Ep 17. Healthcare's 4X Return Secret: How Hospitals Survive Budget Cuts with Alice Ayres AHP

Alice Ayres, President and CEO of the Association for Healthcare Philanthropy, reveals the critical funding lifeline that most people don't know exists. As Congress slashes healthcare budgets and millions face losing Medicaid coverage, Alice exposes how healthcare philanthropy returns $4.16 for every dollar invested and why it's becoming the difference between hospitals thriving and closing their doors.

This powerhouse leader, former Advisory Board Company executive who worked with 4,500+ healthcare organizations and 200,000+ leaders, breaks down the urgent shift happening in healthcare funding. With 10,000 baby boomers daily moving from private insurance to Medicare, operating margins are shrinking fast.

Key Topics Covered:

• Why "grateful patient" programs heal faster than traditional medicine

• How behavioral health donations surged 500% since COVID

• Why 100% leadership giving is non-negotiable for foundation success

• How AI is revolutionizing donor identification while respecting patient privacy

• Mobile clinics funded by donors serving vulnerable populations

• Alice's game-changing advice: "No doctor should ever ask for money—but opening gratitude conversations makes patients heal faster"

From her 20+ years leading healthcare transformation to guiding foundations that collectively raise $11 billion annually, Alice provides the roadmap hospitals need as federal funding disappears.

Introduction and the Power of Gratitude

No physician should ever feel like they're asking someone for money. Ever. It is not a physician's job to ask for money. It is a fundraiser's job to ask for money. The physician's role is to open up conversations around gratitude, in part because it makes the healing of the patient happen faster.

Welcome back to Value Health Voices, episode 17. Today we are talking about a topic near and dear to my heart, which is philanthropy. I know many people who are listening in are either charitable donors or on boards of charitable organizations, so this impacts all. In fact, according to the Association for Healthcare Philanthropy, the average hospital or health system foundation returned $4.16 for every dollar invested. Some saw more than that. They actually note that $75 in gross patient revenue has the same net income impact as a dollar in charitable giving, which is a remarkable statistic. And so we are fortunate to have the President and CEO of that organization, Alice Ayres of the Association for Healthcare Philanthropy, on our podcast today.

In addition to her role as the CEO and President of AHP, she has 15-plus years of career supporting the healthcare industry and improving patient care. She served as the Executive Director for the Advisory Board Company, a global research, technology, and consulting membership organization with 4,500 partners and more than 200,000 leaders across healthcare. While there, she spearheaded the creation of strategy sessions for member hospital and health system C-level executives which attracted the leadership of over 150 of the leading healthcare providers in the United States and abroad. At AHP, she is responsible for membership by inspiring, educating, and serving those who transform healthcare through philanthropy. So we are very excited to have Alice Ayres on the podcast. So stay tuned.

Alice, thank you so much for joining us. As you can see, Amar likes to really hit it out of the park with his intros. We've been on a great streak here on Value Health Voices with "A" players galore, and you absolutely fit that description. So thank you so much for joining us.

Thank you for having me. I'm really excited to have this conversation.

Leadership Strategies in Uncertain Times

In getting to know you and your organization, Alice, we had the opportunity to talk before the session about your tenure as President and CEO dating back to 2018. One of the things I found so compelling about your talk and what I'm really interested to hear about is some of the leadership lessons that you've had through what has been trying periods like the pandemic. I think we're going to get into the current events which are the second in a series of Black Swan events.

Just to give you a feel for AHP, we are an organization that serves the hospital and health system foundation fundraisers across North America. Most of our members are here in the United States, but we also have a very healthy membership in Canada and members across the globe. What we are all about is making sure that as those dedicated fundraisers go out and work with donors, they have the skill set to be able to do that in the very best possible way so that we can return $4.16 or more per dollar and really make a big difference to hospitals and health systems. We have been around for about 50 years and it's been a wonderful experience to get to lead the organization even through things like the pandemic.

