Commonwealth Fund

Last updated
The Commonwealth Fund
The Commonwealth Fund.png
Founded1918;101 years ago (1918)
FounderAnna Harkness
Location
  • New York City
Key people
David Blumenthal, President
Endowment $700 million
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 led by David Blumenthal, M.D. [1]

Until 1969, the term private foundation was not defined in the United States Internal Revenue Code. Since then, every U.S. charity that qualifies under Section 501(c)(3) of the Internal Revenue Service Code as tax-exempt is a "private foundation" unless it demonstrates to the IRS that it falls into another category such as public charity. Unlike nonprofit corporations classified as a public charity, private foundations in the United States are generally subject to a 1% or 2% excise tax or endowment tax on any net investment income.

David Blumenthal Academic physician and health care policy expert

David Blumenthal is an academic physician and health care policy expert, best known as the National Coordinator for Health Information Technology in the period 2009-2011 during early implementation of the Health Information Technology for Economic and Clinical Health Act provisions on "meaningful use".

Contents

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,[ when? ] the Commonwealth Fund’s endowment stands at almost $700 million.

Anna Maria Richardson Harkness was an American philanthropist.

Stephen V. Harkness American businessperson

Stephen Vanderburgh Harkness was an American businessman based in Cleveland, Ohio. He invested as a silent partner with John D. Rockefeller, Sr. in the founding of Standard Oil. He served as a director of Standard Oil until his death.

Standard Oil Co. Inc. was an American oil producing, transporting, refining, and marketing company and monopoly. Established in 1870 by John D. Rockefeller and Henry Flagler as a corporation in Ohio, it was the largest oil refinery in the world of its time. Its history as one of the world's first and largest multinational corporations ended in 1911, when the U.S. Supreme Court ruled, in a landmark case, that Standard Oil was an illegal monopoly.

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]

New York City Largest city in the United States

The City of New York, usually called either New York City (NYC) or simply New York (NY), is the most populous city in the United States. With an estimated 2018 population of 8,398,748 distributed over a land area of about 302.6 square miles (784 km2), New York is also the most densely populated major city in the United States. Located at the southern tip of the state of New York, the city is the center of the New York metropolitan area, the largest metropolitan area in the world by urban landmass and one of the world's most populous megacities, with an estimated 19,979,477 people in its 2018 Metropolitan Statistical Area and 22,679,948 residents in its Combined Statistical Area. A global power city, New York City has been described as the cultural, financial, and media capital of the world, and exerts a significant impact upon commerce, entertainment, research, technology, education, politics, tourism, art, fashion, and sports. The city's fast pace has inspired the term New York minute. Home to the headquarters of the United Nations, New York is an important center for international diplomacy.

Columbia University Vagelos College of Physicians and Surgeons, colloquially known as P&S and formerly Columbia University College of Physicians and Surgeons, is the graduate professional medical school of Columbia University. Located at the Columbia University Irving Medical Center in the Washington Heights neighborhood of Manhattan with its affiliate New York-Presbyterian Hospital. Founded in 1767 by Samuel Bard as the medical department of King's College, the College of Physicians and Surgeons was one of the first medical schools in the thirteen colonies and hence, the United States, to award the Doctor of Medicine (M.D.) degree. Beginning in 1993, P&S also was the first U.S. medical school to hold a white coat ceremony.

Presbyterian Hospital (New York City) former Manhattan hospital

Presbyterian Hospital in Manhattan, New York City, was founded by James Lenox in 1868, and began operations in 1872. It was originally located between East 70th and 71st Streets and Madison and Fourth Avenues, and expanded continuously throughout the late 19th century, adding an outpatient dispensary in 1888, a school of nursing in 1892, and additional beds and services in 1892, 1893, 1904 and 1912.

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]

Child receiving rabies inoculation Child receiving rabies innoculation.png
Child receiving rabies inoculation

In the 1940s, the fund supported research by Dr. Georgios Papanikolaou that 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.

Georgios Papanikolaou Greek pathologist

Georgios Nikolaou Papanikolaou was a Greek pioneer in cytopathology and early cancer detection, and inventor of the "Pap smear".

Pap test screening test used to detect potentially pre-cancerous and cancerous processes in the endocervical canal

The Papanicolaou test is a method of cervical screening used to detect potentially precancerous and cancerous processes in the cervix. Abnormal findings are often followed up by more sensitive diagnostic procedures and if warranted, interventions that aim to prevent progression to cervical cancer. The test was independently invented by Dr. Georgios Papanikolaou and Dr. Aurel Babeș and named after Papanikolaou.

