IVEY Publishing T Fox School of Business W25827 BREASTCANCER.ORG: FUNDRAISING CHALLENGES OF A SOCIAL ENTERPRISE IN A CROWDED MARKET Sheri Lambert and Sara Honovich wrote this case solely to provide material for class discussion. The authors do not intend to illustrate either effective or ineffective handling of a managerial situation. The authors may have disguised certain names and other identifying information to protect confidentiality. This publication may not be transmitted, photocopied, digitized, or otherwise reproduced in any form or by any means without the permission of the copyright holder. Reproduction of this material is not covered under authorization by any reproduction rights organization. To order copies or request permission to reproduce materials, contact Ivey Publishing, Ivey Business School, Western University, London, Ontario, Canada, NG ON1; (t) 519.661.3208; (e) cases@ivey.ca; www.iveypublishing.ca. Our goal is to publish materials of the highest quality; submit any ta to publishcases@ivey.ca. Copyright @ 2022, Ivey Business School Foundation Version: 2022-02-15 More than 20 years ago, Breastcancer.org was founded on the principle that everyone deserves the best care possible for their unique breast cancer situation. When I hear from people that Breastcancer.org has been their lifeline during the most difficult time in their lives, I know we are fulfilling our mission and will continue to deliver on the promise we made from the start. Authorized for use only by Martha Espinoza in NON-PROFIT MARKETING at Douglas College from 9/6/2022 to 12/23/2022. Use outside these parameters is a copyright violation Marisa C. Weiss, MD, Chief Medical Officer and Founder of Breastcancer.org Fundraising at Breastcancer.org (BCO) had become increasingly difficult in 2020. Rita Lusen, vice- president of partnerships and development at BCO, was preparing for the fiscal year-end in late May 2020 with Hope Wohl, the chief executive officer (CEO), and the board of directors (see Exhibit 1) As a non-profit 501(c)(3) global corporation, BCO wanted to expand global reach and programming for its members. However, to do this, it needed funds and had to find ways to increase its revenue. At the upcoming board meeting, Lusen would be expected to make a compelling presentation on revenues and plans for the continued growth. She was carefully and pragmatically evaluating her options to generate needed funds and wondering just how she was going to accomplish the organization's goal. BREASTCANCER.ORG AND ITS FOUNDER Breastcancer.org was founded in 2000 by Dr. Marisa C. Weiss in response to the growing need for information surrounding breast cancer diagnosis. BCO was an expert resource on breast health and breast cancer based in Ardmore, in the suburbs of Philadelphia, Pennsylvania. It reached nearly 150 million people globally, providing breast cancer patients with the information and support necessary to manage risk and Breastcancer.org, "Marisa C. Weiss, M.D.," Breastcancer.org., accessed May 10, 2021, https://www.breastcancer.org/about_us/team/marisa_weiss. 2 The case authors note that individuals' preferences for how they are identified as persons receiving health care vary, with some preferring, for example, to be identified as clients or consumers. The term "patient" is used in this case note to encompass a diversity of individuals who share the common experience of receiving or having received care in the health system.Page 2 W25827 Page 3 W25827 guide treatment decisions. BCO also offered personalized support for patients and their families as they Thinking of my life 13 years ago, I lived on the site. At the time that I was diagnosed, I was a mom worked to adjust their lifestyles of two boys; they were young teenagers [at the time]. I was also very busy at work. I worked for a large newspaper in Philadelphia. In terms of family, I am one of six-so, a lot of family members. Its focus was entirely on the digital delivery of care, providing comprehensive medical content in English And while I had a lot of family by my side, when I was diagnosed, I really didn't have a lot of and Spanish within a robust patient community. BCO's mission was to provide resources for patients and people [who] could answer the questions that I had. their loved ones 24 hours a day, 7 days a week She continued: With more than 30 years of active practice, Dr. Weiss was Lankenau Medical Center's director of breast radiation oncology. She held a seat on BCO's board and was regarded as a visionary for her innovative So, I found myself online. And as y line. And as you know, the Internet was quite different . . . than it is today. approach to informing individuals about their breast health. Dr. Weiss also served on the Centers for Disease At the time, I was 45 years old-which is fairly young for being diagnosed. And I really needed Control and Prevention's federal Advisory Committee on Breast Cancer in Young Women, and she was a answers. BCO was my lifeline. I truly don't know how I would have made it through the diagnosis, book author on breast cancer and breast health.' the treatments-let alone the emotional turmoil-if it hadn't been for BCO. Because of BCO, I felt as College from 9/6/2022 to 12/23/2022. informed and felt that I was be able to make decisions all the way through the process. And I knew that I wasn't alone. The ability to share information with and hear stories from people [like me] RITA LUSEN going through it all was huge. Lusen joined BCO as its vice-president of partnerships and development in 2011. She came to BCO with BCO members posted questions and thoughts and commented on discussions. The members gave advice over 25 years in advertising sales and marketing, which included work in print and online advertising in a and collaborated with each other. Through its medical advisory board, BCO provided medical advice