Real options in project coalitions in Dutch health care: two case studies of construction projects

Uncertainties affecting health organizations inevitably influence real estate decisions since real estate is required to facilitate the primary process in cure and care. Decisions have to be taken when there is little knowledge about the future. Therefore, flexibility is needed in the process of designing, constructing and operating real estate. Real options provide an approach to gain greater insight into flexibility. The aim is to analyse whether real options can be recognized in the real estate strategies of health organizations and what real options are provided by various forms of project coalition. Two case studies reveal that real options thinking can indeed be recognized in specific real estate strategies. The choice of certain real options is partly a result of the type of project coalition applied. Further development of real options thinking in real estate management in cure and care creates opportunities to deal with future uncertainties.