Cogdell Spencer has an integrated design and development firm that can better service the health care industry with specific design elements that lower cost and increase productivity. This integration is especially important, because it diversifies revenue and therefore business risk. With health care reform and a generally competitive health care environment, integration may be a significant strategic advantage.

From the companies about section:

"Cogdell Spencer is not a commercial real estate firm that happens to build and manage a few medical office buildings as a part of its overall business strategy, but rather, a healthcare company, which specializes in facility development and management. This distinction is evident in every aspect of our approach to serving our healthcare clients from our mission statement to our staffing, from our commitment to serve non-profit and public hospitals to our national leadership in physician investment partnerships. Everything we do is focused on improving the delivery of healthcare and virtually all our development and management portfolio consists of healthcare facilities." … "Integrated Design and Development" has a significant impact, so an analyst should put more weight into it.