U.S. health care mergers and acquisitions are on a tear. Those deals may be great for shareholders, but they can bring investment and other challenges for plan sponsors and employees at the companies involved.
今年第三季度标志着八分之一，200多笔交易，根据Irving Levin Associates是医疗保健和一项研究的专家。尽管宣布交易的数量同比下降12％，但在7月363日至9月rankedas the second-busiest third quarter since Levin started keeping track in 1948.
即使体积下降，交易也会继续越来越大。本月早些时候，热烈的卫生服务宣布计划在界限中购买LHP医院小组，将在该国制造第二大私人医院连锁店。
由于这一合并发烧，医疗保健计划赞助商落后于治理和计划管理，这意味着增加了养老金委员会从投资决策中分散注意力的行政头痛。从该陷阱没有明确的逃脱，但企业养老基金会提供了一些潜在的解决方案。
“What we’ve seen in health care as a result of the strong trend toward consolidation over the past five years is a sweeping change in plan sponsorship, and that has significantly changed the relationship between health care employees and their employers,” says Lynn Cornwall, a senior partner at global human resources consulting firm Aon Hewitt.
康沃尔指出，保健是独一无二的，因为该行业不依赖于任何单一退休计划结构。医疗保健提供者可以由非营利组织，宗教组织，营利性公司或医生伙伴关系支持，因此合并赞助商可能最终有一篮计划和要求，其中一些可以合并。
“Part of the problem is that HR issues aren’t part of the merger process,” explains Douglas Johnson, a partner at Mercer, the world’s largest human resources consulting firm. “Retirement plan liabilities are counted on the balance sheet, but there isn’t a strong discussion about how to integrate them postmerger.”
According to Johnson, handling retirement plan issues after a deal closes can leave health care providers with limited options for integration. As a result, the merged companies start looking at ways to derisk, including freezing plans, making lump sum payments to staff to get them off employer-backed programs, and moving as many employees as possible onto defined contribution platforms.
However, closing plans or consolidating them can create a whole new set of headaches unique to health care. Aon Hewitt’s Cornwall points out that because health care providers must have certain levels of operating cash on hand, freezing a retirement plan doesn’t solve the balance sheet problems. “A frozen defined benefit plan can negatively impact the audit rating of a provider if it is underfunded,” she says. “This is often the case in an acquisition if the target was a weaker organization.”
由于现金的要求，也可能难以达到定义的贡献计划。通过传统的义福利养老金计划，医疗保健提供者可以为资金假期提供资金，以降低他们的直接现金需求;定义的捐款计划没有这样的选择。即使他们确实做出了举措，计划赞助商可能会发现自己管理他们无法整合的各种定义的贡献计划。
The realities of juggling multiple plans have left health care plan sponsors lagging other private pension groups when it comes to governance and investment rigor. In a最近的调查养老保健组织由养老金计划咨询公司Nepc，治理问题占据了31名受访者列出的八大担忧。
NEPC partner Ross Bremen, who wrote the report, says consolidation issues and regulatory woes are holding sponsors back from focusing on investment. Investors have been unclear on the protections offered by different types of retirement plans, and in some cases that has prompted lawsuits. “We’ve seen a lot of concern around recent litigation from church plan employees, for example,” Bremen observes. “That makes plan sponsors more cautious about making moves to change things or consolidate.”
普罗维登斯健康与服务，在五个西方国家开展业务的非营利性天主教保健集团，最近同意支付近3.25亿美元的员工课程诉讼，该诉讼诉讼被指责其资金净养老金计划。其他诉讼引用了不正确的资金水平和治理问题今年的教会计划赞助商。
The NEPC survey also shows that the relatively large size of health care retirement committees can hurt plan quality by impeding decision making. Such committees often have more than seven members, versus four to six for their typical corporate counterpart.
但可能有一线希望。医疗保健提供者已开始借用公司养老金计划的女活动集成和计划选择。虽然公司养老金的结构往往更加简单，但他们的一些实践赋予了保健。
例如，集成为赞助商提供审查所有计划提供商的选项，并查看其为降压提供最大的爆炸。要求新的提案可以在定价，佣金和福利上揭示新的灯光。
使退休种种尽职调查的一部分ntial merger can also cut down on integration troubles. “If you move retirement into the due diligence process, you can derisk and come up with solutions at the beginning rather than trying to undo a whole slew of problems after the deal is already done,” says Jeff Black, a partner in Mercer’s M&A group. Considering plans with a smaller menu of investments — something the corporate world is already doing — can help too, Black adds.
Aon’s Cornwall agrees, pointing out that taking a closer look at 403(b) annuity plans or limiting the number of investments available to participants can reduce the pressure on sponsors and employees. “People hear ‘streamlining’ and think lack of choice, but it is often better for everyone involved if there are fewer, higher-quality options for investment,” she says. “Employers can limit risk, and employees can spend less time trying to understand products.”
If health care plan sponsors want to get back to concentrating on investments, nailing down process is essential. Plan sponsors need to be clear about what they offer so they can make timely and informed decisions.
“由于这些合并的性质，我们不太可能在医疗保健中看到一个明确的比赛，”黑人说。“但是有想法借用，可以帮助退休委员会加快速度。幸运的是，这开始发生。“