The Health Management Academy

Episode 16

Evaluating Philanthropy’s New Role at Health Systems

Featuring Sage Bolte, Ph.D.

Episode Description

In her role, Sage oversees comprehensive development strategies to welcome philanthropic investments from those in our community who share Inova’s passion for advancing world-class healthcare. She partners with the foundation’s board of trustees, Inova leadership and team members, volunteers and generous donors to achieve Inova’s mission, advance best practices, and cultivate a culture of philanthropy for the entire system.

About Our Guest

Sage Bolte, Ph.D., Chief Philanthropy Officer, Inova Health System and President, Inova Health Foundation

In her role, Sage oversees comprehensive development strategies to welcome philanthropic investments from those in our community who share Inova’s passion for advancing world-class healthcare. She partners with the foundation’s board of trustees, Inova leadership and team members, volunteers and generous donors to achieve Inova’s mission, advance best practices, and cultivate a culture of philanthropy for the entire system. Read more…


↓ scroll ↓

Renee DeSilva 00:07
Welcome back to the academy table. I’m Renee DeSilva, CEO of The Academy and your host. With the holidays and this season of giving upon us, it’s the perfect time to have a conversation about health system philanthropy. And so to wrap up our second season of the podcast, I’m delighted to welcome Dr. Sage Bolte to the table. Sage is the chief philanthropy officer at Inova Health System and president of the Inova Health Foundation. As many of you know, health systems are facing unprecedented financial challenges far worse than anything we’ve seen over the last 20 years. In turn, the role of philanthropy has shifted significantly towards a true revenue generator. And having served in her role since 2018. Sage has experienced that firsthand. Here are a few of my takeaways from our time together. First, listen to how sage details the new space that philanthropic efforts occupy instead of solely funding nice to have philanthropy or supporting mission critical work, and partnering to meet the everyday and strategic needs of the organization. Next, I love how sage talks about the cues of gratitude are the ways we can all contribute to philanthropy. A perfect example of this is the power of a novice storytelling, a donation of time that matches financial contributions to unveil the real impact on patients and caregivers. And finally, I appreciate how sage calls herself an Inova soldier and that she serves where she is called a true reflection of her servant leadership approach. And the way she arrived at her current position is notable as well. She’s a social worker by training, was previously a leader of patient experience for a novice oncology program, and was asked to consider this role by Dr. Jones, the CEO. I’m a firm believer in trusting others when they recognize skills and gifts that you may not see in yourself. And sage is the perfect example of that. And so with that, and for the final time in 2022, please join me at the table Good morning, sage. Welcome to the table.

Sage Bolte 02:25
Well, good morning, Renee. Thanks for having me.

Renee DeSilva 02:28
I’ve been looking forward to this conversation. You’re such an interesting background. I’m going to dive right in. And before we talk about all of the work that you’re doing across philanthropy, you come at this work from clinical training and social work. Talk to us a little bit about that.

Sage Bolte 02:43
Yeah, I would love to. And again, thanks for having me. So, as you said, I come from a clinical background in social work. I actually have my PhD in social work. And I’ve been at Inova for pretty much my entire career. The first 14 years here were spent working in oncology for the program that we have called Life with cancer that supports those impacted by cancer. And my experience with cancer was in the role of an oncology therapist providing counseling and support. And through that I continue to grow in my leadership roles, specifically in oncology moving from a program manager to a director to an executive director and have found incredible opportunities here and Inova to continue to grow both professionally and personally. And four years ago, I was asked to consider coming into this role and have been incredibly surprised at how much fun I’m having and incredibly surprised at how much I love it as well.

Renee DeSilva 03:46
So yeah, I think that’s super interesting. Your current role as chief philanthropy officer and president of the foundation is not one that you typically see come from a clinical background. So what were your impressions, your early impressions of philanthropy? And did you have any pause when you were asked to consider this role?

