Happy New Year!

The New Year brings us to the 30th anniversary of the Foundation's Aging and Health program and a transition to its future. In 1982, the Foundation began a project, as a small part of its overall work in Health Care Cost and Quality, to recruit physician faculty from other fields into geriatrics. The retraining of these physicians started our efforts to address the shortage of academic leaders in what was foreseen to be a vital discipline for the future aging population. Fast-forward 30 years, and the Foundation has invested hundreds of millions of dollars in the development of faculty and geriatrics curricular models and tools in three key health care disciplines — medicine, nursing, and social work — while maintaining its long-standing commitment to developing and disseminating innovative models of care in which these professionals work.

And finally, after what seems like years of crying in the wilderness supporting programs that have received little notice outside of the small geriatrics community, it feels like our time has come. The leading edge of the Baby Boom cohort started turning 65 in 2011. Health reform passed in 2010 and, despite its focus on regulating commercial health insurance and expanding coverage for the uninsured, has significant provisions for reforming the delivery of care to the Medicare and Medicaid populations and even some attention to workforce issues. The national conversation on health care clearly recognizes that we are on an unsustainable pathway and that the Medicare program must lead the way in delivering better care for lower costs.

We are tremendously proud of the accomplishments of our grantees in these efforts. They have pioneered service delivery innovations that the Center for Medicare and Medicaid Innovation (CMMI) will expand. They have developed educational programs that will provide future professionals with the skills they need to serve their future patients. In every field, energized and exciting grantees and alumni are ready to share their expertise, improve the quality of care, discover new knowledge, and most importantly, get involved in leading change at all levels — institutional, professional, and policy. These people, whose lives and careers we have been privileged to touch, are a national asset and an appreciating one — their influence and impact is still only beginning to be felt.

For example, today the first cohort of CMMI's Innovation Advisors should be announced. This program pursues a leadership development strategy we believe to be essential — training, mentoring, and networking for dedicated health care professionals to create leaders who can drive practice improvement throughout the delivery system. We know that many of our grantees, friends, and alumni have applied to the program and we expect that a strong group of winners will be focused on innovations to improve the care of older people. We have been in active discussion with CMMI's program managers and hope that we will be able to forge a new public-private partnership to enhance the value of this public investment. Similarly, the applications for the $1,000,000,000 Innovation Challenge grant program from CMMI will be due and soon after, this program will begin supporting the scale and spread of quality-improving and cost-saving models. We know that many members of our community are developing proposals and we hope to forge a similar value-enhancing relationship with mission-relevant projects in this initiative.

Given these tremendous successes and the resulting changes in the environment, we've been asking ourselves (and you, our readers): What should the Hartford Foundation be doing going forward? We have uncommitted money in 2013 and beyond and we will need to begin making new grants in 2012 to spend it. With our Board, we've been taking advantage of our forced break from grantmaking to give this question the careful consideration it deserves. We are still not done, but we do know some things:

  • The Board and staff of the Foundation remain committed to the mission of improving the health of older Americans
  • We believe that because of the success of our prior investments, we are now in a position to pursue new approaches to this mission that build upon strengths
  • Our network of grantees and alumni are now and will continue to be our most valuable asset, especially given the reduced grants payouts we expect
  • We will continue and enhance our communications and social media efforts (including a redesigned, more interactive website) to foster this network
  • We know that the funding environment will continue to change rapidly: long-standing philanthropic partners such as The Atlantic Philanthropies and The Donald W. Reynolds Foundation are spending down and revising their strategies. Federal budget issues will no doubt impinge on the work of HRSA and the NIH. However, new resources and partners (such as CMMI, PCORI, and the Margaret A. Cargill Foundation) continue to emerge
  • Teams are clearly understood as an essential part of the solution to quality and cost in health care, we will pursue this theme in our future work
  • As we change our strategies, we will build in time and resources for orderly transitions

We look forward to your continued feedback and ideas. As Winston Churchill said in 1942, "Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning."