What the Affluent Think about Giving to Healthcare. Bentz Whaley Flessner s 2015 Healthcare Survey

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1 What the Affluent Think about Giving to Healthcare Bentz Whaley Flessner s 2015 Healthcare Survey

2 Introduction Our 2015 Healthcare Survey is designed to keep you informed on trends and attitudes towards healthcare giving. We hope the information we produce provides insight and assists you in evaluating and fine- tuning your programs to reflect the constantly changing donor landscape. The FY2014 Giving USA Report estimates an increase of 5.5% in raised funds since 2013 and reached a total of $30.37 billion a total of 8 percent of all donations received by charities in This is good news given the amount of merger and acquisition activity and healthcare reform legislation being fully implemented. The strength of the economy bodes well for healthcare fundraising as the Dow Jones Industrial has reached an all-time high, NASDAQ has reached a post dot-com bubble high, and real estate markets continue to improve.

3 Objective, Methodology, and Design Our Objective For the past 15 years, Bentz Whaley Flessner has conducted research to gauge the perceptions and opinions of affluent Americans toward making philanthropic decisions related to hospitals and healthcare organizations*. We hope that in collecting, analyzing and sharing this data with you that you are better informed of current attitudes toward giving so that you can build stronger, more sustainable development programs for your healthcare organization. Methodology and Design An affluent household is defined as having a household income of greater than $200,000. The survey was distributed late July *Note: Includes community hospitals, academic medical centers/research centers, children s hospitals, and long-term care facilities.

4 Charitable Giving Of Survey Respondents 92% give to charities 5.5% less of individuals indicated they give to charity than in % make their largest gifts to hospitals 15% support hospitals (made a gift to a hospital in 2014)

5 Respondent Demographics } } Age 30 to 44 Age 45 to 59 } Age % of respondents were male; 45% were female Those who have children increased by six percentage points from Those reporting having grandchildren dropped by thirteen percent in Have Children Have Grandchildren

6 Largest Gifts Affluent donors make their largest gifts to: International Affairs Hospitals 1% 1% 2% 3% 1% 2% Arts/Culture/Humanities 3% 5% 6% Public-society Benefit 8% 10% 11% Human Services Education 11% 12% 17% 15% 17% 17% Religion 19% 17% 25% Healthcare Causes* 14% 18% 19% Environment/Animals 11% 14% 19% 0% 5% 10% 15% 20% 25% 30% Note: includes health-related research facilities, disease-specific organizations for research or patient/family support, mental health services and research, and health policy centers.

7 Healthcare Gifts 15% of those surveyed gave a gift to hospitals, and 53% supported healthcare causes at some level during International Affairs 13% 12% 14% 2011 Hospitals 17% 15% 24% Arts/Culture/Humanities 27% 40% 40% Religion Public-society Benefit 41% 39% 38% 43% 42% 51% Education Environment/Animals Human Services 47% 42% 41% 43% 46% 47% 53% 56% 59% Healthcare Causes* 54% 50% 53% 0% 10% 20% 30% 40% 50% 60% 70% Note: includes health-related research facilities, disease-specific organizations for research or patient/family support, mental health services and research, and health policy centers.

8 An Inside Look at Support to Hospitals

9 Hospital Types Supported Children s hospitals and academic medical centers remain a top priority for affluent donors in % Long-term Care Facilities 8% 15% % Community Hospitals 27% 35% 52% Academic Medical Centers 49% 42% 54% Children's Hospitals 59% 55% 0% 10% 20% 30% 40% 50% 60% 70%

10 Support by Gender In the past there have been notable differences in giving trends between the two genders; however, in 2014 giving was consistent in all sectors between men and women Long-term Care Facilities 16% 15% Academic Medical Centers/ Research Centers 42% 42% Community Hospitals 29% 39% Women Men Children's Hospitals 54% 56% Long-term Care Facilities Academic Medical Centers/ Research Centers Community Hospitals 0% 20% 40% 60% 3% 12% % 28% 40% 58% Women Men Children's Hospitals 62% 56% 0% 20% 40% 60% 80% 2011 Long-term Care Facilities 10% 17% Academic Medical Centers/ Research Centers 52% 52% Community Hospitals 37% 42% Women Men Children's Hospitals 46% 64% 0% 20% 40% 60% 80%