Sage Bolte 04:05
So yes, and yes. To talk a little bit about impressions. Early on in my career, I had worked with some individuals in development that, honestly, for me, I didn’t feel comfortable around. My impression and experience had been that they hate to use this phrase, but we’re kind of like used car salesmen like they just come at your real hard, real strong and try to sell you. And especially in oncology, I worked with such vulnerable patients. And I was very aware of how protected I felt of them. And so my initial gut and personal experiences of development was not so positive income, one of my colleagues, Amy Richards, who still works for the Inova Health Foundation She’s probably the first person I worked with in development that really changed my experience in what it looks like to work in development. And there have been others along the way that have been slowly kind of chipping away at my impression as I’ve watched them build relationships with our patients and or the community. And so as my mind started to shift when Dr. Jones asked if I might consider taking this job, I initially said, No, why would you want me in this role, I love what I’m doing. I’m thriving, I was really clinically at the peak of my career. And I really had no interest in moving away from clinical work. And thank goodness, I still get to do a little bit of it. But as I dug in deeper to the role and listened to the advice of my husband, and my parents to at least go through the process of interviewing for the job, what I really came to find was that one, I love Inova, I say to Dr. Jones, often that I am an another soldier, put me where you need me most. I think what we do here is incredible. And I am so proud to work for an organization that is so mission focused and driven, that I can tell the stories of Inova all day long. And the more I got to know what they were looking for within this role, but also what the role of chief philanthropy officer is, the more I realized that my passion for Inova my passion for telling stories of impact, my passion for incredible clinical excellence, all really aligned with what they were looking for in this role. And although different from having a clinician in the other advantages, I can speak to speak, I can speak the clinical speak, and I can speak the donor or patient speak. And that seems to have been a really neat or fun or powerful bridge that we’ve been able to have here in this role. So I dove into the process, and again, along the way, found that the things I’m most passionate about very much aligned with a successful chief

Renee DeSilva 07:14
philanthropy officer. So let’s unpack that a bit. So I guess as we’re sitting here, against the backdrop of most leading health systems, 2022 represents the most challenging financial performance, because of all the forces coming at you. Supercharge on, just in terms of capacity challenges, workforce and labor issues. And so just the overall supply chain, still not completely stable. And so if in the past, philanthropy has been thought of as nice to have funding, its role needs to evolve towards a revenue generator. So how have you thought about that? What does that mean for your team?

Sage Bolte 07:55
Yeah, it’s such an interesting place to be. And you know, at Inova especially, we are very blessed to have a strong balance sheet, strong investment portfolio and have been able to really have philanthropy be the butt fours, the supporting programs, like life of cancer that people don’t have to pay for, to get counseling, or patient assistance funds. And those are all still really important, and we still need to raise money for it. But what we’re seeing with the headwinds that we’re facing, is that the conversations are shifting not just to the but for, but how can you partner with us to ensure that we can continue to meet the needs and, and elevate and escalate our ability to grow and meet the needs of the community in providing world class care. And that means, you know, building buildings, which usually they would say that’s an operational investment, that’s capital investment that the organization should take on talking to the community about the workforce needs, we have, you know, again, in the past, that would be seen as either above four, or isn’t that an operational investment need. And both are true. And that’s a very different conversation as well that both are true that we need support to help really grow our workforce programs and needs in order to meet the needs of the organization and the needs of the community. And it is also an organizational investment. So we’re having more conversations even about helping us in matching or meeting the needs of our community, again, by elevating or accelerating our ability to continue to provide the care that’s needed when we are facing such tremendous financial headwinds. And I can think of a couple of recent areas that we asked for help and one being the pride clinic, which is the first clinic at Inova that specifically is providing primary care and behavioral health to our LGBTQ i A plus community. And we needed additional funds to help cover the costs of the ongoing mental health care that they might need. And, again, that sounds like about four. But it’s a really critical investment in our ability to meet the needs of that community. And additional one is we needed to build out one of the clinics in Loudoun before our Inova Keras clinics, which are safety net clinics, specifically for behavioral health, because there is such a massive gap in our community’s ability to provide people who are under or uninsured with mental health care, and we needed to really elevate and escalate that. And we needed philanthropy to help us do that. So we weren’t taking out additional loans at incredibly high interest rates.

