Since the beginning of the COVID-19 pandemic and sell-off in the equity markets, the Pavilion nonprofit Healthcare team has been in continuous dialogue with our clients to assess operational, financial and capital risk exposures as they navigate through this unprecedented crisis. We have drawn from a wide variety of healthcare systems ranging from large to small, higher credit quality to lower investment grade, with urban, suburban and rural service areas. We thought it would be instructive to offer our observations and the current thinking and actions of our clients1—your peers—as you consider a course of action. Additionally, we sought the perspective of healthcare rating agencies and credit banks.


We discuss the following topics in this paper:


  • Operations
  • Balance sheet
  • Retirement plans
  • Capital expeditures
  • Credit rating agencies
  • Portfolio considerations and opportunities


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Please see Important notices for further information.

Services to be provided by Mercer Investments LLC, which is one of several, associated legal entities that provides investments services to clients as part of a global investment advisory and investment management business (collectively referred to as “Mercer”).

1 Hospitals and healthcare system opinions throughout this paper referred to are those of current Mercer Investments LLC clients. It is not known whether they approve or disapprove of the investment services provided by Mercer.

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