Cover Story: Cancer Survivors Pay It Forward
Michelle A. Gearhart-Pash beat cancer more times than there are words in her name—yet her smile still takes up half her face.
"I am a cancer survivor who is here today because of City of Hope," reads the letter she signed for the Duarte, Calif. nonprofit cancer hospital.
"Who better to tell the story about patient care than a patient?" asked Diana Keim, associate VP of annual giving at City of Hope. The six-time breast cancer survivor, Gearhart-Pash, came to mind immediately as the perfect person to tell her story for the hospital's first fundraising effort specifically sent to City of Hope patients. She became the face of the first patient campaign not only because Gearhart-Pash has been treated at the hospital for 26 years, says Keim, but because the co-founder and member of the Patient and Family Advisory Council is so involved with the hospital and understands its compassionate patient and family care.
Gearhart-Pash was the first, but not the last, patient to tell her story so City of Hope's former and current patients—who haven't been seen at the hospital more recently than three months before the campaigns—could donate to their research and treatment facility.
During the past two years, City of Hope and Arlington, Va.–based direct marketing agency Chapman Cubine Adams + Hussey (CCAH) sent email and direct mail to patients twice during the first year, then quarterly because it's been received so well. The campaign's debut during the 2012 holiday season saw an average gift of $107 from 921 donors among 60,657 direct mail recipients. On Sunday, Dec. 6, 2012, City of Hope and CCAH layered on an email campaign that began with a holiday card and followed up with two letters from Gearhart-Pash. More than 32 percent of recipients opened the emails and 0.13 percent of the patient audience responded, with an average donation of $190.48.
The email campaign, which increased City of Hope's gross revenue per thousand recipients from $69.86 to $246.29, even earned CCAH an award.
Keim says the success all stemmed from one idea.
"Patients have always been in the pipeline for major gifts and planned giving," she says, "but it's never been a written-down strategy to say, 'This is what we're going to do in direct marketing for this patient audience.' So, again, once we went with CCAH [hiring the agency in April 2011] and … implemented a new CRM system … it allowed us to sit down and say, 'OK, we have this group of people, patients, who we feel have the most reason to give to City of Hope—more so than a list that we rent out in the market. So when we're looking for people to become donors to City of Hope, we should really be going to our patients."
Data and Creativity
"There's a very gross, or broad, way you can use to apply data," says CCAH EVP Lon-Given Chapman. "And just sending out a message, or sending out a blast email to everyone, is one way. Or you can actually look creatively at the different subsets of people and how you can … target properly. … Who are going to be the people who are going to respond best? Who are the people who are most at risk and you need to increase the response rate of the average gifts? It's a different way of looking at creative."
Keim says prior to partnering with CCAH, City of Hope "dabbled" in email.
"Maybe that was once or twice—ever—before," she says. "That's just because we weren't set up to do it."
As the ability to deploy fundraising emails came—the first send of the program went out on Aug. 4, 2011—City of Hope and CCAH thought about the larger picture and how to make that become an image of more targeted campaigns.
"I think that creative is not just about the way something looks or the way it's written," Chapman says. "It's actually the whole mindset of the way you look at the strategy, overall. And we really took a lot of time to think about … 'What is the way the patients look at the City of Hope?' and 'What's the way everyone else looks at the City of Hope?' and 'How can we make that message as targeted as possible to them within the constraints of [the Health Insurance Portability and Accountability Act] and … respect for privacy? … ' And then also, it comes into the online and offline strategy and how we did do the targeting. And though it may sound to some people like a numbers game or a data game, we actually believe that to be creative, as well."
First, City of Hope had to have a file to segment.
Building the Email File
City of Hope's workhorse was and is direct mail.
"Direct mail is the first thought we ever have, because we have such a robust direct mail program here," she says.
City of Hope sends 85,000 to 100,000 pieces of direct mail every two weeks, mailing to hundreds of thousands of donors and prospects each year.
"Depending on what we're mailing and the ROI of the segment that we're targeting," Keim says, "we select … which groups of people, based on recency and monetary values, should get any particular piece."
So while the hospital already had a multichannel approach to fundraising prior to hiring CCAH, the partnership helped City of Hope step up its customer contact data gathering efforts.
Starting with the basics, the hospital had to build up its email file to complement its primary fundraising effort—the annual giving campaign that goes out through direct mail.
"We in the annual giving department did not have a lot of emails on our donor file for annual giving donors," Keim says. "And that's something that … the CCAH team have been very helpful in helping us gather."