Renee DeSilva 10:52
I love that I love that, but for really shifting to be really focused on ways in which philanthropy can amplify mission critical work. And I think those examples that you give, certainly resonate. So we’ve talked about how philanthropy matters more than ever at this point, but it’s also a long game. So maybe frame out for us just as a chief philanthropy officer, just ultimately, how you approach the work of building relationships, aligning with the passions and interests of donors, and how that all ends up coming together, over probably a longer over a longer view.

Sage Bolte 11:32
Yeah, so one of the first things in my first six months we did, I did a lot with my team, we did a lot of restructuring, reordering, bringing in new team members who had passion, solidifying and strengthening our team. I found that if you have just an annual goal that focuses on a number, that’s what you’re focused on. And in order to be really successful at anything, relationships are critical. And relationships don’t happen overnight. And meaningful and transformational relationships certainly take years to build. So we decided to experiment, and we just finished year three of it with doing an annual goal and a transformational goal. And that annual sustainable goal is kind of raising money for the things that we really need to consistently raise money for. And then the transformational goal, which is a three year goal, and is a three year $30 million dollar goal. That goal is again set for three years. And there’s a reason specifically for that we know that again, that relationships take time. And in philanthropy, there’s actually science behind this, that transformational relationships typically take three to five years to build. So the person that gives $1,000 In your one that has high capacity, as you build a relationship with them, and bring the stories to life of how their gifts make an impact. Over the course of those three to five years, you’re going to see an increase in their giving capacity and amount if, again, you’re really building that relationship and talking to them about areas where their hearts beat. And for us at Inova, one of the greatest prides and you and I have talked about this Rene but one of the greatest problems I have is we really do a lot if you’re interested in education, we have an area that I can talk to you about that we provide education both for our own team that also for the community. If you’re interested in research, we can talk about the fact that we have tons of opportunities to do research. If you’re interested in clinical care in a specific disease area, we can talk about that as well. If you’re interested in diversity, equity inclusion, we have opportunities there. So our ability to connect with donors’ hearts and their passions is pretty great. Certainly, again, that does as you mentioned, it has to fall in line with the strategy of the organization, you know, there’s no no worse choice than to have a donor idea lead strategy because that’s not sustainable and it could ultimately create more heartache or harm or financial cost to the organization. So as with a novice clear strategy on their commitment to world class care and, and clear areas of both disease specific opportunities, as well as investment in our people here, investment in our community. There are so many opportunities that support our strategy of providing that amazing care and allow us to raise dollars to again either accelerate, elevate, yeah, or amplify,

Renee DeSilva 14:52
amplify, amplify mission. I think that’s great. I mean, you do such a beautiful job of this notion of a As you put it, which is your heartbeat, and using the power of story to really bring that to life. So how does the contribution impact real patients and caregivers? Can you just talk about how you think about the storytelling part of it? Because I’ve been on the receiving end of watching videos from Inova, and just being so emotionally caught up and how do you all play that out? So just what goes into that? How do you source probably have an abundance of examples to source from but just talk about how you approach storytelling, I think you’re really gifted at making that come to life. Thank you.

Sage Bolte 15:39
Yeah. So first of all, I have an incredible team that operate and work together really well, and bring stories to life in really powerful ways. But there are a few ways that we are able to do that one, providing patients the opportunity to share their gratitude, through an email, through a note they send into the foundation, through telling their clinician, hey, I had an incredible experience, I’m really grateful. And that clinician then said, Would you mind sharing your story with my colleague in the foundation, and then being able to talk to that patient or the family that’s grateful and pull out their story of gratitude. So certainly, patients give us incredible stories, and we can then take their story of impact and amplify it with, you know, obviously, interviewing them, but interviewing their clinicians being able to tell a story of impact to a donor on how specifically, for example, your gift to cancer research directly impacted this patient’s life. So a grateful patient certainly gives us opportunity, the others that give us the opportunity to tell really powerful stories just in the clinical work we’re doing and the clinicians, we hire amazing people at Inova. And the work that they are doing every day, is so compelling, and they’re so passionate about it, that the passion comes through every time they’re talking about the work they do. So if I were to go up on the NICU, and ask one of the nurses about what they love about their job, you’re gonna immediately see the passion in their eyes for the work they do, and taking care of the smallest of babies as well as their parents and being able to capture clinical enthusiasm in our ability to talk about what we do at Inova, it’s incredibly motivating to those who are on the receiving end of the videos, as you were referred to Renee, I want to give to something that has high impact I want to give to something that my $10 or my $100,000 is going to have an impact. And that here is it’s just really easy to do. And I think again, my clinical lens certainly allows me to see opportunities in the storytelling that maybe a non clinical lens might not have. But again, I think Adobe makes it really easy for me to tell great stories.

