Hospital Foundations:
23 Statistics That Reveal the Cracks in Your Fundraising Pipeline

The Paradox: High ROI, Huge Missed Potential

Hospital foundations consistently generate outsized value through philanthropy—returns hospitals could never match through patient revenue alone. In 2024, the average foundation raised $7.7 million in net fundraising revenue (NFR). To earn the same profit, a hospital with a typical 3% margin would need to generate $257 million in patient revenue (2024 AHP Report on Giving). 

• • • Academic medical centers: $16M NFR ($1.6M per FTE)

    • Community hospitals: $2.1M NFR ($625K per FTE)

    • Healthcare systems: $15.9M NFR ($1.2M per FTE)

Foundations also deliver impressive fundraising ROI, raising $4.53 for every dollar spent—making fundraising efficiency in healthcare among the highest in the nonprofit sector.

• Academic medical centers: $4.91 ROI

• Community hospitals: $4.15 ROI

• Healthcare systems: $4.61 ROI

The median cost to raise a dollar (CTRD) is $0.22, positioning healthcare philanthropy as highly efficient compared to other nonprofit fundraising benchmarks. 

On paper, these numbers look like a slam dunk. But the cracks become clear when we examine donor retention, recurring giving, and digital fundraising.

Donor Retention Is the Weakest Link

Healthcare philanthropy programs excel at attracting new donors but lose 80% after their first gift. This retention crisis destroys millions in potential lifetime value and forces healthcare nonprofits to constantly chase after new donors instead of nurturing existing donor relationships.

• The donor lifetime value (LTV) for healthcare nonprofits ($427) is well below all nonprofit sectors ($784). (2025 Virtuous Benchmark Report)

• Healthcare nonprofits retain only 40% of donors. (2025 Virtuous Benchmark Report)

• Fewer than 20% of first-time healthcare philanthropists ever return. (2024 AHP Report on Giving) 

• Small donors ($1–$100) fell by 11.1% in Q1 2025, but they still account for 57% of all donors. (Fundraising Effectiveness Project)   

• Across all nonprofit sectors, total dollars raised grew 3.6% in Q1 2025 despite a 1.3% decline in donors, indicating the sector-wide trend toward fewer donors giving larger gifts. (Fundraising Effectiveness Project)   

Retention is only part of the problem. Predictable, recurring giving is also essential.

Recurring Giving is an Untapped Growth Channel for Healthcare Nonprofits

Creating monthly giving programs and optimizing donation pages through digital-first donor acquisition can help stabilize and scale revenue.

• • Monthly donors give 42% more annually than one-time donors. (2024 Philanthropic Landscape) 

  • Yet only 3% of healthcare philanthropy comes from recurring giving, compared to 13% sector-wide. (2025 Virtuous Benchmark Report)

  • Monthly giving already accounts for 20% of online revenue for healthcare nonprofits and 31% of online gifts across all nonprofit sectors. The gap between online performance and total giving reveals massive untapped potential. (M+R Benchmarks 2025, 2024 Philanthropic Landscape) 

Monthly giving alone won’t stabilize revenue. Digital fundraising is also a big missed opportunity. 

• Digital-first donor acquisition strategies show 60% success rates, and 53% donor retention versus 41.5% for traditional methods. Despite these superior results, most hospital foundations haven't adopted digital-first fundraising strategies. (2024 AHP Report on Giving)

• New donors generated 44% of all 2024 online revenue for hospital foundations, the highest of any nonprofit sector. This acquisition strength makes the 80% retention failure even more costly. (M+R Benchmarks 2025) 

• Donor-Advised Funds (DAFs): Healthcare nonprofits raised just $0.01 for every digital dollar raised through healthcare philanthropy, compared to $0.13 across all nonprofits. (M+R Benchmarks 2025) 

• Direct mail vs. online: For every dollar raised online, healthcare raised just $0.35 through direct mail. (M+R Benchmarks 2025) 

• Healthcare nonprofits achieved 6% increases in average online gift size, reaching $125 per transaction in 2024. (2025 Virtuous Benchmark Report)

Five Ways to Plug the Leaks in Your Donor Pipeline

Hospital philanthropy delivers one of the highest returns in healthcare, but the sector is losing too many donors too early. Foundations that strengthen these levers will improve fundraising performance metrics, reduce dependence on one-time gifts, and grow long-term donor value: 

• Fix retention. Convert first-time healthcare donors into repeat givers instead of losing 80% after their initial gift.

• Launch monthly giving programs. Recurring donors give 42% more annually and provide predictable revenue streams.

• Implement digital-first donor acquisition to build fully integrated campaigns. These approaches achieve 53% donor retention compared to 41.5% for traditional approaches. 

• Optimize year-end fundraising with donor segmentation strategies. Segmented campaigns achieve 50% higher engagement rates than broad appeals.

• Download my year-end fundraising checklist and guide to help your healthcare nonprofit prepare for the most important time of the year. 

Hospital foundations deliver extraordinary fundraising ROI, but the paradox remains until these gaps are closed for good. Those who do will turn strong ROI into unstoppable long-term growth.