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.

Harkness House, 1908 Harkness House, 1908.jpg
Harkness House, 1908

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:

Notable early grantees and years funded [4]

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 [11] 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, [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 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

  • 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 Aldric' (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 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.

Related Research Articles

Health care reform- is for the most part, governmental policy that affects health care delivery in a given place. Health care reform typically attempts to:

Medicaid United States social health care program for families and individuals with limited resources

Medicaid in the United States is a federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and personal care services. The Health Insurance Association of America describes Medicaid as "a government insurance program for persons of all ages whose income and resources are insufficient to pay for health care." Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 74 million low-income and disabled people as of 2017. It is a means-tested program that is jointly funded by the state and federal governments and managed by the states, with each state currently having broad leeway to determine who is eligible for its implementation of the program. States are not required to participate in the program, although all have since 1982. Medicaid recipients must be U.S. citizens or qualified non-citizens, and may include low-income adults, their children, and people with certain disabilities. Poverty alone does not necessarily qualify someone for Medicaid.

Medicare (United States) United States single-payer national social insurance program

Medicare is a national health insurance program in the United States, begun in 1966 under the Social Security Administration (SSA) and now administered by the Centers for Medicare and Medicaid Services (CMS). It provides health insurance for Americans aged 65 and older, younger people with some disability status as determined by the Social Security Administration, as well as people with end stage renal disease and amyotrophic lateral sclerosis.

Aetna American managed health care company

Aetna Inc. is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid insurance and benefit programs, and through Medicare. Since November 28, 2018, the company has been a subsidiary of CVS Health.

Health insurance is an insurance that covers the whole or a part of the risk of a person incurring medical expenses, spreading the risk over a large number of persons. By estimating the overall risk of health care and health system expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity.

The Clinton health care plan was a 1993 healthcare reform package proposed by the administration of President Bill Clinton and closely associated with the chair of the task force devising the plan, First Lady of the United States Hillary Clinton.

The Commonwealth of Massachusetts passed a health care reform law in 2006 with the aim of providing health insurance to nearly all of its residents. The law mandated that nearly every resident of Massachusetts obtain a minimum level of insurance coverage, provided free and subsidized health care insurance for residents earning less than 150% and 300%, respectively, of the federal poverty level (FPL) and mandated employers with more than 10 full-time employees provide healthcare insurance. The law was amended significantly in 2008 and twice in 2010 to make it consistent with the federal Affordable Care Act. Major revisions related to health care industry price controls were passed in August 2012, and the employer mandate was repealed in 2013 in favor of the federal mandate. Because Mitt Romney was the governor of Massachusetts at the time, the law has colloquially been called Romneycare, a reference to the nicknaming of the Patient Protection and Affordable Care Act as "Obamacare".

Health insurance in the United States is any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance "is used to describe any form of insurance providing protection against the costs of medical services. This usage includes private insurance and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children's Health Insurance Program, which both provide assistance to people who cannot afford health coverage.

Healthcare reform in the United States has a long history. Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes enacted in 2010: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, which amended the PPACA and became law on March 30, 2010.

Healthcare in Thailand is overseen by the Ministry of Public Health (MOPH), along with several other non-ministerial government agencies. Thailand's network of public hospitals provide universal healthcare to all Thai nationals through three government schemes. Private hospitals help complement the system, especially in Bangkok and large urban areas, and Thailand is among the world's leading medical tourism destinations. However, access to medical care in rural areas still lags far behind that in the cities.

Health insurance coverage in the United States

Health insurance coverage in the United States is provided by several public and private sources. During 2016, the U.S. population overall was approximately 325 million, with 53 million people 65 years of age and over, covered by the federal Medicare program. The 272 million non-institutional people under age 65 either obtained their coverage from employer-based or non-employer based sources, or were uninsured. Approximately 15 million military personnel received coverage through the Veteran's Administration and Military Health System. During the year 2016, 91.2% of Americans had health insurance coverage. Despite being among the top world economic powers, the US remains the sole industrialized nation in the world without universal health care coverage.

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The healthcare reform debate in the United States has been a political issue focusing upon increasing medical coverage, decreasing costs, insurance reform, and the philosophy of its provision, funding, and government involvement.