Renee DeSilva 18:10
Yeah, it’s definitely a target rich environment in terms of at least finding the examples. And then the way that you unfold them is really well done. Another challenge that I think is happening in charitable giving right now is that and I think this is true, even beyond healthcare there seems to be a generational gap or shift in terms of how different cohorts think about giving. What are you noting, in that realm?

Sage Bolte 18:33
Yeah. So I think you know, here in the DC metro area, we are very blessed to have people that are philanthropically minded. We also compete with so many nonprofits that it is certainly challenging to get people’s attention, because there’s so many good things to give to you around here. We certainly are starting to see and this is a nationwide issue, not just an Inova issue, but a shift in giving. From all generations, there had been a hope that the Boomers were going to be some of the most generous of generations, and that isn’t coming to fruition, at least not yet. Or that there would be this massive transfer of wealth and that the younger generation would be highly philanthropic. And we’re not really seeing that either. Where we’re seeing giving being the most successful is still in, you know, the 1% The people that give big gifts. What I would say though, about generational gaps is Millennials get a bad rap about giving. And, you know, there’s this assumption that they’re not getting because we’re not necessarily seeing them give to our foundations. But Millennials actually are incredibly generous. You just don’t see them giving to foundations. They’re giving up their time. They’re giving to their neighbor, they’re buying coats for the coat drive at the school across the street from them. They’re making meals for their neighbor who’s not well, you know, they are giving. We just have to figure out how to translate our mission and work in health care to a group of people that aren’t necessarily utilizing us that much, except for maybe two as they begin to have babies. But I think that’s true in healthcare in general, you know, you’ve got to stay relevant to the generations. And as people are healthier, they don’t necessarily see you as an area of opportunity to give to you there’s definitely, and I don’t want to say an assumption of having us in their backyard. But when you don’t need us, you don’t know that we’re the kicker until you need us.

Renee DeSilva 20:36
That’s right. I mean, all the data would show that millennials and younger generations just access health care differently. So don’t necessarily have the same ties, or sense of loyalty as other generations do. So I think you’re right, that the way in which engaging them has to look different, I mean, that’s not that dissimilar to even how you engage them as team members, or employees in your company, right? Like them, we generally see this generation holding us up to higher standards on social justice issues and equality issues. And so I think you’re right, it’s all about how we tap into that, versus assuming that they are not open to.

Sage Bolte 21:12
Yep, absolutely. And I do think, you know, the blessings, if you will, of having a pandemic, is it certainly did elevate everyone’s awareness of how critical it is to have world class health care in your backyard. And so we have seen an uptick in what I would call the people that run towards the barnburner of burning, like I say, they’re big barn burners, that people that run towards the fire that want to help rally around a cause. When I, when I lost sleep during the pandemic, were these people that ran to help us put out this fire, how do we keep them? How do we keep them engaged when their passion is to help in crisis? And so keeping ourselves relevant to those individuals? And that bridges the generational gap, there are millennials, there are boomers, you know, all in between our Gen Xers? How do we continue to keep them invested and engaged that their dollars continue to help us even though we may not be in crisis mode, and I think we’ve effectively been able to do that we have sustained and retains most of the donors we acquired during the pandemic and have continued to acquire donors, you know, in 2021, which was kind of unprecedented, we had 4000 new donors. And

Renee DeSilva 22:36
That’s the typical new donor engagement, did they start off with a typical range of giving, and then it just spans from there?

