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Medical Centre, Mainz
Healthcare real estate is once again attracting serious institutional attention in Germany, buoyed by a surge in first-quarter transaction volumes, long-anticipated structural reforms, and the renewed appeal of low-risk income streams.
New figures from CBRE, JLL and C&W suggest that over €650 million was invested in nursing homes, senior housing and clinics in Q1 2025—more than treble the quarterly average for 2024. While the €380 million acquisition of 13 Deutsche Wohnen nursing homes by the City of Hamburg inflates the headline figure, brokers confirm that deal flow is improving, with buyer appetite returning across outpatient and long-lease segments.
The demographic fundamentals remain irrefutable: with over 7.5 million people in Germany projected to require care by 2055, the market potential is considerable. But investor strategy is now pivoting from large-scale inpatient facilities to decentralised, outpatient-focused assets known collectively as Gesundheitszentren. As outlined in a recent online panel hosted by RUECKERCONSULT and builtworld, these include medical centres (MVZ), doctors’ offices, rehabilitation clinics, day surgery hubs, and assisted living complexes. The concept is shaped both by the "ambulant vor stationär" thrust of current federal healthcare reform and by a growing preference for accessible, location-stable assets anchored by creditworthy tenants.
"We only acquire properties where at least 80% of the tenancy is made up of healthcare users," said Felix Rotaru, Director Healthcare at Hauck Aufhäuser Lampe. The bank targets Core and Core+ assets in cities and regional centres above 20,000 inhabitants, favouring 10-to-12-year leases with individual doctors, pharmacists or therapists, each with multiple extension options. According to Rotaru, the risk of default in this tenant class lies between 0.2 and 0.5%, a key reason why these buildings are favoured by funds seeking stable distributions of around 5%.
Hospital reforms opening doors to private capital
Carsten Demmler, Managing Director of HIH Invest, pointed to the wider policy backdrop: "The 2016 hospital reform already forced a shift towards outpatient structures. Beds were removed, sites were merged, and services restructured. The current reform is merely the continuation of this trajectory—and that opens the door to private capital." In smaller towns, where provision has often lagged, privately-financed medical centres and assisted living developments are helping to fill the gap left by overstretched public infrastructure.
The panel also featured Alexander Lackner, Managing Director of neworld, which invests across a range of human-centric asset classes including healthcare, serviced apartments and elderly living. "There are no more reliable tenants than doctors and pharmacists," said Lackner. "They pay their rent. And they stay." But he also sounded a note of caution. Rural areas, while underserved, pose a serious staffing risk. "Unless we start viewing healthcare real estate and residential housing as a package—jobs, homes, infrastructure—the labour gap will persist."
CBRE places prime yields for care properties at 5.4%, while outpatient medical centres—a smaller but fast-growing segment—currently trade at yields closer to 4.7%. According to CBRE’s Anna Maria Martin, these assets offer a different type of risk diversification: "Medical centres are the multi-tenant office properties of the healthcare world—only with a demand guarantee."
Peter Tölzel of JLL confirms that investor appetite is building again: "Demand is rising, and asset managers are once again receiving initial capital commitments. These are positive signals and make it clear that investors are once again willing to spend money on nursing homes." However, he adds, transactions are taking longer, with diligence phases stretching up to six months.
Development pipeline under pressure
On the development side, caution continues to dominate. Construction prices have risen faster than pensions, shrinking affordability. The flood of regulation around QNG-certified building standards has further slowed the pipeline. A recent analysis by Elbe Bau found that the share of new-build living space a pensioner can afford has dropped by 43% since 2008. According to Sören-Hauke Stockmann, managing director at Elbe Bau, not only have construction costs surged, but planning timelines have lengthened dramatically: "Where it once took twelve months to build a 120-bed care facility, it now takes eighteen.".
Stockmann also highlights the financial strain QNG compliance imposes on developers. "The planning and administrative costs for a typical 40-unit project run to around €85,000, with a further €57,000 for certification. And the process is highly inflexible—even minor substitutions of building materials require weeks of re-certification."
A number of major clinic portfolios are reportedly preparing for sale, and CBRE expects total healthcare property volumes to exceed €1 billion in 2025.
Medical centres have emerged as the healthcare equivalent of multi-tenant office buildings—delivering diversified income, long leases and near-certain demand. For investors seeking defensive, income-generating assets without exposure to operator risk, the case for Gesundheitsimmobilien is gaining renewed conviction.