There were a number of different health care reforms proposed during the Obama administration. Key reforms address cost and coverage and include obesity, prevention and treatment of chronic conditions, defensive medicine or tort reform, incentives that reward more care instead of better care, redundant payment systems, tax policy, rationing, a shortage of doctors and nurses, intervention vs. hospice, fraud, and use of imaging technology, among others.

Patient Protection and Affordable Care Act United States federal statute

The Patient Protection and Affordable Care Act (PPACA), often shortened to the Affordable Care Act (ACA) or nicknamed Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965.

Health care in the United States is provided by many distinct organizations. Health care facilities are largely owned and operated by private sector businesses. 58% of US community hospitals are non-profit, 21% are government owned, and 21% are for-profit. According to the World Health Organization (WHO), the United States spent $9,403 on health care per capita, and 17.1% on health care as percentage of its GDP in 2014. Healthcare coverage is provided through a combination of private health insurance and public health coverage. The United States does not have a universal healthcare program, unlike other advanced industrialized countries.

Karen Davis is president of The Commonwealth Fund, a national philanthropy engaged in independent research on health and social policy issues. Davis is an economist, with a career in public policy and research. Before joining The Commonwealth 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, becoming the first woman to head a U.S. public health service agency.

Susan Blumenthal American physician, public health expert, and psychiatrist

Rear Admiral Susan Blumenthal, M.D. is an American physician, global health expert, psychiatrist and public health advocate. With more than two decades of service as a senior government health leader in the administrations of four U.S. presidents, Blumenthal served as the first Deputy Assistant Secretary for Women's Health and Director of the Office on Women's Health within the U.S. Department of Health and Human Services (HHS), as well as Assistant Surgeon General of the United States and Senior Global Health Advisor within the HHS. She also was a Research Branch Chief at the National Institutes of Health (NIH), and the Chair of the NIH Health and Behavior Coordinating Committee. As of 2016, she has served as the Senior Medical and Policy Advisor at amfAR, The Foundation for AIDS Research, a Senior Fellow in Health Policy at New America, and a Clinical Professor at Tufts and Georgetown Schools of Medicine. Blumenthal is the Public Health Editor of the Huffington Post. She is married to United States Senator Ed Markey.

References

  1. "David Blumenthal, M.D., M.P.P." Archived from the original on 2013-01-15. Retrieved 2013-01-11.
  2. J. L. Fleishman, The Foundation: A Great American Secret: How Private Wealth Is Changing the World (New Yorjjjjk, New York: PublicAffairs, 2007), p. 42.
  3. 1 2 "The Rockefeller Archive Center – Commonwealth Fund Archives, 1918–1988". Rockarch.org. Retrieved 2012-05-02.
  4. 1 2 "The Rockefeller Archive Center – Commonwealth Fund Archives, 1918–1988". Rockarch.org. Retrieved 2012-05-02.
  5. "The Rockefeller Archive Center – Commonwealth Fund Archives, 1918–1988". Rockarch.org. 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". The New York Times. January 18, 1937.(subscription required)
  7. Fleishman, J L (2007). The Foundation: A Great American Secret: How Private Wealth Is Changing the World. New York, New York: PublicAffairs. p. 217.
  8. "Teams Up With a Foundation to Identify Extraordinary, Unorthodox Opportunities for Philanthropic Investment". InnoCentive. Archived from the original on 2011-07-02. Retrieved 2012-05-02.
  9. "Dickinson W. Richards – Nobel Lecture". Nobelprize.org. 1956-12-11. Retrieved 2012-05-02.
  10. "Foundation History". The Commonwealth Fund. 2010-06-01. Archived from the original on 2009-06-15. Retrieved 2012-05-02.
  11. Carrns, A (26 January 2012). "Health Insurance Deductibles Doubled in 7 Years, Study Finds". The New York Times.
  12. "EDITORIAL; The Plight of the Underinsured". The New York Times. 2008-06-12. p. 30.
  13. C. Schoen; M. M. Doty; R. H. Robertson; S. R. Collins (September 2011). "Affordable Care Act Reforms Could Reduce The Number Of Underinsured US Adults By 70 Percent". Health Aff.
  14. Sack, Kevin (22 September 2011). "More Young Adults Insured Since Health Law Took Effect". The New York Times. p. 1.
  15. "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.