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THE COMMONWEALTHCOMMONWEALTH
FUND
The Commonwealth Fund&
The Harkness Fellowships
Robin OsbornVice President and Director
International Program in Health Policy & Practice
2
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.
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FUND
3The Commonwealth Fund Commission on a High Performance Health Care System
• Recommends comprehensive set of insurance, payment, and
Path to a High Performance U.S. Health System, 2009
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 staffCongressional staff
B di th C 2008Bending the Curve, 2008• Recommends strategies to
expand coverage and save $1.5 trillion over 10 years by$1.5 trillion over 10 years by payment reform, health promotion, IT quality improvement and efficiency
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• New York Times Editorial
4
A New Era in American Health Care:
Examples of Fund ProjectsNational Scorecard on U.S. Health A New Era in American Health Care:
Realizing the Potential of Reform• Series of reports on expansion of
coverage, health insurance exchanges, and delivery system innovations
National Scorecard on U.S. Health System Performance, 2008
• 37 Indicators • U.S. compared to benchmarks
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
IHI/Hospital Readmissions
Medical Homes Grants• Technical assistance to 8 states to create
patient-centered medical homes for low income populations (Medicaid and SCHIP) p
• Grant to Institute for Healthcare Improvement (IHI) for 5-year STAAR demonstration project to reduce preventable rehospitalizations in three
income populations (Medicaid and SCHIP) • 5-year program to transform 65 safety-net
primary care clinics into patient-centered medical homes
• Support to the National Committee for
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p pto five states or regions
Support to the National Committee for Quality Assurance (NCQA) to develop a set of 18 measures for patient-centered care in physician practices
5
WhyNotTheBest.orgHospital Quality Comparison SiteHospital 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 ghealth care quality, pneumonia care, surgical care improvement, patient experiences, and health systems
• Over 6,000 registered users
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6Patient Protection and Affordable Care ActMarch 23, 2010
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7
The Commonwealth Fund
International Program in Health Care International Program in Health Care Policy and Practice
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8International Health Policy & Innovation Program
Participating Countries
AustraliaCanada
Germany
N
United States*
New Zealand
N th l d
Denmark(Under discussion)
StatesNetherlands
United Norway
Switzerland
France*Kingdom
y
Sweden**
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FUND
* Participate in International Symposium and International Health Policy Survey, but do not have a Harkness Fellowships program
** Harkness Fellowship beginning 2012-13
9
The Harkness Fellowships in H lth C P li & P tiHealth Care Policy & Practice
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FUND
10Harkness 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 grunning 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
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11
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 systemGain an in depth understanding of the U.S. health care system• Learn about the Australian, Canadian, Dutch, German, N.Z.,
Norwegian, Swedish, Swiss, and U.K. health care systemsW k ith l di US li t d i li k• Work with leading US policy experts and senior policymakers
• Get a firsthand look at innovative U.S. programs• Enhance methodological skillsEnhance 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
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12Relationship with The Commonwealth Fund
Adds Value to the Fellowship
• Nationally and internationally renowned Fund staff provide expertise across a range of fields in health policy andexpertise 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
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13
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• Funds for project-related travel, research, and conferences • 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 Fellowsairfare, living allowance, and health insurance) for Fellows accompanied by a partner and/or children up to age 18
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14
Partnerships to Expand Harkness Fellowships
• Canada: Health Services Research Foundation
G B B Stift R b t B h Stift• Germany: B. Braun–Stiftung; Robert Bosch Stiftung
• Netherlands: Ministry for Health, Welfare, and Sport
• Norway: Research Council of Norway
• Switzerland: Careum Foundation• Switzerland: Careum Foundation
• Sweden: Ministry of Health and Social Affairs
• United Kingdom: The Nuffield Trust; NHS National
Institute for Health Research/SDOTHE
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15Examples of Harkness Fellows’ ProjectsHealth Care Financing and RegulationHealth Care Financing and Regulation• Designing Value-Based Insurance Plans to Expand Coverage• The Impact of Regulation on the Performance of Health Care OrganizationsImproving 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 CareInformation Technology• Use of Computers for Clinical Care 5 Case Studies of Advanced US Sites• Use of Computers for Clinical Care—5 Case Studies of Advanced US SitesPharmaceutical 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
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g g p gWorks for Whom?