Sage Bolte 22:42
Yeah, and it varies, it really varies on why they’re giving. So if they had a positive experience with a clinician, and they want to honor that clinician, you know, they might give a smaller amount. And then we build them. You know, here in this area, we have incredibly generous people that we talked about, and some give, because they just want to see health care continue to improve in their backyard, and they give substantial checks, and I’ve never even met them. And I think this is where that relationship comes into play, and how telling the story connects people to purpose connecting them to our mission, that people find their own way. If I were to say, here’s the standard way that you get somebody into giving out a note and then giving more with the they have a positive experience, or they’ve been, they’ve been introduced to us, as someone who potentially wants to give a gift, we begin to build a relationship with them, they give an initial small gift to something that is they’re passionate about, or potentially that we just say we have real need. And as that relationship evolves, they’re giving increases over time to whether it’s a substantial transformational gift, or they’re giving you know, they’re part of our annual giving and giving $1,000 a year to an area of need at Inova.

Renee DeSilva 24:01
It was super helpful. All right, I want to switch gears a bit and talk about how you engage the CEO, other members of the executive team and boards around the philanthropy mission. What’s your approach there?

Sage Bolte 24:16
Yeah, so one of the conversations that Dr. Jones and I had early on when I was in the process of interviewing for this role was actually around the reporting structure. And I felt pretty passionate about this role reporting directly to the CEO because I really believed that without that reporting structure, I would not be able to be as successful in leading the philanthropic initiatives and fundraising here and he agreed he really sees himself he would say, He’s the chief philanthropy officer and CEO, and Steven Dr. Jones makes an incredible partner with this. So it engages him. It’s really both having regular meetings and hearing, you know, what he is thinking about for the years to come both, you know, something that is now that we can activate in a in supporting the strategy from the philanthropic standpoint, but also looking down the road because a lot of donors want to know, not just what are we doing now? But what are we doing five years from now? What’s our path forward, and continuing to meet the needs of the community? So he’s critical of me and my team being successful in connecting those dots for donors. He’s also critical in some of our significant or transformational gift relationships, they do want to sit down with the CEO, they want to understand where they’re giving is going, and both his leadership and how he leads the organization as well as what they can continue to do to support his success and the success of the organization. So his relationships with our donors are significant. Getting the boards on board, we have several boards, like many organizations do, from our parent board, it’s really making sure they continue to stay informed on how philanthropy is playing a role in supporting the strategy, getting them connected to the stories of impacts, you know, I think, the more you feel connected to an organization that you’re supporting, and or leading, the better job you’re going to do at continuing to lead. So making sure we keep them informed on any big gifts, asking them to do introductions, you know, as board members, it’s not just keeping an eye out and investing in a nova themselves, but it is making those introductions and helping us meet people who have capacity to continue to give and help us meet our philanthropic goals and needs. So storytelling with them, keeping them connected, asking them to do introductions. And the same goes for our organizational leaders, ensuring that we are meeting with them, getting to know them understanding you know, what their needs are, and ensuring that gets risen up to our triad leadership, and that their needs and desires are also aligned with strategy so that we are supporting what our clinical leaders need as well, and ensuring that we have a really strong grateful patient program that our physicians and our clinical leaders understand so that when they hear the hues of gratitude, when a patient says, Thank you so much, is there anything I can do for you? You know, I, as clinicians, and I am guilty of this, so many years went by where somebody would say, Thank you, Can I do anything? And I would say no, that’s exactly why I went into this work, I’m so happy that I can help you, and helping our clinical leaders have a mindset of gratitude, but also a mindset that when a patient expresses gratitude to you and asks, How can I help, it is an opportunity to allow them to heal even further, because we know that gratitude and the expression of gratitude, actually is an incredibly healing and, and wonderful opportunity for our patients. So when a clinician, here’s the cues of gratitude, leaning in and when they say, How can I help instead of, I’m so happy just to have been able to help you say I’m so happy to have been able to help you. And there’s a lot of opportunity for you to continue to help what we do here at and other Would you mind sharing your story with my foundation colleagues and hearing about the opportunities where we could use your support and reminding our clinicians? Yeah, reminder, your questions. It’s not just getting a gift. We’re not asking them to ask a patient for money because that patient may not have high capacity, they may want to give $10 But their story may inspire $100,000. Yeah.

