Commonwealth Fund

The Commonwealth Fund

Founded	1918
Founder	Anna Harkness
Location	New York City
Key people	David Blumenthal, President
Endowment	$700 million
Slogan	A private foundation working toward a high performing health system
Website	www.commonwealthfund.org

The Commonwealth Fund is a private U.S. foundation whose stated purpose is to "promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable" and the elderly. It is active in a number of areas related to health care and health policy. It is currently led by David Blumenthal, M.D.^[1]

Founding and early program history

The Commonwealth Fund, one of the first foundations to be established by a woman, was founded in 1918 with an endowment of almost $10 million by Anna M. Harkness. The widow of Stephen V. Harkness, a principal investor in Standard Oil, Mrs. Harkness wanted to “do something for the welfare of mankind.” Anna’s son, Edward Stephen Harkness, became the Commonwealth Fund’s first president and hired a staff of people to help him build the foundation. Edward Harkness possessed a "passionate commitment to social reform" and was "determined to improve health and health services for Americans."^[2] Through additional gifts and bequests between 1918 and 1959, the Harkness family's total contribution to the Fund's endowment amounted to more than $53 million. Today, the Commonwealth Fund’s endowment stands at almost $700 million.

According to the Rockefeller Archive Center, The Commonwealth Fund’s “early grants supported a variety of programs while generally promoting welfare, especially child welfare.”^[3] Over the years, it has given support to medical schools and to the building of hospitals and clinics. In New York City, the Commonwealth Fund was a major contributor to the building of Columbia-Presbyterian Medical Center of the College of Physicians and Surgeons and Presbyterian Hospital at Columbia University in 1922. By the mid-1920s the chief interest of the foundation had become public health, including mental hygiene, community health, rural hospitals, medical research, and medical education.^[4] Other grant areas included war relief, educational and legal research, and international medical fellowships.^[3]

In 1925, the Commonwealth Fund launched its international program of fellowships called The Commonwealth Fund Fellowships (now the Harkness Fellowships).^[5] Until the 1990s, the fellowship was open to scholars of all academic disciplines, and included many who went on to excel in science, the arts and business.

From the late 1920s through the 1940s, the Commonwealth Fund supported the construction of rural hospitals, paving the way for the Hill-Burton Act in 1946.^[6] Following World War II, the foundation supported the development of new medical schools in the United States in an effort to address doctor shortages and meet the needs of communities lacking health care services. Other achievements include the Rochester Regional Hospital Council and the development of the Nurse Practitioner and Physician Assistant professions.^[7]

Dr. Georgios Papanikolaou’s Commonwealth Fund-supported research in the 1940s pioneered the Pap test^[8] as the basic technique for detecting cervical cancer. Refinement of cardiac catheterization into routine treatment resulted in a 1956 Nobel Prize^[9] for the Fund-supported researchers.

In the 1960s and early 1970s, the organization focused on developing urban health care systems, and in the late 1970s, worked to improve medical school curricula. In the 1980s, the Commonwealth Fund played a prominent role in the development of the patient-centered care movement and helped draw attention to the needs of older Americans.

While the Commonwealth Fund does not typically accept donations, several gifts to the foundation have increased the endowment and expanded the scope of the Commonwealth Fund’s projects and programs:

• In 1986, Jean and Harvey Picker merged $15 million in assets of the James Picker Foundation with those of The Commonwealth Fund.
• In 1996, the Commonwealth Fund received $1.7 million from the Health Services Improvement Fund with a mandate to use the funds to improve health care coverage, access, and quality in the New York City greater metropolitan region.
• In 1999, Floriana Hogan left $100,000 to the Fund, and Frances Cooke Macgregor contributed $3.1 million to the endowment in 2002.^[10]

Notable early grantees and years funded[4]

American Board of Pediatrics, 1972–1975 American Red Cross (Emergency Relief) 1919–1920, 1922, 1928 1937, 1955, 1960 American Museum of Natural History, 1969–1970, 1979–1983 Boy Scouts of America, 1919, 1921, 1928 Brigham and Women's Hospital, 1974–1987 Columbia University, 1920–1982, 1979–1991 Food Packages for Austria, 1946–1950 Food Packages for England, 1947–1948 Guttmacher Institute, 1977–1983 Harkness Community and Medical Center, 1967–1975 Harvard University, 1920–1987 International Women's Health Coalition, 1984–1986 Johns Hopkins University, 1919–1984, 1977–1981 Juilliard School, 1972–1981 Lincoln Center for the Performing Arts, 1957–1966 Museum of the City of New York, 1971–1974 New York Botanical Garden, 1946–1958, 1968–1969, 1975–1980 Planned Parenthood of New York City, Inc., 1967–1980, 1982–1986 Royal Society of Medicine, 1969–1981 University of Saint Andrews, 1960–1961 The Urban Institute, 1981–1986 Vanderbilt University School of Medicine, 1981–1988 War Relief and Related Purposes, 1939–1949 Yale University, 1921–1982

Activities

Today, the Commonwealth Fund works in the following areas:

• health care delivery system reform
• health care coverage and access
• international health policy
• breakthrough health care opportunities

Health care delivery system reform

The goal of the Health Care Delivery System Reform program is to improve outcomes and lower costs for high-cost, complex and vulnerable patient populations. Work supported by the program is governed by five strategies:

• Promoting care systems that coordinate medical care, long-term care services, and community-based resources.
• Reforming how providers are paid for their services to encourage more coordination, better quality, and greater efficiency.
• Strengthening primary care.
• Partnering with payers, particularly Medicare and Medicaid, and with private payers to test and spread effective innovations.
• Developing the physician leadership needed to address the health needs of vulnerable populations through the Mongan Commonwealth Fund Fellowship Program in Minority Health Policy.

Health care coverage and access

As the Affordable Care Act's central coverage reforms go into effect, The Commonwealth Fund’s Health Care Coverage and Access program aims to furnish policymakers and key stakeholders with timely analysis to inform successful implementation. Activities include the following:

• Providing timely information about the law's reforms and the status of their implementation.
• Tracking enrollment and people’s experiences with the new insurance options.
• Evaluating the effects of insurance reforms and state and federal innovation on the extent and quality of health coverage, access to health care, changes in employer-based coverage, affordability of premiums and out-of-pocket costs, health plan competition, innovation in insurance markets, and sustainability of the insurance marketplaces.
• Analyzing and developing national and state short-term policy solutions to address implementation issues as they arise.
• Identifying gaps in the law and its implementation that may leave some groups of people without coverage or adequate protection from costs.

This works builds on a history of tracking insurance coverage in the United States. The program's Biennial Health Insurance Survey^[11] has enabled researchers to examine the effects of the recent severe economic recession on insurance coverage, as well as to assess changes in coverage, access to care, and medical bill problems over a decade. It also helped identify the problem of the underinsured,^[12][13] which are people with health insurance but high medical expenses relative to income. The survey found that between 2003 and 2010, the number of underinsured rose from 16 million to 29 million. The program also conducts surveys^[14] of young adults, which, prior to the Affordable Care Act, have found they delay care because of lack of coverage.

International health policy

The Commonwealth Fund’s International Program in Health Policy and Innovation promotes cross-national learning. Its annual international health care policy symposium in Washington, D.C., organized in collaboration with the U.S. health policy journal, Health Affairs, brings together health ministers and other policymakers from nations including Australia, Canada, France, Germany, New Zealand, the Netherlands, Norway, Sweden, Switzerland, the United Kingdom, and the United States. The international health policy survey,^[15] which is released annually in November, provides valuable cross-country information about health care access, costs, and quality. The program also sponsors the Harkness Fellowship, which recruits researchers and practitioners from Australia, Germany, the Netherlands, New Zealand, and the United Kingdom, among other countries, to conduct health policy research in the United States.

Breakthrough Health Care Opportunities

The new Breakthrough Health Care Opportunities program will explore emerging technologies, care delivery processes, organizational models, incentives, and policies that could have a game-changing effect on health system performance. By bringing together innovators, users, entrepreneurs, venture capitalists and regulators, the program will facilitate the translation of these innovative ideas into practice.

In its first year, the program will focus on three areas: Engaging consumers in their health care through information technology; next-generation provider incentives that are grounded in behavioral change theory; and "frugal innovations" from the developing world that may be transferable to the United States.

Current leadership

President

The Commonwealth Fund's current president is David Blumenthal, M.D. Blumenthal is formerly the Samuel O. Their Professor of Medicine at Harvard Medical School and Chief Health Information and Innovation Officer at Partners Healthcare System in Boston. From 2009 to 2011, Blumenthal served as the U.S. National Coordinator for Health Information Technology, with the charge to build an interoperable, private, and secure nationwide health information system and to support the widespread, meaningful use of health IT. Previously, he was a practicing primary care physician, director of the Institute for Health Policy, and professor of medicine and health policy at Massachusetts General Hospital/Partners Healthcare System and Harvard Medical School. He is a member of the Institute of Medicine and a former board member and national correspondent for the New England Journal of Medicine.