11 Giving Motivations Importance and value to the community has consistently been a lead motivation in giving to hospitals since Physician Recommendation 5% 12% 15% Request from Friend 12% 19% 19% Recent Personal or Family Experience 45% 50% 51% Importance / Value to Community 61% 63% 70% 0% 10% 20% 30% 40% 50% 60% 70% 80%

12 Asking and Giving This year 64% of affluent donors reported that they were not asked to make a gift; however, still made a contribution. I was not asked to make a gift, nor did I make a donation.* 13% 17% 26% 44% I gave a gift without being asked.* 39% 64% 39% I was asked to make a gift and as a result, I made a donation. 21% 22% I was asked to make a gift and declined. 1% 1% 3% % 10% 20% 30% 40% 50% 60% 70% * Donors not asked to make a gift

13 How Asked Direct mail solicitations continue to dominate solicitation attempts versus success. E-newsletter Brochure in hospital room 22% 15% 14% 18% 10% 10% Brochure in discharge packet 13% 10% 10% Post-hospital visit 8% 5% 22% Hospital room visit 0% 5% 31% Newsletter 15% 24% 33% Telephone call(s) 10% 19% 33% Direct mail 56% 51% 52% 0% 10% 20% 30% 40% 50% 60%

14 Donor Benefits Program In 2015, 16% of affluent individuals not currently making gifts to hospitals indicated that a donor benefits program would motivate them to give to their hospital. This is a 5% decrease from 2013; however, is consistent with trends seen in 2009 and % 84% Yes No % % Yes No 15% 85% Yes No % 80% Yes No

15 Recognition Some affluent donors to hospitals expect to be recognized during a hospital visit. The number of those expecting recognition fell by 12% since % 7% 85% Yes No Don't Know % 14% 81% Yes No Don't Know % 19% 72% Yes No Don't Know

16 Who Impacts a Donor s Giving?

17 Giving Influencers Spouses or partners and family members are strong influences in determining gifts from donors to hospitals and non-donors to hospitals. Organization Representatives 36% 40% Financial Advisors 17% 28% Donors, Not to Hospitals Donors to Hospitals Peers 40% 49% Other Family Members 48% 55% Spouse or Partner 80% 85% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

18 Gift Size Influencers Among donors and non-donors to hospitals, spouses and partners have the highest influence on determining gift size. It is, therefore, important to have both partners involved in philanthropic decisions when possible. Organization Representatives 14% 21% Donors, Not to Hospitals Financial Advisors 18% 32% Donors to Hospitals Peers 18% 24% Other Family Members 20% 36% Spouse or Partner 73% 81% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

19 Hospital Influencers Medical and/or nursing staff continue to have the largest influence in affluent donor s giving decisions. No One 27% 41% 53% Medical/Nursing Staff 19% 23% 36% Board/Volunteer CEO/President 14% 12% 11% 14% 9% 20% Other Fundraising Staff 6% 3% 4% Chief Development Officer 0% 2% 6% 0% 10% 20% 30% 40% 50% 60%

20 Influencers by Hospital Type Medical and nursing staff play a significant role in influencing giving decisions across all hospital types. Type of Hospital Medical/ Nursing Staff CEO/ President Board/ Volunteer Chief Development Officer Other Fundraising Staff Community Hospitals 19% 13% 14% 4% 3% Academic Medical Centers/ Research Centers 21% 11% 14% 1% 0% Children s Hospitals 17% 8% 10% 2% 8% Long-Term Care Facilities 10% 10% 19% 3% 0%

21 Motivating Qualities While knowledge of the hospital is a main motivator in giving, longevity of a relationship remains around 30% as a quality that motivates individuals to give. 61% Knowledge about the hospital 42% 69% 29% Longevity of our relationship 28% 29% 2011 Knowledge about me and my circumstances 20% 28% % Expertise with setting up gift plans 6% 9% 15% 0% 10% 20% 30% 40% 50% 60% 70% 80%