Renee DeSilva 29:07
Yeah, there are two things as you’re talking that I just wrote down that really encapsulates your thoughts before I get to my final wrap up question, which is philanthropy operates in lockstep with system level priorities. And your job is to bring that to life in a way that makes it easy. And then this cues of gratitude, which is interesting, I think we all see that in our day to day life and just figuring out how to answer that in a way that, in some ways, returns agency and power to people who have gone through a challenging moment. I think those two things really resonate for me.

Sage Bolte 29:38
Yeah. That, I think, is a mindset shift for us to continue to be successful. We, as an organization, need to keep reminding our clinicians and not just our physician, any of our clinicians, that when they hear a cue of gratitude to connect that cue to something actionable, so that the patient again Then you said empowered, they feel empowered to do something with their gratitude.

Renee DeSilva 30:04
Indeed. All right, final question, one that I asked all of my guests, which is, if you could invite two people for a conversation at a table that you personally curate on any topic, who would they be? And why? Oh, my goodness.

Sage Bolte 30:17
Those are questions I’ve prepared for this question. And I’m going to answer it, the one so there’s somebody I would love to bring to the table, who is no longer living. But I would love it if I could, if I had the magic of bringing her back would be my grandma. Yeah. My grandma Palmer, my mom’s mom, and you’ll hear the emotion of my voice. What I would love to bring to the table to talk about is, I would love her advice on how I can, as a female leader, continue to lead and encourage and empower other women to lean into their leadership to break down some of those walls that we as women still face. I would love to hear from her, you know, all the ways that she wished she would have done things differently in my grandma was of the generation that she worked in my grandpa, she was married for over 60 years. I think she worked but she was mostly you know, home. But she was a Spitfire and had lots of opinions. And up until my grandpa’s passing. I didn’t even know it because of the role she played in life. And in that marriage and watching, literally, my grandma QCon came to life in front of my eyes after my grandpa had died. I have so many questions for her that I didn’t get to ask about, you know, again, who she would be if she were to rewrite her life right now, how would she encourage me to continue to empower other women to use their voice and be a leader, as a female leader. I love that. So the second one is not as creative, but I just literally could imagine laughing for hours with her. And I like to laugh and I love her directness. She’s also a social worker, and has written incredible books that I find nuggets in every single one I read. I love her directness, I have incredible respect for the research that she has done. And really looking at, you know, how do we help improve humankind and her research around shame really captured me specifically, because in the field of oncology, there actually was some diseases like lung cancer, that patients really got stuck in the shame cycle, except it wasn’t filled, they felt such shame around their diagnosis. And the work she did really helped me unpack that with them. So

Renee DeSilva 33:10
I would love her work to She’s amazing. I would say if people have asked me this, if there’s been one book from a professional perspective, that has been the most helpful to me, it’s not the Good to Great, and those are all wonderful, but it was her book, the gift of imperfection, which is all about vulnerability and where your next level of maybe impact and leading people is just being more comfortable with your vulnerability. That was a challenge for me very early in my career. And that has been really transformative to me. So if I think you could get dinner with Brene Brown because you are so good at connecting with people. So if you do, I will pay for the dinner if you invite me.

Sage Bolte 33:49
I will invite you if I get that dinner.

Renee DeSilva 33:52
All right. Good stuff. Well, always lovely chatting with you, sage. Thank you so much for joining us today and I will talk to you soon.

Sage Bolte 33:57
Thanks so much for having me. Appreciate it.

Renee DeSilva 33:59
Thanks again for joining me at the table. The Table is a podcast produced by the Health Management Academy. Make sure you catch future episodes by visiting our website,, or by subscribing on the podcast platform of your choice, and if you have suggestions for topics or guests, I’d love to hear from you. Please drop me a note at I look forward to talking with you soon.