How to Earn Donors in a Market That’s Leaving Hospitals Behind...Source: Sparrow Health...

transcript

Philanthropy Leadership Council

How to Earn Donors in a Market

That’s Leaving Hospitals BehindEstablishing Your Advantage for

Community Wellness Philanthropy

Who’s up for a de-construction campaign?

I run a health system and we have about 13 or so

hospitals, and I think my job is to close every

single one of them.”

Dr. David Feinberg, Former CEO of Geisinger Health

ROAD MAP3

Confronting a shift in the philanthropy marketplace1

2 Crafting your hospital’s “Impact Advantage”

3 Influencing allies to be the partners you need

Your mandate is moving away from the hospital

Community wellness is the latest evolution of philanthropy’s main purpose

Source: Philanthropy Leadership Council interviews and analysis.

Priorities:

Buildings and renovations

Clinical focus Community focusCapital focus

Third wave of philanthropy’s focus looks beyond acute care

Priorities:

Psychosocial factors of health

Examples of community wellness investment areas

Food and nutrition

Transportation and access

Health education

Behavioral health

Neighborhood safety Housing

Priorities:

Service line needs

Top donors are moving that direction too!

Large community wellness gifts growing in both number and value

Source: “Big Charitable Gifts.” Chronicle of Philanthropy, https://www.philanthropy.com/

factfile/gifts; Philanthropy Leadership Council analysis.

Percentage of $1M+ gifts in health

sector going to community wellness1

18%17%

2013 2014 2015 2016 2017 2018

1) Community wellness gifts are defined here as donations

to psychosocial factors of health, primarily behavioral

health and social determinants.

9 11 12 15 28 16

Number of community wellness gifts

$31M $35M$55M

2013 2014 2015 2016 2017 2018

Total value of $1M+ gifts to

community wellness

$7M $3M $3M $4M $13M $12M

Average value of community wellness gifts

2012 2013 2014 2015 2016 2017

Hospital giving Uncaptured market share Non-hospital health giving

But shifting tide has lost you billions since 2012

Overall health giving is growing twice as fast as giving to hospitals

Giving to health sector and hospitals

In billions of inflation-adjusted dollars

The cost of

falling behind

$6.5BCumulative hospital

philanthropic

revenue loss,

2012-20172

Source: American Hospital Association; “Giving USA 2018,” Giving USA; “AHP Report on Giving

2018,” Association for Healthcare Philanthropy; Philanthropy Leadership Council analysis.

1) Difference between original hospital percentage of health giving (34% based on 2012) and actual hospital

percentage of health giving, for each year.

2) Calculation: Sum [(34%-actual hospital % of giving)*total health giving that year].

Total:

34% of

27% of

The root of our market share woes

CDOs challenged to position hospital as charity of choice

Development staff lack ally support to

make a convincing case to the contrary

Potential donors don’t see the hospital as

their best choice among many options

Two challenges for hospitals’ community wellness fundraising

Donors have more options to choose from…

Established nonprofits already at work

Source: Google Maps; Philanthropy

Leadership Council interviews and analysis.

Nonprofits focused on acute care vs. community health in sample market

Nonprofit accepting health care

building and service line giftsNonprofits accepting community

wellness gifts

Food bankRegional hospital

Addiction support center

Education, cancer patient support

… and hospitals aren’t the first choice

Poor public perceptions handicap hospitals’ ability to make case

1) Survey question: Are you open to receiving information about how to make a charitable donation to the medical

facility? If “no,” why not?

Source: “Legislative Search Results,” Congress.gov, https://www.congress.gov/; 2018 Philanthropy

Leadership Council Patient Gratitude Survey; Philanthropy Leadership Council interviews and analysis.

“They get enough gouging people $10 for aspirin.”

