Unlocking the Hidden Value of Hospital Annual Funds: Building Pipelines, Strengthening Donor Journeys and Driving Transformational Giving

Speaker A: Welcome to the Go Beyond Fundraising podcast brought to you by Allegiance Group plus Pursuant. We're a passionate team of strategists, practitioners and technologists who believe in the power of nonprofits to create positive change. Each episode we host insightful conversations, practical tips and inspiring stories from experts on our team and change makers around the globe. Together, let's explore how to go beyond traditional fundraising and unlock the full potential of your mission.

Speaker B: Welcome everyone to another episode of the Go Beyond Fundraising Podcast. Today we are talking all about hospital annual fund programs and why they're so valuable and why you should be thinking about your investment there maybe differently, especially as we're heading into year end and maybe fiscal year 26 for a few people. I'm sitting down with a couple of ladies today to help me with this conversation and help me with this topic. First, I'm excited to be joined by Alyssa Boger, our EVP of client experience. Alyssa, welcome.

Speaker C: Thank you for having me, Leah.

Speaker B: I'm also excited to be welcoming our friend and client, Jennifer Lomax from City of Hope. Jen, welcome.

Speaker D: Thank you so much, Leah.

Speaker B: So excited to have you. Like I said at the start, so before we kind of get into our discussion, I'd love to know a little bit more about your role at City of Hope and a, uh, bit about your journey getting there.

Speaker D: I am the team lead, if you will, the senior Executive Director of direct response for City of Hope. My journey as far as coming to City of Hope, like so many folks, what they stand for is really near and dear to my heart. I've had loved ones touched by cancer and diabetes, so it just makes that much more compelling. I've been around the industry for about 25 years. I've definitely touched on the health sector with my time at American Cancer Society, but there's something different about working for a direct hospital.

Speaker B: So let's talk about annual fund. We know that it's one that can be not as resourced at lots of organizations as maybe it could be or should be. So Jen, how have you seen a well run annual giving program act as the most reliable, cost effective engine to feed upgrade pipelines?

Speaker D: I think with mass market, we're a low cost point of entry. I feel like we do the heavy lifting, right? We have that one to many approach as opposed to one to one. And I think with that we're able to establish those pockets of loyal donors such as sustainers, those folks that are definitely going to upgrade with you a lot faster. So I feel like we are able to do this at scale in mass Market and from there, folks then can refine as folks go up the giving pyramid, if you will.

Speaker C: I would say in working across, being able to partner with a number of different hospital systems and foundations, when that patient experience team or individuals who are really responsible for the patient experience are partnering and in lockstep with annual giving or philanthropy, that's really where the magic happens that it's seen as an opportunity and a, uh, benefit to be able to tie the two together instead of keeping them walled off and not introducing philanthropy until a patient is discharged or has been discharged for a while. Always being very mindful, thoughtful, and having integrity about the patient experience. But finding ways to weave in the story of philanthropy is really where that integration and boost into annual giving takes place. And that's sometimes rare to find, but when you do, it's just amazing to see how I think patients feel like they can be part of that story and community and had, uh, an active role in their own experience and those of other patients and really broadens like the engagement they're able to have and the relationship that they're able to have with the hospital itself.

Speaker B: I love that you brought up that point, Alyssa. Ah, about storing relationships. Because at least my perception kind of as an outsider looking in with a lot of hospitals is they can sometimes seem m these very large, complex organizations. And I think donors want to be able to see their place in it. And you know, so many of the gifts that we see going to hospitals are from major gifts. As a lower dollar giver, you may be thinking, well, what can I do to make a difference at this really large, complex, powerful organization?

