Keevan Kosidowski, Executive Director

Regions Hospital Foundation

January 14, 2014

“Giving by individuals closely linked with income and wealth.” Giving USA 2012

Similar trend for high net worth individuals – giving stable from

2009 to 2011.

$9,235(2002)

$10,168 $11,192

$12,214 $13,382

$14,500 $15,609

$16,771 $18,074

$19,393(2011)

$20,944 $22,620

$24,430

$26,384

$28,496

$30,774

$33,236

$35,895

$38,767

$41,868(2021)

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021

Health care expenses for U.S. families:2002-2021 (projected at present growth rate)

Source: 2011 Milliman Medical Index

Income: $59,858

Source: Alliance of Community Health Plans

Shuts out other investments

Decrease in annual philanthropic support

Will this trajectory compromise planned giving pipeline of the future?

“High net worth individuals have become more intentional about their giving.” 2012

Bank of America Study of High Net Worth Philanthropy

Some immediate reduction in discretionary income ◦ Medicare premiums to go up for couples with joint

income of $170,000 or more; individuals with income of $85,000 or more

Long-term unsustainability of Medicare Cut benefit set

Elevate age of enrollment

More expensive

Reduction in future discretionary income

More money directed to living expenses

Reduction in disposable income; reduction in annual giving

Living longer – more uncertainty about assets

Decreased value of estates

Compromise planned giving pipeline of future

Strong focus on donors with assets greater than $1 million

“Family foundations and business formation are cornerstones of wealth accumulation,” John Havens and Paul Schervish

Source: 2012 Bank of America Study of High Net Worth Philanthropy

According to the National Federation of Independent Business, since 1986 the NUMBER ONE concern for Small Businesses every year has been access to AFFORDABLE HEALTH CARE.

Source: SBA – Affordable Care Act 101

Current costs

Premiums continue to increase

Healthcare costs – biggest business challenge of American Manufacturers

23% will reduce employment or stop hiring1

Uncertainty (National Federation o f Independent Businesses)

Actual coverage provided

Plans for adjusting to the ACA

How the ACA will affect them and their business

Disincentive for growth or new startups?

Fewer than 50 employees – do not need to offer coverage and will not pay a penalty (2015 and 2016)

“In particular, direct giving often appeals to sole proprietors or small partnerships, because ‘what comes out of their own pockets and their company’s pockets is one and the same thing.’” Ramsay Slugg, Bank of America Private Wealth Management

Sensitive to patient siutations

Danger that donors think we don’t need philanthropy

Media portrayals paint negative picture

Be informed about what reform is and what it is not – access not affordability

Create our own story

Test research with real-life meetings – don’t make assumptions

Be prepared to discuss your and your organizational stance on reform

Build relationships – focus on long-term