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Nearly three-quarters (72%) of healthcare organizations responding to recent polling reported they gained revenue (64%) or at least stayed even (8%) during 2025. The not so good news is that 28% reported a decrease in revenue during the period.
Additional bad news, more than half reported being negatively impacted (42%) or were unsure (13%) of the impact on the organization of government policies.
The data is included in the 2026 Philanthropy Pulse, the fifth annual report from agency CCS Fundraising. The report is based on polling data from leaders at 618 nonprofits of all types across 47 states and 18 countries.
Looking ahead to 2026, leaders expressed more confidence in individual giving than in government funding, where expectations are more mixed. Use of technology, including AI, varies widely across organizations, with differences in training, readiness, and application.
A surprise in the data, according to Lindsay Marciniak, managing partner at CCS Fundraising, is that leaders “reported fundraising increases in the last fiscal year despite really dynamic macro conditions. I was also pleasantly surprised that individual giving is a main area of focus for known philanthropic growth in the coming year, specifically focusing on mid-level giving and major giving,” she said. “I was pleasantly surprised to see the focus and creativity in understanding the importance of donor retention.”
Respondents to the polling were generally optimistic about revenue for 2026. Looking back to 2025, it was the rich getting richer and the poor getting more poor with 39% of respondents reporting flat or declining revenue. Two of the larger groupings of respondents $500,000 to $1 million and $100 million to $500 million tied with 72% of each silo responding that more money was raised during 2025.
Smaller organizations didn’t do as well. Of organizations with revenue between $250,000 and $500,000, more than one-quarter (26%) reported a decline in revenue and it was 24% of nonprofits with income of $250,000 or less reporting declines.
“Donor retention will always be important. Always. And our Philanthropy Pulse report reveals that most organizations actually experienced an overall stability if not increase in their three-year retention averages,” said Marciniak. Retention has a cascading effect, she said. “When an organization has strong donor retention practices in place, acquiring new donors creates a stickiness for those new donors to repeat their giving and to become loyal to the organization,” said Marciniak.
Just more than half (51%) of respondents said it cost between 10 cents and 24 cents to raise $1 and 5% of respondents reporting from 50 cents to 99 cents to raise that $1. According to authors of the report, although cost to raise a dollar remains a standard metric of fundraising efficiency, it is rarely measured at scale in today’s environment.
“When we do development assessments, we look at different forms of revenue sources and the efficiency of each of those revenue sources. And in those more precise, more involved analysis points, we find always that major gifts are the most efficient form of fundraising and has a consistent strong return on investment,” said Marciniak.
Efficiency cannot be measured in just one metric, but rather needs to be understood in terms of the short and long-term impact of those investments. which comes back largely to an organization’s need for acquiring and retaining donors based on where they are in their own life,” she said.
Analysis of staff allocation across organizations shows no fundraising role is linked to consistently higher efficiency. Overall, workforce composition has only a minimal relationship to cost to raise a dollar, with no single function proving more cost-effective than others.
Government funding declined for 61% of all respondents. The five largest impacts of government policies were: Changed Programs Or Services Offered (31%); Experienced Increased Demand For Services (35%); Reduced Budgets (39%); Adjusted Communications Or Language 40%; and, Received Reduced Government Funding (61%).
“Something we know from our full experience is that organizations that invest in development operations are ones best positioned to grow sustainably because they invest in the data, the systems which, yes, includes a CRM but it can also include other technologies and systems for ticketing or marketing or other outreach,” said Marciniak.
The full 41-page report is available from CCS Fundraising by clicking here … https://www.ccsfundraising.com/insights/ccs-philanthropy-pulse/