Speaker C: It makes me actually think of. So I had my first child about six years ago. What a journey that was. Gave birth. Our local hospital then started going to weekly, like new moms classes. I was a nursing mom. Trying to figure that out for the first time was insane. Um, and so went to this class every single week with probably 20 other brand new moms. We still have our own WhatsApp, uh, chat group where we're talking to each other six years later. But we were there every week. A few of us made gifts to the hospital in honor of the woman who led our, like, the nurse who led our classes. And I never received any outreach or follow up from that hospital, which I know well in like, the area that I live. It's a big system and I think they've been able to have a lot of success at that major transformational gift level. And it's kind of like, yeah, we'll take your 25, $50. And you can then just go back into the community. But there could have been a really cool opportunity to engage this mom grew or to be able to build up that patient experience, community experience, into something just really beautiful and long term. But it just felt, even though I had this tie to that experience to the hospital, that my engagement on the philanthropy side was just kind of like a transaction that was ignored to some degree, which is just a shame.

Speaker D: Yeah, completely agree, Alyssa. Um, it's interesting that no one reached out to you because again, like you said, that could have been a really great entry point as far as just building a relationship with you and really that entire group of moms.

Speaker C: It is important as a fundraiser. I was like, key moment for outreach. I'm m clicking on your emails, like I'm, uh, taking your surveys.

Speaker B: I love that you shared that, Alyssa, because it actually makes me think of another story which was Elisa Greer, friend and author. She had a very kind of interesting journey that parallels a little bit of what you're talking about where, you know, for most of her, her life she was an annual fund type of donor. And then her husband's business took off, they sold the business, they became kind of millionaires overnight. And uh, she wanted to make a large transformational gift at a research hospital in their area. She was not on any of their lists as somebody that they should be have been cultivating for a major gift because of that kind of sudden windfall. But if she had been making smaller gifts before that with the hospital and been stewarded, then that journey could have looked a lot different. She did end up making the gift and she's got a whole story about that. But her story and your story, I feel like, are kind of like bookends to what an experience can be like for different types of donors and how that experience, experience across that spectrum is really, really important.

Speaker D: I completely agree with that, Leah. Uh, you know, you never understand or know the capacity unless you were continuing to engage right with constituents. And that's key. It's something that we definitely try to stay cognizant of, obviously at City of Hope around us, making sure that we're staying engaged and we're staying before folks for that potential transformational gift.

Speaker B: So I think that segues nicely into kind of my next question for you, Jen, which is what early signals or metrics should leaders at hospitals look at to prove out that story of, you know, small to large transformational giving?

Speaker D: Yeah, I think again, you probably will hear me say this several times. It's all about the data. Like, you have to stay up to date on what your key performance indicators are telling you, your file health trends. Really, really important. I think for this particular area. You know, looking at those folks that are sticky, those folks that make multiple gifts in the first six months of acquisition, they tend to have a direct line to, you know, moving up to major gifts, especially that hundred dollar plus cohort. They're really special. I think the other cohort that you would look at is again, your consecutive year givers, like those folks who continue to give to you time and time again. Their behavior and what's happening with them is really important. And then one thing that I feel like at times, at least in my experience, a lot of nonprofits don't necessarily pay a lot of attention to, and that's just donor feedback, even if it's negative. Those folks are engaged. They want you to understand their stance with your mission, with your organization. A tactic that I've, uh, deployed in past lives and now with allegiance. You have those limited communication populations where they say, only email me once a year, only mail me twice a year. We actually reach out to them via that cadence and we remind them that, hey, you've asked to only hear from us one time a year. And we have some of the most phenomenal response rates when it comes to those particular populations. So really, again, just listening to donor feedback and again, looking at those donors who just have that behavior to move up.

Speaker B: Uh, so, Alyssa, uh, why do hospital boards sometimes struggle to see the value of investing in the annual fund?

