McKinsey & Company

McKinsey on Society


Voices How We Give

Money for Life: Transforming the American Cancer Society

John SeffrinCEO
American Cancer Society

John R. Seffrin, Ph.D., has been CEO of the American Cancer Society since 1992. Under Seffrin’s leadership the Society has become the world’s largest voluntary health organization fighting cancer.


Greg BontragerCOO
American Cancer Society

As staff president and chief operating officer for the American Cancer Society, Gregory P. Bontrager oversees the overall day-to-day operations of the world’s largest voluntary health organization.

The TakeawayIn this interview, the leaders of the American Cancer society explain how they are transforming the nonprofit’s performance culture, organizational structure, and approach to fundraising in order to advance their goal of ending the fight against cancer in this century.

Like most nonprofits, the American Cancer Society saw a clear decline in fundraising during the recession, after decades of steady growth. In 2010 the Society embarked on a comprehensive transformation of its performance culture. Concrete changes include the largest reorganization undertaken by a nonprofit organization in US history, and a shift in how the Society raises money. Voices managing editor Richard McGill Murphy interviewed ACS chief executive John R. Seffrin and staff president and chief operating officer Greg Bontrager about their progress to date and their plans for the future.

Voices: What prompted you to transform the American Cancer Society?

John R. Seffrin: Interestingly, it wasn’t that we weren’t making progress on our mission. We were saving 400 lives a day that otherwise would have been lost to cancer. But we asked, “Can we do better?” The answer was simple. I told the board that if we were willing to go through a major transformation, we could build a platform that could save 1000 lives per day.

Voices: Give me a quick progress report on your strategic transformation. What have you accomplished so far, and what remains to be done over the next couple of years?

John R. Seffrin: When we started the transformation process three years ago we had 15 governing boards across the country. Now we have a single national board. In terms of our field structure, every division was organized differently. As I speak we’re implementing a consistent field structure in all of our 11 operating divisions. We’re quickly building out our capacity in the social media area. While 2013 portends to be the toughest year yet in terms of the amount of heavy lifting and the challenges we face, we certainly hope to begin to see some changes and turnaround in 2014 and some major objective evidence of success in 2015.

Voices: You’ve compared your transformation initiative to rebuilding a plane in flight. In addition, you set out to rebuild a flying plane while the world economy was falling apart. How did the global recession and its aftermath impact your efforts to reshape the American Cancer Society?

“Our transformation wasn’t the result of a bad economy. I would acknowledge though that while the recession was an unwelcome opportunity, it was an opportunity nonetheless.”

Greg Bontrager: In round numbers we took about a $120 million fundraising hit during the recession, which is more than most nonprofits raise in a year. That said, our transformation wasn’t the result of a bad economy. I would acknowledge though that while the recession was an unwelcome opportunity it was an opportunity nonetheless. We seized on the idea that the economy is bad so we need to be more impactful and more efficient. We took full advantage of that, but we remind the organization constantly that transformation, in and of itself, has very little to do with economic pressure. It’s about efficiency, effectiveness and impact.

Voices: How do you differentiate your value proposition from all the other charities that are seeking support for worthy causes in a difficult fundraising environment?

John R. Seffrin: The value proposition for us is very straightforward. Cancer is a major threat to every single family, not only in America but around the world. People care about this disease. We now have the experience and the knowledge and the tools to reduce dramatically any given family’s risk from cancer and increase their chance if they get cancer of surviving and here are the results.

Greg Bontrager: I would add that we are a solutions enterprise. In other words we’re not about getting money, we’re about providing answers and solutions. So if you have questions about cancer we have answers. If you have problems, we can provide support. One manifestation of that is our call center. We literally take millions of calls a year, 24 hours a day, seven days a week. We’ll address any issues relating to cancer. Whether you’re a caregiver or a patient, whatever your age or your diagnosis, the approach you want to take, or where you live in the country, the American Cancer Society is there.

Voices: What’s different about your overall approach to fundraising now versus before you embarked on the transformation initiative?

Greg Bontrager: We are building a consistent organization with a consistent value proposition for our consuming public, wherever they may be. Today we’re a billion dollar a year organization. The vast majority of those billion dollars come to us from small donations at a community level, and boy do we appreciate those gifts. Now we need to augment those gifts with new and different kinds of fundraising. In terms of the giving pyramid, we’re very strong at the base of the pyramid and at the top of the pyramid, which is people thinking enough about the American Cancer Society to leave us money in wills and trusts. Now we’re building out the middle of the pyramid with larger gifts, more efficient fundraising, more appropriate and comprehensive use of social media. We’re working on major gifts and high-net-worth individuals, as well as corporations with programs like CEOs Against Cancer®.

Voices: How has the strategic transformation impacted your overall mission?

John R. Seffrin: The American Cancer Society is the only international, community-based, voluntary health organization dedicated to eliminating cancer as a major public health problem by preventing it, by saving lives from it, and by reducing human suffering from it through research, education, advocacy and service. We’re the only cancer fighting organization in the entire world with that comprehensive mission statement. It’s a mouthful, and marketing people say it’s too many words, but our volunteers and staff believe in it. We’re not going to just become the American Cancer Research Association, we’re not going to become just the Breast Cancer Organization, we’re about all kinds of cancer and we’re about reaching out to all people.

So the mission doesn’t change, but our transformation will allow us to focus more on where we can do the most. We are going to do what will save the most lives the quickest. That’s a different question from saying we’ll just continue to fund research and hope for more cures to come through. We’re also going to try to take the money entrusted us by the American people and donors from around the world and spend it where we can do the most to prevent unnecessary deaths from cancer.

The American Cancer Society at a glance

Founded in 2013, the American Cancer Society (ACS) is the largest voluntary health organization in the United States. Last year it raised just under $1 billion to pursue its ambitious goal of finishing the fight against cancer in this century. In addition to conducting and funding cancer research, the ACS supports a wide range of support programs for cancer patients, survivors and caregivers.

E-mail alerts

Get our latest knowledge emailed to you

Follow us