A new free-standing hospital in Middletown, N.Y., will use the design-build method as part of an effort to lower construction costs. With the design-build approach, a project's architect and general contractor work for the same company. This tends to limit the schedule and scope of a project and also helps eliminate turf battles between a contractor and architect, observers say. HBE Corp. of St. Louis will design and build the $269 million Orange Regional Medical Center, and the design-build approach is expected to reduce the cost of the project by about one-third.

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