Speaker C: I think in a lot of cases it comes down to just directly attributed revenue. Especially in today's world where things are becoming less and less clear cut, we might have strategies that are targeting folks through different media channels and then sending a direct mail piece and then sending emails and maybe also making a phone call. That can be really hard to track. What is maybe driving someone's gift? Ultimately, they may end up making a more significant gift through an event that they're attending. But all of those touch points along the way were a reminder of, uh, the mission and impact that then helped them to make that larger gift in a different channel or program. What can be challenging is in a lot of going through budgeting cycles and seasons, you're pulling apart that bigger hole and into events, major giving, mid M level giving, annual giving, planned giving, like you're breaking it all apart into pieces into what can be directly attributed to that program. And annual giving, by and large, is going to have the lowest roi. You know, we're spending the most to get communications out, lower average gifts and postage just keeps getting more and more expensive. And so it can be a, uh, costly endeavor. And when you look at it in isolation, I think there's an easy tendency to say, oh, this doesn't work as well as all these other programs. Like, we can just cut this and save money and reinvest it elsewhere. But once you actually look at some of those metrics Jen mentioned, you know, what is the upgrade from general to mid to major? How many plan giving donors originated from your annual fund, how many of your event donors receive annual giving communications. You start to then see how everything is interconnected and the importance of, uh, investment at the annual giving level that then feeds and serves as a pipeline for all of the other areas of fundraising. There's great but sad case studies with organizations like ACS that have pulled back on acquisition and then saw a ripple effect across all of their programs. Not just direct response because they started to pull back on that pipeline of donors. I think because you have to be a little more patient with annual giving, you have to be okay with not always having that positive or really high roi. It can be easy for more of those business minded board members to just see it as a line item and feel like they can just cross it out or minimize it without impacting other areas. So I think that's where from an, uh, a leadership standpoint, being able to have strong partnerships with other departments within philanthropy or the foundation, being able to present a, uh, united front to your board of how all of these programs work together in concert can really help to lift all boats as opposed to it being seen as these separate pieces that can be changed without impacting one another.

Speaker D: Yeah, Lissa, I completely agree, you know, and I think for me, I'm going to pick on my age old friend data. I know at times it can be hard to pull together an attribution model. However, like, we do know that one thing is connected to another also. Just trying your best in the data to understand what is that omnichannel strategy and again, how all those different touch points are making a impact to that ultimate gift, if you will.

Speaker B: So Jen, what does that framework look like for you?

Speaker D: I would say, you know, very similar to what Alyssa just walked through. We all, I think Alyssa gave the American Cancer Society example of really being able to see what disinvestment can do to a program. And I don't want to pick on American Cancer. I love them. I was there for eight years. Other organizations also have made those type of decisions. So I feel like how you can show the value of mass market fundraising to leadership. I'll come back to again, your file health trend data. You know, your key performance indicator data. You know, there is like a flowchart of looking at those populations that are really important, the new to file folks, and then how they then flow into new last year and then how they then flow into consecutive year givers. You can understand how, you know, if you have a group of like 50,000 brand donors that came in in fiscal year 24, now you only have 40,000 of them. You'll see how they flow through like the file health trends to understand like their value. And it's really apparent when you have a year of disinvestment how long it sort of takes that to work through that particular flowchart. So I think just really, again, continuing to lead with data, uh, in an easily digestible way and really showing them over time how the impact of one decision can affect you in years to come.

Speaker B: I love that framework, Jen, and it makes me as a marketer, think about the marketing funnel as an analogy. You have your impressions at the top, that's your awareness. And then you have people in that consideration stage who are maybe you've gotten their name, you've gotten their email address, you've gotten permission to communicate with them. And then down there, uh, lower in the funnel, you have people that are actually engaging in those sales conversations. And you would never go to a marketing leader and say, we're going to cut your investment in impressions because that's just going to cut off the top of our funnel. Thinking about it that way holistically as a journey is so important.

Speaker D: Yeah. And I think from a mass audience perspective, of course, obviously there's a ton of strategy that drives how we approach things. But one thing I also think is important, you know, I guess in the spirit of a, uh, healthy competition, you also have to remember if you're not there, somebody else is and your mission is just as important as someone else's. And again, we're all here for a greater cause, but why not have that constituent engage with you as opposed to another like organization?

Speaker B: So how do you help make the case for that with your data and your communications with leadership.

