Abstract
Health philanthropy faces the basic challenge of how best to use limited resources to have a positive effect on policy, practice, or institutions in a trillion-dollar health care system. Insightful, well-crafted grants, coupled with effective communication of results, are the best way for a foundation to increase its impact. Evaluation also is essential to guide ongoing and future work. The Picker-Commonwealth Patient-Centered Care Program was an important initiative of the Commonwealth Fund that produced groundbreaking research in its area and serves as an illustration of how a foundation can move a new field forward.