1. THE
COMMONWEALTH
FUND
The Commonwealth Fund
&
The Harkness Fellowships
Robin Osborn
Vice President and Director
International Program in Health Policy & Practice

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The Commonwealth Fund
Established in 1918, the Commonwealth Fund is a
private, independent foundation based in New York
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
COMMONWEALTH
FUND

3. The Commonwealth Fund Commission on a
3
High Performance Health Care System
Path to a High Performance U.S. Health System, 2009
• Recommends comprehensive set of insurance, payment, and
system reforms that would generate $3.0 trillion in savings
by 2020 and ensure affordable coverage for all Americans
• Featured in briefings for Members of Congress and
Congressional staff
Bending the Curve, 2008
B di th C
• Recommends strategies to
expand coverage and save
$1.5 trillion over 10 years by
payment reform, health
promotion, IT quality
improvement and efficiency
• New York Times Editorial
THE
COMMONWEALTH
FUND

4. 4
Examples of Fund Projects
A New Era in American Health Care: National Scorecard on U.S. Health
Realizing the Potential of Reform System Performance, 2008
• Series of reports on expansion of • 37 Indicators • U.S. compared to benchmarks
coverage, health insurance exchanges,
and delivery system innovations
• Series of reports on implications of U.S.
health reform for specific populations,
including women, young adults, and small
businesses
• Detailed online descriptions of health
reform provisions with links to further
information
Medical Homes Grants
• Technical assistance to 8 states to create
patient-centered medical homes for low
income populations (Medicaid and SCHIP) IHI/Hospital Readmissions
p
• 5-year program to transform 65 safety-net • Grant to Institute for Healthcare
primary care clinics into patient-centered Improvement (IHI) for 5-year STAAR
medical homes demonstration project to reduce
• Support to the National Committee for p
preventable rehospitalizations in three
p
Quality Assurance (NCQA) to develop a set to five states or regions
THE
of 18 measures for patient-centered care in COMMONWEALTH
physician practices FUND

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WhyNotTheBest.org
Hospital Quality Comparison Site
• Hospital rating and comparison website on measures of evidence-based care,
patient experience, readmission and mortality rates, and costs
• Over 25 case studies and improvement tools featured on topics ranging among
p p g g g
health care quality, pneumonia care, surgical care improvement, patient
experiences, and health systems
• Over 6,000 registered users
THE
COMMONWEALTH
FUND

6. Patient Protection and Affordable Care Act
6
March 23, 2010
THE
COMMONWEALTH
FUND

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The Commonwealth Fund
International Program in Health Care
Policy and Practice
THE
COMMONWEALTH
FUND

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International Health Policy & Innovation Program
Participating Countries
Canada
Germany Australia
New
N Denmark
Zealand (Under discussion)
United
Netherlands
N th l d States
States*
Switzerland
Norway
y United
Kingdom
Sweden** France*
* Participate in International Symposium and International Health Policy Survey,
but do not have a Harkness Fellowships program THE
COMMONWEALTH
** Harkness Fellowship beginning 2012-13 FUND

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The Harkness Fellowships in
Health C
H lth Care Policy & P
P li Practice
ti
THE
COMMONWEALTH
FUND

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Harkness Fellowships in
Health Care Policy and Practice
Originally established in 1925, the Harkness Fellowships were
modeled after the Rhodes Scholarship and are the Fund’s longest
p g
running program.
The Harkness Fellowships provide a unique opportunity for
researchers and practitioners from Australia, Canada, Germany, the
Netherlands, New Zealand, Norway, Switzerland, the United
Kingdom, and, beginning in 2012-13, Sweden to spend up to 12
months in the United States conducting original research and
working with leading health policy experts.
g g p y p
THE
COMMONWEALTH
FUND

