Abstract
In the context of increasing financial constraints and technological demands in public healthcare, fundraising and donor care emerge as strategic levers for sustainability and innovation. This paper explores how philanthropic engagement complements public funding by enhancing hospitals' transformative capacity, governance, and social mission. Through Italian cases such as ASST FBF-Sacco and ASST Pini-CTO-it highlights how integrated fundraising models, transparency, and organizational culture can strengthen reputation, drive innovation, and create sustainable value within public healthcare systems.