It's funny, I think we all look back on those years and in some ways it's trepidation. But I also think we all learned that we needed to be a whole lot more flexible than we normally were. Strategic planning has totally changed. I think we think a lot more these days, or at least we do at AHP, about where we're headed in 10 years, but not so much regarding the rigidness of a strategic plan, more sort of a journey. So how do you think about the kinds of twists and turns that might happen and how to respond to those just in case?

An example of that, getting into the current issues, is that about a year ago we said, well, what would happen if there wasn't research funding anymore or there wasn't as much in terms of federal funding around Medicaid or Medicare? We thought we were talking about something that might be 10 years out. It turned out it was not 10 years out at all, but being able to think that far away and then think about the kinds of things you do to respond was the big lesson for me throughout the pandemic. That and charging forward toward change rather than being afraid of it. I think a lot of people get nervous about change and you just can't anymore because it feels like change is where it is now. It's just the norm.

Navigating Economic Headwinds and Policy Changes

I think embedded in what you said there is a really important leadership lesson too. It's a kind of disaster preparedness, or stress testing if you take it from banking. That's in its own right a great lesson. You're speaking about the issues of NIH funding compression as well as a more challenging reimbursement environment, both of which are long-standing issues now, but even becoming more acute as we are in the midst of budget reconciliation in Washington. Tell us maybe how that is affecting your organization and your thinking and your engagement with your stakeholders around the country. Canada too, I bet.

Less Canada, at least in terms of reimbursement, fortunately. Otherwise, I leave them out. There are all kinds of other issues that are affecting Canada vis-à-vis this administration, but certainly not reimbursement for that. Fortunately for them.

I'm a native Washingtonian. I don't know whether or not I've said that, but I have lived in the city for 50-plus years and it's been a particularly interesting time to live in D.C. because of just how much change there's been in the last six months or so. So when I'm talking with our members, when we're talking about the kinds of things that are going on, you mentioned reimbursement as one example. We were always facing headwinds. 10,000 baby boomers a day go from private insurance to Medicare. That's a stunning number. And there are not enough of the younger generations to fill that private insurance. So we were already facing pretty significant headwinds from an overall operating margin perspective.

But then when you roll in things like the potential for another 12 million people not to have Medicaid as an example, which is the CBO estimate of what it is that it's going to be assuming the bill passes, or the NIH funding, where you're talking about indirect grant costs being cut and organizations having to think about how to find different ways to fund those things. It used to be that philanthropy was always there to fund mission. Increasingly, it feels like there's a question around whether there are donors out there who are interested and willing to help support operations. It's a much harder conversation to have with a donor. Nobody is really super excited about giving to lights and toilet paper. But if you can figure out ways to have those kinds of conversations with donors where they begin to understand that between the reimbursement changes and possibly some of the research changes, there are going to be real needs across the organization in different ways than before. That's kind of the conversation that I'm having with a lot of my members.

The other thing I think a lot about is there is so much coming at all of us. There are so many things that feel scary or create anxiety or can be very distracting in the midst of just trying to function on a daily basis. I've heard people say this a lot lately, but I think it really is the mantra of the day: You've got to focus on the things that you can control. Control what you can control. And one of the things I say to a lot of my members when I'm asked to come talk about what's going on in Washington is that one of the things we can control is being really good fundraisers. That is the best gift that we can give to our hospitals and health systems across the country.

Identifying and Engaging Grateful Patients

Alice, I wanted to thank you actually for coming to our hospital system at one point and speaking to our board of directors around this topic. It's very timely because with, like you said, the challenges around Medicare reimbursement, I was hoping you could talk a little bit about this concept you explained to us around the grateful patient and how to identify the grateful patient as a potential donor. In the context of that, I did want to quote this statistic that The Fidelity Charitable 2021 survey showed that donors found access to basic health services their second priority following hunger. So there's a lot of people out there who want to donate to this cause. How do we identify them?