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Harkness Fellows can expect to:
• Conduct research on a key health care delivery or policy issue
• Gain an in depth understanding of the U.S. health care system
in-depth
• Learn about the Australian, Canadian, Dutch, German, N.Z.,
Norwegian, Swedish, Swiss, and U.K. health care systems
• Work ith leading US policy experts and senior policymakers
W k with l di li t d i li k
• Get a firsthand look at innovative U.S. programs
• Enhance methodological skills
• Develop networks of valuable contacts for ongoing cross-
national exchange and collaboration
A chance to Think Big about some of the most important
challenges in health care policy and practice
THE
COMMONWEALTH
FUND

12. Relationship with The Commonwealth Fund
12
Adds Value to the Fellowship
• Nationally and internationally renowned Fund staff provide
expertise across a range of fields in health policy and
practice
• Through the Fund’s grants, Fellows can connect to many of
the country’s most innovative projects and research
• Fund’s name-recognition and network of health leaders and
experts opens doors for Fellows
THE
COMMONWEALTH
FUND

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The Harkness Fellowship Award
The Harkness Fellowship awards up to U.S. $107,000
which covers the following:
• Roundtrip airfare to the United States
• Living allowance
• Funds for project-related travel research and conferences
project related travel, research,
• Travel to attend the Harkness Fellowship seminars
• Health insurance
• U.S. d t t t
U S and state taxes
• PLUS: a family supplement up to U.S. $45,000 (including
airfare, living allowance, and health insurance) for Fellows
accompanied by a partner and/or children up to age 18
THE
COMMONWEALTH
FUND

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Partnerships to Expand Harkness Fellowships
• Canada: Health Services Research Foundation
• G
Germany: B. B
B Braun–Stiftung; Robert Bosch Stiftung
Stift R b tB h Stift
• Netherlands: Ministry for Health, Welfare, and Sport
• Norway: Research Council of Norway
• Switzerland: Careum Foundation
• Sweden: Ministry of Health and Social Affairs
• United Kingdom: The Nuffield Trust; NHS National
Institute for Health Research/SDO
THE
COMMONWEALTH
FUND

15. Examples of Harkness Fellows’ Projects
15
Health Care Financing and Regulation
• Designing Value-Based Insurance Plans to Expand Coverage
• The Impact of Regulation on the Performance of Health Care Organizations
Improving Quality of Care
• Public Disclosure of Hospital Performance Data: The U.S. Experience
• Consumer Involvement in Comparison Effective Research
• The Impact of Financial Incentives on Quality in Primary Health Care
Information Technology
• Use of Computers for Clinical Care—5 Case Studies of Advanced US Sites
Care 5
Pharmaceutical Policy
• Comparing Cost, Coverage and Access to Pharmaceuticals in Aus. vs U.S.
• Reference Pricing for Drugs: Is it Compatible with U.S. Health Care?
Chronic Illness & the Elderly
• Chronic Disease Self Management Programs: Scope of Programs and What
g g p g
Works for Whom?
THE
COMMONWEALTH
• Improving the Emergency Care Experience for the Elderly FUND

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Examples of Harkness Fellows’ Placements
• Harvard University, Boston
• Stanford University, San Francisco
y,
• University of California, San Francisco
• Johns Hopkins University, Baltimore
p y,
• RAND/University of California, Los Angeles
• Agency for Healthcare Research and Quality (
g y y (AHRQ), Wash DC
),
• Veterans Health Administration, Wash DC
• Kaiser Permanente, San Francisco
,
• Institute for Healthcare Improvement (IHI), Boston
THE
COMMONWEALTH
FUND

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2010-11 Harkness Fellowships Seminars
• September: Five-Day Orientation Seminar at the Fund in NYC
• October: Two-Day Qualitative Research Methods Workshop in NYC
• November: International Symposium on Health Care Policy in
Washington, D.C.
• February: Institute for Healthcare Improvement (IHI) Quality Seminar in
Boston
• March: Washington Policy Briefing
• May: Canadian Policy Briefing in Montreal and Toronto
• June: Final Reporting Seminar; Farewell Dinner for Fellows and
Families
• June: AcademyHealth Annual Meeting
• Throughout the Year: Leadership Seminar Series
THE
COMMONWEALTH
FUND

