcare construction CONs and RFPs by state

RankStateNumber of CONs and RFPs 2019-2023State requires CONExplore dataset
1New York2,757YesExplore
2Texas774NoExplore
3California680NoExplore
4Virginia642YesExplore
5Georgia542YesExplore
6North Carolina470YesExplore
7Florida425YesExplore
8Illinois411YesExplore
9Michigan386YesExplore
10Massachusetts329YesExplore
11Ohio329YesExplore
12Pennsylvania309NoExplore
13Maryland304YesExplore
14South Carolina293YesExplore
15District of Columbia281YesExplore
16Washington272YesExplore
17Missouri252YesExplore
18Kentucky223YesExplore
19Tennessee215YesExplore
20Alabama184YesExplore
21Oklahoma154YesExplore
22Mississippi151YesExplore
23Arkansas149YesExplore
24New Jersey147YesExplore
25Louisiana145YesExplore
26Connecticut138YesExplore
27Colorado137NoExplore
28Wisconsin*131NoExplore
29Iowa130YesExplore
30Indiana129YesExplore
31Kansas105NoExplore
32West Virginia99YesExplore
33Arizona*93NoExplore
34Hawaii91YesExplore
35Oregon91YesExplore
36Minnesota*89NoExplore
37Nevada86YesExplore
38Utah83NoExplore
39Maine80YesExplore
40Wyoming65NoExplore
41South Dakota60NoExplore
42New Mexico59NoExplore
43Montana57YesExplore
44Delaware55YesExplore
45Rhode Island49YesExplore
46Alaska48YesExplore
47Idaho41NoExplore
48Nebraska40YesExplore
49Vermont37YesExplore
50North Dakota29NoExplore
51New Hampshire25NoExplore

*denotes CON state program
Arizona, Minnesota, and Wisconsin do not have official CON laws but have other healthcare related application processes in place.
Fig. 1 Data is from the Definitive Healthcare HospitalView product. Accessed October 2023.

Which states have the most healthcare construction activity?

New York had the most construction CONs and RFPs from January 2019 through September 2023 with more than 2,700. The state’s CON requirements, large population, and number of healthcare facilities likely contribute to this number. Texas had nearly 800 CONs and RFPs while Georgia had more than 500.

What are the trends for healthcare construction?

When looking at the annual number of healthcare construction CONs and RFPs for the top five states, some trends emerge. From 2019 to 2020, most of the states saw decreases in healthcare construction activity, likely related to the COVID-19 pandemic.

Between 2021 and 2022, Virginia had an increase of more than 160 healthcare construction CONs and RFPs. The states of New York and Georgia also had increases of 85 and 75 healthcare construction CONs and RFPs, respectively.

Top healthcare construction activity states 2019-2023

State20192020202120222023 through SeptemberExplore dataset
New York453374609694627Explore
Texas158149164186117Explore
California14314711819379Explore
Virginia1008291253116Explore
Georgia64106140124108Explore

Fig. 2 Data is from the Definitive Healthcare HospitalView product. Accessed October 2023.

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Healthcare Insights are developed with healthcare commercial intelligence from the Definitive Healthcare platform. Want even more insights? Start a free trial now and get access to the latest healthcare commercial intelligence on hospitals, physicians and other healthcare providers.