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COMMONWEALTH FUND

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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 Karen Davis, Ph.D. [1]

The Commonwealth Fund Commonwealth Fund logo

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:

• delivery system innovation and improvement

• health reform policy

• health system performance tracking

• international health policy

Health Care Delivery System Change

The Program on Health System Quality and Efficiency focuses on greater coordination and accountability among all those involved in the delivery of health care. One project of note is State Action on Avoidable Rehospitalizations(STAAR), run by the Institute for Healthcare Improvement (IHI) with Commonwealth Fund support since 2009. To date nearly 150 STAAR hospitals in three states have joined more than 500 community-based partners such as nursing homes in the push to improve care transitions. The program also operates WhyNottheBest.org, an online resource for health professionals that enables them to track performance across hospitals and regions.

The Program on Patient-Centered Coordinated Care sponsors activities aimed at improving the quality of primary health care in the United States, including efforts to make care more centered around the needs and preferences of patients and their families. In April 2008, The Commonwealth Fund launched the five-year Safety Net Medical Home Initiative to support the transformation of 65 primary care clinics serving low-income and uninsured people into patient-centered medical homes.

The Picker/Commonwealth Fund Program on Long-Term Care Quality Improvement aims to 1) raise the quality of postacute and long-term care services and supports, and 2) improve care transitions for patients by integrating these services with the other care that they receive. The program supports Advancing Excellence in America’s Nursing Homes, a national, voluntary quality improvement campaign in which half of all U.S. nursing homes participate.

The Program on Vulnerable Populations is designed to ensure that low-income, uninsured, and other minority populations are able to obtain care from health systems capable of meeting their special needs. This program includes the Mongan Commonwealth Fund Fellowship Program (formerly the Commonwealth Fund/Harvard University Fellowship in Minority Health Policy ), a Harvard Medical School-based fellowship that develops physician leaders.

Health Reform Policy

The Program on Affordable Health Insurance envisions an equitable and efficient system of health coverage that makes comprehensive, continuous, and affordable coverage available to all Americans. Its 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.

The Commission on a High Performance Health System was established by the Board of Directors in 2005. The Commission's 17 members, a group of experts and leaders representing every sector of health care, as well as the state and federal policy arena, the business sector, professional societies, and academia, are charged with promoting a health system that provides all Americans with affordable access to high-quality, safe care while maximizing efficiency in its delivery and administration. The Commission is chaired by David Blumenthal, M.D., the Samuel O. Thier Professor of Medicine and Professor of Health Care Policy at Massachusetts General Hospital/Partners HealthCare System and Harvard Medical School. [15] The Commission has released a number of reports, including The Path to a High Performance U.S. Health System: A 2020 Vision and the Policies to Pave the Way, Bending the Curve: Options for Achieving Savings and Improving Value in U.S. Health Spending, and Organizing the U.S. Health Care Delivery System for High Performance.

The Commonwealth Fund’s Program on Federal and State Health Policy is designed to strengthen the link between the work of the foundation, including the Commission on a High Performance Health System, and policy processes at the federal and state levels. The program hosts an annual Bipartisan Congressional Health Policy Conference for members of Congress, as well as other briefings for congressional members and their staff throughout the year.

The Program on Payment and System Reform supports the development and analysis of options for reforming how health care is paid for, focusing on incentives to improve the effectiveness and efficiency of care delivery while curbing spending growth. Recent publications have examined the role of accountable care organizations and how best to test and disseminate innovative payment and delivery methods.

Health System Performance Tracking

The Commonwealth Fund gathers and disseminates evidence of excellence in health care from across the country and the world to show what it is possible to achieve, and to stimulate health care providers, policymakers, and stakeholders to take action to improve performance. Since 2006, The Commonwealth Fund and its Commission on a High Performance Health System have tracked the performance of U.S. health care through a series of national, state, [16][17] and regional scorecards.

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, [18] 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.

