On a snowy day in Cleveland, construction on the Cleveland Clinic's seven-story, nearly $300 million dollar cancer center is underway.
A couple of trucks hum as they move supplies. But with snow falling and below freezing temperatures, it's really too cold to make much progress.
Cliff Kazmierczak is with Turner Construction. He points to the sky, using his hands to outline what will be there when the building opens in 2017…
"There will also be skylights that will be located just a little bit south of where this crane is situated right now," Kazmierczak says.
When it comes to coping with cancer, good lighting can be important.
"The big thing is to make the patient comfortable with the treatments that they're going through so lighting, light colors, as much natural light as possible are always very important to, to cancer patients," Kazmierczak says.
Kazmierczak knows a thing or two about construction projects for cancer. He took over this project after finishing the massive Ohio State University James Cancer Hospital a few hours south of here in Columbus.
And Ohio is not unique. Across the country, the health care industry is ramping up to take care of an influx of cancer patients.
The global health care consulting group, The Advisory Board, surveyed its members last year. They found that about 25 percent of those with oncology services were either constructing a cancer center or had built one in the past three years.
The Board's Deirdre Fuller says the investment in cancer has intensified.
"Now, that everyone is looking forward and seeing the aging of the Baby Boomer's it's certainly adding some fuel to that fire," Fuller says.
Cancer is largely a disease of the aging. That means as Boomers get older many will be faced with cancer. And much of their health care will be covered by Medicare, a steady paycheck for hospitals.
This is all happening as improved screenings as well as new therapies and equipment have changed the way cancer is treated and enabled more survivors.
Dr. Brian Bolwell, chair of the Clinic's cancer center, says they had to respond.
"In the past five years, volumes go up, depending on location between 5 and 10 percent a year. And there's no end in sight to that volume growth," Bolwell says.
The Clinic along with nearby University Hospitals treat about 70 percent of the region's cancer patients. Bolwell shies away from saying the two compete for patients, but there are reasons a hospital would want as many cancer patients as possible.
"It's true that if you can run enough procedures through a facility you're going to get some economies of scale that will generate margin," says Bill Ryan, president and chief executive of The Center for Health Affairs, the Northeast Ohio hospital advocacy group. "The other thing you get when you run enough procedures through a facility is a level of expertise that improves the quality of care that the individual gets."
That upside of improving the quality of care for patients is what the Clinic's Bolwell focuses on.
For him a new building means an opportunity to better coordinate care for patients and respond to payment reforms coming down the pike.
"We have to figure out how to successfully manage these changes so that we can continue to do what we want to do, which is try to cure cancer and deliver state of the art, compassionate care," Bolwell says.
In Cleveland, construction is part of that plan.