• Improving the Emergency Care Experience for the Elderly
16
Examples of Harkness Fellows’ Placements
• Harvard University, Boston
• Stanford University, San Franciscoy,
• University of California, San Francisco
• Johns Hopkins University, Baltimorep y,
• RAND/University of California, Los Angeles
• Agency for Healthcare Research and Quality (AHRQ), Wash DCg y y ( ),
• Veterans Health Administration, Wash DC
• Kaiser Permanente, San Francisco,
• Institute for Healthcare Improvement (IHI), Boston
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17
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• 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 SeriesTHE
COMMONWEALTHFUND
Throughout the Year: Leadership Seminar Series
182010–11 Harkness Orientation
Karen Davis, The Commonwealth Fund
2010–11 Harkness Fellows
Diane Gray (UK), Berit Bringedal (NOR)
Commonwealth Fund, Antoinette De Bont (NETH)
Thomas H. Lee, MDCEO of Partners
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CEO of Partners Community Healthcare, Inc. Ansgar Gerhardus (GER)Iren Bischofberger (SWITZ),
Sara Kreindler (CAN)
19Harkness Fellows Breakfast with Health Ministers at 2010 International Symposium
U.K. Minister of State for Health Simon Burns with Fellows Sarah Garner, Emma Stanton,
Swiss Minister Pascal Strupler with Fellow Iren Bischofberger
Harald Schmidt and Diane Gray
THE COMMONWEALTH
FUNDDutch Fellows with Ministry of Health delegation
Berit Bringedal with Norwegian Ministry of Health delegation
20Harkness FellowsWashington 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 PollstersDemocratic versus Republican Political Pollsters
• Site Visit to the Veterans Health Administration
•Fellows attend historic vote in Congress on
Breakfast Meeting with Congressman Tom Price
(R-Ga)
Ezekiel Emanuel, White House Office of Management and
Budget
Haynes Johnson, Pulitzer Prize Winning Journalist
Fellows attend historic vote in Congress on health reform passage on March 21, 2010
Eleanor Dehoney, Legislative Director, Senator Sherrod Brown
THE COMMONWEALTH
FUNDKaren Ignagni, president of America’s Health Insurance Plans U.S. Congressman John Lewis (D-GA,
2009–10 Harkness Fellows
21
Washington Policy BriefingFebruary 2007y
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2006-07 Class of Harkness Fellows with Senator Barack Obama
22Harkness Fellows’ Canadian Policy Briefing, May 2010
Presentation on pharmaceutical policy with Helen Stevenson, Assistant DeputyAssistant Deputy Minister, Ontario
Dinner with Philippe Couillard, former Quebec Minister of Health
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Dinner with Brian Postl, former President and CEO of Winnipeg Regional Health Authority and
Federal Advisor on Wait TimesBriefing on St. Michael’s Hospital’s Program for
Vulnerable Populations, Toronto
23
Harkness Fellowship Leadership Seminar Series
2010 L d hi S kPast Leadership Speakers
2010 Leadership Speakersp p
Thomas Zeltner
Mark McClellan, MD, PhD Former Administrator for Centers for Medicare and
Medicaid Services
Don Berwick, MDAdministrator for
Centers for Medicare and Medicaid ServicesThomas H. Lee, MD Ron Paterson
A seminar series designed to provide Harkness
Former Swiss Secretary of State for Health
,CEO of Partners Community
Healthcare, Inc.NZ Health and
Disability Commissioner
Fellows with:
Understanding of the principles of effective leadership
Karen DavisPresident of the
Commonwealth Fund
Martin Marshall, CBE, MDFormer Deputy Chief Medical Officer Department of Health
Opportunity for candid discussion with influential U.S. policy leaders and guest policymakers from Fellows’ home countries
Commonwealth Fund Officer, Department of Health
THE COMMONWEALTH
FUNDJohn Rowe, MD Former Chairman & CEO of Aetna
countries
Focus on ‘lessons learned’ from real world experience
Carolyn Clancy, MDAgency for Healthcare Research and Quality
24
Harkness Fellows’ Publications
• Over 250 peer-reviewed publications, 1998-2010p p ,
• Health Affairs, British Medical Journal, JAMA, Lancet, Health Policy New England Journal of Medicine QualityHealth Policy, New England Journal of Medicine, Quality and Safety in Health Care, Journal of Health Politics, Policy and Law, Canadian Medical Association Journal, H lth S i J lHealth Services Journal
• Reports to Health Ministers and Congress
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25
Harkness Fellows Having a Policy ImpactJulia Kreis (2009 10) invited to write the IOM report on• Julia Kreis (2009–10) invited to write the IOM report on 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 phome health care to the German Ministry of Health
• Robin Gauld (2008-09) won the British Medical Association Book A d i H lth d S i l C f Th N H lth P li
Julia Kreis
Award in Health and Social Care for The New Health Policy
• Vidhya Alakeson (2006–07) helped shape Medicaid mental health policy at U.S. Dept of Health and Human Services
B t V ijh f (2008 09) i t d b th D t h Mi i t t Bert Vrijhoef
• John Hobbs (2001-02) appointed as senior health advisor to the Honorable Tony Ryall New Zealand Minister of Health
• Bert Vrijhoef (2008–09) appointed by the Dutch Minister to an advisory commission on bundled payment systems for chronic care
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 theTHE
COMMONWEALTHFUND
• Peter Broadhead (2002–03) and Sharon Willcox (1999–00) appointed by the Prime Minister to the Australia National Health and Hospitals Reform Commission
26Highlighted Harkness Fellows’ PromotionsMartin Marshall (1998-99 United Kingdom)• Deputy Chief Medical Officer U K Department of Health 2006• Deputy Chief Medical Officer, U.K. Department of Health, 2006• Director of Clinical Quality, The Health Foundation, 2007
Derek Feeley (2005-06 United Kingdom)• Acting Director-General Health & Chief Executive, Scottish NHS, 2010Acting Director General Health & Chief Executive, Scottish NHS, 2010
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
R h l Elli tt (2004 05 U it d Ki d )Rachel Elliott (2004-05 United Kingdom)• Lord Trent Chair in Medicines and Health, School of Pharmacy,
University of Nottingham, 2007
Jonas Schreyögg (2006-07 Germany)Jonas Schreyögg (2006-07 Germany)• Professor for Health Services Management, Munich University
Andreas Gerber (2007–08 Germany)• Head, Department of Health Economics, IQWiG, Cologne
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, p , Q , g
Katharina Janus (2006-07 Germany)• Professor (with tenure), Ulm University, Germany, 2010.
276-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 Harkness2 of 3 changed career objectives or research (all said Harkness contributed to change)
• The majority reported ongoing collaboration with other fellows or their mentorstheir mentors
• 97% would recommend highly to a colleague
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28
2012-13 Harkness Fellowships in H lth C P li d P tiHealth Care Policy and Practice
DEADLINE FOR RECEIPT OF APPLICATIONS IS SEPTEMBER 12 2011SEPTEMBER 12, 2011
For more details and an application form please visit:For more details and an application form, please visit: www.commonwealthfund.org/fellowships
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FUND