Speaker C: So I think where we've come alongside other leaders within hospitals or hospital foundations, it's in creating usually some type of KPI dashboard. Executive leaders are not going to want to look at your campaign deep dive reports or they're going to get lost in all the data that Jen and I love. So, so Much and they want like the top line. So for City of Hope for example, we've worked with Jen and other leaders to create a very succinct like KPI dashboard report that we can provide monthly. You know, how do we then distill that down into just a slide or two each quarter? That can be those high points that just reinforce, yes, this program is providing direct revenue and impact, but we also have seen X number of donors make gifts of X amount to other areas of the City of Hope. We've had this many donors who started an annual giving now upgrade into major gifts or make a plan giving gift. So it doesn't have to be tons and tons of reports. It does mean you have to have the data. So having solicitation history in your database, being able to have trust in your appeal codes and source codes and be able to get to the numbers and then creating that compelling story that can be easily digested, those bite sized numbers that can be remembered and like, oh wow, I didn't know that we were generating that much revenue.

Speaker D: That's great.

Speaker C: So I think just trying to keep that in mind. How can you make it as simple and impactful as possible? That may mean that you have lots of reports behind the scenes to back it up and numbers that you know really well as the leader of annual giving or that agency partner, but then being able to create that succinct and powerful story for an executive leader that helps to reinforce the direct and indirect impact.

Speaker D: Yeah, I agree and I just really appreciate the work as you spoke to, that you all do with us, those one to two slides that tell that super high level story around, like how many folks that originated in annual giving are now giving major gifts. How many folks are actually given to other areas of philanthropy? Again, just I think in many ways that is part of like that attribution story of how folks begin with us and they still might be with us, but they decided they then want to, you know, engage elsewhere and you know, having in one past life, we called it having open borders if you will, when it comes to other parts of philanthropy, like really helping like the major gift officers understand that hey, you know, we have six or seven new prospects that you all can go and really try to create a relationship with. So it's just really important I think when it comes to just having this again, shared goals if you will. Uh, when it comes to that makes

Speaker C: me think of like the concept of the donor vortex as opposed to the donor pyramid. Yes, we want to continue upgrading donors as much as we can, but there are always going to be donors that fall back down. So in general, there could be people who are coming closer, closer and then farther away from the mission. They might be engaging in events, or they're in a season where they can't be as engaged in events, but they could give to a direct mail piece. So it's like creating just all of those different opportunities for engagement that are centered around the constituent instead of the organization being at the center and just trying to push donors into whatever bucket you think they should be in or fit into provides almost that, uh, kind of safety net or catch all for donors who may be in that period where they're not giving significant gifts or they can't at this period of time, or, you know, life is crazy and they can't be that same level of peer to peer donor that they've been in the past, but they could still engage through email or through a mailing or through a text message and feel like they're still part of the mission, even if the amount that they're giving or the time they're investing looks a little bit different.

Speaker D: Yeah, I love that list of, uh, the vortex. I love that because you're right, like, it's not linear. I think I tend to be a little old school and I go to that donor pyramid because I feel like where I was raised and cut my teeth. But as time has gone on, like you said, folks do move all around. And are you prepared as an organization to meet them where they are at that point in time?

Speaker B: I think that gets into my next question really well, which is from the donor's perspective, how does consistent stewardship across gift sizes build that lifetime value and trust where they want to stay engaged with you no matter where they are in their life stage?

Speaker D: Going back to how coming to City of Hope has been a new challenge for me in so many really positive ways, I think just not losing sight of, uh, a patient's primary relationship with the organization. As I mentioned before, the focus on the patient population is something that I hadn't experienced before, but I'm a quick study. Uh, it's been really refreshing to learn how important this particular cohort is to hospitals or in a hospital direct response setting. So I think it's just really important to keep that at the core of how you are engaging with someone in philanthropy. They have a very different experience. You know, it's very personal, if you will, and you always want to make sure that you're honoring the patient and the family relationship. And I feel like if you have these pillars in your approach. It will just make that case for long term support come a lot more naturally.

Speaker B: Well, and especially with a, uh, cancer journey, you see so often when someone in your community has gotten a cancer diagnosis that half of Facebook is following the journey through updates that their family is posting. They might be coming in to bring in care packages or sit by the bedside while a chemo treatment is happening. A cancer journey really does engage a whole community of people, and I think that's a really unique way of looking at it, especially with what City of Hope does, because it's thinking about, like, yes, there's the patient and their immediate circle that's affected by our hospital's care, but there's a larger universe of people in various levels of closeness to that story that also care.

