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Germany’s Ärztehäuser—medical centres housing GPs, specialists, and associated services—are moving into sharper focus for institutional real estate investors, as REFIRE learned at the launch of a new report on the sector recently.
The new market update from Hauck Aufhäuser Lampe Privatbank (HAL), in collaboration with CBRE, estimates the investable universe of outpatient healthcare properties at over €30 billion, based on 3,500 suitable assets across the country. For 2025, CBRE expects transactions in this segment to hit €200 million—more than double the €79 million recorded in 2024, and already likely surpassed in Q1 of this year.
Prime yields for outpatient medical properties held at 4.7% at year-end 2024. Despite constrained dealflow, international investors sharply increased their presence in the segment, accounting for 58% of transactions in 2024—up from just 19% a year earlier. Interest is driven by long lease durations, creditworthy tenants, and reliable occupancy across multiple medical disciplines.
“We are seeing increased interest from institutional investors in outpatient healthcare properties,” said Dr. Jan Linsin, Head of Research Germany at CBRE. “For the current year, we expect the transaction volume to increase to up to €200 million.” He cited the stable cash flows and structural resilience of the segment as key factors behind the uptick in capital allocation.
Growing 'outpatientisation' of healthcare services
HAL’s report attributes the growth in investor interest to structural healthcare reform and accelerating “outpatientisation” of services. As part of the updated AOP (Ambulantes Operieren) catalogue, an estimated 400,000 procedures previously handled in hospitals are expected to be shifted to outpatient settings. The hospital reform law, still in legislative process, will further reinforce this shift, driving demand for intersectoral care facilities that bridge clinical and ambulatory models.
“The trend will continue to strengthen and support the demand for modern outpatient healthcare properties in the long term,” said Felix Rotaru, Director of Healthcare at HAL. According to the study, while most surgical procedures still take place in hospitals, expert consensus puts the outpatient potential at over 20%.
HAL’s Real Estate Investment Management arm is now launching its second Article 8 healthcare fund—HAL Soziale Infrastruktur (SI) Deutschland 2—targeting €150 million in equity. The fund will focus on core and core-plus Ärztehäuser and Gesundheitszentren, with no operator-run assets, and a 12-year term. “We had to change our strategy in the meantime,” said Patrick Brinker, Head of Real Estate Investment Management at HAL. “HAL is now focusing solely on equity. This is in line with the wishes of institutional investors, who mostly favour this approach due to the changed interest rate landscape and the associated financing conditions.”
Expected capital deployment includes more than ten assets, each valued between €5 million and €30 million, with an unlevered cash-on-cash yield of at least 4.75%. Over 60% of rental income is expected to come from core medical users—doctors, dentists, outpatient rehab providers—supplemented by social care services and health-oriented retail tenants such as pharmacies and opticians.
HAL’s pipeline includes 20 potential assets totalling over €180 million. The properties typically comprise 3,000 sqm of rental space, at average cold rents of €13 per sqm. The average purchase price stands at €8.7 million, based on a gross multiplier of 18.5. The report notes that mixed-use buildings with predominantly healthcare functions may significantly expand the investable base beyond the 3,500 pure outpatient properties currently identified.
Investor appetite is particularly strong in the mid-size segment, with more than two-thirds of the properties analysed in HAL’s database offering between 1,500 and 5,000 sqm of rentable space. Properties below 1,500 sqm are generally considered too small for institutional deployment. “Smaller locations are only attractive to institutional investors to a limited extent,” said Anna Maria Martin, Senior Analyst at CBRE. “Investment interest is particularly focused on medium-sized and large properties with a diversified tenant structure.”
Strong differentials between eastern and western states
Geographically, there is a marked east–west divide. Eastern federal states—reflecting the legacy of more centralised healthcare provision—show a higher density of outpatient care properties per capita. Berlin and Hamburg register the highest asset concentration among major cities, while rural and structurally weaker regions remain under-supplied. According to HAL and Rebmann Research, the national average is one outpatient healthcare property per 24,141 inhabitants, with significant headroom for growth outside the top seven cities.
HAL’s strategy—focusing solely on equity, excluding operator risk, and prioritising single-use medical assets—mirrors a shift in institutional preferences. The revised fund structure reflects investor caution in light of financing conditions, favouring unlevered or low-leverage vehicles with predictable, income-driven performance.
Despite the upward momentum, CBRE notes that limited availability of investable assets remains a bottleneck. “Interest is being curbed by the limited availability of suitable investment opportunities and the mostly small-scale transaction sizes,” said Linsin. Many Ärztehäuser are still held privately or form part of fragmented deals. Nonetheless, the inclusion of repositioning and development projects—up to 30% of the HAL fund’s allocation—may begin to expand supply, particularly through the conversion of non-viable office space or former clinics.
With fundamentals shaped by healthcare policy rather than real estate cycles, outpatient medical centres are carving out a defensible space within the healthcare segment. For institutional investors willing to work through fragmented sourcing and granular asset management, Germany’s Ärztehäuser offer a stable, income-oriented addition to core and core-plus portfolios.