flexiblefullpage -
billboard - default
interstitial1 - interstitial
catfish1 - bottom
Currently Reading

Primer: Using 'parallel estimating' to pinpoint costs on healthcare construction projects

Healthcare Facilities

Primer: Using 'parallel estimating' to pinpoint costs on healthcare construction projects

Healthcare owners are turning to advanced estimating processes, like parallel estimating, to minimize unknowns and improve their understanding of exposure.


By Andrew Sumner, CBRE Healthcare | February 11, 2015
Primer: Using 'parallel estimating' to pinpoint costs on healthcare construction projects

Photo: U.S. Navy photo by Chief Warrant Officer 4 Seth Rossman via Wikimedia Commonshosp

As pressure increases to understand capital cost prior to the first spade touching dirt, more healthcare owners are turning to a Parallel Estimating process to improve understanding of exposure and ensure a successful preconstruction phase and subsequent bid and award. When procuring a project with a Construction Manager (CM) under a Guaranteed Maximum Price (GMP) contract (also referred to as a CM at Risk), there are definitive advantages of employing an owner’s representative cost estimator to triangulate estimating in the preconstruction process and produce a parallel estimate.

Since a GMP contract transfers project risk to the CM, Parallel Estimating or triangulation is an effective way to validate the GMP developed by the CM and understand just how much risk has been built into the number. While CM at Risk is the delivery method specifically identified, this same process is also effective with other approaches such as Design-Build and Integrated Project Delivery.

On average, GMP projects can be as much as 2-5% higher than a project contract that is procured through a hard bid with a general contractor.  While there are numerous reasons for this, aside from eliminating the competitive bid process; it is primarily due to the CM accepting complete responsibility for the project and the bid documents.  Thus the CM is at risk and will protect themselves as needed based on exposure, given the quality of the documentation the GMP is based on.

CM at Risk is typically used on complex and fast paced projects whereby the conditions and circumstances do not allow for a clear and easy bid process. In many instances, it is worth paying slightly more to have the CM manage and be accountable, especially if they base their GMP on insufficient documentation.

When an owner pursues a GMP procurement strategy, they are advised to engage a cost estimator to provide a secondary touch-point for risk identification and risk elimination. Having these two view points and opinions on scope, rates, quantity and constructability is an excellent way to flush out issues through the preconstruction process. This is often an unquantifiable benefit but the two contrasting views allow for a healthy discourse at the reconciliation meeting, highlighting areas of the project where both parties see risk and potential cost exposure.

 

CASE STUDY #1

On a low lying flood plain, this project would accommodate numerous sports fields and recreational areas. Given the nature of its elevation, it would require large earth berms to allow bridges to connect the fields to the surrounding high level campus. These berms would require large, complex geotechnical solutions and a series of gravel pyramidal “lifts” to stop subsiding.

The healthcare team employed a parallel estimating approach. At the Schematic reconciliation, both the CM and the Estimator came to the table with different approaches and different costs for assembling the berms. Since there was significant cost involved in the two approaches, the process allowed for the owner and design team to assess the cost and risk involved with both and highlighted the necessity to solve the geotechnical solution before the next round of estimating.  By merely highlighting the risk, the process escalated the need for a geotechnical direction, solidifying the approach and the cost exposure early in the project.

As the CM is taking on the risk, from a business perspective, they will always understandably protect themselves when producing a GMP estimate. This is not a fault of the CM taking on the risk, but a reality of the nature of the contractual model chosen by owner. Naturally, the incentive is not always aligned with the owners desire to have the lowest cost project possible.

A parallel estimating process allows the owner’s cost estimator to help manage the “risk” or “fluff” in the number. The approach should not be so definitive that the team is too aggressive with the GMP, but through accurate quantification, seeking market rates and validating assumptions and the nature of cross checking the approach, the triangulation should breed confidence with the CM to be more finite with their number.

 

CASE STUDY #2

This particular project had close to a million square feet of office space. The majority of closed offices existed as standalone “pods” dotted around the space with glass walls and individual ceiling caps to make them cube like. The ceilings were specified with a product called Baswaphon, a highly technical, sound absorbing panel with a trowel applied finish. At the reconciliation, the CM had the cost represented by an allowance on a cost per square foot basis.

