Why underperforming assets cost more than you think
The Value+ joint venture model: strategy, structure, execution
How strategic lease-up can increase valuations 20-40%
Shared investment Shared upside No capital outlay required
The Challenge
Health systems across the country are sitting on underperforming real estate assets that drain resources, depress balance sheet performance, and divert capital from mission-critical priorities. Vacancy in outpatient facilities, aging infrastructure, and misaligned tenant strategies quietly erode asset value, yet fixing these problems typically demands significant capital investment with uncertain returns.
The conventional response, injecting capital into physical improvements before addressing the underlying leasing and tenant-mix issues, rarely delivers It is the equivalent of renovating a building that has no plan to fill it The result is a cycle of spending without a corresponding lift in net operating income (NOI)
Could your facilities be working harder for your patients and your balance sheet? With Value+, Boldt co invests in your underperforming assets and leads the leasing strategy to attract mission aligned tenants. The result: improved occupancy, stronger financial performance, and a healthier real estate portfolio.
WHAT’S AT STAKE
A healthcare facility's value is directly tied to its NOI Today, an underperforming building is worth only what its current income stream can support But once fully leased with a strategic tenant mix, valuations can rise 20 to 40 percent, driven by stronger income and favorable market capitalization rates That gap between current value and stabilized value represents trapped capital that most health systems have no clear mechanism to unlock
The Value+ Model
Boldt's Value+ Model is a strategic joint venture framework purpose-built for health systems seeking to transform underperforming outpatient real estate into high-value, fully leased, revenue-generating facilities, without deploying capital and without sacrificing governance or mission alignment
Rather than asking health systems to invest more in assets that are already underperforming, Value+ brings Boldt's capital, leasing expertise, and long-term stewardship to the table The model is structured so that both parties share in the investment and in the upside as the asset stabilizes
Identify: Underutilized Facility
The health system identifies an underperforming healthcare facility with vacancy or sub-optimal tenant mix that is depressing NOI and asset value.
Diagnose: Root Cause Analysis
Boldt diagnoses why the asset is underperforming This goes beyond physical condition to examine leasing gaps
Structure: Joint Venture Formation
Boldt purchases the facility and forms a JV with the health system This upfront cash transaction strengthens the system's balance sheet while preserving control
Execute: Strategic Lease-Up
Boldt fills vacancy by leasing space to mission-fit, health-system-approved providers. Every tenant placement is vetted for clinical and strategic alignment.
Unlock: Shared Value Creation
As the facility stabilizes, the system monetizes the asset at its new, higher market rate The difference between today's value and stabilized value is shared upside
Make Every Square Foot Count
No Capital Outlay
The health system deploys zero capital Boldt co-invests through the joint venture structure, funding the acquisition and targeted improvements The system redirects freed capital toward clinical priorities and mission-critical initiatives.
Mission-Aligned Tenancy
Every prospective tenant is vetted and approved by the health system. Boldt's leasing strategy is built around attracting providers that complement the system's service lines, not just anyone who can sign a lease
Strategy Before Capital
Most approaches begin with capital improvements. Value+ begins with the tenant strategy, because filling space with the right tenants is what drives NOI and, by extension, asset valuation. Physical improvements follow once the leasing plan validates them.
Control Retained
The health system retains governance over the facility Boldt commits to long-term stewardship, not a flip The JV is structured so the system maintains indefinite control and decision-making authority
Shared Upside
As vacancy is filled and NOI increases, the asset's market value rises. Both parties share in the value creation. The health system captures the spread between today's depressed value and the fully stabilized value.
Why Boldt Real Estate
Boldt Real Estate is the healthcare and senior-living development and investment arm of The Boldt Group, a company with over 135 years of experience in the built environment Boldt's long history navigating uncertain markets and evolving healthcare delivery models makes the firm a reliable, long-term partner for health systems seeking strategic real estate solutions.
Unlike traditional investors who seek short-term returns and exit strategies, Boldt is a longterm steward. The company does not flip assets. It invests in relationships, aligns with the system's clinical mission, and builds real estate strategies that sustain value over decades, not quarters
135+ Years of experience in the built environment, including complex healthcare facilities
Long-Term Stewardship with a commitment to hold and manage, not resell
Healthcare Specialization across outpatient, ambulatory, physician-owned, and senior living
National Reach with projects and partnerships spanning health systems across the country
Integrated Capabilities spanning development, construction, leasing, and asset management