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What the Affluent Think about Giving to Healthcare
Bentz Whaley Flessner’s Annual SurveySeptember 2008
© 2008 Bentz Whaley Flessner1
Introduction
This past year has brought about significant changes to the economic and philanthropic climate. As we launched our 8th annual survey on healthcare giving, we took into consideration the potential impact of an unstable economic environment.
As development professionals, we know that affluent donors play an important role in philanthropy and that our industry is focused upon developing relationships with affluent donors for ongoing program support or prospective campaigns to support our organizational missions. But with the uncertainty in the marketplace, how do we shape our work to accommodate these challenging times?
Affluent donors are renegotiating their giving terms and taking more of an active role in the direction and use of their charitable dollars. How will this affect our ability to meet healthcare philanthropic needs? While many experts believe that giving from affluent individuals will not drastically change, other factors such as timing of gifts will be critical considerations in the months to come.
Our Annual Healthcare Survey is designed to help prepare you and your development program for long-term success.
© 2008 Bentz Whaley Flessner2
Objective, Methodology, and Design
Our Objective: Annually, Bentz Whaley Flessner’s healthcare practice conducts research to gauge the perceptions and opinions of affluent Americans toward making gifts to healthcare organizations. Our goal in collecting this data is to help enable you to become a stronger, more vibrant healthcare development organization.
Methodology and Design: An “affluent household” is defined as having a household income greater than $200,000 or assets in excess of $1 million.The electronic survey is distributed annually in August or September. . The online survey is open for approximately one week after delivery of the email invitation.
© 2008 Bentz Whaley Flessner3
2008 Demographics
Giving84% of survey respondents contribute to charities*51% of respondents contributing to charities support healthcare facilities
Gender50% men; 50% women
Age11% under age 3045% age 30–4427% age 45–5914% age 60 or older
Family68% have children20% have grandchildren
*Note: In 2007 and 2008, 84% of survey respondents reported contributing to charities.
© 2008 Bentz Whaley Flessner4
The majority (84%) of our affluent respondents contribute to charities. Donors provide the greatest amount of support to the following types of organizations.
Type of Organizations Donors Allocated Greatest Amount of Support
1%
3%
9%
10%
10%
14%
15%
18%
24%
2%
3%
9%
11%
10%
12%
17%
17%
1%
3%
7%
10%
13%
11%
15%
19%
20%21%
0% 5% 10% 15% 20% 25%
International Affairs
Hospitals
Arts/Culture/Humanities
Public-society Benefit
Environment/Animals
Education
Human Services
Healthcare Causes
Religion
200820072006
© 2008 Bentz Whaley Flessner5
Although 24% of affluent donors report supporting hospitals at some level, only 3% made their largest gifts to hospitals.
Organizations Supportedat Any Level in 2008
12%
22%
40%
42%
43%
43%
49%
49%
51%
12%
24%
37%
39%
38%
47%
44%
54%
50%
0% 10% 20% 30% 40% 50% 60%
International Affairs
Hospitals
Public-society Benefit
Environment/Animals
Arts/Culture/Humanities
Religion
Education
Healthcare Causes
Human Services
20082007
Let’s take a closer look at support to hospitals.
© 2008 Bentz Whaley Flessner7
Of the donors that support hospitals, 42% give to more than one type of healthcare institution.
Children’s hospitals remain the top priority among affluent donors, and the percentage of affluent individuals who support children’s hospitals continues to increase.
Types of Hospitals Supported by Donors
17%
35%
49%
60%
18%
42%
47%
16%
38%
48%
67%63%
0% 20% 40% 60% 80%
Long-term CareFacilities
CommunityHospitals
Academic MCs
Children'sHospitals
2008
2007
2006
© 2008 Bentz Whaley Flessner8
While overall gender differences in giving have decreased, women continue to support children’s hospitals, while more men report greater support to community hospitals and long-term care facilities.
Types of Hospitals Supported by Men and Women in 2008
17%
41%
48%
63%
16%
36%
48%
71%
0% 20% 40% 60% 80%
Long-term CareFacilities
Community Hospitals
Academic MCs
Children's Hospitals
WomenMen
Hospitals Supported by Women
0% 20% 40% 60% 80%
Long-term Care Facilities
Com m unity Hospitals
Academ ic MCs
Children's Hospitals
200820072006
Hospitals Supported by Men
0% 20% 40% 60% 80%
Long-term Care Facilities
Com m unity Hospitals
Academ ic MCs
Children's Hospitals
200820072006
© 2008 Bentz Whaley Flessner9
Importance to community and a direct experience with a hospital remain key motivators for giving. The influence of a friend or a physician continues to increase as motivating factors.
Motivations that Drive Giving to Hospitals
0% 10% 20% 30% 40% 50% 60%
PhysicianRecommendation
Request fromFriend
Reputation ofHospital
Recent Personal orFamily Experience
Importance toCommunity
2008200720062005
© 2008 Bentz Whaley Flessner10
Despite the importance of a recent personal or family experience with the hospital to giving, 69% of affluent donors were not asked to make a gift. When asked, overwhelmingly a gift resulted.
*Donors not asked to make a gift.
Impact of Recent Personal or Family Experiences with a Hospital on Giving
I was asked to make a gift and declined.
1%
*I was not asked to make a gift, nor did I
make a donation.8%
*I gave a gift without being asked.
61%
I was asked to make a gift and as a result, I
made a donation.30%
© 2008 Bentz Whaley Flessner11
Hospitals are not doing an effective job of making the case for philanthropy.
Reasons Given for Not Supporting Hospitals
12%
17%
14%
10%
18%
4%
55%
10%
18%
17%
18%
30%
39%
41%
Government, not charity should do more forhospitals.
I have never been asked to make a gift.
I receive my healthcare at a for-profit hospital.
I do not think my hospital needs my money.
Hospitals are businesses and do not need my gift.
Other organizations need my money more.
I pay for my healthcare through health insurance.
Donors, not hospitals
Non-donors
© 2008 Bentz Whaley Flessner12
Some individuals not making gifts to hospitals indicated that a “grateful patient” program would motivate them to give to their hospital.
Non-Donors
YesNo
Donors, Not to Hospitals
YesNo
If your hospital had a special program that recognizes and gives special consideration to patients if they are contributors, would that motivate you to give?
77%
23%
72%
28%
© 2008 Bentz Whaley Flessner13
Of those who support hospitals, approximately one out of four expect to be recognized and receive special consideration.
As a donor, do you expect to be recognized and receive special consideration as a patient?
69%
23%
8%
YesNoI don't know
Who influences donors to give?
© 2008 Bentz Whaley Flessner15
Giving decisions are influenced by those closest to the donor.
The influence of organization representatives and financial advisors is reported at a greater level among donors to hospitals than among donors who do not support hospitals.
Influence on Giving Decisions
71%
63%
75%
77%
91%
60%
34%
57%
60%
83%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
OrganizationRepresentatives
Financial Advisors
Peers
Other FamilyMembers
Spouse or Partner
Donors to Hospitals Donors, Not to Hospitals
© 2008 Bentz Whaley Flessner16
Family members, especially spouses/partners, have the greatest amount of influence on gift size.
Hospital donors reported that their spheres of influence—other family members, peers, financial advisors, organization representatives—have a far greater impact on decisions on gift size.
Influence on Gift Size
0% 20% 40% 60% 80% 100%
OrganizationRepresentatives
FinancialAdvisors
Peers
Other FamilyMembers
Spouse orPartner
Donors to Hospitals Donors That Do Not Support Hospitals
© 2008 Bentz Whaley Flessner17
Medical staff, board members, and hospital leaders play an influential role in securing major gifts for healthcare organizations.
Hospital Representatives Influencing Giving Decisions
0% 10% 20% 30% 40% 50% 60%
Other DevelopmentOfficer
Chief DevelopmentOfficer
CEO/President
Board/Volunteer
Medical/Nursing Staff
No one
2008
2007
2006
Type of Hospital
Who, within a hospital, most influences your giving decisions?
No OneMedical/
Nursing StaffCEO/
PresidentBoard /
Volunteer CDOOther Dev.
Staff
Community hospitals 23% 16% 20% 31% 5% 5%
Academic medical centers/research centers 32% 18% 12% 27% 4% 7%
Children's hospitals 37% 18% 11% 23% 6% 5%
Long-term care facilities 29% 20% 14% 23% 11% 3%
© 2008 Bentz Whaley Flessner18
Knowledge about the hospital continues to be the most important factor in working with affluent donors. The value of the relationship with the donor is growing in its importance.
