Compare Project Delivery Methods to Build Smarter, Faster, and with Greater Cost Certainty
Life sciences organizations, healthcare systems, and higher education institutions transform our world with breakthrough therapeutics, best-in-class patient care, and next-generation research and learning environments. To maintain the levels of precision, quality, and innovation required to deliver these solutions, their facilities must be just as advanced.
Yet building these complex environments is a high-stakes endeavor with intense demands, elevated financial risk, and increasing competition. This raises a critical question: How do capital project owners navigate shifting timelines, regulatory compliance, stretched resources, multiple stakeholders, and tight budgets—often all at once?
With these pressures only growing due to supply chain challenges, labor shortages, and accelerating demand for innovation, more leaders are turning to the design-build delivery model as a streamlined solution.
In fact, it is estimated that by 2028, nearly 50% of all construction spending will be design-build, totaling $2.6 trillion within the $5.5 trillion total construction forecast.
Project owners often navigate barriers like a lack of resources and time, competing priorities, inexperience, multiple stakeholders, administrative tasks, regulatory compliance requirements, and increasing competition.
Advantages of Design-Build Over Traditional Delivery Methods
Design-build construction is a modern integrated project delivery method, sometimes called EPCMC, with collaboration at the forefront. Project owners work directly with one design-build firm that fills the role of both designer and general contractor—and should have the capabilities to efficiently deliver the project through commissioning and operational readiness. Unlike traditional models that involve multiple contracts and disjointed handoffs, design-build consolidates project leadership, reducing miscommunication, delays, and risk.
Design-build services can be customized to meet project needs and most often include:
- Site assessments
- Program, project, and construction management
- Cost controls: cost management, value engineering, and scheduling
- Move management
- Commissioning and operational readiness
In many cases, organizations use progressive design-build (PDB) to allow for iterative collaboration, increased transparency, and early involvement of key partners. This enables better budgeting, alignment of goals, flexibility, and faster decision-making. According to the Design-Build Institute of America (DBIA), design-build, a single-contract, full-service approach, is the “nation’s fastest-growing, most efficient delivery method.”
Design-Build Integrated Project Delivery
For years, industrial construction in general has centered around traditional models in which an owner or an owner’s representative serves as the program and project manager, facilitating the work, managing the scope, and supporting multiple stakeholder groups from project start to completion. However, in today’s fast-paced economic environment, and because each organization’s needs and each project’s requirements are different, it is important for project owners to understand how to best structure their next capital project.
Design-Build vs Design-Bid-Build vs. CMAR: What You Need to Know
Option 1
Design-Build Integrated Project Delivery
Design-build contractors unite design and construction under one contract with a single point of accountability. This integrated approach reduces risk, streamlines communication, accelerates timelines, and ensures a smoother path from concept through commissioning, all with greater cost certainty. Project logistics, long-lead material procurement, and constructability are continually evaluated through each phase of design and adjusted to meet project needs. Owners have the benefit of selecting design-build partners through a qualification-based selection process, therefor partnering with the design-builder, design team, and trade partners that best fit project requirements.
Option 2
Design-Bid-Build (DBB): The Most Traditional Method
DBB delivery is the most traditional, and perhaps the most fragmented of all the methods, which includes separate contracts for design and construction. DBB often leads to scope gaps, miscommunication, and longer timelines due to siloed teams and added owner coordination. The lowest bid is often selected without the benefit or requirement of qualifying the contractor and subcontractor capabilities or capacity.
Option 3
Construction Manager at Risk (CMAR): A Method with Multiple Stakeholders
CMAR offers a guaranteed maximum price, but like DBB, separates design from construction. While it provides some cost predictability, it introduces complexity and potential conflict due to multiple stakeholders and contracts. Project cost, logistics, long-lead material procurement, and constructability are evaluated at each phase of design and adjusted to meet project needs. Owners have the benefit of selecting the construction manager at risk and the design team separately, through a qualification-based selection process. The two teams may or may not have experience working together. Trade partners are typically selected by open bid means.
Benefits of Design-Build for Life Sciences, Higher Education, and Healthcare Capital Projects
Design-build integrated project delivery offers a wide range of benefits once you have the right general contracting firm in the lead. The approach delivers clear advantages across cost, schedule, and risk management. Below, we explore the types of projects that benefit most from design-build, followed by the specific outcomes owners can expect when they choose this integrated model.
Ideal Projects for Design-Build Success
Design-build is particularly well-suited for capital projects that require speed, technical precision, and tight coordination between design and construction teams. These most often include:
- Life sciences facilities such as biomanufacturing plants, research labs, and cleanrooms, where regulatory requirements and commissioning protocols demand early and ongoing alignment.
- Healthcare environments like hospital expansions, surgery centers, specialty clinics, or imaging centers that must be built or renovated without disrupting essential services for patient care.
- Higher education projects including STEM buildings, research greenhouses, or adaptive learning spaces, which benefit from phased delivery and rapid decision-making to ensure student schedules are not disrupted.
- Startups or scaling organizations that need a partner to manage the full project life cycle due to limited internal resources or aggressive timelines.
These project types share common characteristics—technical complexity, stakeholder diversity, and urgency to deliver—which make them ideal candidates for the collaborative, integrated structure of design-build delivery.
Reduced Complexity
One team oversees everything from design through commissioning and operational readiness, simplifying the owner’s role in coordination and risk management. With fewer handoffs, projects flow more smoothly, and decision-making is streamlined.
Faster Time to Market
Design-build enables early collaboration among designers, engineers, and contractors. This accelerates planning and procurement, helping clients respond quickly to evolving needs or market demand.
