Commonwealth Fund

The Commonwealth Fund operates as one of the nation's oldest and most sophisticated health policy foundations, with a $922.7M endowment and over 100 years of continuous health system grantmaking. Its philosophy centers on funding evidence that changes policy and practice — not direct service delivery. Understanding this distinction is the single most important foundation for any successful approach.

All prospective grantees must enter through the Letter of Inquiry process at cmwf.my.site.com. There is no other door. LOIs are accepted on a rolling basis and typically receive a response within six weeks. If the project fits current program priorities, staff will invite a full proposal. The Fund does not review unsolicited full proposals under any circumstances, and submitting one does not accelerate the process — it ends it.

The Fund's grantee geography reveals clear organizational preferences. New York State accounts for 781 of 2,685 recorded grants in the DB dataset, with Washington, D.C. (525 grants), Massachusetts (302), and California (214) rounding out the primary tier. These concentrations reflect long-standing relationships with major policy research institutions, academic medical centers, and health advocacy organizations in those hubs. Organizations outside these corridors can succeed, but typically do so with national or cross-state research agendas rather than single-jurisdiction projects.

Multi-year commissioned relationships dominate the top of the grantee roster. The single largest grantee received $15.9M across 93 grants; the second received $8.0M across 56 grants. First-time applicants should view an initial LOI as the opening of a long-term conversation, not an immediate funding transaction.

In early 2025, President Joseph Betancourt, M.D., announced a strategic refocus for 2026 including a state health care learning collaborative and a community-engaged initiative to redesign health coverage. This signals growing interest in on-the-ground convening, state implementation expertise, and multi-stakeholder learning — a meaningful expansion beyond pure research synthesis. Organizations with state-level policy implementation experience or capacity to design and facilitate cross-sector learning communities should highlight these capabilities prominently in LOIs submitted during 2025-2026.

Commonwealth Fund's grantmaking has undergone a dramatic contraction. Total giving dropped from $52.4M in fiscal 2022 to $48.9M in fiscal 2023 to $26.5M in fiscal 2024 — a 49% reduction in two years, even as the endowment grew from $864.8M to $922.7M. This contraction is the most critical pattern for prospective applicants: the Fund is concentrating resources on fewer, more strategic commitments, not broadening access.

From the DB grantee dataset of 2,685 recorded grants totaling $140.7M, the median grant size is $11,000 and the average is $49,402, with a range from $60 to $1,444,391. This spread reflects two distinct categories: small membership, conference sponsorship, and nonprofit sector support grants at the low end, and multi-year commissioned research projects at the high end. The Fund's own approval tiers confirm this: small grants ($50,000 or less) and intermediate grants ($50,001–$200,000) are approved monthly; large grants (over $200,000) require board approval at the April, July, or November meetings.

Program area concentration is clearly visible from grantee purposes. Recurring themes include: Medicaid and Medicare policy analysis, health insurance market research, coverage gap analysis, behavioral health, telehealth policy, health equity research, maternal health, and survey research (e.g., the International Health Policy Survey, the Commonwealth Fund Health Care Affordability Survey of Federally Qualified Health Centers). These are primarily commissioned from a core group of policy research institutions and universities — high-trust, high-dollar relationships renewed annually or biennially.

Geographic concentration: New York and D.C. together account for approximately 49% of all grants. Massachusetts (11%) and California (8%) are secondary hubs. Organizations in other states tend to succeed with national comparative or multi-state research designs.

Revenue is almost entirely investment-based: net investment income of $36.6M in fiscal 2024 against total revenue of $39.8M confirms the endowment funds the grant budget. This makes grantmaking relatively stable, but directly tied to endowment performance and asset allocation decisions.

The five foundations matched to Commonwealth Fund by asset size and NTEE category all hold endowments between $900M and $943M but differ sharply in programmatic focus — none concentrate on health policy. The table below reflects this contrast and positions the Fund within its health philanthropy peer group.

Among health policy-specific funders, Commonwealth Fund occupies a distinct niche. The Robert Wood Johnson Foundation ($12B+ assets, $600M+ annual giving) is the dominant U.S. health funder and covers a far broader health agenda. Arnold Ventures operates across health, criminal justice, and education with a preference for policy research and systems change. The Milbank Memorial Fund is a smaller but closely aligned peer focused on state health policy and operates by invitation only. Commonwealth Fund distinguishes itself through its international comparative health research program (Harkness Fellowships, operational since 1925), its sustained focus on Medicare and Medicaid policy, and its 100+ year institutional continuity — factors that strongly favor established research organizations with verifiable policy influence track records over newer entrants.

The most significant development in 2025 is the strategic announcement made by President Joseph Betancourt, M.D., under the headline 'A Focused Direction for the Future.' Two new initiatives are planned for 2026: first, a collaborative of states — including rural and underserved states alongside those with established strengths — designed to share learning, take action, and improve health care delivery, building on the Fund's long record of state scorecards. Second, a community and health care leader engagement initiative aimed at designing a new model for the future of health coverage that meets the needs of all Americans.

In March 2025, the Fund released a widely cited policy report projecting that proposed Medicaid and SNAP funding cuts could eliminate more than 1 million jobs in 2026, with 477,000 of those in the healthcare sector. This reflects the Fund's active and rapid-response role in the federal coverage debate — a signal that Medicaid expansion, coverage continuity, and the ACA remain top-tier research priorities.

The Harkness Fellowship program, which marks 100 years in 2025, will have no 2026-27 application cycle. The next call opens June 2026 for the 2027-28 fellowship year. On October 14, 2025, the Fund held an informational webinar for prospective applicants to the Commonwealth Fund Fellowship in Health Policy Leadership at Harvard University. No major leadership transitions beyond Betancourt's strategic communications have been publicly reported.

Confirm programmatic fit before writing a word. The Fund's five program areas — Expanding Coverage and Access, Improving Care Delivery, Making Health Care Affordable, Achieving Equitable Outcomes, and Promoting International Learning and Exchange — are the only recognized entry points. A proposal that does not fit within one of these will be declined at the LOI stage regardless of quality or institutional reputation.

Submit through the portal and only through the portal. The grants portal at cmwf.my.site.com is the exclusive submission channel. Do not email program staff attachments or postal inquiries. The rolling LOI window means you can submit any time, but 'rolling' does not mean all timing is equivalent — if you are targeting a large grant requiring board approval, work backward from the April, July, or November board meetings to determine the latest viable LOI submission date.

Write a tight, policy-first LOI. The three-page limit is firm. Lead with the specific policy problem you are addressing and how your research design will generate evidence that changes it. The Fund is not interested in organizational histories or capacity demonstrations in the opening pages — those belong in supporting sections. Common mistake: foregrounding organizational background rather than the policy theory of change.

Health equity is foundational, not optional. Every proposal should explicitly name the population experiencing disparity — low-income people, the uninsured, or people of color — and articulate how the project will improve outcomes for that group. In 2025-2026, maternal health disparities, rural health access, and tech-enabled equitable care delivery represent active priority windows within the Improving Care Delivery and Achieving Equitable Outcomes programs.

For RFPs, treat them as a separate track. RFPs carry fixed deadlines, specific topic requirements, and are more competitive than rolling LOIs. Watch the Fund's grants portal and website announcements for new RFPs, especially in early 2026 as the new state collaborative and coverage design initiatives begin generating funded research needs.

Build the relationship before the large ask. For projects exceeding $200,000, consider reaching out to program staff informally before submitting — staff names and program areas are listed on the Fund's website. Noting a prior conversation with program staff in your LOI signals genuine engagement and increases the probability that your submission receives close attention.