22 Creating and Strengthening the Case for Support

23 Reasons for Not Giving In 2015, more than half of non-donors reported that other organizations need their money more. With the spike in 2015 of 39% of respondents having not been asked for a gift, there is an opportunity for more solicitations of this group who did not give to hospitals. Hospitals will not need my support because of recent healthcare legislation* 4% 2% 6% I receive my healthcare at a for-profit hospital. 13% 13% 12% 2015 Government, not charity should do more for hospitals. 6% 10% 17% I do not think my hospital needs my money. 17% 22% 25% Hospitals are businesses and do not need my gift. 27% 31% 33% I have never been asked to make a gift. 16% 24% 39% Other organizations need my money more. 32% 52% 51% I pay for my healthcare through health insurance. 48% 43% 51% 0% 10% 20% 30% 40% 50% 60%

24 Perceived Importance of Revenue Sources More than half the groups believe that governmentsponsored healthcare insurance is important or very important as a revenue source. Bonds/Loans Donors, not to hospitals 12% 33% 43% 10% 2% Donors to hospitals 18% 41% 34% 1% 6% 0% 20% 40% 60% 80% 100% Very Important Important Neutral Not Important Not Important at All Government Medicare or Medicaid Donors, not to hospitals 52% 30% 16% 1% 2% Donors to hospitals 57% 27% 13% 2% 1% 0% 20% 40% 60% 80% 100% Very Important Important Neutral Not Important Not Important at All Managed Care Contracts Donors, not to hospitals 45% 34% 18% 2% 2% Donors to hospitals 54% 33% 10% 2% 1% 0% 20% 40% 60% 80% 100% Very Important Important Neutral Not Important Not Important at All (continued)

25 Perceived Importance of Revenue Sources Respondents from both donor and non-donor groups indicate that health insurance is the most important source of revenue. Investment Income Donors, not to hospitals 17% 38% 37% 5% 3% Donors to hospitals 26% 45% 24% 3% 2% 0% 20% 40% 60% 80% 100% Very Important Important Neutral Not Important Not Important at All Private Healthcare Insurance Donors, not to hospitals 49% 30% 18% 2% 1% Donors to hospitals 60% 33% 1% 6% 0% 0% 20% 40% 60% 80% 100% Very Important Important Neutral Not Important Not Important at All

26 Importance of Giving Donors to hospitals reported that philanthropy is a very important source of revenue. However, non-donors to hospitals also recognize charitable giving as an important source of funding. While donors and non-donors remain neutral on charitable giving, very few individuals reported giving as not important at all. Donors, not to hospitals 28% 38% 30% 3% 2% Donors to hospitals 43% 39% 13% 3% 1% 0% 20% 40% 60% 80% 100% Very Important Important Neutral Not Important Not Important at All

27 Motivating Factors More than half of affluent non-donors indicated a need to understand why their support is needed. A third also indicated a family or personal experience. I need to understand why my support is needed. 39% 55% 53% A family or personal experience. 28% 30% 43% Nothing could motivate me to give. 21% 29% 30% If asked, I might give. 12% 15% 20% A new, exciting program. 8% 14% 11% A change in hospital leadership. 4% 4% 3% 0% 10% 20% 30% 40% 50% 60%

28 Factors to Consider for Your Program

29 Frequency of Asks In 2015, more than half of those surveyed were not solicited for a gift by their community hospital. Those who were solicited tended to receive one to three appeals a year. Ten percent reported being solicited once a year; an increase of two percent from The number of asks differs by donor type. Individuals who reported themselves as being a donor were asked more often than those not supporting hospitals. The largest variation is between two to three asks a year, with a difference of 14%. Frequency of Gift Asks Per Year Four or More 8% 7% 6% 2011 Two or Three Once 15% 14% 15% 8% 10% 21% Not at All 49% 50% 60% I don't know 13% 16% 11% 0% 10% 20% 30% 40% 50% 60% 70% Frequency of Gift Asks By Type Four or More Two or Three Once 3% 9% 8% 7% 15% 22% Donors, not to hospitals Donors to hospitals Not at All 44% 71% I don't know 11% 10% 0% 10% 20% 30% 40% 50% 60% 70% 80%

30 Estate Plans While a majority of affluent donors report having a will or estate plan, 23% indicate that a charity is included. To whom are you leaving your assets? Employees Other Pet 1% 1% 1% 5% 3% 1% 5% 9% Friends 4% 4% 9% Charity Other Family 15% 16% 23% 20% 23% 28% Children Spouse 65% 68% 67% 66% 81% 80% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% No 21% Do you have a will or estate plan? 2015 No 13% 2011 Yes 79% No 15% 2013 Yes 87% Yes 85%

