Quarterly Industry Insights: Hospitals & Healthcare Systems (Webinar Recording)

As their retirement plan advisor, CAPTRUST serves hundreds of the top hospitals and healthcare systems in the country. Our advisors recently completed quarterly review discussions with these clients. In this recorded webinar, we discuss a few key takeaways from those reviews, with unique insights into how hospitals and healthcare systems are approaching retirement benefits in 2024.

Topics covered will include:

  • Current economic trends and issues impacting retirement plans;
  • Strategies to enhance benefits for physicians, nurses, and staff; and
  • Peer perspectives for industry challenges and overall goals for 2024.

Whether or not your organization currently has a retirement plan advisor, this roundtable discussion provides an executive summary of the top issues a plan sponsor should be considering, plus an in-depth comparison of what other hospitals and healthcare systems are doing for their retirement programs and strategies.

Quarterly Pulse Check—How Hospitals & Health-Care Systems Are Tweaking Retirement Benefits in 2024

Senior CAPTRUST advisers Ellen Sher, Danny Lowe, Earl Allen, Jan Resler, and Mike Pratico distilled the top themes that surfaced during fourth-quarter reviews with more than 200 hospital and health-system clients (≈ $24 billion in retirement assets). Here’s the executive summary:

1. Market backdrop 2023 → early 2024

2023 delivered a banner +26 % S&P 500 return—but almost all of it came from the “Magnificent Seven.” Active U.S. managers and target-date funds with heavy foreign-stock tilts lagged.

International equities trailed once again; small-caps only caught up in Q4 as 10-year yields fell from 5 % to 3.9 %.

Committees entered 2024 expecting seven Fed cuts; by April the market is bracing for two (or fewer) as inflation proves sticky.

2. Governance & litigation defenses

Plaintiff firms that targeted higher-ed plans have pivoted to hospital systems; even sub-$1 billion plans are now benchmarking record-keeping fees every year, purging revenue-sharing, and documenting watch-list actions more tightly.

Many boards are upgrading to ERISA §3(38) investment-manager mandates to shift lineup discretion—and courtroom discovery files—to an outside fiduciary. Independent ERISA counsel now sits in most large-system committee meetings.

3. Plan-design moves to attract and keep staff

Automatic features 2.0: higher default deferral rates, annual auto-escalation, and periodic re-enrollments so exhausted nurses don’t have to act.

Student-loan matching (SECURE 2.0): high interest as a nurse-recruitment perk, but record-keeper build-outs remain patchy.

Emergency-savings sleeves: on radar, though most providers are still busy with mandatory SECURE 2.0 items.

Cash-out threshold lifted to $7 k: nearly all sponsors adopted it to shrink missing-participant risk and lower per-capita admin costs.

Retirement-income options: committees are vetting in-plan annuities or managed-payout CITs so long-tenured clinicians can replicate DB-like paychecks.

4. Investment-menu architecture

Three-tier structure dominates:

Target-date series as QDIA (90 % of clients).

Low-cost index core for do-it-yourselfers.

Best-in-class active funds—plus self-directed brokerage to satisfy physicians who want specialty assets.

Stable-value vs. money-market debate has re-ignited; some systems now offer both, while others embed a GIC inside custom target-date funds.

5. Cyber & fraud protection steps

Committees demand annual SOC 1/SOC 2 reviews, incident-response walk-throughs, and participant-loss indemnification language.

CAPTRUST’s independent cyber-scorecard—mapped to the DOL’s 12-point guidance—helps document prudence for future DOL exams.

6. Looking ahead

Headwinds: rich U.S. valuations, fewer-than-hoped-for Fed cuts, geopolitical flashpoints.

Tailwinds: election-year fiscal support, AI-driven productivity stories, and a still-resilient labor market that keeps contribution flows healthy.

Bottom line: hospitals and health-care systems are tightening fiduciary process (fees, forfeitures, cyber) while layering SECURE 2.0 tools and discretionary 3(38) mandates to stay competitive in a brutal talent market—and to keep plaintiffs’ attorneys at bay.

To download a copy of the transcript, click here.

Additional Resources

Webinar Presentation Deck


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