Florida’s rapid population growth comes with a climbing demand for health care services.
As a result, the state’s health care construction market is soaring, according to Robins & Morton, an Alabama-based construction firm specializing in health care facilities. It employs around 400 across its offices in Fort Lauderdale, Tampa and Orlando. From 2019 to 2024, the company’s Florida-specific revenue jumped 127% from $483.6 million to $1.1 billion.
Todd Watson, Robins & Morton’s Florida division manager, tracks that surge back to Florida trimming its certificate of need program, which previously required proof of demand and state approval for certain new or expanding health care services. After legislation passed in 2019, the program no longer regulates facilities like hospitals and outpatient entities.
“Now it’s basically a free market,” Watson says. “There are way more projects. There are additional health care systems moving into Florida to take advantage of this.”
He points to Encompass Health, the nation’s largest provider of inpatient rehabilitative services, which started beefing up its Florida presence following the 2019 change in the law. That December, it moved its central business office to Pasco County. Since then, Encompass has added facilities to north Tampa, Pensacola, Jacksonville, St. Augustine, Lakeland, Naples, Cape Coral and other spots. It’s on track to more than double its Florida footprint from 2021 to 2026.
Health care systems that already had a prominent presence in Florida — including AdventHealth, Orlando Health and HCA Florida Healthcare — also are in expansion mode, Watson says.
Many are planning future capacity into their incoming spaces, adding biggerthan- necessary rooms or extra floors that operations could eventually grow into. That forward thinking helps them hedge against inflation or other project escalations, which have driven health care construction costs up about 35% since 2019, Robins & Morton estimates.
Some growth comes as larger health care systems acquire smaller community hospitals.
“It’s a quicker way to get a market share than building a new facility,” Watson says. “You can purchase a hospital, change the signage, keep a significant amount of the staff and doctors that are already affiliated with that hospital, and you’re instantly in the market.”
The biggest trend he’s seeing in Florida — one predating the certificate of need reform — is an influx of freestanding emergency departments and outpatient centers painting the state. From 2013 to 2018, Robins & Morton built two freestanding emergency departments in Florida. From 2019 to 2024, the firm built nine, representing a 350% increase. Several more are in progress.
Watson credits that as a strategy for health care systems to better integrate into communities. Rather than siting a large hospital in a downtown area, they’re following residential growth and bringing services closer to neighborhoods.
“As residential construction continues to boom in Florida, and the population continues to relocate, we’re sprawling farther and farther out in the suburbs,” he says. “A lot of these health care organizations can stick an off-site ED out in that suburb and grab that market share. … Their return on investment on those things is pretty good, very quick.”
Despite continued construction challenges, like skilled labor shortages and longer lead times for certain equipment, Watson expects to see continued growth in health care construction in east Tampa Bay, South Florida, the Space Coast and around Orlando.