I think there are a lot of different types of donors that give to healthcare. So thinking about them in different sort of categories is useful. You mentioned grateful patients. Grateful patients tend to be those donors who have had a life-altering experience in one of our hospitals, whether it's themselves or their children or their parents. For them, there is a compulsion through gratitude to want to give back. For some, that is just volunteering, which is great. Being able to give of their time and being able to give in that way can be very powerful both for their own health and well-being from a gratitude perspective, as well as helping the organization. Some want to help fund. And those patients tend to be ones who, for example, have had an incredible experience in one of our oncology service lines and want to help fund research around ending whatever cancer it is that they had. Or children's hospitals where you see a child who has had an incredible experience and the parents just want to give back to the organization.

There are stories too about people that you wouldn't expect. It's not people who have a lot of money. It doesn't have to be the super wealthy. It can also be people who are just enormously grateful and their friends and family want to express gratitude. There's an amazing story from during the pandemic where a person who had been rushed to the hospital but the ICU beds were full was then transferred 12 miles away to another hospital and different system. But we were load balancing anywhere we could do it at that point. He was in the ICU for six months, and they weren't even sure he was ever going to walk out. He finally did and he decided because he didn't have a lot of money, he decided what he would do is a GoFundMe page and he'd have all of his friends and family give. He ran the 12 miles between the two hospitals.

This is someone who was on a ventilator for months. And he ran that distance. When I talked to the system that received this gift of $15,000, they said, "Look, this was not our largest gift, but it was so powerful." Not just for his friends and family who were able to show their gratitude, which is actually part of the patient healing process, but on top of that, for all of our nurses that were there with him, all of our staff, all of our doctors. To see someone go to that length to try to figure out how to say thank you is also an incredible way to deepen physician and clinician engagement and reduce burnout. So grateful patient fundraising is actually the money part is at the end. The stuff of grateful patients really is about healing the patient, giving the patient the space to be able to say thank you and almost level the playing field a bit, and then also to engage physicians and nurses and other staff members so that they feel the gratitude that that patient is showing.

The Physician's Role in Donor Conversations

So the physician or clinician who would feel maybe a little uncomfortable around asking a patient about this or the ethical implications, this is a good way for them to approach it. Right from an aspect of gratitude.

No physician should ever feel like they're asking someone for money. Ever. It is not a physician's job to ask for money. It is a fundraiser's job to ask for money. The physician's role is to open up conversations around gratitude again, in part because it makes the healing of the patient happen faster. There was a study that was done of people who had acute coronary episodes, and those that were encouraged to express gratitude to their caregivers stayed on the protocol that the physician gave them for significantly longer. They exercised, they ate better, they followed the regimen of their medicines, and as a result, they were healthier. Their outcomes were better.

So part one is physicians, nurses, everybody. When somebody says, "I really don't know how to thank you," instead of saying, "I'm just doing my job," which is unfortunately what a lot of medical schools teach people to say, say, "Gosh, I'm so glad that I was able to be here. Tell me more, or tell me why this is important to you or your family." Because you're opening the door to someone being able to actually express how they feel. And that alone is amazing. On top of that, if they then say, "I want to figure out how to help you do the work you're doing or fund something here at the hospital, or I want to find a way to give back," that's a great time to just say, "Let me introduce you to my colleague who is the one who can help you think about whether there are ways that you might want to give back." That's not my role.

That's very practical, very useful advice, almost an outline for the conversation. We have a range of folks in different roles who listen to our podcast and the clinician segment is a growing one. So I would just flag that and we'll call that out specifically in our notes about the episode.

Shifting Trends in Donor Interests

One of the things we were talking about regarding the pandemic before, and we were looking at statistics and some changes around philanthropic preferences that changed in that period. One of the things that's interesting, and you told us this previously if I have it correct, is that giving levels throughout the pandemic actually remained quite strong, did not fall off a cliff like in other sectors. The other point being that through the period of the past six or seven years, there's been evolving donor interest shifting towards specific kinds of donations that were less common in the past. Could you comment on that, Alice?

Absolutely. And I think the pandemic put a spotlight on healthcare in particular. So I think the reason that we held pretty steady through that process where other sectors didn't was because the spotlight was on healthcare. And so it made sense that people wanted to give. But you're right, it's been very interesting to see some of those changes.

