The Health Care Transformation: Five Trends Engineering Firms Need to Know

The health care and science+technology market is undergoing profound change — not just in how care is delivered, but in the physical environments where it happens. From AI-powered research labs to rural hospital closures, the forces reshaping this $70 billion sector are creating both urgent challenges and significant opportunities for engineering and design firms. ACEC’s Winter/Spring 2026 Market Intelligence Brief identifies five trends that will define the market in the years ahead. 

1. AI Investment Is Reshaping Health Care Infrastructure 

Artificial intelligence is no longer a future consideration — it’s a present-day operational reality. Already, 20% of life science companies spend more than $5 million annually on generative AI, with that share expected to grow to 32% in 2025. Private investment in health care AI climbed from $3.7 billion in 2023 to $9.3 billion in 2024. 

In the words of Mead & Hunt CEO Amy Squitieri, “AI is transitioning from a helpful tool to a true operational partner.” That partnership enables real-time performance and compliance monitoring in high-consequence environments. It’s a shift that has direct implications for facility design. Organizations are reassessing physical infrastructure to support AI-driven operations, driving significant upgrades in space, power, and cooling. Firms with expertise in data-intensive environments and specialized lab design are well positioned to capture this demand. 

2. Rural Hospital Closures Are Accelerating — and Inviting Federal Investment 

Thirty percent of rural hospitals are currently at risk of closure, with the most immediate threats in Connecticut, Alabama, and Mississippi. Twenty percent of the U.S. population depends on these facilities, which generate $220 billion in economic activity. Yet small rural hospitals receive less than 3% of total national hospital spending. 

The federal response presents a direct opportunity for design firms. The Centers for Medicare & Medicaid Services recently launched the Rural Health Transformation Program — a $50 billion, five-year initiative targeting facility upgrades, equipment, cybersecurity, and digital infrastructure across all 50 states. 

3. Life Science Labs Are Entering a Market Correction 

After a pandemic-era surge in venture capital and rapid lab construction, the life science real estate market is poised for correction. Available U.S. lab space reached 61 million square feet in 2025 — three times the 2021 level. JLL projects that 18.7 million square feet will fall into distress or be converted to other uses by 2030. 

For engineering firms, Life Science labs development is cooling, but repositioning and adaptive reuse work could ramp up. Firms with expertise in the conversion of distressed assets could find demand even in a softening market. 

4. Tariff Uncertainty Is Disrupting Construction — and Spurring Onshoring Momentum 

Health care’s global supply chain is under pressure. The sector relies on $14.9 billion in annual medical equipment imports from China, and 60% of industry leaders expect some business impact from current tariff policy. That uncertainty has already contributed to fewer year-over-year construction starts. 

The opportunity lies in onshoring momentum. As health care companies invest in domestic pharmaceutical manufacturing and medical device production, engineering firms with sector-related project experience are positioned to benefit. 

5. An Aging Population Is Fueling Long-Term Demand for Medical Office Buildings  

Medical office buildings are emerging as one of the most stable corners of health care real estate. Today, 42,000 MOBs account for 1.6 billion square feet nationwide, and major metros have added 44.4 million square feet in just three years. 

Even with construction rising slowly, demand remains resilient — supported by outpatient‑enabled technologies that shift more care outside the hospital and by the growing clinical needs of an aging population. 

The Bottom Line 

The health care and science+technology market is not a single story. AI is restructuring research environments. Rural closures are triggering major federal investment. Lab oversupply is creating adaptive reuse opportunities. Tariff pressure is accelerating domestic manufacturing. And an aging population is generating durable demand for medical office buildings for at least the next decade. 

For engineering firms paying attention, the question isn’t whether opportunity exists — it’s which of these trends aligns best with your firm’s capabilities. 

To learn more, download ACEC’s Winter 2026 Health Care & Science+Technology Market Intelligence Brief.