1. The Commonwealth Fund and The Harkness Fellowships in Health Care Policy and Practice International Forum on Quality and Safety in Healthcare Paris, France April 11, 2014
Robin Osborn
Vice President and Director
International Health Policy and Practice Innovations

2. Harkness Alumni Panelists
Dale Bramley, M.B., Ch.B., M.P.H., FAFPHM Harkness Fellow (New Zealand) Placement: Mount Sinai-New York University Medical Center and Health System Project: “Indigenous Disparities in Health Status: A Cross-Country Comparison of New Zealand, Australia, Canada and the United States” Current Position: Chief Executive Officer, Waitemata District Health Board Derek Feeley Harkness/Health Foundation Fellow (United Kingdom) Placement: Kaiser Permanente, Veterans Health Administration Project: “Developing Health Services fit for 2020 – Improving the Management of Complexity in Chronic Disease” Current Position: Executive Vice President, Institute for Healthcare Improvement Martin Hefford, P.G.dip, M.A. Placement: Kaiser Permanente Project: “Using Financial Incentives to Promote Evidence Based Interventions in Primary Healthcare: Early Results from the California Pay for Performance Program” Current Position: Chief Executive Officer, Compass Health

3. The Commonwealth Fund
Established by Anna M. Harkness in 1918, 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.

4. Patient Protection and Affordable Care Act March 23, 2010

5. Examples of Fund Projects
Realizing the Potential of Health Reform
Scorecard on Local Health System Performance, 2012
Series of reports on expansion of 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
Series of longitudinal surveys of young adults, low-income adults, and older adults between 2011 and 2015 to measure changes and trends in insurance coverage
Annual Congressional Retreat
Integrated Care and Accountable Care Organizations (ACOs)
3-day Briefing for Members of Congress
Topics: payment reform, insurance exchanges, price variation, ACOs, public health
Tracking the development of ACOs through case studies and national surveys, and evaluating their impact on quality, cost, and reducing disparities
Grants to analyze models for integrating care, including through multi-payer initiatives, “hybrid” integrated systems, and coordinating care for patients dually covered by Medicaid and Medicare
High Need/High Cost Patients
Identifying promising models of health care delivery for better managing patients with high needs.
Grants to define subpopulations to proactively identify those at high risk of becoming high cost.

6. International Program in Health Policy & Practice Innovations
The Commonwealth Fund’s international program in health policy is designed to stimulate innovative policies and practices in the United States and other industrialized countries.
Adults, 2013
Easy getting after-hours care without going to the ER
International Symposium on Health Policy: Ministers’ Policy Roundtable
Percent
The Hon. Daniel Bahr (Minister of Health, Germany)
John K. Iglehart (Health Affairs)
The Hon. Una O’Brien CB (Permanent Secretary, Dept. of Health, England)
Base: Needed care after hours.

7. Harkness Fellowships in Health Care Policy and Practice
Canada
Germany
Australia
Switzerland
(under discussion)
New Zealand
United States
United Kingdom
Netherlands
France
(being launched )
Norway
Sweden

8. Harkness Fellows can expect to:
Spend 12 months in the United States
Conduct research on a key health care delivery or policy issue
Gain an in­ depth understanding of the U.S. health care system
Learn about the Australian, Canadian, Dutch, French, German, New Zealand, Norwegian, Swedish, Swiss, and U.K. health care systems
Work with leading policy experts and senior policymakers
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

9. Relationship with The Commonwealth Fund Adds Value to the Fellowship
Nationally recognized 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
The Fund opens doors and provides entrée to its networks of health leaders and experts for Fellows

10. The Harkness Fellowship Award
The Harkness Fellowship awards up to U.S. $119,000
which covers the following:
Roundtrip airfare to the United States
Living allowance
Funds for project-related travel, research, and conferences
Travel to attend the Harkness Fellowship seminars
Health insurance
U.S. and state taxes
PLUS: a family supplement up to U.S. $55,000 (including airfare, living allowance, and health insurance) for Fellows accompanied by a partner and/or children up to age 18