One that I hear a lot from our membership is that it used to be that getting people to give to behavioral health was not something that they were able to do, or if donors were interested in giving around behavioral health, they wanted to do so anonymously. The pandemic has changed that and there is an enormous amount of donor interest in giving to organizations that either are building behavioral health programs or strengthening them. I think people really understand that we are woefully understaffed and under-resourced when it comes to behavioral health, and people are really leaning in there.

Another one is health equity. Coming out of the summer of George Floyd's murder and moving from there into a better understanding of how vulnerable populations were more significantly impacted than other populations—when it came to COVID in particular—there are a lot of people who sort of understood that they could give and create better access. So mobile units that were funded by corporations as well as individuals so that they could send people out into the communities and be able to provide either preventative care, vaccinations, and those kinds of things, or dental care. That was one small example, but there are lots of them where we saw donors who may not actually be the grateful patient donors. They may be the people who have always cared about social justice and health equity and access, but didn't see the hospital as a part of that conversation, who understood that the hospital could be part of that conversation. In fact, central to that conversation.

The last one is giving to employee funds. One of the things that happened during the pandemic was we went from expecting that employees would give to employee funds, but maybe nobody else would, to seeing donors who were really interested in giving to employee emergency funds. That hasn't changed. It's perhaps not as much as it was during the pandemic, but we're still seeing people interested in doing things like funding education in order to be able to increase the number of nurses in their hospital, or helping to upskill certain clinicians in order to create more skilled workers within the organization. It's interesting because all three of those were things we didn't historically think of to approach donors on, and increasingly that's something that donors want.

I just wanted to reflect on the first two points you brought just briefly and say it's such a win-win for the hospital system and the community. Unlike oncology, which as we know as oncologists can sometimes be a cash cow for the hospital system, behavioral health and population health oftentimes have to be supported from the other areas in the hospital. So for donors to actually want to support those programs is huge for a hospital system.

It is. One of the interesting things that it's doing, especially the health equity piece and access as well as even behavioral health—there's a great example of this out of the Eagle Valley in Colorado—is that donors are also encouraging hospitals to work alongside community foundations even more. I feel like that practice, which really got going in a much more significant way during the pandemic, is going to serve us very well as we move into this next phase where we're going to have to figure out how to work with lots of different types of organizations in order to continue funding research as an example, given the cuts that are likely to come down.

One other thing you mentioned, Alice, that caught my ear is something that I have seen in my own experience in my organization really have traction with donors, and that is the upskilling of employees. I actually wouldn't have imagined that it would be so motivating for donors, but it's a great call out. I've seen it a few times actually, and I've been surprised each time. I guess I should stop being so surprised that people are interested in this now that I've seen the trends for a while.

It definitely is the case that people are interested in doing that increasingly.

Philanthropy Supporting Population Health Initiatives

You started talking about philanthropy as a source of funds to support outreach programs and population health initiatives—keeping people well, keeping them out of the hospital, out of the ED, out of trouble. Alice, tell me about that from your members.

Absolutely. For some organizations, it's something that they've been doing for a long time. For others, it's a newer area for fundraising and for programs that the hospital is driving. There's a system here in this area that has community health clinics that are entirely funded by donors and they are put in areas where people who have shown up in the emergency room with an acute situation, but who will need long-term primary care and do not have insurance or do not have a primary care document. These clinics are entirely focused on that population. So if you come into the emergency room meeting those different requirements, they immediately direct you as your next point of care to one of these health clinics.

Donors are funding all of it. And that's true across the country in lots of different ways. There's a system in Ohio that created financial literacy programs and resume review. There are lots of organizations that have granted grocery stores basically within their hospitals. So a doctor can write a prescription for food and the patient who is food vulnerable is able to go and pick up food that is part of their prescription for themselves or their family. There are all kinds of examples of this and in lots of cases it's being funded by donors or at least partially funded by donors. Often it's a combination of a donor and a hospital program that come together and co-fund. Sometimes it's individuals and sometimes it's corporations that are leaning into this as well because they want to help upskill the community in order to be able to support a healthier and more vibrant community.

