The John A. Hartford Foundation (JAHF or the Hartford Foundation) is a private United States–based philanthropy whose current mission is to improve the care of older adults. For many years, it made grants for research and education in geriatric medicine, nursing and social work. It now focuses on three priority areas: creating age-friendly health systems, supporting family caregivers and improving serious illness, and end-of-life care.
History Based in New York City, the foundation was founded in 1929 by John Augustine Hartford and later joined by his brother George Ludlum Hartford, the family owners of the A&P grocery chain. The foundation's mission from the beginning has been "to do the greatest good for the greatest number."Jacobson, J. S. (1984). The Greatest Good: A History of the John A. Hartford Foundation. The foundation.
In the early and mid-20th century, the foundation primarily made grants for research centered on basic and clinical medicine and health care quality and costs. It was at one time the largest funder in these areas. In 1982, the focus turned towards improving the care of older adults, as there became an increasing need to fund this underserved area. In 1994, the foundation made this priority its chief mission."John A. Hartford Dies in Elevator. Chairman of the A. & P. Chain 3 Succumbs After Attending Chrysler Board Meeting". New York Times. September 21, 1951. Retrieved 2013-07-29. 4.Jacobson, J. S. (1984). The Greatest Good: A History of the John A. Hartford Foundation. The foundation.
Leadership
Rani E. Snyder is president of the John A. Hartford Foundation. She assumed the role in 2026 after serving as acting president and previously as vice president of program.
Snyder is an American nonprofit executive and philanthropy leader with more than 25 years of experience in health care and aging. Her work has focused on improving care for older adults, including support for family caregivers. Prior to joining The John A. Hartford Foundation, Snyder worked at the Donald W. Reynolds Foundation, where she held leadership roles in its health care grant-making programs.
Snyder serves on the board of the American Society on Aging and is a past board chair of Grant-makers In Aging. She is also a fellow of the New York Academy of Medicine. She earned a Master of Public Administration in health care policy from New York University and completed doctoral studies in health services research at the UCLA School of Public Health.
Priority areas In a rapidly evolving health care environment, the Foundation supports the spread of evidence-based models that can accelerate care improvement for older adults. The three priority areas are: Age-Friendly Health Systems; Family Caregiving, and Serious Illness & End of Life.
Age-Friendly Health Systems
To prevent harm to older adults, improve health outcomes, and lower overall costs, health systems must adopt evidence-based models and practices that deliver better care to the aging population across all settings, including the home and community. By collaborating with experts in the healthcare industry, The John A. Hartford Foundation is working to create health systems that are age-friendly and able to meet the goals of the Triple Aim.
Grant-making in this area will: （1）Develop large-scale approaches that help health systems transform care; （2）Operationalize the essential elements of good care, building on the Foundation’s investments in evidence-based models and best practices; and （3）Better integrate community-based supports and services within the health system and across the continuum of care.
Family Caregiving
There are nearly 18 million people in the US regularly providing care to an older loved one who needs assistance. These family caregivers often manage complex care responsibilities, but frequently report receiving limited preparation and systemic support.
Recognizing the critical role that family caregivers play, The John A. Hartford Foundation is committed to transforming our health care and social services systems to meet the needs of family caregivers.
Grantmaking in this area will: （1）Improve the ability of health systems and providers to identify, assess, and support family caregivers; （2）Raise awareness among policymakers, health system leaders, funders, and the public to drive change; and （3）Create large-scale change in partnership with national efforts.
Serious Illness and End of Life
With increasing age comes greater risk for serious illness and the natural progression towards the end of life. Too often, care at this time fails to meet the goals and preferences of older adults and results in harm and burden. Palliative care and other effective approaches must be more widely available.
The John A. Hartford Foundation will continue to promote care that preserves dignity and honors the wishes of older adults and their families.
Grantmaking in this area will: (1) Increase access to high-quality palliative care services and other evidence-based models and practices; (2) Develop approaches for better educating and preparing the health care workforce; and (3) Foster communication and community-based solutions while informing public policy supportive of the needs of the seriously ill and their families.