11. Partnerships to Expand Harkness Fellowships
Canada: Canadian Foundation for Healthcare Improvement
Germany: B. Braun–Stiftung
Netherlands: Ministry for Health, Welfare, and Sport
Norway: Research Council of Norway
Sweden: Ministry of Health and Social Affairs
United Kingdom: The Nuffield Trust and NHS National Institute for Health Research

12. Examples of Harkness Fellows’ Placements
Harvard University, Boston
Stanford University, San Francisco
University of California, San Francisco
Johns Hopkins University, Baltimore
Columbia University, New York City
RAND/University of California, Los Angeles
Veterans Health Administration, Washington, D.C.
Kaiser Permanente, San Francisco
Group Health Cooperative, Puget Sound
Institute for Healthcare Improvement (IHI), Boston
Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health & Human Services, Washington, D.C.
Assistant Secretary for Planning and Evaluation (ASPE), U.S. Department of Health & Human Services, Washington, D.C.

13. Prominent U.S. Mentors are a Key Feature of the Program
John Hobbs (NZ)
Tom Marshall (UK)
Emma Stanton (UK)
Jonny Taitz (AUS)
Alexandra Norrish (UK)
Nikola Biller-Andorno (SWIZ)
Mirella Cacace (GER)
Katharina Janus (GER)
Adam Oliver (UK)
Robin Gauld (NZ)
James Mountford (UK)
Russell Gruen (AUS)
Stephen Davies (UK)
Katharina Janus (GER)
David Blumenthal, MD
Massachusetts General Hospital/ Harvard Medical School
Thomas H. Lee, MD
Partners Community Healthcare, Inc.
Sherry Glied, PhD
Mailman School of Public Health, Columbia University
Christopher Millett (UK)
Peter McNair (AUS)
Bruce Guthrie (UK)
Elana Taipapaki Curtis (NZ)
Colin Tukuitonga (NZ)
Julia Murphy (UK)
Bert Vrijhoef (NETH)
Rhiannon Edwards (UK)
Malcolm Battersby(AUS)
Richard Hamblin (UK)
Ngaire Kerse (NZ)
Linda Gask (UK)
Peter Sprivulis (AUS)
Rae Lamb (NZ)
Timothy Wilson (UK)
Donald Berwick, MD
Institute for Healthcare Improvement
Andrew Bindman, MD
UCSF/San Francisco General Hospital
Edward Wagner, MD
Group Health Cooperative at Puget Sound
Diane Gray (UK)
Antoinette De Bont
(NETH)
Dawn Dowding (UK)
Derek Feeley (UK)
Richard Gleave (UK)
Martin Hefford (NZ)
Daniela Koller (GER)
Sara Kreindler (CAN)
Kimberlyn McGrail (CAN)
Michael Schull (CAN)
Adam Elshaug (AUS)
Ansgar Gerhardus
(GER)
Sonj Hall (AUS)
Kathryn Rowan (UK)
Cynthia Farquhar (NZ)
Carolyn Clancy, MD
Agency for Healthcare Research and Quality
Benjamin Chu, MD/Murray Ross, PhD Kaiser Permanente Southern California/
Kaiser Foundation Health Plan
Elliott S. Fisher, MD
Dartmouth Institute for Health Policy & Clinical Practice 13

14. 2013–14 Harkness Orientation at the Fund
Imogen Mitchell (AUS), Jan Frich (NOR)
Aziz Sheikh (UK), Beatrice Podtschaske (GER)
Keynote Speaker
2013–14 Harkness Fellows
Harkness Mentors
Site Visits to Walgreens and Montefiore Medical Center
Elizabeth Bradley (Yale), Tom Delbanco (Beth Israel Deaconess Medical Center), Joseph Newhouse (Harvard)
Sherry Glied (former Assistant Secretary for Planning and Evaluation) 14

