Clarian Health Partners made a big splash last December in Hamilton County when it opened a 154-bed medical center, but competitors in that market are showing they know how to flex development muscles, too.
The county's three other hospitals all have planned, started or completed expansion projects in the last few years, and those who know the market see plenty of room for more health care.
"If you're in the hospital business, it's hard to fail in a market like that," said Duane Sobecki, a principal with Sobecki & Associates, an Indianapolis health care consulting firm.
Analysts and hospital executives point to Hamilton County's population boom as the driver behind construction. The county's population is expected to increase 47 percent during this decade, reaching 266,545 by 2009, according to estimates from Indianapolis-based Health Evolutions Inc.
St. Vincent Health CEO Vincent Caponi thinks at least three cities in the county could wind up longer term with populations approaching 100,000. Indianapolisbased St. Vincent Health is the parent of the 125-bed St. Vincent Carmel Hospital.
The county's population also is aging, and older people require more health care, Sobecki noted.
Indeed, the portion of Hamilton County residents over age 65 should grow 64 percent this decade, to 22,079, according to the Health Evolution projections.
Noblesville's Riverview Hospital is the latest system to prepare an expansion. An $11 million project that will triple the size of its emergency department is scheduled to open next summer.
The 156-bed county hospital also opened $5.2 million Riverview Health Park in Carmel last year, which offers primary and immediate care, along with a fitness center.
The Heart Center of Indiana, which opened only three years ago in Carmel, already has spent $4 million to add 20 beds.
St. Vincent Carmel, which opened in 1985, plans to add six pediatric beds and clear out 20,000 square feet for growth by relocating St. Elizabeth Ann Seton Hospital, which offers long-term, acute care.
St. Vincent Health wants to consolidate St. Elizabeth Ann Seton's three locations-in Carmel, Kokomo and Indianapolis-into a 74-bed hospital it plans to start building this spring near St. Vincent Women's Hospital in Indianapolis.
The extra space opens the door for more affiliations between the Carmel hospital and St. Vincent's main campus on 86th Street in Indianapolis, Caponi said.
Health care consultant Jeff Williams calls Hamilton County an "exploding market."
"The growth out there is, I think, very well substantiated," said Williams, who works for the Indianapolis office of PricewaterhouseCoopers LLP. "It's a market that has a good pay reputation, good insurance, low bad-debt rates, just very desirable for health care services."
And there's room for more. Caponi thinks Westfield will post especially rapid growth. St. Vincent Carmel is the closest hospital to that area.
Clarian North makes the Meridian Street corridor in Carmel-also home to St. Vincent Carmel and the Heart Center-crowded, said Steve Dobias, a principal with Indianapolis office of Somerset CPAs.
But he sees room for additional health care to the east in Fishers. Community Health Network has launched a $170 million expansion of its north campus just south of Fishers in Marion County.
Even so, Dobias calls Fishers an "ignored demographic" with incomes and growth similar to Carmel's.
"It's a market you could plunk a hospital down in and probably be quite successful in," he said. "It's got to be on people's radar screens. I can't imagine it's not."