Activities
From about 1980 to 2012, the foundation focused on a two-pronged effort to build training capacity and conduct research into different models of care for older adults at schools of medicine, nursing, and social work. Regenstreif, Donna I., Christopher A. Langston, and Corinne H. Rieder. "Decades of focus: Grant making at the John A. Hartford Foundation." Health Affairs 23.2 (2004): 258-264. Its current programs aim to more directly impact the health of older adults. In 2013, the Foundation organized its grantmaking in five portfolios: Interprofessional Leadership in Action, Linking Education and Practice, Developing and Disseminating Models of Care, Tools and Measures for Quality Care, and Policy and Communications. In 2015 and 2016,The John A. Hartford Foundation. “Priority Areas.” Retrieved 1 September 2021. Institute of Medicine. 2008. Retooling for an aging America: Building the health care workforce. Washington, DC: The National Academies Press. the foundation implemented its current priority areas: creating age-friendly health systems, supporting family caregivers, and improving serious illness and end-of-life care. In 2016, the Age-Friendly Health System initiative was started in collaboration with the Institute for Healthcare Improvement (IHI), American Hospital Association (AHA), and the Catholic Health Association of the United States (CHA).John A. Hartford Foundation. "About The John A. Hartford Foundation". Retrieved 2013-06-14.6.
In 2008, the foundation led a consortium of grantmakers to fund a study from the Institute of Medicine to look at the "crisis" of an ill-prepared workforce and outdated models of caring for older adults."Institute of Medicine . 2008. Retooling for an aging America: Building the health care workforce. Washington, DC: The National Academies Press.
Geriatric training In order to grow the geriatric workforce, JAHF has helped to develop training programs across various disciplines, from university-based physicians to nurses and social workers. The intention has been to establish a strong interdisciplinary labor force that is well-trained clinically and well-equipped academically to further geriatric research and care.
Medicine One of the largest and most important programs in the foundation's recent history has been to help build academic capacity in geriatric medicine through the Centers of Excellence in Geriatric Medicine, which started in 1986. They are located at academic medical centers around the country, and are known as high-throughput producers of academic geriatricians as well as the generators of basic, clinical, and population level medical knowledge about older adults. As many as 55,000 physicians are trained or mentored at these centers annually.Reuben, David B., et al. "Building academic geriatric capacity: an evaluation of the John A. Hartford Foundation Centers of Excellence initiative." Journal of the American Geriatrics Society 52.8 (2004):1384-1390
The Paul Beeson Physician Faculty Scholars in Aging Research Program was launched in 1994, in partnership with Atlantic Philanthropies, the Commonwealth Fund, and the Starr Foundation. As of 2019, the three-year fellowship has trained 225 scholars, with significant impacts to aging research.
The foundation has also supported training and development programs for medical students, fellows, junior faculty, and senior thought leaders through its funding of the Association of American Medical Colleges for geriatric scholarships, residence programs, and curriculum development. Another important initiative has been building bridges from geriatric medicine out to the subspecialties of internal medicine and surgical and related specialties.Hazzard, W.R., Woolard, N., & Regenstreif, D.I. "Integrating geriatrics into the subspecialties of internal medicine: The Hartford Foundation/American Geriatrics Society/Wake Forest University Bowman N. Gray School of Medicine Initiative." Journal of the American Geriatrics Society 45.5 (1997): 638-640.
Nursing Geriatric nursing has long been an important focus of JAHF, and this culminated in $5 million of funding to establish the John A. Hartford Foundation Institute for the Advancement of Geriatric Nursing in 1996, the first of its kind in the US. From supporting nursing societies to the American Association of Colleges of Nursing, the institute helped to build curriculums and experiences to expose nursing students to geriatrics in their programs.
To further the academic training of nurses, five centers of geriatric nursing excellence were established – 300 trainees had received pre- and postdoctoral fellowships through 2015, and as of 2012, 95% were part of nursing school faculties.
Social work The foundation focused on enhancing the capability of schools of social work to train aging-competent social workers through the Geriatric Social Work Initiative in the late 1990s. There were three core goals for the initiative: (1) work with the Council on Social Work Education to incorporate geriatrics into the curriculum; (2) offer scholarships and fellowships to faculty and students to fund their pursuits in geriatric social work; and (3) provide practical exposure by placing upper-level social work students in field experiences.Robbins, L. A., & Rieder, C. H. (2003). The John A. Hartford Foundation Geriatric Social Initiative. Journal of Gerontological Social Work, 39(1-2), 71-89.
Care models
Community-based care Programs of All-Inclusive Care for the Elderly (PACE) has long been championed by JAHF. Providing services for approximately 40,000 people, the model allows persons older than fifty-five to receive health and social services in their homes, instead of resorting to long-term care facilities. Despite being reimbursed by Medicare and Medicaid, PACE still only covers a small portion of those who are eligible.
Team Care
Separate from the foundation’s support of geriatric training, there were multiple studies done on promoting the interdisciplinary nature of care teams. Beyond just physicians and nurses, these teams also included social workers and others, and were especially effective for managing those with complex conditions and multiple comorbidities.
Hospital and home care