Patient survey respondent

Top reasons patients don’t give related

to poor perceptions and competition1

Public questions hospitals’

nonprofit status

Excerpt

Letter to IRS Commissioner

Rettig from Senator Chuck

Grassley

February 19, 2019

Unfortunately, according to reports,

it appears that at least some of

these tax-exempt hospitals have

cut charity care, despite increased

revenue, calling into question their

compliance with the standards set

by Congress.

n=1,967

My charitable priorities lie elsewhere

I already pay enough for my health care

I do not have the financial resources

to make a donation at this time

The medical facility does not

have a need for my donation

Unclear path back to donors without ally support

Unsure how to adapt or fill usual case-making roles

Source: “Social Determinants Matter, But Who Is Responsible?”, Leavitt Partners,

https://leavittpartners.com/whitepaper/social-determinants-matter-but-who-is-

responsible/; Philanthropy Leadership Council interviews and analysis.

“Everyone that we’ve relied on—interactions with

service partners, the administration—that’s changing.”

Foundation Director in the Pacific Northwest

80% of physicians believe social

determinants are not their responsibility

Allies fulfill critical roles in

traditional fundraising…

Clinicians

Visionaries

Storytellers

CXOs uncertain about how to prioritize

community wellness investments—

or whether to make them at all

…but many are unready to provide

similar support for community wellness

Regain a growth trajectory with “Impact Advantage”

Identify and plan around unique solutions for community wellness

• Solve a specific community wellness challenge

• Leverage unique hospital attributes for donor impact

Influence key stakeholders to make your

“Impact Advantage” a deliverable reality

Craft an “Impact Advantage” that positions your

hospital as the ideal vehicle for a health-focused donor

• Identify philanthropy relationships that need to change

• Inflect needed attitude and behavior shifts

Two solutions to capture community wellness philanthropy

ROAD MAP12

Solution 1: Craft an “Impact Advantage”

• Solve community wellness challenge

Two solutions to capturing community wellness philanthropy

Size, assets enable unmatchable use of philanthropy

“Impact Advantage” highlights hospitals’ ability to leverage donor dollars

Scale donor dollars Multiply donor dollars Sustain donor dollars

Three built-in mechanisms for stretching donor dollars

Hospital advantage:

size and reach

Hospital advantage:

investable assets

Hospital advantage:

economic incentives to succeed

Donor positioning:

Fund investments that touch

a large number of lives and

communities

Donor positioning:

Unlock system funds to

effectively multiply the impact

for both parties

Donor positioning:

Prove the long-term ROI of

community wellness initiatives

and attract sustainable funding

Donor positioning:

Prove the long-term ROI of

community wellness initiatives

and attract sustainable funding

System reach offers donors impact at scale

Donors provide additional layers of services and access

Scale donor dollars

Source: Sparrow Health Foundation, Lansing, MI:

Philanthropy Leadership Council interviews and analysis.

Donors on board

From family foundation

Event proceeds used to

fund endowment

$250K12

Access point visits per year Counties served

Initial scope Expanded scope

Extending the reach of a mobile health

program through philanthropy

Access point visits and counties served by mobile

health clinic

From individual donor

Matching fund magnifies donors’ impact

Social determinant funding at a level no other organization can match

Multiply donor dollars

1) Pseudonym.

$100M Hayes Health1 endowment signals system commitment to community wellness

Health

system

fundsSystem creates

$100M endowment

for community

wellness investments

Foundation courts

donors and funders

with matching gift via

system investment

Pairing system and philanthropic

money amplifies investment and

impact in community wellness

Community wellness initiatives

Foundation

Donors provide seed funding for long-term solution

Successful philanthropy pilot program taken up by health plan

Sustain donor dollars

Source: Geisinger Health Foundation, Danville, PA;

$2M donor-funded pilot secures long-term Geisinger investment in food pharmacy

Philanthropy funds

food pharmacy pilot

Donors fund meals,

nutrition education for

patients at cost of $3,500

per patient per year

Health plan sustains program

Strong cost avoidance outcome

prompts health plan to take over

funding, incorporate food

pharmacy as member benefit

Philanthropy funding Plan funding

Food pharmacy delivers

robust cost savings

Total cost of care per food

pharmacy patient reduced by

$16,000-24,000 per year

What an “Impact Advantage” is, and is not

Philanthropy enables real, unique solution to specific community need

Source: Philanthropy Leadership Council

interviews and analysis.