Schedule Performance: Other Models Compared to Design-Build
| Schedule Growth | Delivery Speed | |
|---|---|---|
| CMAR vs DB | 3.9% more | 61% slower |
| DBB vs DB | 1.7% more | 102% slower |
Lower Costs
When complexity and conflict are reduced, so are costs. Integrated teams can optimize value engineering and proactively address cost drivers before they escalate.
Cost Performance: Other Models Compared to Design-Build
| Unit Costs | Cost Growth | |
|---|---|---|
| CMAR vs DB | 1.9% more | 2.4% more |
| DBB vs DB | 0.3% more | 3.8% more |
Risk Mitigation
Fewer contracts and clearer accountability mean fewer opportunities for disputes, delays, or scope creep. With one team responsible from start to finish, owners are better protected from unexpected challenges.
Streamlined Commissioning and Operational Readiness
In regulated environments like pharma and healthcare, commissioning is critical. Design-build firms embed commissioning early to ensure systems are validated, compliant, and aligned with user needs—from the first day of operations.
Flexibility and Customization
Because no two projects are the same, experienced design-build teams should adjust their approach to meet each owner’s unique goals, timeline, and level of project experience.
Decades of research continues to show that projects developed via the design-build method have higher success. Projects are easier and delivered faster at a lower cost, even for the most complex life science facilities.
How to Choose the Best Design-Build Firm
It is critical to vet prospective general contracting firms to find an experienced partner who can deliver on the benefits of the design-build methodology without sacrificing quality. Below is a benchmark to aid owners in the process of choosing the right design-build partner for their next project.
1
Have deep industry experience with complex or technical projects and a proven track record.
Technical or complicated projects go beyond the standards of typical industrial construction. Look for companies that understand the nuances of complex projects and can showcase previous successful executions with a range of satisfied clients.
2
Can customize to meet your specific project needs.
Firms with extensive expertise can easily adapt their standard design-build approach upfront to incorporate regulatory factors, stakeholder requirements, and geographical considerations, lessening the likelihood of mix ups or mistakes down the road.
3
Have the right talent, at the right time, for the right job.
Some firms employ in-house designers and builders, which may seem like a benefit at first glance. However, program, project, and construction management firms that build strong relationships with outside designers and builders with various specialties and strengths, are better positioned to select the right team from their broader network for specific projects. These firms are not limited by the strength of their own bench and can curate an “A team” for every project
4
Can collaboratively develop governance and processes to support integrated project delivery.
In many cases, this will be established via a project execution plan (PEP) that is developed at the start of a partnership. The owner and the design-build firm will talk about all major elements of managing the project including key roles, authority, schedules, budgets, and how decisions will get made. By establishing clear governance and processes from the start, it ensures complete alignment and accountability for all project teams.
5
Keeps commissioning front and center.
Integrating commissioning (and operational readiness) early, with actions such as writing user requirements, developing master plans, following good documentation practices, reviewing contractor submittals, developing systems manuals, and more, reduces the risk of disruptive and sometimes costly change orders later in the project–while also helping to expedite the validation process.
6
Starts with the end in mind.
Many firms will walk away from a project after construction is completed. The best design-builders, though, maintain oversight with an end-to-end approach from site selection all the way through commissioning and operational readiness. This ensures everything is ready for the owner to take possession and safely start their work from day one. Deliverables should include preventive maintenance, spare parts inventory, and calibration programs uploaded into CMMS or CCMS systems.
7
Plans for supply chain resilience.
By engaging all stakeholders, including end-users, quality, and procurement owners, and identifying long-lead items early, teams can align procurement strategies to streamline the project and avoid material delays that negatively impact budgets and timelines.
5 Traits of the Best Design-Build Project Owners
While design-build simplifies project delivery, the client’s engagement is still crucial to success. The best outcomes are driven by effective clients who:
- Share goals and information collaboratively and transparently.
- Solicit and accept feedback from the design-builder about any barriers that might impede progress—and take action to mitigate them, as needed.
- Understand that the process is iterative and stay flexible.
- Appoint a single point of contact (or streamlined process) to enable fast internal decisions.
- Embrace digital collaboration tools to coordinate across teams and locations.
Design-Build: A Game Changer for Capital Projects
Whether a public or private project, life sciences, healthcare, and higher education organizations are grappling with myriad external forces—regulatory compliance, budget availability, labor shortages, heightened public scrutiny, and more—that complicate the nature of their work. Having the right facility is essential to each organization’s mission. In today’s increasingly competitive and rapidly evolving environment, speed to market, operational efficiency, and long-term flexibility are more important than ever.
Design-build is not the right fit for every project, but for some, it can unlock major advantages for certain scenarios—particularly for organizations with limited bandwidth and for complex life sciences, healthcare, or higher education projects where speed, compliance, and coordinated execution are non-negotiable.
As demand continues to grow for cell and gene therapies, and other innovative products, speed to market will differentiate first movers from the competition. The right design-build firm can help.
Let’s Build What’s Next, Together
To see if design-build is the right choice to drive unmatched speed and efficiency with greater cost certainty, 35 North would be happy to discuss your next capital project. Whether you are planning a renovation, expansion, or ground-up facility, our team has the experience to help you move forward—faster and more confidently with the right choice of delivery method.
Contact us to learn more about how we partner with project owners to streamline the construction process and maximize ROI with turnkey solutions like design-build or individual services like site assessments, program and project management, general contracting, or commissioning and operational readiness. We are here to help you succeed.
Scott McEntee is the founder of 35 North and serves as president and chief executive officer. He has 30 years of industry experience, including over $2 billion in construction experience, and is known for effective project governance and making the complex simple.
