Health organizations saw revenue growth in 2025 while maintaining predominantly centralized fundraising structures, most often through centralized foundations or hybrid teams.
Of 618 organizations participating in the 2026 Philanthropy Pulse survey in late 2025, 52 self-identified as belonging to the health sector. Their responses provide insight into how organizations are balancing major gift performance, revenue mix, donor acquisition, and retention as expectations around efficiency and engagement evolve.
Here are three themes shaping health fundraising this year:
1. Fundraising Operating Models and Team Structure
Centralized fundraising structures continue to define the health sector. Most organizations operate through fully centralized teams (61%) or hybrid models (30%), and hybrid structures have grown from 20% the prior year. At the same time, fully decentralized programs have declined sharply, dropping from 11% to just 2%.
Revenue increased for 63% of health organizations. At the same time, operating models remained largely consolidated: 52% report no change in structure, 45% became more centralized over the past year.
2. Revenue Mix and Major Gift Performance
Health organizations generate a significant share of fundraising revenue through major gifts and philanthropic grants. Major gifts account for 22% of total fundraising revenue, and philanthropic grants contribute 21%, together representing more than two-fifths of funds raised. Events and direct response follow at 17% and 13%, respectively, while corporate partnerships and grateful patient programs contribute to smaller shares.
At the same time, most health organizations rely primarily on cash giving. Nearly 60% receive 20% or less of total giving from noncash assets, and 40% report donor-advised funds accounting for 0% to 10% of overall giving. While revenue sources vary, large gifts and grant funding remain the primary drivers of fundraising revenue.
3. Donor Acquisition and Retention Dynamics
Health organizations continued to expand their donor base in 2025. Nearly 60% saw an increase in new donors over the past year, even as 71% identified acquisition as their top fundraising challenge. Most donors gave one-time contributions (46%) or annual recurring gifts (35%), reinforcing a pattern of episodic rather than long-term giving.
Retention, however, declined over time. Over the past three years, 34% of health organizations retained 45% or more of newly acquired donors, down from 40% the prior year. While organizations are bringing new supporters into the pipeline, converting those donors into sustained relationships remains an ongoing focus.
Explore the 2026 Philanthropy Pulse Health Sector Spotlight
These findings identify key areas of focus in health fundraising this year. The Health Sector Spotlight examines staffing investments, physician engagement, and how organizations are integrating AI and technology into fundraising operations.