Not an “Impact Advantage” The “Impact Advantage” difference

A need-based case for support Position philanthropy as catalyst

Giving is framed as central to impact

A “vision statement”Accept some elevated risk

Donors should be compelled by your

ambition, not just your eloquence

A description of all community health

efforts at your hospital

Respond to a specific community need

“Impact Advantage” should be focused on a

specific issue or challenge

An argument against other

community health organizations

Highlight your hospital’s strengths

The solution is one only your hospital can

provide, but it’s not at the expense of others

Identify your “Impact Advantage”

Shape your pitch through individual and collaborative activities

Working session activities

• Identify current or future community

wellness priority

• Develop concise argument for why your

organization is the charity of choice

• Share your draft

“Impact Advantage” statements

• Collect and provide

constructive feedback

1 2Create your own “Impact Advantage”

Individual activity

Test your pitch

Small group discussion

Write your own “impact advantage”

Individual activity

Activity overview

Considering a current or future community wellness initiative at your hospital, develop a concise

argument for why your organization is the ideal investment choice for a donor focused on health issues.

Emphasize how you can leverage and stretch philanthropy for maximum impact.

Instructions

1. Answer questions 1-3 below.

2. Write a summary “Impact Advantage” statement (approx. 50-100 words).

Guiding questions

1. What is a critical community wellness challenge that your hospital is currently addressing, or is likely

to address in the future?

2. What unique strengths does your hospital bring to bear on this challenge that other non-profits or

entities in your market don’t share?

3. How can your hospital apply philanthropy to solving this challenge in a way that extends a donor’s

impact beyond what any other organization could do?

• How would the hospital benefit from the

“impact advantage"?

• What support and agency would philanthropy

need from me, and is that feasible?

Share and gather peer feedback

Small group discussion

Activity overview

Share your draft “Impact Advantage” statement with a small group of peers, collecting and providing

constructive feedback.

Instructions

1. Group members will take turns presenting their “Impact Advantage” statements and receiving feedback. Pick

the first volunteer to present their “Impact Advantage” statement (2-3 minutes).

2. Provide feedback to your peers based on your assigned stakeholder perspective (donor or CXO). Use the

feedback prompts below (5 minutes).

3. Repeat steps 1 and 2 with all remaining group members, keeping group roles the same (7-8 minutes each).

Guiding questions

Hospital executive perspectiveDonor perspective

• Is the “impact advantage” clear and compelling

to me?

• Is this a unique impact I could not accomplish by

giving to any other community organization?

ROAD MAP22

Solution 2: Influence key stakeholders

Two solutions to capturing community wellness philanthropy

• Solve community wellness challenge

Find allies who are up to the challenge

Geisinger seeks community wellness thought leaders across system

Philanthropy conducts research

in ally opportunities

Curate cross-section of

hospital perspectives

Iterate on opportunity

with appropriate partners

Investigate

opportunities for

philanthropy

Interactions examine

full spectrum of

partnership

opportunities.

Diverse ally

candidates provide

visibility into systemic

community wellness

needs, opportunities.

Philanthropy confers

regularly with

strategic allies to

determine next steps.

Wide sampling

Research and analysis

New insights

Demonstrate commitment to change yourself

Willingness to abandon “business as usual” builds trust with allies

Geisinger demonstrates how philanthropy can adapt to meet allies’ new needs

Sustainability

Venture philanthropy

launches new programs and

services where sustainability

is built into the model

Previous perceptions of

philanthropy role have centered on:

Flexibility

Philanthropy partners with

allies to both design and fund

opportunities that address

systemic community needs

New community wellness role for

philanthropy is focused on:

Implementation

Philanthropy provides

one-off funding for capital

needs or time-limited

grants for programs

Restriction

Philanthropy picks up all

or part of the tab in line

with mandate of specific

clinicians and/or donors

Perspective of a development leader on the frontier

Geisinger’s strategic shift, in their Chief Philanthropy Officer’s own words

Source: Abela A, Advanced Presentations by Design: Creating Communication That Drives Action, Pfeiffer,

2013; Geisinger Health Foundation, Danville, PA; Philanthropy Leadership Council interviews and analysis.