The large file is a mix of:
- Opt-in subscribers to the monthly patient e-newsletter, eHope;
- Previous online donors who pioneered their paths there;
- Former patients, many of whom were added to the file when they didn't opt out of marketing and fundraising communications during the patient registration process;
- Industry groups and chapters; and
- Other City of Hope stakeholders.
The annual giving program also collects email addresses through direct mail replies.
With direct mail continuing—City of Hope and CCAH deployed their first campaign together in June 2011—the first email fundraising supplement to direct mail came during a matching gift campaign on Aug. 4, 2011.
"I am a firm believer in the use of telemarketing or email supporting the mail campaign," Keim says. "We've seen nothing but lifts when another channel is used to support the mail campaign."
What's That, You Say?
For the patient-centric campaign, patients seemed like the best storytellers.
"We always are trying to present a very hopeful message, so that it's a positive message," Chapman says. "Regardless of where the person is in the treatment or whatever situation the family's in, they can still take away from this a … universality to the experience of City of Hope. And that goes for every patient. And that's what we're trying to get to in the copy."
That's why CCAH writers interview patients and get their approvals before sending messages bearing their signatures.
"Our standard operating procedure is to always have a writer at CCAH interview our patients for our appeals," Keim says. "It is, I would say, done 95 percent of the time. The only time it's not done is when it's hard for us to get in contact with a patient. And, in that case, we just use written resources that our marketing and communications team already has on-hand."
A patient's point of view is invaluable, but can present a challenge. When a patient is speaking to patients, for instance, privacy laws mean messages can't specifically say the recipient receives healthcare from City of Hope.
"There were certain artful ways of phrasing to allude to a common experience," Chapman says, "in the second-person plural, 'we' language, starting with the patient standpoint, from the signer, and then talking about how 'we,' speaking for patients—though never specifically stating that the recipient was a patient."
Still, having Gearhart-Pash talk to "Amanda" or any other patient is far more personalized and worth the effort, they say.
"It's very important to capture the essence of what the person is saying and the experiences that she or he has and how they relate to City of Hope," Chapman says. " … In this case, she had a very visceral way of expressing it for other patients. I mean, without talking to her first, we could not capture that and be able to convey that, without it sounding completely false to other patients."
Hope Comes in Small Packages—And Emails
Holiday wishes began arriving for the first patient audience segment in late November 2012. First in the form of a direct mail test, then in two mail drops.
Finally, a light blue e-card adorned with a peace dove arrived in inboxes on Sunday, Dec. 6, 2012.
"May your holiday season be filled with warmth, joy and hope," reads its headline.
That first email didn't ask for money, but some gave, anyway. If recipients clicked on the card, it led them to a donation landing page.
Of the 5,739 e-card recipients, 33 percent opened the message and 0.4 percent clicked through. As former patients gave or unsubscribed, City of Hope removed them from subsequent mailings—making the sends of Gearhart-Pash's letters reach 5,311 and 5,191 members of the patient audience, respectively.
Most of that audience already received direct mail from City of Hope, unless they opted out of direct mail and kept email as their preferred channel. So those 5,739 e-card recipients already saw the companion direct mail piece, as they were among the 35,700 direct mail addressees.
Patients who passed away were removed from the sends, because CCAH runs lists through a data hygiene process right before sending.
Learning something a little unexpected, City of Hope found out the holiday card with a picture of Gearhart-Pash and her husband, along with a handwritten note signed by Gearhart-Pash, didn't perform as well as the control.
City of Hope sent out 6,518 of the photo cards in late November 2012, costing $6,520 and bringing in $5,542 in donations from the patient audience. City of Hope lost money on the handwritten note. Conversely, the control, sent to 6,741 people, cost $5,560 and generated $8,710.
In the end, City of Hope sent 60,657 pieces of mail to the patient audience, generating donations of $98,997 from 921 gifts. That's an average of $107 given by patients and former patients.
The email campaign saw an average gift of $190.48, exceeding City of Hope's previous best of $159.87, while the average gross per thousand was $246.29, compared to the previous collection of $69.86. So it says on the documentation for CCAH's March 31 receipt of the Hubbies 2014 Courageous Client Award for the "I Am a Cancer Survivor" email campaign on behalf of City of Hope.
Perhaps the best award of all, though, is the one Keim received on the evening of May 7, 2014. Keim heard Gearhart-Pash is still active in the hospital council and still pleased to have her story told.
The message came via email.