All of those sound like truly amazing programs, high impact in their communities. I wonder, Alice, if you wouldn't mind if we put a link into those programs in all of our materials for these episodes because I want our listeners to know about them. If you think about the first program, they all sound amazing. The program that you mentioned in the greater D.C. area, funding a program like that is only going to become more and more important. You can just imagine the impact it has on those patients' lives. So I want to make a highlight of that program in our notes.

I'm happy to. And I have not only an understanding of it because I work closely with the remarkable leader who is the head of fundraising there, but also because my son, who is on his way—knock on wood—to being a doctor as a pre-med student, he spent a couple of summers ago volunteering and came home and said, "Mom, did you know that these clinics are all funded by donors?" And I said, "Yes, I did, sweetheart." So I've got one doctor who fully understands the power and value of philanthropy, even if he's a budding one coming along.

Funding Innovation and New Technology

Well, that's great to hear. I was thinking to wrap up this segment around donor-funded programs, maybe we could talk a little bit about the programs around new technology and de-risking that new technology to invest in innovation and some of those shifts you've also seen.

I think this is a newer area and we're seeing it in bits and pieces. But one of the things that we are finding is that especially when you've got really narrow operating margins, being able to invest in innovation is a difficult thing to do. So as those operating margins get narrower and narrower, I think we're going to see more of this. Donors love to think big and have a big vision and be part of something that feels like it could be life-altering not only for them but for lots of other people. So approaching them to ask them to help, whether it's a new technology that maybe the organization just doesn't have the operating budget to be able to purchase, or whether it's thinking differently about a research program or some kind of a clinical trial, those are the things that some of those donors are interested in thinking about in a very different way.

In general, when we talk with our members about what they do and how they do what they do best, it really comes down to being able to meet a donor where they are and understand what their interests are and what their needs are, and to help them then figure out how to marry what they're interested in with the kinds of things that the system needs in order to be able to continue to do the remarkable things that all of our hospitals across this country do every day. It's not always the case that the first thing or the thing that they were with us for is even the compelling idea. It could be that it's something completely different. So a lot of getting to a point where a donor wants to fund something—whether it's innovation or a service line or a mobile vaccine unit—all of that conversation leading up is about really good listening and really good question asking. Being able to ask the right questions and get people talking about what they care about is the beginning of helping them to see their own vision come to fruition within one of our organizations.

Institutional Readiness and Leadership Commitment

That's very well said. Speaking about your organizations, your members around the country, one of the things I really love to hear about is what does institutional readiness look like? So for hospital systems that maybe don't have a thriving philanthropic program, what do they need? What does institutional readiness for establishing or improving their foundation operations really look like?

This may surprise you, but the first and most important thing is a leader, likely the CEO of the hospital or health system, who is supportive and believes that this is important and believes that so much that they themselves put a great deal of emphasis on giving throughout the C-suite. So that the leadership of the organization is giving and are willing to put their own time and effort against it. Whether that's opening their own Rolodex or being there for sessions with groups of donors or even some one-on-one conversations. If you don't have the face of the organization supporting the work, it is much more difficult to have a donor think that they should invest in the organization.

We have all kinds of statistics from our report on giving that show that when the C-suite, when the employed leadership of the organization as well as the volunteer leadership—so the system fiduciary board as well as any foundation board—if they all give, you are significantly more likely to be one of AHP's high performers. And it's not because they're giving a ton of money. It's because then the fundraiser can go out and say 100% of our leadership, employed and volunteer, are giving. And what that means when you're a donor and you hear that is, geez, the people who know this organization best really believe in it. They believe in the mission, they believe in the direction of the organization, and they're putting their money literally where their mouth is.

The second thing you've got to have is sort of a culture of philanthropy overall. And that gets back to this question of gratitude. Encouraging physicians, encouraging the janitorial team, encouraging everybody in the organization to look for gratitude, to open the doors to gratitude within every conversation that they have can be really powerful. Lots of people I talk to, I get into an Uber on my way from the airport to giving a speech, which I do a lot. Often they'll say, "Oh, why are you going to fill-in-the-blank hospital?" And I'll say, "Well, you know, I'm there to talk to the fundraiser." "Oh, I didn't know that they were a charitable organization. I thought they were a for-profit company. I didn't realize I could give to them." So there's also this other piece of educating the community on the fact that we are in fact a charitable organization and they can make real impact to the things that are happening on the ground in our organizations as a result of their giving. So that invitation to give I think is really important.

