Competition is building — literally — in the Boulder Valley health-care sector.

Even as Boulder Community Hospital continues its $130 million expansion of its Foothills Campus at Arapahoe Road and Foothills Parkway in Boulder, Exempla Healthcare announced plans for a future medical campus at Interstate 25 and Colorado Highway 52 in Frederick.

Exempla is also building a 147,000-square-foot Comprehensive Cancer Center at Exempla Good Samaritan Medical Center in Lafayette, putting it in competition with other cancer facilities, including those at Boulder Community and Longmont United Hospital.

Boulder Community’s expansion means a shift of most medical operations from the main hospital on Broadway, while rehabilitation services will move from the Mapleton facility — formerly Boulder Memorial Hospital — to the Broadway location.

For Exempla, which operates the 234-bed Exempla Good Samaritan Medical Center on U.S. Highway 287 in Lafayette, a future campus in Frederick will put it in direct competition with University of Colorado Health’s Poudre Valley Health System, which is building the Indian Peaks Medical Center in the area.

All in all, Exempla’s announcement felt like déjà vu. In 2008, Phoenix-based Banner Health, which operates North Colorado Medical Center in Greeley and McKee Medical Center in Loveland, announced plans for a medical campus in Frederick, before abandoning the plans in the wake of the recession two years later. The land purchased by Exempla is the same parcel once targeted by Banner.

Meanwhile, Kaiser Permanente this year expanded into Northern Colorado, with facilities in Fort Collins and Loveland. Kaiser is a major player at Exempla Good Samaritan Medical Center and forged an alliance with Banner Health for its Northern Colorado expansion.

These days, to speak of the Boulder Valley health-care sector or the Northern Colorado health-care sector is really a misnomer. All of the hospitals within Boulder County, including Boulder Community, Longmont United, Exempla Good Samaritan and Avista Hospital in Louisville, target patients from areas far wider than just municipal boundaries, stretching into Larimer and Weld counties, or farther into the Denver metropolitan area.

Poudre Valley is now a component of University of Colorado Health, along with University of Colorado Hospital. The group also recently assumed management of Memorial Hospital in Colorado Springs and is completing a management agreement with Ivinson Memorial Hospital in Laramie, Wyoming.

What’s driving all of the joint ventures and head-to-head competition? The joint ventures at the same time reflect a desire to contain administrative costs, and to place individual hospitals in a position to survive the uncertainties of health-care reform. And each of these facilities is hoping to secure a hefty share of new patients as population increases, and as more patients enter the health-care system.

For local observers of the health-care scene, we’re likely to experience déjà vu all over again. And again.

Christopher Wood can be reached at 303-440-4950 or cwood@bcbr.com.