31 Charities Included in Plans While education and religion are typically included in estate plans, hospitals have historically placed near the bottom. Hospitals International Affairs Public-society Benefit Human Services 14% 12% 7% 6% 8% 13% 17% 20% 15% 27% 17% 22% Healthcare Causes* 15% 23% 26% Arts, Culture, and Humanities Religion 23% 23% 30% 35% 39% 30% Education 32% 44% 55% Environment and Animals 27% 31% 42% 0% 10% 20% 30% 40% 50% 60%

32 Giving Priorities Don t Always Align with Estate Plans Of those surveyed, 54% indicated they currently give to hospitals, and only 23% have included hospitals in their estate plans. While this number is up 10% since 2013, it is an area where there is opportunity to expand fundraising efforts. Age 45 Years or Older and Have a Will Organization Largest Gift to Currently Give to Estate Plans Include Education 15% 44% 32% Religion 20% 42% 30% Arts/Culture/Humanities 3% 28% 23% Human Services 11% 46% 22% Healthcare Causes 17% 54% 23% Environment/Animals 18% 45% 42% Hospitals 2% 18% 7% Public-Society Benefit 12% 43% 15% International Affairs 3% 16% 13%

33 Impact of Tax Changes (IRA Rollover) This year we asked if tax changes will affect giving. 58% of respondents indicated tax changes would not make a difference, up 18% from the 2013 healthcare survey, while a total of 43% indicated that it would make a difference, or they were not sure. 33% 10% Yes 58% No I don t know

34 Priorities for 2015

35 Prioritize The larger the organization, the more important it will be to define and demonstrate the role of philanthropy. Additionally, prioritizing which donors should be engaged will be critical. Across the philanthropic landscape, donors are becoming increasingly more restrictive in their giving. In a large budget healthcare market (healthcare reform, mergers, acquisitions) it will be particularly important to re-evaluate fundraising priorities. Healthcare organizations must show that philanthropy will have clear impact on the organization s mission and have a measurable outcome.

36 Educate While prospects are bombarded by consumer information around healthcare, philanthropy is less clear. As indicated in the survey, most non-donors are unclear on the role of philanthropy at their hospital. Looking for clear, consistent, and powerful ways to communicate to donors is critical. While philanthropy remains an emotional decision, larger gifts will demand that donors be better informed. Competition is increasing, while local hospitals are bound by their service area, national healthcare organizations are not. Being able to clearly articulate to your prospective donors what the role of your organization in their healthcare experience will be essential. Segmenting a multi-channel philanthropic educational effort from traditional marketing efforts will produce positive results.

37 Engage Philanthropy remains a contact sport. Face-to-face contact is critical in the process to engage donors. Engagement with volunteers, leadership, and medical personnel remains the single most effective tool. Healthcare philanthropy requires stronger engagement on the front end. Donor interest traditionally dissipates the further away from point of service swift engagement is key. Best practices demand triaging of prospects to ensure those with greatest capacity are engaged.

38 Ask In a congested philanthropic marketplace, there must be an appropriate call to action the ASK! Building effective prospect strategies is integral to moving donors along the gift making process. Preparing donors for the ask strengthens the opportunity for successful outcomes. Continue to expand your prospect pool to enable you to have new donors to each significant effort.

39 About BWF Bentz Whaley Flessner fundraising consultants build robust partnerships with hospitals, academic medical centers, children s hospitals, and other healthcare systems that seek to grow their philanthropic resources and execute successful campaigns. We are the nation s leading fundraising consulting firm for healthcare systems and provide expert counsel for every facet of the development process including: Evaluating capital campaign readiness through feasibility studies. Planning and implementing capital campaigns. Unlocking major, planned, and annual giving potential. Developing comprehensive grateful patient and family programs to help you engage your most committed constituents. Strategically focusing your fundraising efforts. Boosting philanthropic commitment through board and other volunteer involvement. Applying best practices and tailoring fundraising solutions to your specific needs. For more information about this study or Bentz Whaley Flessner, please contact Mark J. Marshall at mmarshall@bwf.com or (952) :MJM:jub

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