Given that the owner’s cost estimator was unfamiliar with the product, research on the product was conducted and the local supplier was identified and thus produced the quote that had been provided. The cost was $5 per square foot less than the allowance by the CM. This allowed the CM, a degree of confidence to reduce his GMP by $570,000. This is a classic example of how the parallel effort helps reduce the contingency held within the numbers. The estimating window is often very short as projects move fast, having two separate independent numbers often allows for a more collaborative process once around the reconciliation table.

The above case study demonstrates how the parallel estimating process reduces the GMP. The triangulation process can also eliminate risk in the other direction and often ensures the GMP is the “right” number in the sense of moving it higher.

While a CM looks to cover exposure with a GMP number, occasionally, depending on the economic circumstances, a CM could produce a low number in an effort to ensure the project proceeds and the contract is awarded.  In these circumstances, a triangulation effort guards against an artificially low number and the subsequent costly aftermath of a tenuous and lengthy change order battle as the CM looks to recoup costs. The preconstruction process is never perfect and in some instances the triangulation effort helps capture scope missing from the CM’s GMP and while increasing the number, reduces risk to the client in the long run.

 

CASE STUDY #3

On this 80,000 sf building project, the owner employed two separate independent estimating teams to triangulate with the CM; one estimator representing the Owner and one estimator representing the Architect.  Although this was an unusual approach, three numbers certainly helped mitigate the risk and get a consensus on the right number.

The local CM, experienced in the local market, was particularly inexperienced in the triangulation process and some of the misses in the preconstruction process were exposed through the diligence of the two parallel estimates. In one instance, it was identified that the CM had missed an entire elevation of the curtain wall. This was easy to do on such a complex, multi-elevation building, as the one in question. The omission was captured and therefore, all three estimates helped the team work towards the “right” number.

Triangulation in preconstruction is a great method of implementing due diligence into the financial aspects of a construction project.  It eliminates risk and validates the construction cost at each stage.

Given that no one is perfect, along with the fast paced nature of construction in the US, aggressive schedules drive the process. CMs, cost estimators and the like endeavor to understand, digest and calculate construction costs from vast quantities of drawings and specs in a defined period of time. Therefore, mistakes, assumptions and “plug” numbers are very common. A thorough and methodical preconstruction process with stage gate reconciliation touch points is an excellent way to assure clients, owners and stakeholders that the numbers are solid and the project is on budget through design ahead of committing to the GMP.

There has been much success using the reconciliation process in the healthcare sector. Due to the nature of the work, the capital costs in healthcare are often significant and, given the complexity of these projects, lend themselves to this process.

Typically, owners are looking at the costs as a secondary tier, beyond just the overall construction cost. Many owners have a desire to understand how much ICU areas cost in comparison with their cardiology wing and how much the ambulatory care department costs.  Given this requirement to understand the costs programmatically, employing an independent Cost Consultant to lead the process is the best solution to drive the CM to follow suit and produce a GMP with similar breakdowns and transparency. Establishing the framework early is critical to setting up the preconstruction process for success.

 

CONCLUSION

A solid reconciliation process will instill confidence in the project team, owners and stakeholders as they move through preconstruction and aim to manage financial constraints and establish a realistic GMP.

Employing a fiduciary in the form of a cost consultant to oversee and coordinate this process drives value for owners in numerous ways. A cost consultant can assist clients in reducing risk, validating costs and guiding the projects teams to arrive, agree and award “right” number. Following this path will ensure that the project stays on budget and stands the best chance of success without sacrificing desired scope and devaluing your investment.

About the Author: Andrew Sumner, MRICS, is Director of Cost Management at CBRE Healthcare.

Related Stories

| Aug 11, 2010

Philadelphia cancer center seeks LEED certification

The New York office of Thornton Tomasetti provided structural engineering services for the Ruth and Raymond Perelman Center for Advanced Medicine in Philadelphia, a $232 million medical research center and advanced treatment center for cancer and cardiovascular disease. Designed by a joint venture of Perkins Eastman Architects and Rafael Vinõly Architects, the 340,000-sf facility will hous...

| Aug 11, 2010

High-level NICU opens in Washington, D.C.

