Winter Jacket: Considerations for Non-Profit Hospital Systems To Strengthen Their Portfolio Amid Economic Uncertainty and Operational Pressures

Executive summary:

  • Macroeconomic uncertainty remains elevated. We believe a recession in 2024 is more likely than not.
  • Non-profit hospital systems have faced significant operational pressures, and may continue to experience challenges in the near-term.

The bottom line: By partnering with a trusted strategic advisor like Russell Investments that has extensive experience in working with non-profit hospital systems, your organization can be better equipped to build a resilient portfolio while navigating operational pressures.


Howling winds, frigid air, and a seemingly endless amount of snow. Winter storms can disrupt the lives of millions of commuters. In these arduous times, it’s more important than ever to have a reliable winter jacket to protect you.

Similarly, amid the elevated economic uncertainty and significant operational pressures that face non-profit hospital systems, we believe that it’s important to ensure that your investment portfolio is sufficiently resilient.

In this article, we discuss our broad macroeconomic views as well as the operational pressures that non-profit hospital systems like yours might have experienced. Then, we discuss three asset classes that may be attractive and help enhance the robustness of your investment portfolio.

A vertigo-inducing economy: the dizzying mix of opposing economic signals

2023 has been a dizzying year for investors. As of early December 2023, the benchmark S&P 500 index was up roughly 20% year-to-date, a welcome reprieve from the double-digit declines experienced in 2022. And economic growth has continued to defy expectations. Data from the U.S. Bureau of Economic Analysis suggests that the U.S. economy grew at a whopping 5.2% annualized rate in Q3 2023, significantly above the typical trend GDP growth of 1.8%