Delivering Savings and Clarity: Dual Advisor and Custodian Search for a Healthcare System

Healthcare System Dual Advisor and Custodian Evaluation and Search

Through RFPs for both its investment consultant and custodian, North Pier helped the healthcare system achieve more than 40% in cost reductions, improved operational efficiency, and greater confidence in liquidity management.

Client & Objective

A large nonprofit healthcare system with more than 30,000 employees and several billion dollars across multiple investment pools engaged North Pier to lead a dual evaluation and search for an investment consultant and a custodian/master trustee.

As one of the nation’s largest nonprofit health systems, the organization manages a complex investment structure spanning operating reserves, a captive insurer, a frozen defined benefit plan, and multiple defined contribution plans.

The system sought a unified, strategic solution to strengthen fiduciary oversight, improve service delivery, and reduce expenses.  

Process

• North Pier partnered with the committee to define success criteria and develop two focused RFPs — one for investment consulting and one for custodial services. 
• We managed outreach, Q&A, timelines, and ensured proposals were complete and comparable. 
• Submissions were scored against a defined rubric reflecting priorities such as organizational strength, technology and cybersecurity, reporting, cash management, transition planning, fees, and investment oversight. 
• North Pier led the committee through structured and robust due diligence meetings with each of three finalists to assess fit and implementation readiness.
• Findings, scores, and rationale were consolidated into a comprehensive report supporting a clear, well-documented recommendation.

Results

• Fiduciary excellence: Delivered a detailed, well-documented summary supporting a prudent and transparent selection process.
• Significant savings: Achieved over 40% total fee reduction largely from more competitive investment management fees across all investment pools — generating several million dollars in annual savings.
• Operational improvement: Enhanced provider service and coordination, leading to a more accurate and confident cash-flow forecasting process, including greater precision in projecting days cash on hand.
• Better aligned investments: Ensured the new investment consultant helped deploy an LDI strategy appropriate for their pension.