The Strategic Value of Fundraising Events

What's so interesting to hear about when you describe this... I chair the board of a nonprofit organization that is the largest provider of scholarships for students to study abroad. We have these same conversations around the board about how to boost fundraising. And we have also made it our policy that 100% giving among the board is required to advertise that. So it's just so interesting for me to hear that that is a universal thing. One of the things that we discuss, which I'd love to hear your thoughts on, is the value around specific events, such as galas or other fundraising events. Do you believe they're really successful at actually raising funds, or are they more just kind of branding or networking opportunities?

Events are the thing that all fundraisers love to hate. That is because they tend to take a ton of staff time, they tend not to raise a lot of money, and often they don't even raise enough to cover the staff time. Even if it feels like you've turned a profit because the expenses for the food and the tables are lower, it still doesn't make up for the staff time. And often, especially in healthcare, it's a different kind of donor. So somebody who wants to buy a table at a gala or come to a silent auction is there for more of a transactional event. They're there because somebody asked them to, or they're interested in the silent auction because they want to see whether or not there's something good to buy.

So I would say events for the purpose of raising money, you want to really scrutinize. You want to make sure that you really are raising money and that it really is worth the effort. On the other hand, if it's part of a strategy to meet new people in the community or to share the direction that the organization is going with a CFO as an example, talking about the financial stability of the organization, or even explaining healthcare finance, which we all know is way more complicated than it probably should be—if it's an educational event, if it's something that makes people feel closer to the hospital and what the hospital is doing, then it's not about raising money, it's about getting closer to people who might become donors.

Another version of an event that can be really powerful is where you're doing some sort of stewardship. So you've got donors, they've given, and you want to do something for them to thank them. Some donors like being thanked on their own by themselves, just want a thank you note or a call. Others maybe want to come and see the piece of equipment that they helped fund in action. That's another kind of event. So you just want to think really strategically generally about events, rather than just doing the golf tournament or the rubber chicken gala because we've always done them before. The good news, one of the silver linings of the pandemic is that at least in my membership, we saw people cut by about 50% the events that they were doing. I haven't seen people edging them back up again.

Building a Culture of Philanthropy and Storytelling

If they haven't bounced back by now, that says a lot in terms of the ROI. That's a really nice overview. You mentioned leadership being very committed to fundraising. You mentioned board, so volunteer and paid leadership, giving and reaching that 100% as a kind of litmus test for organizational culture and culture of philanthropy. Help us understand, are these the table stakes to having a functioning program, or are these the characteristics of a high-functioning philanthropic program at a hospital system?

I think most of what I described, especially the giving numbers as an example, having all of the leadership give, are table stakes. It needs to happen. It sadly doesn't happen as often as you would hope it did. But then the next level up is all of those people really actually engaging and saying, "You know what, I get it. Warm conversations and warm introductions to donors is a much better way to go about a conversation than a fundraiser just trying to find people. So I'm going to go through my Rolodex and figure out who I ought to invite over to dinner for a small group to talk about what we're doing with this particular service line or that particular effort."

So really engaging in helping the fundraisers to identify potential donors. I also, when I'm with foundation boards, I challenge them to think about what they say when they run into someone they haven't seen in six months at the grocery store or the country club or wherever it is that they are. My natural instinct is, "Great. Charlie's coming home, my oldest is coming home. My second one just graduated from high school and we're off to this great vacation," and all of that kind of stuff. But if they instead say, "I've got to tell you, I joined the board of this hospital and I want to tell you about something that happened last week. There was a donor that was so driven to do something to help this program that they wrote a check for fill-in-the-blank."