or wide variety of industries and non-profit sectors. specific health care research One of Lusen's many responsibilities at BCO was to lead the organization's fundraising activities. She was key NG at D Since its founding in 2000, BCO's community was best known for providing peer-to-peer support to over to expanding and diversifying the organization's funder base, which included both individual and corporate 219,000 members globally (see Exhibit 2). Its audience was dominated by female visitors (96 per cent), donors. The position required that Lusen develop and implement a strategic development plan while working with an average age of 55 (see Exhibits 3-4). Not surprisingly, the members of BCO's community were closely with BCO's leadership team. She had to collaborate on strategies for well-researched priorities, effective also on Facebook (see Exhibit 5) fundraising, strategic communications, and grant writing in accordance with BCO's strategic plan and the Use outside these parameters is a copyright violation . Authorized for use only by Martha Espinoza in NON-PROFIT MARKETING at Douglas College from 9/6/2022 to 12/23/2022. Use outside these parameters is a copyright violation. donors' priority areas. She also had to test and validate new ideas in programming and philanthropy. THE PINK LANDSCAPE In her role, Lusen served as a sounding board, thought partner, and key adviser to the CEO. To this end, she was responsible for helping to identify opportunities for BCO to serve specific unmet needs in the community. BCO, a source of 24/7 online information for patients with breast cancer and their family and friends, competed for dollars with a myriad of organizations in the breast cancer marketspace (see Exhibit 6). This included regional, national, and global organizations, such as Susan G. Komen, Living Beyond Breast VALUE PROPOSITION AND BRAND Cancer, and others. Some organizations exclusively focused on breast cancer, while others supported people dealing with all types of cancer. Even those dedicated specifically to breast cancer had different missions. BCO was a digital-only non-profit. It was the first mover in the digital non-profit space that provided an Some were focused on research for a cure for breast cancer; others were dedicated to improving the lives online, virtual community for breast cancer survivors and their families, which offered a place where of those with breast cancer by providing them with information, inspiring them, and connecting them to members could interact with each other. Consisting of a "family of connected friends," much like communities of support. There were so many names and logos associated with "pink"-the hallmark colour Facebook, the virtual community felt like home for many people. and branding for breast cancer awareness-that it was challenging for people to know where to go for help Authorized for use only by Martha and where their money went when they wanted to support breast cancer research initiatives Those who wanted to be a part of an online community had to become members through the organization's they were members, participants had access to specific content and links. A branded Individuals on BCO's site relied heavily on BCO's content as a source of information (see Exhibits 7-8). community provided people with a way to gather around a shared experience or purpose for collaboration. Lusen expanded on this need (see Exhibit 9): As a breast cancer survivor herself, Lusen was intimately familiar with and passionate about BCO's mission Breastcancer.org stands apart [from the crowd] for our global reach, comprehe comprehensive medical and cause. She reflected on her own experience content, and robust patient community. We are entirely focused on the digital delivery of care that millions of people need now. Many organizations that we "compete" with strive to find "the cure." Breastcancer.org, "Marissa C. Weiss, M.D." Breastcancer.org, itself, is not about research or providing research for a cure; it is, as our mission 4 Market Business News, "Online Community-Definition and Meaning," MBN, accessed May 13, 2021, states, about complex medical and personal information about breast health and breast cancer so https://marketbusinessnews.com/financial-glossary/online-community-definition-meaning 5 "About Facebook," Facebook, accessed May 13, 2021, https://about.facebook.com. the women and men affected by breast cancer can make the best decisions for their lives. 6 Melanie Bond, "What Is an Online Community? The Basics & Benefits," Higher Logic, December 16, 2020, https://www.higherlogic.com/blog/what-is-an-online-community.Page 6 W25827 Page 7 W25827 Corporate sponsorships could come in varying forms: financial contributions; in-kind donations of services; syndicated. A video, blog post, article, or infographic, for example, could be republished on one or more paid media (money donated to purchase advertising); earned and owned media (social media, public websites, spreading the original publisher's content on multiple forums. Website hosts also liked syndicated relations); employee giving campaigns organized by the corporation; or volunteer, pro bono assistance. content because it provided fresh information for the website's viewers.21 BCO could target specific audiences with focused messages or purposes," which would then be republished Option #3: Events by third-party websites. The third-party websites would receive free, relevant content, and BCO would get free exposure and publicity of its proprietary content. Inserting backlinks to BCO's website in the A third option would be to organize special fundraising events. While in-person events were limited by content should also increase organic traffic on BCO's website. pandemic restrictions, events were increasingly virtual, held online. The social benefits of in-person events were meaningful to both the non-profit