Personal Qualities of Hospital Representatives that Motivate Giving among Donors
14%
23%
61%
15%
27%
65%
21%
35%
35%
63%
28%28%
0% 10% 20% 30% 40% 50% 60% 70%
Expertise with settingup gift plans
Knowledge about meand my
circumstances
Longevity of ourrelationship
Knowledge about thehospital
200820072006
Donors to hospitals place a higher value on all components of hospital revenue.
© 2008 Bentz Whaley Flessner20
Revenue Sources
Importance of Bonds and Loans
0% 20% 40% 60% 80% 100%
Non-Donors
Donors, but Not to Hospitals
Donors, Support Hospitals
Very important Somewhat importantNot important I don't know
Importance of Investment Income
0% 20% 40% 60% 80% 100%
Non-Donors
Donors, but Not to Hospitals
Donors, Support Hospitals
Very important Somewhat importantNot important I don't know
Importance of Managed Care Contracts
0% 20% 40% 60% 80% 100%
Non-Donors
Donors, but Not to Hospitals
Donors, Support Hospitals
Very important Somewhat importantNot important I don't know
Importance of Government Medicare or Medicaid
0% 20% 40% 60% 80% 100%
Non-Donors
Donors, but Not to Hospitals
Donors, Support Hospitals
Very important Somewhat importantNot important I don't know
© 2008 Bentz Whaley Flessner21
The role and impact of philanthropy need to be more defined and communicated.
Regardless of donor status, more than 64% of affluent Americans regard healthcare insurance as somewhat or very important to a hospital’s bottom line.
Donors to hospitals understand the importance of philanthropy to a greater extent than others; yet 23% of donors and more than 50% of prospective donors need additional education on the role philanthropy plays.
Importance of Healthcare Insurance
0% 20% 40% 60% 80% 100%
Non-Donors
Donors, but Not toHospitals
Donors, SupportHospitals Very important
Somewhat importantNot importantI don't know
Importance of Philanthropy
0% 20% 40% 60% 80% 100%
Non-Donors
Donors, but Not toHospitals
Donors, SupportHospitals Very important
Somewhat importantNot importantI don't know
Considerationsfor your program.
© 2008 Bentz Whaley Flessner23
How often did your community hospital seek a gift from you over the past year?
As in past years, the majority of respondents reported that they were not solicited for a gift.
Donor type does make a difference in the number of asks.
Individuals who support hospitals report being asked more frequently.More than 65% of individuals not supporting hospitals were never asked for a gift.
Frequency of Gift Asks by Year
0% 10% 20% 30% 40% 50% 60%
*I don't know
Zero
Once
Two or Three
Four or More200820072006
Frequency of Gift Asks by Donor Type
0% 10% 20% 30% 40% 50% 60% 70% 80%
*I don't know
Zero
Once
Two or Three
Four or More Donors, to hospitalsDonors, not hospitalsNon-donors
© 2008 Bentz Whaley Flessner24
Effective communication and making the case may result in bringing additional donors to your program.
Factors That May Motivate Giving to Hospitals
3%
6%
15%
45%
22%
21%
3%
9%
17%
19%
32%
50%
A change in hospitalleadership.
A new, exciting program.
If asked, I might give.
Nothing could motivateme to give.
A family or personalexperience.
I need to understand whymy support is needed.
Donors, not hospitalsNon-donors
© 2008 Bentz Whaley Flessner25
While the vast majority of respondents claim to have an estate plan, only 19% have included nonprofit organizations in their gift planning.
Estate Plan or Will AmongIndividuals Age 45 or Older
87%
89%
87%
0% 20% 40% 60% 80% 100%
2006
2007
2008
Beneficiaries Among Individuals Age 45 or Older
1%
3%
5%
5%
19%
23%
71%
78%
2%
3%
5%
6%
19%
19%
75%
73%
0% 20% 40% 60% 80% 100%
Employees
Pet
Other
Friends
Other Family
Charity
Spouse
Children
20082007
© 2008 Bentz Whaley Flessner26
Among charities in estate plans, hospitals are not among the most frequently designated organizations.
