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Commonwealth Fund 2011 Annual Report—Printable Version A Private Foundation Working Toward a High Performance Health System 2011 ANNUAL REPORT The Commonwealth Fund, among the first private foundations started by a woman philanthropist—Anna M. Harkness— was established in 1918 with the broad charge to enhance the common good. The mission of The Commonwealth Fund is to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults. The Fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy. An international program in health policy is designed to stimulate innovative policies and practices in the United States and other industrialized countries. Cover photo: Donnelly Marks The Commonwealth Fund 2011 Annual Report Working toward the goal of a high performance health care system for all Americans, the Fund builds on its long tradition of scientific inquiry, a commitment to social progress, partnership with others who share common concerns, and the innovative use of communications to disseminate its work. The 2011 Annual Report offers highlights of the Fund’s activities in the past year. 1 Health Reform's First Year: Supporting the Rollout In her essay, Commonwealth Fund President Karen Davis discusses how The Commonwealth Fund's work in 2011 has centered on three major goals: helping health care leaders and the American people understand the Affordable Care Act and what it means for them; supporting implementation of the new law and assessing its potential to move the U.S. along the path to high performance; and laying the groundwork for future health care delivery system change and policy action. 9 Bringing the International Experience to Bear on the U.S. Health Reform Debate: The Commonwealth Fund's Harkness Fellowships Foundations have a long history of investing in programs that seek to launch or transform the careers of talented individuals. In his essay, Executive Vice President and COO John E. Craig, Jr., draws on the Fund's long experience with fellowship programs, beginning in 1925 with the Commonwealth Fund Fellowships, later to become the Harkness Fellowships. 33 The Fund’s Mission, Goals, and Strategy Program Highlights, 2011 43 Health System Quality and Efficiency 51 Long-Term Care Quality Improvement 58 Patient-Centered Coordinated Care 65 Vulnerable Populations 75 Affordable Health Insurance 84 Commission on a High Performance Health System 90 Federal and State Health Policy 94 Payment and System Reform 100 Health System Performance Assessment and Tracking 104 International Program in Health Policy and Innovation 115 Treasurer’s Report 127 Financial Statements 140 The Fund’s Founders and Benefactors 141 Directors and Staff 148 Grants Approved, 2010–2011 A Private Foundation Working Toward a High Performance Health System 2011 Annual Report President’s Message HEALTH REFORM’S FIRST YEAR: SUPPORTING THE ROLLOUT Karen Davis, President The Commonwealth Fund The Commonwealth Fund is a private foundation that promotes a high performance health care system providing better access, improved quality, and greater efficiency. The Fund’s work focuses particularly on society’s most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults. The Fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy. An international program in health policy is designed to stimulate innovative policies and practices in the United States and other industrialized countries. Pub. no. 1568 Cover photo: Donnelly Marks. Page 6 photo: Roger Carr. HEALTH REFORM’S FIRST YEAR: SUPPORTING THE ROLLOUT Karen Davis President potential to reverse these trends and put the nation When the first provisions of the on a path to a high performance health system that Affordable Care Act took effect over a year ago, they provides affordable access to high-quality, efficient heralded the promise of better access to health insur- care. Over the last year, The Commonwealth Fund’s ance coverage, financial relief, and health security for work has centered on three major goals: millions of Americans. Already health care spend- ing is growing slower than experts originally antic- • Helping health care leaders and the ipated. Further significant savings should material- American people understand the Affordable ize for government, employers, and families as pro- Care Act and what it means for them; visions aimed at transforming health care financing • Supporting implementation of the new law and delivery lead to lower insurance administrative and assessing its potential to move the U.S. costs, fewer avoidable hospitalizations and hospi- along the path to high performance; and tal-acquired infections, and better management of • Laying the groundwork for future health chronic conditions. care delivery system change and policy The need for health reform in the United States action. is irrefutable. The ranks of the uninsured and under- The Fund has strived to clarify the implications insured continue to swell, even as health care spend- of the Affordable Care Act, bring expertise to bear ing consumes almost a fifth of the nation’s economic on its implementation, and help health care organi- resources—yet without producing health outcomes zations respond to the opportunities embodied in as good as those in countries that spend half as much the legislation. per person as we do. The health reform law has the EXPLAINING HEALTH REFORM AND analysis, and commentary. Every month since its ITS IMPACT launch, the Health Reform Resource Center has In the past year, the federal government made con- been one of the most-viewed pages on our Web site. siderable progress in rolling out the first provisions To explain the impact that reform will have on of the health reform legislation: our health system, we introduced a new series of l According to data released by the Centers for issue briefs, Realizing Health Reform’s Potential, to Disease Control and Prevention, the Affordable explore how the Affordable Care Act benefits differ- Care Act is already benefiting this group: since ent populations and groups, such as women, young September 2010, when a policy allowing chil- adults, and small businesses, as well as how it will dren to remain on their parents’ insurance plans improve insurance coverage and help transform the through age 26 took effect, approximately 2.5 delivery of care. For example, once the law is fully million more young adults ages 19 to 25 have implemented in 2014, nearly all the 27 million coverage, compared with the number who would working-age women who went without health cov- have been insured without this policy. Many members of the public—and l Seniors and disabled individuals no longer face a even a number of policymakers— “doughnut hole” in their prescription drug cov- do not understand what is in the erage. The Centers for Medicare and Medicaid Affordable Care Act or how the Services estimates that more than 2.2 million law will improve health care in people have saved in excess of $1.2 billion on their prescriptions this year, for an average of the U.S. $550 per person. erage in 2010 will gain affordable, comprehensive l Financial barriers to preventive care services have insurance benefits. Health reform will accomplish been removed. this by expanding Medicaid to those with the lowest l Tax credits are now available to help small busi- incomes, providing premium tax credits to middle- nesses offer affordable coverage to their workers. income individuals, requiring health plans to offer Still, many members of the public—and even comprehensive benefits like free coverage of preven- a number of policymakers—do not understand tive care services, issuing tax credits to small busi- what is in the Affordable Care Act or how the law nesses, offering new affordable coverage options, and will improve health care in the U.S. That’s why The instituting insurance market reforms—for example, Commonwealth Fund launched its online Health by banning gender rating, which contributes to Reform Resource Center last spring. Here, visitors higher premiums for women in the individual insur- can find reader-friendly summaries of all the law’s ance market. provisions, a tool for sorting through the provisions, Along with greatly expanding access to afford- an implementation timeline, and links to federal reg- able, comprehensive health coverage, the reform ulations and related Commonwealth Fund research, 4 The Commonwealth Fund 2011 President’s Message law also aims to improve the efficiency and effec- premium increases may lose the opportunity to tiveness of health care delivery. By making major participate in the new health insurance exchanges. investments in primary care, including preventive A recent Commonwealth Fund report had under- services and chronic disease care, the law will shore scored the need for such transparency, finding that up an undervalued part of our health system. The employer premiums had increased an average of 50 Commonwealth Fund’s Realizing Health Reform’s percent across the states between 2003 and 2010. Potential series explores how provisions in the law will help to expand and train the primary care work- INFORMING AND SUPPORTING force, improve reimbursement for primary care ser-
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