and its corporate sponsors. Option #6: Grants The costs for attendees were quite high, but the events had large expenses that often cut heavily into the net amount of money raised. Expenses included gifts for high-level sponsors and donors; catering, food, as College from 9/6/2022 to 12/23/2022. BCO was already seeking grants, and that activity could be enhanced with focused grant writing efforts. beverages, and decorations; invitations and publicity; and entertainment, for galas. Applications needed to be submitted to foundations, government, and private institutions and organizations for specific grants of money that were available to worthy causes for specific projects." Hosted virtual events had grown in number since the onset of the pandemic. Unlike in-person events, virtual events had minimal costs since they did not require physical venues, food and beverages, and more. They Grants were different from general donations because people who donated money to a cause decided how were offered for a much lower cost of entry yet yielded far more net revenue for many non-profits. they would allocate their money: they could donate nothing, to one cause, or to many. A grant, however, was a fund that was established for the purpose of providing funding to support various programs and at Dough causes. The money was going to be donated; however, many organizations competed for the grant money. Option #4: Non-Sponsored Advertising If BCO were to seek grant money, it would be in competition with others doing the same; therefore, it would need to convince the grant organizers that BCO should receive funding over another organization. Banner advertising revenue for online advertising was calculated at a rate per thousand clicks on a web page, known as cost per mille (CPM; see Exhibit 11). Using online advertising on a non-profit's website was a growing fundraising strategy for non-profits in general, especially with the rise of digital media as a Option #7: Earned-Income Strategies or Fee for Service Authorized for use only by Martha Espinoza in NON-PROFIT MARKETING at Douglas College from 9/6/2022 to 12/23/2022. Use outside these parameters is a copyright violation . Use outside these parameters is a copyright violation. method for sharing an organization's message A final strategy could be to earn income. Earned-income strategies were efforts a person or organization Monetizing BCO's site might be an innovative way to increase revenue for the non-profit. Monthly undertook to generate revenue for work, services, or products that they provided. For non-profits, earned incremental revenue could be calculated by using a CPM rate (see Exhibit 12)." However, one concern income often came from mission-related sales." with selling online banner advertising was that non-profits needed to maintain their 501(c)(3) status.18 inoza in Money raised by selling ads in the form of banner advertising could be considered unrelated revenue and This option would be complex and could distract BCO's management team from the work that went into could subject a non-profit organization to "unrelated business income tax."" BCO could consider this developing the organization's current content and shaping the messaging of its programs. option to attract a broader list of corporations, such as those in the pharmaceutical trade or offering breast cancer drugs and treatments RUNNING ON EMPTY Option #5: Content Syndication Authorized for use only by Martha Es BCO relied heavily on its donors to provide the funds necessary to sustain and develop its programming. However, while donor revenue was greatly valued, the organization needed to drive revenue growth through As industry began to view technology as a critical factor in opening many doors and lowering hurdles to other sources to relieve the pressure of relying upon donors. What other revenue sources could Lusen fundraising, content syndication became a source of raising funds."Any kind of digital content could be access, and was there a way to convert community members to sustaining donors? The answers would aid Lusen in preparing a strategy that she could present to the board at the upcoming board meeting. 15 Learning to Give, "Special Event Fundraising," L Learning to Give, accessed May 26, 2021, https://www.learningtogive.org/resources/special-event-fundraising. 21 Irina Nica, "Content Syndication: What It Is and How to Do It Successfully," HubSpot, September 23, 2019, 16 Miranda Brookins, "How to Sell Banner Advertising," CHRON, accessed July 29, 2021, https://smallbusiness.chron.com/sell- https://blog.hubspot.com/marketing/how-to-syndicate-content. banner-advertising-10066.html. 2 Alexander Kesler, "Content Syndication Basics: Who, What, Where, When, Why, and How," Search Engine Journal, November Tapjoy, "CPM 1 in Advertising-Everything You Need to Know," Tapjoy, accessed July 29, 2021, 23, 2020, https://www.searchenginejournal.com/content-syndication-basics/263415. https://www.tapjoy.com/resources/cpm-in-advertising. 23 Outbrain, "How to Grow Your Blog with Content Syndication," Outbrain, accessed June 1, 2021, 18 Joanne Fritz, "Should a Nonprofit Sell Ads in its Newsletter? Beware the UBIT," The Balance Small Business, May 30, 2019, https://www.outbrain.com/help/advertisers/content-syndication. https://www.thebalancesmb.com/should-a-nonprofit-sell-ads-in-its-newsletter-2502464. Jitasa Inc., "Grant Management: A Nonprofit's Complete Guide," Jitasa Nonprofit Blog, January 14, 2021, 19 Fritz, "Should a Nonprofit Sell Ads." https://www.jitasagroup.com/jitasa_nonprofit_blog/grant-management. Galaxy Digital, "The Top 17 Nonprofit Trends for 2021," Galaxy Digital, accessed June 3, 2021, 25 Randy Hawthorne, "Earned Income for Nonprofits: What It Is and How It Works," Nonprofit Hub, May 18, 2018, https://www.galaxydigital.com/blogonprofit-trends-2021. https:/onprofithub.org/earned-income