People gravitate towards stories. And so if you are giving them a story, the other thing it can do is open up a conversation because that person might then say, "Gosh, I had no idea that you were on the hospital board. My sister was actually there two months ago," and off you are to the races. So opening those conversations and trying to find ways to insert discussion about the organization through your entire life when you are part of one of these organizations can be really powerful. If we are able to train everybody to think about what the story is that they're going to tell this month if somebody walks up and says "hi" in the grocery store, just imagine the kinds of things that we'd be sharing. At a time when trust in all nonprofits and all systemic organizations within the country is at an all-time low, it can just all by itself help with the trust side of things.

I must say, just even hearing you speak is so inspiring. I just want to go out there and start talking to people in grocery stores now. All of us, given our day jobs, are trained to have elevator pitches ready. Alice, you're the CEO that people are bringing these things to, but having that story, that elevator pitch ready, is just a great little nugget of information. If we're not already there in a state where people are craving positivity, we're going to be there soon. So you might as well lean into that and be ready.

Artificial Intelligence in Fundraising

I'm curious about the healthcare setting. We use AI to help with some of the grant writing and everything, but given the positive aspects of using AI to maybe identify donors, but balancing it against some of the ethical implications around HIPAA and scouring through the databases for that potential donor, how do you reconcile that and deal with AI in that context?

First and foremost, I think when you split AI into predictive and generative, we've been using predictive analytics for a long time. You mentioned HIPAA. HIPAA has a component that talks about what information a fundraiser can and cannot have. There are rules. Those rules are very clear cut. And so the data that we put into our databases is different than the data that your physician or your nurse is going to be looking at when you're a patient. We've been using predictive analytics to be able to think about who maybe we ought to be sending an appeal to and to some degree around what service line or what topic area.

The piece that's exciting and new for the fundraising universe is this question of how to use generative AI and how to marry the two in a way that gives us the ability to spend more time face-to-face with donors and less time doing the things that are the back-end stuff. Writing thank you letters, writing appeals, writing proposal requests. You also think that we have to be careful because you never want a donor to feel like somehow you have outsourced the relationship to the machine. Fundraising is, at its core, deeply relationship-based. So making sure that you're transparent about when you are and when you are not using it is really important.

We actually just did a summit a couple of weeks ago on AI and it was really interesting. Where everybody kind of came out was, you just have to make sure that if a donor knows—if it ended up on the front page of the New York Times—would it be okay? Would you be okay with the way that you've used it? I think we've had conversations around things like wealth screening and other things for years. Again, that's sort of on the predictive side of things. And where we've come out is, it's okay, because what we're doing is looking at data that is universal. It doesn't change how we treat a patient, doesn't change how we treat a donor in terms of a relationship, but it helps us to understand better the kinds of things that we might talk to a donor about.

My prediction is that we will be using it a great deal more and using the two together a great deal more. It's a little bit like doctors using AI as a transcriber. We all know how much doctors like to then have to transcribe their notes—not much. So if this thing is able to do that for a doctor, and that means a doctor is able to either go home to their family or spend more time with a patient, great. And I think that's a goal with fundraising too. If it's a way for us, in a world where we're being asked to do everything on a shoestring all the time, to make sure that we are spending more time with donors and less time in front of a computer, then that's a good thing.

Conclusion

Huge plus. Absolutely. Well, Alice, we have covered tremendous ground in this episode. Started from your experience and your role since 2018, all the things learned there, characteristics of highly effective philanthropic programs, foundations in the hospital setting. We just went through AI and all that. I think the best way we can finish is really to thank all the people who are the donors, large and small around the country, that give so much time and give money to support all the programs at our hospitals.

Absolutely. We're really very fortunate and I feel super fortunate to get to work with the fundraisers. You will all find that as you get to know the Chief Development Officer or Chief Philanthropy Officer and the rest of their team, that they are among the most giving, caring humans you've ever met. I encourage you to go meet a fundraiser while you're at it and see whether or not that's a relationship that's worth developing.

We have to thank you as well, of course, for your time. One thing that I'm really inspired to do as part of this growing platform that we have is perhaps through your network, Alice, we can find some people around the country, your members doing great work, and bring them onto the podcast.

Great idea. It'd be amazing.

Thank you so much.

Thank you. I really appreciate it. It's been fun.