Commonwealth Fund

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." 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.” 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. Other grant areas included war relief, educational and legal research, and international medical fellowships.

In 1925, the Commonwealth Fund launched its international program of fellowships called the Commonwealth Fund Fellowships (now the Harkness Fellowships). 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. 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.

In the 1940s, the fund supported research by Dr. Georgios Papanikolaou that pioneered the Pap test as the basic technique for detecting cervical cancer. Refinement of cardiac catheterization into routine treatment resulted in a 1956 Nobel Prize 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:

Activities

Today, the Commonwealth Fund works in the following areas:

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:

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:

This works builds on a history of tracking insurance coverage in the United States. The program's Biennial Health Insurance Survey has enabled researchers to examine the effects of the recent severe economic recession on insurance coverage, and to assess changes in coverage, access to care, and medical bill problems over a decade. It also helped identify the problem of the underinsured, 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 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, 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.

President

The Commonwealth Fund's president is David Blumenthal, M.D. Blumenthal used to be the Samuel O. Thier 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

Kathleen Regan is the executive vice president and chief operating officer of the Commonwealth Fund. Ms. Regan reports to the president and serves as a member of the executive management team. She is responsible for advising the president on all major policy, management, financial, board, and regulatory issues. Ms. Regan also serves as the foundation’s chief operating officer, chief financial officer, and corporate treasurer and secretary, and have oversight responsibility for the fund’s investments. Ms. Regan has been advising and investing in health care companies for the past 25 years. She became a venture partner at Radius Ventures, a venture capital fund focused on the life sciences and health care industry in 2010. She served as a senior advisor to the U.S. Department of State Global Health Initiative, and led the development of a $200 million public‒private partnership, Saving Mothers, Giving Life, to address maternal mortality in Sub-Saharan Africa in 2012.

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

Select past board members

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.