Transformational change within health care will not occur without the active involvement of all sectors of the health system. In the nursing home field, pioneers such as the Green House Project are starting to achieve dramatic improvements in quality by implementing resident-centered approaches to care. Each Green House, such as this one in Tupelo, Miss., provides a sunny, homelike environment where residents are free to make their own choices-about when to sleep and eat, which activities to engage in, and how to decorate their rooms.

round the country and the world, resourceful people are finding new ways to improve the quality of their health care systems and make health care more accessible. The Commonwealth Fund supports some of the most promising of those innovations, as described in this Annual Report for 2004. Transformational Change: A Ten-Point Strategy to Achieve Better Health Care for All: Fund president Karen Davis highlights strategies that could help the United States achieve commensurate value for what it spends on health care. The Fund's Mission, Goals, and Strategy Program Highlights, 2004     Improving Health Insurance Coverage and Access to Care     Improving the Quality of Health Care Services     International Program in Health Policy and Practice Regulating Foundations: A Delicate Balance: Fund executive vice president and chief operating officer John E. Craig, Jr., addresses the challenges of regulating foundations effectively and proposes steps that the foundation sector could take to ensure strong performance by a very diverse group of institutions. Treasurer’s Report and Financial Statements The Fund's Founders and Benefactors Directors and Staff Grants Approved, 2003 — 2004     Printable version of entire report (189 pages)