We Analyzed 9 High-Performing Mid-Level Donor Programs. Here’s What They All Have in Common

The most effective mid-level donor programs share a clear pattern. Behind the tactics, we found a consistent strategy: deepen donor loyalty, increase donor engagement, and create natural pathways that help lead mid-level donors to give larger gifts. And the best programs don’t just rely on generosity. They build the systems and stories that make mid-level philanthroppists want to give more.

Mid-level donors can be a major driver of long-term growth at your healthcare foundation. They show stronger loyalty, higher retention rates, and deeper emotional connection than other donor segments. Many have given to the same nonprofit for five years or more and are critical pipelines for major gifts if stewarded properly.

Yet too often, they’re lumped into mass appeals or pulled out of annual giving streams without ever receiving the kind of personalized donor messaging that could turn them into major donors.

So how can your healthcare nonprofit organization retain mid-level donors? 

We pored over a huge stack of healthcare case studies, donor engagement reports, and mid-level giving white papers to find out. The result was six proven strategies that the most successful healthcare mid-level donor programs share. Best of all, you can put many of these moves to work right now, without a big investment in technology or high-priced consulting.

• Prioritize donors with the highest combined scores. You can refine even further by grouping donors based on the fund or program they supported—such as cancer services, research, or pediatric care. Building mid-level appeals and stewardship around these shared interests makes your outreach more personal and powerful.

• Segmentation isn’t a one-time exercise. Keep your donor segments updated based on real-time behavior. As donors engage, lapse, or shift their giving patterns, your segmentation needs to evolve with them. Continuous updates keep your messaging relevant, timely, and effective, helping you maintain strong connections with your mid-level donors for the long haul.

2. Map Out the Mid-Level Donor Journey

After carefully reviewing their existing donor journey, the Intermountain Health team realized mid-level donors weren't receiving follow-up communication, personalized donor messaging and stewardship, or clear next steps—a sure way to lose these donors for good.

So, they launched a cross-departmental effort to create a distinct mid-level donor experience, partnering with caregivers to develop emotional storytelling, creating more personal, impactful donor communications, streamlining the work of mid-level gift officers, and customizing stewardship to show donors exactly how their support makes a difference. 

Their new mid-level donor journey included five critical stages: 

• Consideration: The donor learns the organization exists and considers giving. 

• First Gift: The donor makes their first gift—but without follow-up, many stop here. 

• Education: The donor receives personalized updates about the mission and the impact of their gift. 

• Second Gift: The donor gives again—a major indicator of future loyalty. 

• Mid-Level Invitation: The donor is invited to increase their giving and receives tailored stewardship moving forward. 

At every stage, Intermountain added specific touchpoints—like impact reports, personalized emails, and video updates—to build trust, strengthen emotional ties, and invite deeper engagement.

3. Use Multi-Channel Donor Engagement Strategies

Mid-level donors don’t stay in one lane; they move fluidly across email, mail, web, and phone. A donor might be moved to give after receiving a direct mail piece, for example, but prefer to visit your website directly to make the donation. 

In fact, 29% of online donors are triggered by outreach through another channel, proving that multi-channel engagement strategies drive real results. So, be sure to customize content for each channel (longer storytelling for email, bold visuals for social media, for example), but keep a consistent emotional hook, theme, and call to action across every channel.

4. Send a Personalized Thank-You Note

Didi Hirsch Mental Health Services nearly tripled its fundraising revenue in less than a year, in part by thanking donors immediately after receiving their gift. Personal calls, especially thank-you calls and special invitations, can also drive strong action, particularly among mid-level and younger donors.

5. Create Personalized Messaging for Mid-Level Donor Engagement

Catholic Relief Services boosted average gift size by 43% and added $425,000 in net revenue, in part by creating a personalized messaging for their mid-level donor program. Working with an outside agency, they combined high-touch cultivation with strategic asks all year long and strengthened existing materials with sharper messaging and better design. 

They also sent exclusive cultivation pieces (without any asks) and invited donors to special Stakeholder Briefing calls with leadership, followed by targeted solicitations to deepen engagement.

6. Measure and Improve

Track these KPIs every quarter to instantly see what’s working, what’s stalling, and where your next best move is. Test small adjustments, like adding a thank-you call after a mailing, and measure the results. Quick experiments now can lead to bigger wins later.

1. Donor Retention Rate: Percentage of mid-level donors who renew year over year. High retention signals strong stewardship and future major gift potential.

2. Value Retention Rate: Tracks the total revenue kept from mid-level donors compared to last year. Shows if donors are sustaining—or growing—their giving.

3. Upgrade Rate: Measures how many mid-level donors move into major gift status. A strong upgrade pipeline is the hallmark of a healthy program

4. 4. Annual Revenue from Mid-Level Donors: Total dollars raised from mid-level gifts, upgrades included. Provides a clear financial benchmark for your program's impact.

5. Average Gift Size: Tracks the average donation within your mid-level donor segment. Helps spot trends and identify opportunities for strategic asks.

6. Donation Frequency: Measures how often mid-level donors give (annually, quarterly, monthly). High frequency = strong engagement.

7. Donor Acquisition and Attrition Rates: 

   • Acquisition: New donors entering mid-level giving.

   • Attrition: Donors dropping out or downgrading.

8. Cost to Acquire and Steward Mid-Level Donors: Tracks how much you’re spending to win and keep mid-level donors. Essential for making sure your program stays profitable.

Try these 8 personalized donor outreach strategies 

You don’t need a big budget or fancy AI to build stronger mid-level donor connections. Start small. Test these personalized outreach tactics with a segment of your donors. See what works, then scale what sticks.

1. Send personalized donor videos. Services like ThankView or Gratavid can help you create custom video messages at scale. 

2. Write a handwritten note. A handwritten birthday card or thank-you note stands out in a world of mass emails. Recruit volunteers or staff to help write a batch, or use a service like Scribe or Handwrytten.

3. Send a short, 3 - 5 question donor survey. Ask donors to share why they give. Link to the survey via a QR code in direct mail pieces or URLs in emails. Use their responses to personalize future communications.  

4. Call donors on the phone. A quick thank-you call can spark lasting loyalty. 

5. Create a branded donor society. A named society gives mid-level donors a special identity, builds loyalty, and reinforces exclusivity. 

6. Host exclusive donor events. Invite mid-level donors to behind-the-scenes tours, executive briefings, or networking happy hours. These experiences create strong emotional connections and a sense of belonging. 

7. Send targeted donor impact reports. Improve donor engagement by showing donors exactly how their gifts to their chosen funds made a difference. For example, share NICU success stories with pediatric donors, or announce your latest cancer treatment breakthrough to donors who support your research and/or cancer services. 

8. Personalize your greetings. Intermountain Health made every donor interaction feel more personal by replacing their generic "Dear Friend” greeting with each donor's first name in emails and direct mails.