Executive vice president and chief operating officer

John E. Craig, Jr., M.P.A., is the executive vice president and chief operating officer of The Commonwealth Fund. Craig writes regularly on foundation endowment investment and management issues; his most recent publication is New Financial Realities: The Response of Private Foundations. A graduate of Davidson College, he received his M.P.A. from Princeton University's Woodrow Wilson School of Public and International Affairs.

Board of directors

The Commonwealth Fund’s Board of Directors comprises 11 members which make up four committees: the Executive & Finance Committee, the Audit & Compliance Committee, the Investment Committee, and the Governance & Nominating Committee. The members’ backgrounds are diverse and include hospital administration, journalism, university administration, consulting, financial management, and teaching.

Current board members

• James R. Tallon, Jr., Chairman: president of the United Hospital Fund of New York.
• Cristine Russell, Vice Chairman: Journalist Maureen Bisognano: Ms. Bisognano is president and chief executive officer of the Institute for Healthcare Improvement.
• Benjamin K. Chu, M.D.: regional president, Southern California, Kaiser Foundation Health Plan and Hospital.
• David Blumenthal, M.D.: president of The Commonwealth Fund.
• Sheila P. Burke, R.N., M.P.A., FAAN: a faculty member and former executive dean at Harvard University’s John F. Kennedy School of Government.
• Michael V. Drake, M.D.: chancellor of the /University of California, Irvine.
• Julio Frenk, M.D., Ph.D.: Dean of the Faculty and T & G Angelopoulos Professor of Public Health and International Development at the Harvard School of Public Health.
• Jane E. Henney, M.D.: professor of medicine at the University of Cincinnati Academic Health Center, in Cincinnati, Ohio.
• Robert C. Pozen: chairman of MFS Investment Management.
• Simon Stevens: executive vice president of UnitedHealth Group. He will serve as the head of the U.K.'s National Health Service (NHS) starting in April 2014.
• William Y. Yun: executive vice president of Alternative Investments for Franklin Templeton Investments.

Select past board members

• Mary Harkness (1872–1952) served as Honorary President from 1940 to 1950.
• Dean Sage Jr. (1875–1943) was a partner of the law firm of Sage, Gray, Todd & Sims. He became President of the Presbyterian Hospital in 1922, and in 1924 announced its merger with the College of Physicians and Surgeons of Columbia University, to become the Columbia-Presbyterian Medical Center.
• Malcolm Aldrich (1900–1986) spent many years with the Commonwealth Fund, from the time he graduated from college in 1922 until his death. He served as the executor of Edward Harkness’ estate and also the second president of the Commonwealth Fund.
• Hulbert S. Aldrich (1908–1995) a former president and director of the New York Trust Company and a former vice chairman and director of Chemical Bank.
• Calvin Hastings Plimpton, M.D., (1918–200) was an American physician and educator who served as president of Amherst College and American University of Beirut. He is known for appointing a commission in 1970 whose findings resulted in the admission of women to Amherst in 1975.
• Arthur Robert Ashe, Jr. (1943–1993) was a professional tennis player, born and raised in Richmond, Virginia. During his career, he won three Grand Slam titles. Ashe was the first black player ever selected to the United States Davis Cup team and the only black man to ever win the singles title at Wimbledon, the US Open, or Australian Open.
• Charles A. Sanders, M.D, was a professor of medicine at Harvard Medical School and CEO of the Massachusetts General Hospital. As a senior executive at Squibb and later as CEO of Glaxo, he led vigorous research and development programs.
• Blenda J. Wilson has served as the chief executive officer of several colleges and universities. She is currently a member of the Trusteeship Committee of Cedar Crest College and Union Theological Seminary. She is chair of the board of directors of HERS, a national leadership development organization for women higher education administrators.
• Samuel O. Thier, M.D., is a professor of medicine and health care policy at Harvard University. He previously served as the president of Brandeis University from 1991–1994 and the president of the Massachusetts General Hospital from 1994–97.

The Commonwealth Fund Commission on a High Performance Health System

Established in 2005, the Commission was composed of distinguished experts and leaders representing every sector of health care, as well as the state and federal policy arenas, the business sector, and academia. After publishing a number of influential reports on health reform leading up to and following the passage of the Affordable Care Act, the Commission concluded its activities in March 2013.

References

External links

• Commonwealth Fund
• Commonwealth Fund Archives