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2010–11 Harkness Orientation
Karen Davis, The
Commonwealth Fund
Fund,
Antoinette De Bont (NETH)
Diane Gray (UK), Berit
Bringedal (NOR)
2010–11 Harkness Fellows
Thomas H. Lee, MD
CEO of Partners
Community Healthcare, Inc. Ansgar Gerhardus (GER)
Iren Bischofberger (SWITZ), THE
Sara Kreindler (CAN) COMMONWEALTH
FUND

19. Harkness Fellows Breakfast with Health Ministers
19
at 2010 International Symposium
Swiss Minister Pascal Strupler
U.K. Minister of State for Health Simon Burns with Fellow Iren Bischofberger
with Fellows Sarah Garner, Emma Stanton,
Harald Schmidt and Diane Gray
THE
Berit Bringedal with Norwegian COMMONWEALTH
Dutch Fellows with Ministry of Health FUND
Ministry of Health delegation
delegation

20. Harkness Fellows
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Washington Policy Briefing, March 2010
An “Inside the Beltway” Look at Policymaking and
Health Reform with Multiple Stakeholders and a
Wide Range of Viewpoints:
•Perspectives from the Administration, Members
of Congress, Washington Post journalists, Pharma
and other Lobbyists, Health Insurers, States, and
Democratic versus Republican Political Pollsters
Breakfast Meeting with • Site Visit to the Veterans Health Administration Ezekiel Emanuel, White House
Congressman Tom Price Office of Management and
(R-Ga) Budget
•Fellows attend historic vote in Congress on
Fellows
health reform passage on March 21, 2010
Haynes Johnson,
Eleanor Dehoney, Legislative
Pulitzer Prize Winning Journalist
Director, Senator Sherrod Brown
THE
COMMONWEALTH
FUND
Karen Ignagni, president of
U.S. Congressman John Lewis (D-GA,
America’s Health Insurance Plans
2009–10 Harkness Fellows

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Washington Policy Briefing
February 2007
y
2006-07 Class of Harkness Fellows with
Senator Barack Obama THE
COMMONWEALTH
FUND

22. Harkness Fellows’ Canadian Policy Briefing, 22
May 2010
Presentation on
pharmaceutical policy
with Helen Stevenson,
Assistant Deputy
Minister, Ontario
Dinner with Philippe Couillard,
former Quebec Minister of Health
Dinner with Brian Postl, former President and
THE
Briefing on St. Michael’s Hospital’s Program for CEO of Winnipeg Regional Health Authority and
COMMONWEALTH
FUND
Vulnerable Populations, Toronto Federal Advisor on Wait Times

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Harkness Fellowship Leadership Seminar Series
Past Leadership Speakers
p p
2010 L d
Leadership S
hi Speakers
k
Don Berwick, MD Mark McClellan, MD, PhD
Administrator for Former Administrator for
Centers for Medicare Centers for Medicare and
Thomas H. Lee, MD
, Ron Paterson Thomas Zeltner and Medicaid Services Medicaid Services
CEO of Partners Community NZ Health and Former Swiss Secretary
Healthcare, Inc. Disability of State for Health
Commissioner
A seminar series designed to provide Harkness
Fellows with:
 Understanding of the principles of effective Karen Davis Martin Marshall, CBE, MD
leadership President of the Former Deputy Chief Medical
Commonwealth Fund Officer,
Officer Department of Health
 Opportunity for candid discussion with
influential U.S. policy leaders and guest
policymakers from Fellows’ home
countries
 Focus on ‘lessons learned’ from real world John Rowe, MD
THE
COMMONWEALTH
Carolyn Clancy, MD
FUND
experience Former Chairman Agency for Healthcare
& CEO of Aetna Research and Quality