From To

Philanthropy is a translator

Development team exists to pass departmental

priorities on to donors

Philanthropy is an innovation partner

Philanthropy is an integral strategic component to

power the evolution of our health system

Identify funding needs and priorities

Pass down institutional or departmental initiatives

for development to develop a case

Co-create investment opportunities

Share responsibility with development to incubate

and sustain community wellness initiatives

Moving executives from “philanthropy as ATM” to “philanthropy as sparkplug”

Take the first step in identifying next steps

“Think-Do, From-To” framework points to essential changes

Source: Abela A, Advanced Presentations by Design: Creating Communication That

Drives Action, Pfeiffer, 2013; Philanthropy Leadership Council analysis.

What shifts do you need to help allies make?

Ally’s status quo approach to supporting

philanthropy case making

Essential changes in ally’s attitude toward

and participation in philanthropy case making

Think How does your target ally

think today about their role in

helping make a case for

philanthropic investment?

How will your ally’s thinking about

philanthropy need to change in order

to deliver on your “Impact Advantage”?

Do What work does your target ally

typically do to help your case

making activities?

What new or different work will your

target ally do to fulfill the promise made

to donors in your “Impact Advantage”?

Complete a “Think-Do, From-To” of your own

Individual capstone activity

Activity overview

Philanthropy teams will continue to need allies. Choose a specific ally that you believe will be most necessary

in fulfilling the promise to donors that your “Impact Advantage” makes. Then outline the ways you need to shift

the ways in which that ally thinks and acts toward philanthropy.

Instructions

1. Review the sample “Think-Do-From-To”.

2. Identify a critical ally, or group of allies, for fulfilling your “Impact Advantage.”

3. Explain how you believe your ally would currently Think about philanthropy’s role in the hospital. (upper left

quadrant)

4. Explain what your ally would Do to assist philanthropy today. (lower left quadrant)

5. Pinpoint the most significant way(s) you need to shift how your ally will Think about philanthropy to help

fulfill your “Impact Advantage.” (upper right quadrant)

6. Determine what you will need that ally to Do differently in order to fulfill your “Impact Advantage.” (lower

right quadrant)

What will you do on Monday morning?

Plan to build on today’s momentum

Polish “Impact Advantage”

with your team

• Brainstorm alternate priorities

and positioning

• Use feedback questions on

p. 9 of Workbook to facilitate

discussion

Pressure-test new approach to community wellness

Seek new role feedback

from friendly ally

• Gauge appetite for and

chart obstacles to realizing

“Impact Advantage”

• Identify other potential and

essential allies

Which way will we go?

Source: American Hospital Association; “Giving USA 2018,” Giving USA; “AHP Report on Giving

2018,” Association for Healthcare Philanthropy; Philanthropy Leadership Council analysis.1) Calculation: Sum [(34%-actual hospital % of giving)*total health giving that year]

2012 2013 2014 2015 2016 2017 2018 2019

Hospital giving Total upcaptured market share Non-hospital health giving

Giving to the health sector and hospitals

In billions of inflation-adjusted dollars

With an ambitious case, significant market share gains within reach

Total:

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Philanthropy Leadership Council

Project DirectorJohn League

leaguej@advisory.com

202-568-7822

Research TeamHelen Liu

Program LeadershipNick Cericola

Russell Davis

Jared Landis

Design ConsultantHailey Kessler

How to Earn Donors in a Market That’s Leaving Hospitals Behind...Source: Sparrow Health...

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