M+A Architects


ACA Impacts: Designing More Efficient Medical Facilities

  • JUNE 27, 2016
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It’s been more than six years since President Barack Obama signed the Affordable Care Act into law and overhauled health insurance. The ACA impacts the design of healthcare facilities across the United States as well in order to accommodate the estimated 20 million Americans that have gained health insurance coverage since 2010 (HHS.gov).

The ACA impacts have brought two major shifts to the designing of healthcare facilities:
-operational efficiencies to support healthcare as a financially viable business

With programs such as Medicare Value-Based Purchasing which reward acute-care hospitals for the quality of care they provide, the ACA is pushing patient-centeredness, patient satisfaction and patient engagement to a whole new level. Doing business as usual is no longer an option when it comes to efficiency for health systems. The ACA legislation is asking providers to do more with less to reduce costs. Health systems are challenged to achieve financial and care-delivery goals in new ways. They’re becoming more efficient while providing a better, more holistic patient experience. This explains why many systems are looking to the retail, corporate workplace, and hospitality industries to discover new approaches to operations and facility design. The ACA impacts have made it difficult for healthcare facilities to accommodate increased patient volumes -- this is where we come in.

Our projects have been no exception to these ACA impacts—designing a more complete patient experience is the overarching purpose behind the facilities we design.

“We pay a lot of attention to what is happening in each space. For example, an exam room in a primary care practice could have an exam chair instead of an exam table, which could reduce building area,” said Wes Hawkins, director of our healthcare studio. “We are also unitizing the spaces to retain ultimate flexibility in the changing environment of healthcare. An exam room, a consult room, and a manager’s office are all created to be interchangeable as needs fluctuate.”

For example, research has found that 30-40% of medical office building real estate is tied up in private offices that are unoccupied 90% of the time. That is a lot of costly square footage that could be used in other ways. To curb this inefficiency and allow for better utilization rates, you can provide small hoteling stations where doctors can have private phone calls and do notations however, these areas aren’t dedicated to one specific doctor.

Whether it’s consolidating different centers into one space or minimizing private offices in medical buildings, we are all about helping our clients update their facilities to maximize flow and efficiency.

Taking cues from retail and hospitality, we’ve also been designing waiting rooms to be more engaging. “Retail environments are designed to attract customers and that’s one of the new aspects of healthcare architecture,” said Hawkins. Moving beyond a few rows of chairs and scattered magazines, waiting areas can be consolidated into a shared space that serves the whole medical office building. Patients would have the opportunity to choose seating that matches their comfort level, whether that’s a table to do something on, a comfortable couch to read on, or an intimate setting with family.


Healthcare project manager Mark Hollern adds that “in retail settings the public are expecting comfortable environments that clearly direct them to desired services or products. We choreograph our integrated finishes and wayfinding elements into a warm, calming and attractive experience that veers away from the common sterile healthcare environment and provides the consumers with a sense of healing, clarity of services and positive distractions.”

These changes aren’t easy. Some doctors and other healthcare staff can be resistant to change, but with more ACA regulations going into effect each year and patients becoming more like consumers—thoughtfully choosing their healthcare providers and services as active decision makers—healthcare systems will need to be proactive in enhancing operational efficiencies and being more patient-centric.

M+A Architects