The fourth part of the Financing the Future series is presented. The final report in the Financing the Future III series, Healthcare Construction Trends and Capital Implications, examines today's healthcare construction environment, drivers of facility construction, types of facilities being built, and financing strategies healthcare executives are undertaking. building new healthcare facilities is a risky game. To come out ahead, hospitals and health system leaders will need successful approaches to planning, financing, and constructing the buildings of tomorrow. Healthcare construction project starts doubled from 2004 to 2006 and are expected to continue at rapid pace. In response, hospitals will decrease the design/construction execution time by deploying newer delivery models, such as lean construction, and designing new facilities that reduce operating costs. The margins are very narrow in the not-for-profit world, which makes it even harder to make capital investment decisions.