15. Harkness Fellows Breakfast with Health Ministers at the International Symposium
The Hon. Daniel Bahr, Minister of Health, Germany, with Tobias Esch
Una O’Brien CB, Permanent Secretary, Department of Health, England, with
Felix Greaves
The Hon. Lena Furmark, State Secretary, Ministry of Health and Social Affairs, Sweden, with Charlotta Levay
The Hon. Tony Ryall, Minister of Health, New Zealand, with Sue Wells 15

16. Harkness/IHI Fellows Summit
Visit to the Institute for Healthcare Improvement in Boston
Briefing on IHI’s world-renowned programs and pioneering techniques to improve quality, outcomes and efficiency
Networking with IHI Quality Improvement Fellows and Staff
Maureen Bisognano, President and CEO, Institute for Healthcare Improvement (IHI) with Harkness Fellows 16

17. Harkness Fellows Washington Policy Briefing, March 2014
An “Inside the Beltway” Look at Policymaking with Multiple Stakeholders, and a Wide Range of Viewpoints, including:
Democratic vs. Republican perspectives on health reform
Perspectives from government agencies, members of Congress, industry lobbyists, States, and political strategists
Site Visit to VA Hospital, Kaiser Center for Total Health
Karen B. DeSalvo
Office of the National Coordinator for Health Information Technology
Congressman Tom Price (R-Georgia)
Robert A. Petzel
U.S. Department of Veterans Affairs
Joe V. Selby
Patient-Centered Outcomes Research Institute
Richard Kronick
Agency for Healthcare Research and Quality
Karen Ignagni
America’s Health Insurance Plans
Robert Reischauer Urban Institute 17

18. Harkness Fellows’ Canadian Policy Briefing, May 2013
Keynote Speech:
“A National Strategy for Improving Mental Health Services in Canada: The Plan and its Prospects”
David Goldbloom, Chairman, Mental Health Commission of Canada
Site visit to Seaton House Men's Shelter (associated with St. Michael’s Hospital), Toronto
Helen Angus, Associate Deputy Minister, Ontario Ministry of Health and Long-Term Care
Vickie Kaminski, President & CEO, Eastern Health, Newfoundland and Labrador
André Picard, The Globe and Mail
Michael Nashat, Board Member, Pharmacy Council, Ontario Ministry of Health and Long- Term Care; Director, OnPharm 18

19. Harkness Fellowship Leadership Seminar Series
Past Leadership Speakers
Leadership Speakers
Don Berwick, MD
Former Administrator, Centers for Medicare and Medicaid Services
Mark McClellan, MD, PhD
Former Administrator for Centers for Medicare and Medicaid Services
Thomas Lee, MD
CEO of Partners Community Healthcare, Inc.
David Blumenthal, MD
President of the Commonwealth Fund/ Former National Coordinator for Health Information Technology
Kenneth Kizer, MD
Former Under Secretary, Veterans Health Administration
Julio Frenk, MD,
Former Minister of Health, Mexico
A seminar series designed to provide Harkness Fellows with:
Understanding of the principles of effective leadership
Opportunity for candid discussion with influential U.S. policy leaders and guest policymakers from Fellows’ home countries
Focus on ‘lessons learned’ from real world experience
Thomas Zeltner
Former Swiss Secretary of State for Health
Karen Davis
President of the Commonwealth Fund
John Rowe, MD
Former Chairman
& CEO of Aetna
Carolyn Clancy, MD
Agency for Healthcare Research and Quality 19

20. Harkness Fellows’ Publications
Over 2,300 peer-reviewed publications,
Health Affairs, British Medical Journal, JAMA, Lancet, Health Policy, New England Journal of Medicine, Quality and Safety in Health Care, Journal of Health Politics, Policy and Law, Canadian Medical Association Journal, Health Services Journal
Reports to Health Ministers and Congress

