The defining procurement feature of Construction-Manager-at-Risk is that the builder is hired early and largely on qualifications, not on a hard bid against a finished design — then the price is established later, collaboratively, as a Guaranteed Maximum Price (GMP). This article walks the procurement path end to end: how an owner selects the CM, how the preconstruction-services contract is structured, and how the project advances from that initial agreement to an accepted GMP and a converted at-risk build contract.
In Design-Bid-Build the two questions — who builds it and what does it cost — are answered by the same lump-sum bid against complete construction documents. CMAR deliberately splits them. The owner first answers "who" by selecting a CM during schematic or early design, primarily on qualifications and fee. The CM then helps the design team answer "how much" through preconstruction-phase cost modeling, culminating in a negotiated GMP once the documents are mature enough to price with confidence.
This ordering is what unlocks CMAR's value — early constructor input, constructability review, real-time budget feedback, and long-lead procurement — but it also means the owner commits to a builder before the price is fixed. The integrity of the selection process and the GMP-development discipline are therefore the two pillars that protect the owner's interest. Getting the procurement right is how an owner captures the model's collaboration upside while keeping cost certainty and competitive tension.
The CM is chosen on a qualifications-based or best-value basis. Hard low-bid selection is structurally incompatible with CMAR because, at the point of selection, there is no complete design to bid. Public owners (state hospital systems, public university medical centers, military health facilities) typically run a formal two-step or best-value process whose evaluation criteria are published in advance; private health systems run a similar but less prescriptive process.
A representative selection sequence:
What is competed at selection is the fee and general-conditions structure plus qualifications — not the cost of the work. The cost of the work is established later in the GMP. Owners preserve competitive tension on the work itself through open-book subcontractor bidding during GMP development (see below).
Healthcare emphasis: evaluators weigh demonstrated competence in infection-control risk assessment (ICRA), interim life-safety measures (ILSM), maintaining egress and fire-protection continuity under NFPA 101, occupied-facility logistics, utility/medical-gas shutdown coordination (NFPA 99), and the ability to deliver inspection-ready work for the AHJ and the accreditation/licensing path (CMS Conditions of Participation, TJC or DNV, state HCAI/department-of-health review). A low fee from a firm with no healthcare track record is a recognized red flag.
| Criterion | Typically evaluates | Notes |
|---|---|---|
| Relevant experience | Comparable acute-care / occupied-campus / phased projects | Often a pass/fail or heavily weighted gate |
| Key personnel | Named PM, superintendent, precon lead, MEP coordinator | Resumes + interview; superintendent is pivotal |
| Preconstruction approach | Estimating cadence, target-value design, BIM, value-engineering process | How they will protect the budget during design |
| GMP methodology | How and when GMP is built, contingency logic, open-book bidding plan | Should show transparent, competitive subcontractor buyout |
| Schedule approach | Phasing, long-lead strategy, occupied-campus sequencing | Healthcare schedules are constrained by clinical operations |
| Self-perform scope | What the CM intends to self-perform and how it will be priced/competed | Must remain transparent and competitively tested |
| Fee and general conditions | CM fee %, GC basis, precon fee | The price components actually competed at selection |
| References / past performance | Owner, A/E, and AHJ feedback on prior healthcare work | Claims discipline, safety, closeout/commissioning record |
CMAR procurement is delivered through a phased contract structure. The owner and CM execute an agreement covering both phases, but the at-risk construction commitment does not become firm until the GMP is accepted.