Current Leadership

President

The Commonwealth Fund's current president is Karen Davis, a nationally recognized economist who has an extensive background in public policy and research. Before joining the Fund, she served as chairman of the Department of Health Policy and Management at the Johns Hopkins School of Public Health, where she also held an appointment as professor of economics. She served as deputy assistant secretary for health policy in the Department of Health and Human Services from 1977–1980, under the Carter administration, and was the first woman to head a U.S. Public Health Service agency. Prior to her government career, Davis was a senior fellow at the Brookings Institution in Washington, D.C., a visiting lecturer at Harvard University, and an assistant professor of economics at Rice University. A native of Oklahoma, she received her Ph.D. in economics from Rice University.

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. Mr. 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 12 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.

• Karen Davis, Ph.D.: president of The Commonwealth Fund.

• Michael V. Drake, M.D.: chancellor of the University of California, Irvine.

• Samuel C. Fleming: managing director of Briland, LLC.

• 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.

• Glenn M. Hackbarth, J.D.: Mr. Hackbarth, an independent consultant, and chairman of the Medicare Payment Advisory Commission (MedPAC).

• 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.

• 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 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 is made up of 17 members—distinguished experts and leaders representing every sector of health care, as well as the state and federal policy arenas, the business sector, and academia.

Current Commission Members

• David Blumenthal, M.D., M.P.P. (Chair), Samuel O. Thier Professor of Medicine and Professor of Health Care Policy, Massachusetts General Hospital/Partners HealthCare System and Harvard Medical School.

• Maureen Bisognano, M.Sc., President and Chief Executive Officer, Institute for Healthcare Improvement

• Sandra Bruce, M.S., President and Chief Executive Officer, Resurrection Health Care

• Christine K. Cassel, M.D., President and Chief Executive Officer, American Board of Internal Medicine and ABIM Foundation

• Michael Chernew, Ph.D., Professor, Department of Health Care Policy, Harvard Medical School

• John M. Colmers, M.P.H., Vice President, Health Care Transformation and Strategic Planning, Johns Hopkins Medicine

• Patricia Gabow, M.D., Chief Executive Officer, Denver Health

• Glenn M. Hackbarth, J.D., Consultant

• George C. Halvorson, Chairman and Chief Executive Officer, Kaiser Foundation Health Plan Inc.

• Jon M. Kingsdale, Ph.D., Consultant

• Gregory P. Poulsen, M.B.A., Senior Vice President, Intermountain Health Care

• Neil R. Powe, M.D., M.P.H., M.B.A., Chief, Medical Services, San Francisco General Hospital, Constance B. Wofsy Distinguished Professor and Vice-Chair of Medicine, University of California, San Francisco

• Louise Y. Probst, R.N., M.B.A., Executive Director, St. Louis Area Business Health Coalition

• Martín J. Sepúlveda, M.D., FACP. IBM Fellow and Vice President, Integrated Health Services, IBM Corporation

• David A. Share, M.D., M.P.H., Vice President, Value Partnerships, Blue Cross Blue Shield of Michigan

• Glenn D. Steele, Jr., M.D., Ph.D., President and Chief Executive Officer, Geisinger Health System

• Alan R. Weil, J.D., M.P.P., Executive Director, National Academy for State Health Policy

References

1.  "Davis Karen". The Commonwealth Fund. http://www.commonwealthfund.org/Bios/D/Davis-Karen.aspx. Retrieved 2012-05-02.

2.  J. L. Fleishman, The Foundation: A Great American Secret: How Private Wealth Is Changing the World (New York, New York: PublicAffairs, 2007), p. 42.

3.  "The Rockefeller Archive Center - Commonwealth Fund Archives, 1918-1988". Rockarch.org. http://www.rockarch.org/collections/nonrockorgs/commonwealth.php. Retrieved 2012-05-02.