Charities included in Estate Plans for Individuals Age 45 Years or Older
6%
18%
24%
18%
15%
49%
30%
37%
61%
3%
8%
20%
25%
27%
27%
31%
41%
53%
10%
28%
23%
23%
28%
23%
26%
36%
51%
0% 10% 20% 30% 40% 50% 60% 70%
International Affairs
Public-society Benefit
Hospitals
Environment and Animals
Human Services
Healthcare Causes
Arts, Culture, andHumanities
Religion
Education
2008
2007
2006
© 2008 Bentz Whaley Flessner27
The estate plans of affluent donors do not necessarily reflect their current giving behaviors.
Organization
Age 45 Years or Older and Have a Will
LargestGifts to:
Currently Give to:
Estate Plans include:
Education 10% 49% 54%Religion 26% 56% 38%Arts/Culture/Humanities 6% 45% 24%Human Services 13% 56% 27%Healthcare Causes 16% 56% 24%Environment/Animals 13% 40% 22%Hospitals 4% 25% 24%Public-society Benefit 11% 40% 27%International Affairs 1% 9% 11%
© 2008 Bentz Whaley Flessner28
The majority of respondents indicate that the current economy will not impact their giving patterns.
42%58%
YesNo
The survey was conducted in August 2008 prior to the financial turmoil of September 2008.
What does this mean for your development program?
7 Action Items
© 2008 Bentz Whaley Flessner30
Develop a case for support and strategies for effectively communicating it.
The importance of philanthropic support for hospitals is not fully understood.Affluent donors and potential donors are seeking information about your hospital and want to understand why their support is needed.
1
© 2008 Bentz Whaley Flessner31
Focus your case on the value and worthiness of your hospital.
Your hospital’s value to the community ranks as the most important reason for giving. However, knowing the role of philanthropic support in the hospital’s financial planning is also of value and needs to be articulated. Remember to focus on your hospital’s role and impact in the community.
2
© 2008 Bentz Whaley Flessner32
Involve your board members in the development process.
The commitment and the knowledge of board members will influence potential donors. Training and education make board members more confident in their fundraising roles.
3
© 2008 Bentz Whaley Flessner33
Be attentive of potential support from grateful patients and families.
A personal or family experience is one of the strongest motivations for giving to hospitals. Donors often expect to be given special consideration when they or family members are patients at the hospital they support. Likewise, non-donors to hospitals indicate that consideration may motivate them to give. Develop a grateful patient program that is focused on building a relationship with those who are donors and those who may become donors.
4
© 2008 Bentz Whaley Flessner34
Create a lasting culture of philanthropy within your hospital.
Educate the CEO, caregivers, and others at your hospital on the role of philanthropy in healthcare and at your hospital. Invite them to participate in cultivation and solicitation visits, and keep them informed of the outcomes of those visits.Ask others to identify and communicate with grateful patients and families. Remember to say “thank you” to those involved.
5
© 2008 Bentz Whaley Flessner35
Build strong and lasting relationships with donors and potential donors.
Strong relationships are essential for major and planned giving programs.
Even when hospitals are not the recipients of donors’ largest gifts, those who support hospitals are more likely to make provisions for those hospitals in their wills.
With increased competition among non-profit organizations, those donors with relationships are the ones who will be loyal and will make significant gifts while they are living and in their estate plans.
6
© 2008 Bentz Whaley Flessner36
Ask!
While some affluent individuals give without being asked, the greatest rewards come from those who are cultivated.
The uncertainty of the economy may change the way people give, but philanthropy has remained strong through past downturns in the economy and projections are that giving will continue to play an important role in healthcare.
While attitudes change form one year to the next, many opportunities to reach affluent individuals with a solid case for support remain untapped.
7
© 2008 Bentz Whaley Flessner37
About Us
In 2008, Bentz Whaley Flessner marks its 25th Anniversary. For a quarter of a century, the philanthropic consulting firm has partnered with community hospitals, academic medical centers, children’s hospitals, and multi-hospital systems to build strong development programs.
From development assessments to comprehensive campaigns, from prospect management to data analysis, from donor relations to systems conversion, we have helped healthcare organizations throughout North America to meet their philanthropic goals. The extensive experience of our team of consultants gives us the ability to bring you and your organization an approach that is designed to meet the needs of your development program.
William D. Tippie
Janet L. Hedrick, CFRE
Jana K. Olslund, J.D.
7251 Ohms Lane Minneapolis, MN 55439 952-921-01112461 South Clark Street, Suite 910 Arlington, VA 22202 703-413-5505
www.bwf.com [email protected]
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