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Harkness Fellows’ Publications
• Over 250 peer-reviewed publications, 1998-2010
p p ,
• Health Affairs, British Medical Journal, JAMA, Lancet,
Health Policy New England Journal of Medicine, Quality
Policy, Medicine
and Safety in Health Care, Journal of Health Politics,
Policy and Law, Canadian Medical Association Journal,
Health S
H lth Services Journal
i J l
• Reports to Health Ministers and Congress
THE
COMMONWEALTH
FUND

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Harkness Fellows Having a Policy Impact
• Julia Kreis (2009 10) invited to write the IOM report on
(2009–10)
consumer involvement in comparative effectiveness research
• Stephanie Stock (2007–08) presented findings from Harkness
Fellowship on strategies for implementing best practices in
p g p g p
home health care to the German Ministry of Health
Julia Kreis
• Robin Gauld (2008-09) won the British Medical Association Book
Award in Health and Social Care for Th New Health P li
A d i H lth d S i l C f The N H lth Policy
• Vidhya Alakeson (2006–07) helped shape Medicaid mental health
policy at U.S. Dept of Health and Human Services
• Bert Vrijhoef (2008–09)
B t V ijh f (2008 09) appointed by the Dutch Minister to an
i t d b th D t h Mi i t t Bert Vrijhoef
advisory commission on bundled payment systems for chronic care
• John Hobbs (2001-02) appointed as senior health advisor to the Honorable Tony
Ryall,
Ryall New Zealand Minister of Health
• Geraint Lewis (2007-08) received Veterans Health Administration award and
recognized in U.S. and Canada for “virtual ward” innovation
• Peter Broadhead (2002 03) and Sharon Willcox (1999 00) appointed by the
(2002–03) (1999–00)
Prime Minister to the Australia National Health and Hospitals Reform THE
COMMONWEALTH
Commission FUND

26. Highlighted Harkness Fellows’ Promotions
26
Martin Marshall (1998-99 United Kingdom)
• Deputy Chief Medical Officer U.K. Department of Health, 2006
Officer, U K Health
• Director of Clinical Quality, The Health Foundation, 2007
Derek Feeley (2005-06 United Kingdom)
• Acting Director General Health & Chief Executive, Scottish NHS, 2010
Director-General
Ron Paterson (1998-99 New Zealand)
• New Zealand Health and Disability Commissioner, 2000 and
reappointment in 2005
Peter Sprivulis (2004-05 Australia)
• Project Leader, National E-Health Authority, 2006
Rachel Elli tt (2004 05 U it d Ki d
R h l Elliott (2004-05 United Kingdom)
)
• Lord Trent Chair in Medicines and Health, School of Pharmacy,
University of Nottingham, 2007
Jonas Schreyögg (2006-07 Germany)
• Professor for Health Services Management, Munich University
Andreas Gerber (2007–08 Germany)
• Head, Department of Health Economics, IQWiG, Cologne
, p , Q , g
THE
Katharina Janus (2006-07 Germany) COMMONWEALTH
FUND
• Professor (with tenure), Ulm University, Germany, 2010.

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6-Year Review of International Program
by Harvard University
Ratings of Fellowship:
• 97% of Fellows said it was an excellent or very good one-year
investment
• Majority had a promotion or significant change in position
following the Harkness Fellowship
• 2 of 3 changed career objectives or research (all said Harkness
contributed to change)
• The majority reported ongoing collaboration with other fellows or
their mentors
• 97% would recommend highly to a colleague
THE
COMMONWEALTH
FUND

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2012-13 Harkness Fellowships in
Health C
H lth Care Policy and P
P li d Practice
ti
DEADLINE FOR RECEIPT OF APPLICATIONS IS
SEPTEMBER 12 2011
12,
For more details and an application form, please visit:
form
www.commonwealthfund.org/fellowships
THE
COMMONWEALTH
FUND