21. Examples of Harkness Fellows in Leadership Positions
Mark Booth ( AUS), First Assistant Secretary, Primary and Ambulatory Care Division, Australian Department of Health and Ageing
Dale Bramley ( NZ), Chief Executive Officer, Waitemata District Health Board
Derek Feeley ( UK), Executive Vice President, Institute for Healthcare Improvement
Andreas Gerber ( GER), Head, Department of Health Economics, IQWiG
Richard Gleave ( UK), Chief Operating Officer, Public Health England
Martin Hefford ( NZ), Chief Executive Officer, Compass Health
Rae Lamb ( NZ), Aged Care Commissioner, Australian Department of Health and Ageing
Geraint Lewis ( UK), Chief Data Officer, NHS England
Martin Marshall ( UK), Chair, Health Care Improvement, University College London
Stephanie Stock ( GER), Professor, Department of Health Economics and Clinical Epidemiology, University of Cologne
Diane E. Watson ( CAN), Chief Executive, National Health Performance Authority, Australia
Jennifer Zelmer ( CAN), Executive Vice President for Clinical Adoption and Innovation, Canada Health Infoway

22. Robin Osborn, Donald M. Berwick (CMS), Karen Davis
Reaching a Washington Policy Audience Harkness Alumni Washington Policy Forum, May 2011
24 Harkness alumni from AUS, GER, NETH, NZ, CAN, and UK, highlighted health care policy and delivery system innovations for key US policymakers
Alumni produced 14 research papers (10 co-authored)
Robin Osborn, Donald M. Berwick (CMS), Karen Davis
David Blumenthal (formerly ONCHIT), Elizabeth Fowler (National Economic Council), Sherry Glied (ASPE)
Martin Marshall (UK),
Stephanie Stock (GER),
Jako Burgers (NETH)
International innovations included: individual financial incentives, shared services/networks for primary care, after-hours care arrangements, medical home models, mobile health interventions, translating research into practice, and patient safety in primary care
“I was so glad I could make it. It was a joy to see once again the energy and brilliance of the Harkness Fellows. What a gift to us all that program is!”
-- Donald Berwick , Administrator, Centers for Medicare and Medicaid Services

23. 10-Year Review of Harkness Fellowships: Almost All Fellows (91%) Regard the Harkness Fellowship as Extremely or Very Valuable to their Career Advancement
Source: Harkness Impact Survey (n=75)

24. How Do The Harkness Fellowships Work For Families?
“I was a bit concerned that my daughter would not make friends easily - how wrong I was! We all had a great time. Also many fellows tended to have young children - I would encourage prospective fellows with older children to also take up the opportunity.”
Mark Booth (New Zealand), a Commonwealth Fund Harkness Fellow, Assistant Secretary, Department of Health and Ageing, Australia.
Family: Spouse, two children ages 14 and 18.
“Loved the school and the whole experience. They really grew through it. The school drove them academically and in every other way (very focused on high performance!). My daughter made wonderful friends (first grade), and had a strong American accent by the time we departed for home (lost it in two weeks). The transition home was very smooth, back into our house which was rented to visiting academics on sabbaticalhomes.com.”
Robin Gauld, Ph.D. (New Zealand), a Harkness Fellow, is associate professor of health policy in the Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand, and director of the newly-formed Centre for Health Systems, Otago Medical and Business Schools.
Family: Spouse, two children ages 6 and 10.

25. Who Should Apply?
Academic researchers, government policymakers and analysts, clinical leaders, health care and insurance industry managers, and journalists
Applicants should be mid-career and Fellows are typically between late 20’s and mid-40’s
Applicants must be citizens of Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, or the United Kingdom, or have permanent residency and lived in that country for at least three years.
All applicants must submit a formal application that includes a research proposal which falls within the scope of The Commonwealth Fund’s principal areas of interest

26. Applying for the 2015-16 Harkness Fellowships in Health Policy and Practice
For applicants from Australia and New Zealand – the deadline is September 15, 2014
For applicants from Canada, Germany, the Netherlands, Norway, Sweden, and the U.K. – the deadline is November 17, 2014
For applicants from France – the deadline is December 15, 2014
For more details and application form, please visit:
For questions about the program, eligibility, and proposed projects, please contact:
Robin Osborn
Vice President and Director
International Health Policy and Practice Innovations
The Commonwealth Fund