Design to the highest distinction available by the American Academy of Pediatrics, the new Level IIIC neonatal intensive care unit (NICU) at Children's National Medical Center in Washington D.C., is equipped to care for the sickest premature babies, including those that require open-heart surgery. The 54-bed facility, designed by Karlsberger with KLMK Group as space planner, is four times large...

| Aug 11, 2010

San Bernardino health center doubles in size

Temecula, Calif.-based EDGE was awarded the contract for California State University San Bernardino's health center renovation and expansion. The two-phase, $4 million project was designed by RSK Associates, San Francisco, and includes an 11,000-sf, tilt-up concrete expansion—which doubles the size of the facility—and site and infrastructure work.

| Aug 11, 2010

New hospital expands Idaho healthcare options

Ascension Group Architects, Arlington, Texas, is designing a $150 million replacement hospital for Portneuf Medical Center in Pocatello, Idaho. An existing facility will be renovated as part of the project. The new six-story, 320-000-sf complex will house 187 beds, along with an intensive care unit, a cardiovascular care unit, pediatrics, psychiatry, surgical suites, rehabilitation clinic, and ...

| Aug 11, 2010

Manhattan's Gouverneur Healthcare Services tops out renovation, expansion

One year after breaking ground, the Building Team for the renovation and expansion of the Gouverneur Healthcare Services facility on Manhattan's Lower East Side topped out the $180 million project. Designed by New York-based RMJM, the development involves a 316,000-sf renovation and 108,000-sf addition that will house a 295-bed nursing facility and five-story ambulatory care center.

| Aug 11, 2010

Decline expected as healthcare slows, but hospital work will remain steady

The once steady 10% growth rate in healthcare construction spending has slowed, but hasn't entirely stopped. Spending is currently 1.7% higher than the same time last year when construction materials costs were 8% higher. The 2.5% monthly jobsite spending decline since last fall is consistent with the decline in materials costs.

| Aug 11, 2010

Construction under way on LEED Platinum DOE energy lab

Centennial, Colo.-based Haselden Construction has topped out the $64 million Research Support Facilities, located on the U.S. Department of Energy’s National Renewable Energy Laboratory (NREL) campus in Golden, Colo. Designed by RNL and Stantec to achieve LEED Platinum certification and net zero energy performance, the 218,000-sf facility will feature natural ventilation through operable ...

| Aug 11, 2010

Stimulus funding helps get NOAA project off the ground

The award-winning design for the National Oceanic and Atmospheric Administration’s new Southwest Fisheries Science Center replacement laboratory saw its first sign of movement last month with a groundbreaking ceremony held in La Jolla, Calif. The $102 million project is funded primarily by the American Recovery and Reinvestment Act.

| Aug 11, 2010

National Intrepid Center tops out at Walter Reed

SmithGroup, Turner Construction, and the Intrepid Fallen Heroes Fund (IFHF), a nonprofit organization supporting the men and women of the United States Armed Forces and their families, celebrated the overall structural completion of the National Intrepid Center of Excellence (NICoE), an advanced facility dedicated to research, diagnosis, and treatment of military personnel and veterans sufferin...

| Aug 11, 2010

Alabama hospital gets a four-story addition

Birmingham, Ala.-based Hoar Construction has completed the North Tower addition at Thomas Hospital in Fairhope, Ala. The four-story, 123,000-sf addition accommodates an ER on the first floor, 32 private patient rooms and nursing support on the second and third floors, and room for 32 planned patient rooms on the top floor.

boombox1 - default
boombox2 -
native1 -

More In Category


Healthcare Facilities

Advancing Healthcare: Medical Office Buildings at the Forefront of Access and Safety

This article explores the pivotal shift from traditional hospital settings to Medical Office Buildings (MOBs), focusing on how these facilities enhance patient access. Discover the key drivers of this transformation, including technological advancements, demographic trends, and a growing emphasis on integrated, patient-centered care. Learn how MOBs are not only adapting to modern healthcare demands but are also leveraging modern access control and safety innovations.



halfpage1 -

Most Popular Content

  1. 2021 Giants 400 Report
  2. Top 150 Architecture Firms for 2019
  3. 13 projects that represent the future of affordable housing
  4. Sagrada Familia completion date pushed back due to coronavirus
  5. Top 160 Architecture Firms 2021