Speaker D: Yeah, absolutely, Leah. Um, and I have to say, because you had a buzzword that took me back, so you mentioned care packages. So, you know, I worked for CARE for almost 13 years and that was the origination of the CARE faculty. But I think everything that you're saying is completely spot on and important. Yeah.

Speaker B: All right, uh, a quick question to wrap us up here, which has been a really fun discussion. What's one practice or kind of mindset shift that hospitals can adopt in the next 60 to 90 days as we're kind of staring down the barrel of year end to unlock more pipeline value from their annual fund without any major new investment?

Speaker D: So we've talked a little bit about return on investment, as Alyssa spoke to earlier. Many times, the return on investment can be difficult to prove in a mass audience space. But that doesn't mean that you shy away from it here and in past lives. I think it's just really important to take the time to understand your return on investment by channel and really determine where that next best dollar should be spent based on your goals and objectives. Once you identify where that next best dollars should be spent, actually move the money there and start to execute and start down the path of that strategic plan.

Speaker C: I'd probably also add maybe think about what partnerships or relationships you could start to cultivate. So do you have a, uh, data analyst that you might want to become BFFs with who can help you tell that more cohesive story to your board or, uh, to your leadership? Is there a partnership with mid and major gifts that needs to be built or restored to have more of that united front, collaborative approach to donor engagement and donor relationships? Are there community partnerships you could help to build or think differently about? We work with a couple of Other hospital foundations that are more regional, localized. And so they've identified ways to really engage with the community beyond hospital walls. Community Health Network foundation, they have a program working with school nurses, like really being part of the school system. Parents see their logos, like they. They know that community health is in it with their kids at school. Memorial Herman in Houston has a really amazing partnership with a new high school and building out like a pre med, pre nursing program. Recognizing those things can take investment. What are maybe some of those types of partnerships that help to broaden that annual giving base beyond patients to the community at large? That's something that City of Hope has done just really well through their investment in mass market fundraising, recognizing they have a full research team and department that can be funded through national donors. There's been that commitment to community building, relationship building, partnerships with corporations that really help to magnify and amplify the mission and the brand beyond their more limited patient audience. Who are those people you can get to know that might allow you to expand and support your efforts so that you're not feeling that weight all on yourself?

Speaker B: All right, a few minutes left. Is there anything else we wanna touch on before we wrap?

Speaker C: I would just add, Jen is amazing. I mean, I think anyone who works with Jen knows that or has had the privilege of working with her across many of her different roles. Just being able to partner with a leader like her in City of Hope is the highlight for me. And just the belief they have in annual giving, the power of philanthropy, and thinking through just the patient and donor experience so thoughtfully. So. So I just appreciate you, Jen, as the leader that you are, and the ways that you push us and colleagues and the industry to always do better and be better.

Speaker D: I really appreciate that. My love for you. Absolutely.

Speaker B: Yeah.

Speaker D: You know, I think it's just about coming in and bringing your best self to work every day. And that's what I aspire to do. You know, I feel like I'm here for a reason. I'm here for a purpose. Right. So you saying that really warms my heart. It's very humbling. But I do try very hard to show up as that person that you'd want to work with. And we're all in this together. And that's the part that's really so refreshing for me is we're all just trying to do good in the world, especially these days. It's just so much more important. It's always been important to me. I've spent my entire career in nonprofit. But yeah, it's really important for me to wake up in the morning and give back and to really appreciate what you have.

Speaker B: Well, thank you, Alyssa and Jennifer for joining us today. I've really enjoyed today's conversation genuinely so thank you both.

Speaker C: Thank you.

Speaker D: Thank you.

Speaker A: Thanks for joining us on another episode of Go Beyond Fundraising. We hope these conversations have equipped you with the tools and inspiration to take your fundraising, marketing and advocacy and effort to the next level. If you're ready to transform your nonprofit's growth and impact, visit teamallegiance.com to get in touch with the experienced team at Allegiance Group and pursuant we are here to help you make a lasting difference. Until next time, Keep up the phenomenal work you do every day. Together we can create a brighter future.

Speaker D: Sam m.