4.  "The Rockefeller Archive Center - Commonwealth Fund Archives, 1918-1988". Rockarch.org. http://www.rockarch.org/collections/nonrockorgs/commonwealth.php#grants. Retrieved 2012-05-02.

5.  "The Rockefeller Archive Center - Commonwealth Fund Archives, 1918-1988". Rockarch.org. http://www.rockarch.org/collections/nonrockorgs/commonwealthharkness.php. Retrieved 2012-05-02.

6.  "MEDICAL RESEARCH GETS LARGE GIFTS; Commonwealth Fund Reports That Benefactions in 1936 Totaled $1,967,153. BUILDS NEW HOSPITALS Large Share to Institutions in This City—Income Largest in Several Years. Gift Aids Study of Hospitals Scholarships to Physician". January 18, [year missing]. http://select.nytimes.com/gst/abstract.html?res=F00F10FA3D5C1A7A93CAA8178AD85F438385F9&scp=11&sq=The%20Commonwealth%20Fund&st=cse. (subscription required)

7.  Fleishman, J L (2007). The Foundation: A Great American Secret: How Private Wealth Is Changing the World. New York, New York: Public Affairs. p. 217.

8.  "Teams Up With a Foundation to Identify Extraordinary, Unorthodox Opportunities for Philanthropic Investment". InnoCentive. http://www.innocentive.com/innocentive-teams-foundation-identify-extraordinary-unorthodox-opportunities-philanthropic-investmen. Retrieved 2012-05-02.

9.  "Dickinson W. Richards - Nobel Lecture". Nobelprize.org. 1956-12-11. http://www.nobelprize.org/nobel_prizes/medicine/laureates/1956/richards-lecture.html. Retrieved 2012-05-02.

10.  "Foundation History". The Commonwealth Fund. 2010-06-01. http://www.commonwealthfund.org/About-Us/Foundation-History.aspx. Retrieved 2012-05-02.

11.  Carrns, A (26 January 2012). "Health Insurance Deductibles Doubled in 7 Years, Study Finds". The New York Times. http://www.nhttp://bucks.blogs.nytimes.com/2012/01/26/family-health-insurance-costs-doubled-in-7-years-study-finds/?scp=6&sq=commonwealth%20fund&st=cse.

12.  "EDITORIAL; The Plight of the Underinsured". The New York Times: p. 30. http://www.nytimes.com/2008/06/12/opinion/12thu2.html.

13.  C. Schoen, M. M. Doty, R. H. Robertson, and S. R. Collins (September 2011). "Affordable Care Act Reforms Could Reduce The Number Of Underinsured US Adults By 70 Percent". Health Aff. http://content.healthaffairs.org/content/30/9/1762.full?ijkey=hE02tU8XwcgZ6&keytype=ref&siteid=healthaff.

14.  Sack, Kevin (22 September 2011). "More Young Adults Insured Since Health Law Took Effect". The New York Times: p. 1. http://www.nytimes.com/2011/09/22/us/young-adults-make-gains-in-health-insurance-coverage.html.

15.  "Blumenthal tapped for top spot". Harvard Gazette. June 2011. http://news.harvard.edu/gazette/story/2011/06/blumenthal-tapped-for-top-spot/.

16.  "EDITORIAL; Bad Grades on Long-Term Care". The New York Times. 12 September 2011. http://www.nytimes.com/2011/09/13/opinion/bad-grades-on-long-term-care.html.

17.  "Big Variations Found in Health Care Quality, Community to Community". National Journal. 14 March 2012.. http://www.nationaljournal.com/healthcare/big-variations-found-in-health-care-quality-community-to-community-20120314.

18.  "New 2011 Survey of Patients with Complex Care Needs in 11 Countries Finds That Care Is Often Poorly Coordinated". Health Affairs Web First. 9 November 2011. http://content.healthaffairs.org/content/30/12/2437.abstract?sid=d92d895d-f5de-43a3-bc16-51d5ae9f2922.

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