As healthcare leaders in Florida face increasing pressure to do more with less, the design of healthcare facilities is playing a critical role in driving operational success, improving access, and optimizing long-term investments.
Enter Ray Wong, Managing Principal of Florida Operations for Lawrence Group, a firm bringing more than 40 years of experience in healthcare design to the forefront of one of Florida’s most transformative healthcare projects — Health First’s Cape Canaveral Replacement Hospital on Merritt Island.
From Lawrence Group’s new Tampa office, Ray Wong leads efforts to grow the firm’s healthcare portfolio across the state. In this conversation, he shares what executives need to know about facility strategy in today’s high-stakes healthcare environment: from designing for efficiency and scaling ambulatory care to understanding how legislation and labor pressures are reshaping capital plans.
Hospitals are under more pressure than ever to be “efficient.” What does that look like from a design perspective?
Wong: Efficiency is a top priority for healthcare systems, right behind patient safety and the delivery of excellent care. At its core, efficiency in healthcare design means making every minute and dollar count without compromising care, all while supporting employee morale and satisfaction. As design partners, we embrace this challenge by creating environments that go beyond aesthetics, creating spaces that streamline workflows, enhance flexibility, and support both clinical and back-of-house teams. When done well, design becomes a strategic tool that reduces friction, lowers operating costs, and helps attract and retain talent.
Hospital volumes are up, but margins aren’t always following. What’s driving that disconnect?
Wong: That’s a wonderful question. There are economies of scale that tend to benefit larger healthcare systems, and there’s a lot of truth in your observation, especially for smaller systems. What’s painfully obvious is that growth and size don’t necessarily equate to profitability…at least not like they historically might have. Labor costs remain historically high, especially in larger, more competitive metropolitan areas, like Tampa Bay. The improved volume numbers that you allude to are offset, to some extent, by the labor premiums that hospitals need to pay to adequately staff their facilities. Now consider the cumulative effects that inflation, energy, materials, and labor are having on healthcare systems, and we begin to see a clearer picture as to why increased volumes are not necessarily in line with improved margins.
Ambulatory care seems to be everywhere. Is this a trend or is it here to stay?
Wong: Ambulatory care is an important part of a healthcare system’s product mix and is far from a passing trend. For years, healthcare systems have been strategically investing in ambulatory facilities like surgery centers and medical office buildings. These facilities are growing in number, faster than hospitals, because they allow systems to extend reach, manage costs, and improve the patient experience. Patients want convenience and better access; healthcare providers want to grow market share while controlling delivery costs. Ambulatory real estate hits that sweet spot by delivering care closer to where people live while optimizing operational performance. We’re seeing significant investment in imaging, oncology, orthopedics, women’s health, and same-day surgical centers. These are lower-cost, high-access points of care that resonate with today’s healthcare consumer.
Are Freestanding Emergency Departments (FSEDs) part of that outpatient strategy?
Wong: Absolutely. FSEDs offer 24/7 care access in markets that may not support a full hospital. Their increasing popularity stems from access, convenience, and how COVID-19 changed people’s willingness to visit hospitals. They’re a smart, strategic play for health systems looking to grow presence without the full capital and operational load of inpatient infrastructure. FSEDs sit at the intersection of convenience and cost-efficiency. They’re also becoming more popular among developers as viable real estate investments, especially in rapidly growing communities across Florida. Helping developers understand this niche makes them better equipped to engage healthcare partners in meaningful ways.
There’s been a lot of discussion about the recently passed ‘One Big Beautiful Bill.’ How might this impact capital planning for healthcare systems?
Wong: The most immediate risk I see is Medicaid cuts. Rural health systems, in particular, will be hardest hit. Many depend on Medicaid to serve vulnerable populations, and tightening eligibility coupled with reduced reimbursement could result in budget shortfalls that delay or cancel capital improvement plans. Larger systems will likely shift their capital strategies toward flexibility, scalability, and efficiency. What we’re seeing now is a prioritization of resilient design – facilities that can adapt to fluctuating reimbursement and policy shifts without compromising care delivery.
What kinds of economic conversations are you having with healthcare executives right now?
Wong: The conversations we’re having, especially with our larger and more sophisticated healthcare clients, revolve around scenario planning. Executives are navigating uncertainty around payer mix, shifting demographics, and real estate investment. My team and I are frequently asked to be at the table for these discussions, using early design studies to help model expansion strategies and operational costs. The conversation keeps coming back to this: how do we design facilities that are efficient, resilient, and still inspiring? Financial stewardship is crucial, but never at the cost of clinical excellence or human experience.
What gives you optimism about healthcare in Florida?
Wong: Hands down, it’s the people. We have incredibly committed clinical teams, administrators, and leaders across this region who are laser-focused on delivering better care. Florida’s healthcare systems are bold, innovative, and community-driven. In Tampa Bay and beyond, we see healthcare partners willing to reimagine care delivery and collaborate deeply – with each other and with firms like ours – to shape what healthcare looks like for the next generation.
Connect with Ray Wong
Ray Wong is Managing Principal of Florida Operations at Lawrence Group. To continue the conversation, reach out at Ray.Wong@thelawrencegroup.com.
Lawrence Group is a national architecture, design, and planning firm, using the power of people with great ideas to bring our clients’ dreams to life.
As Managing Principal of Lawrence Group’s Florida office, Ray Wong is focused on leadership and motivation, guiding his team and each project to success. His design philosophy emphasizes the integration of operational considerations and aesthetics, particularly in healthcare design, where he aims to create spaces that enhance the patient experience while aligning with client aspirations.
This article was featured on Tampa Bay Business Journal on August 1, 2025.