Updated: April 2023
Drew E. Altman, Ph.D., Founding President and Chief Executive Officer
This is an essay about the mission and role of KFF, which is unique among nonprofits today.
KFF is an independent source of health policy research, polling, and journalism. We have four major program areas: KFF Policy; KFF Polling; KFF Health News (formerly Kaiser Health News); and KFF Social Impact Media, which conducts specialized public health information campaigns. You can learn more about the organization, including why we call ourselves KFF.
What’s unique about KFF, however, can’t be found in any description of our programs because we’re more than a sum of our parts. KFF is a one-of-a-kind information organization. Not a policy research organization. Not a polling organization. And not a news organization. But rather, a unique combination of all three. That’s the vision behind KFF and its this combination that allows us to leverage our combined expertise and assets to play our national role on health policy.
To be clear, there’s a lot in health care we’re not experts on, and we leave those issues to others who are. We also don’t think better information is the answer to everything that ails our country or our health system; but we do believe facts and data can be a counterweight to the money, politics, and misinformation that often dominates health policy and that through credible information, we can amplify the voices of people who often don’t have one. It’s the role we have chosen to play and the niche we have chosen to fill.
The hallmark of KFF is our focus on how policy affects people. Our work deals with the intricacies of financing and with policy and public programs. We are experts on Medicaid, Medicare, the ACA, problems like the uninsured or employer health coverage, and many more similar issues. The work is often quite technical. But almost everything we do, no matter how arcane, is at its core also about inequality and economic security, racism and racial equity, and the future of our diverse society. These larger issues that animate and sometimes divide our society lie behind the technical work we do and motivate us. COVID-19, with its disproportionate impact on communities of color and profound economic consequences, is the perfect example of a health issue that surfaces every one of these larger challenges. I am proud of how our organization has pivoted to devote our capabilities to the pandemic in recent years, and of how we are focusing on what lies ahead as the public, and government, begins to move on from COVID public health interventions.
We believe in the importance of evidence and facts—these are core values for us—but we also approach our job with respect for diverse views about health and social policy and more than a little humility about the role we or any one organization can play in our giant health care system. We cannot change what’s broken in the American political system by ourselves, but we can and do try to be a constructive force in it. We are a voice for people, we want to hold both government and the health system accountable for its failures, but we never try to achieve any particular outcome, or take positions or advocate for policies or programs. We want to ensure that debate is informed by credible and timely information—whether it’s an analysis, a poll, a KFF Health News story or investigation, or a COVID-19 information campaign on vaccines.
We also place a premium on communications. We produce thousands of products each year tailored to our audiences. Our experts are expected to be communicators, too. We see communications as much more than dissemination. We are in continuous real time communication with our audience, and we have to be to play our role in fast moving health policy debates.
I had the opportunity to come to California to found the modern day KFF and have led the organization for more than 30 years. The core mission we established then is still the one we pursue every day. But over time, we’ve evolved. We established all kinds of new programs (and eliminated others when the time came), recruited expert staff, became an operating foundation and then later, a public charity, choosing the legal status that fit us best and most honestly represented what we are. Overall, we have grown tremendously. I owe special gratitude to the first board who empowered me to launch this experiment, especially the late Hale Champion, my first board chair and early co-conspirator, Congresswoman Barbara Jordan, as well as to my friend, Secretary Joseph Califano.
We have a Board of Trustees, including myself, with backgrounds in public service, academia, nonprofits, health care, and media. They serve two, five-year terms. Ours is a true governing board that exercises ultimate authority over everything at KFF and is deeply engaged, but it is not a board involved in program or operations, funding KFF, or fundraising, as is the case in some nonprofits.
Our current chair is former Senator Olympia Snowe. As a student of these things, I can say that no nonprofit organization enjoys a healthier partnership between its staff and board, and no board operates more effectively or with better chemistry or more democratically. The relationship between the CEO and board at KFF, and the commitment everyone involved with KFF has to our mission, has been an essential ingredient to our success over many years and one of the things that has made this job so enjoyable.
We made a fundamental decision to remain a California-based organization with our headquarters in San Francisco. We also maintain a substantial presence in D.C., where we built an office and the Barbara Jordan Conference Center, because many of our core audiences are in Washington. We also have a presence in about 30 states, with more on the way, as our news operations expand.
Our expert staff is our principal organizational asset. They conduct analyses, polls and surveys, produce the great journalism distributed by KFF Health News, and run our public information campaigns on HIV and COVID-19. We are an operating organization; everything you see from us is produced by us. We try to balance policy debate with facts and new information through our policy analysis, working in real time, or as close to it as we can. We try to give people a voice about policy and their health care experiences with our gold-standard polling, maintaining the highest methodological standards in a changing polling industry. And we try to decode and dissect health policy and hold government and the health system accountable through in-depth reporting from KFF Health News.
Our fastest-growing program is KFF Health News, which I started in 2009. The idea was to establish a nonprofit national news service inside KFF dedicated to in-depth reporting on complex health policy issues, and health systems changes, with a focus on people, unencumbered by the incentives that sometimes affect commercial news organizations or destination websites. KFF Health News, which was previously known as Kaiser Health News or KHN, would produce original coverage of national health issues and their impact on people, and bring it to the American people directly. To do that, we built KFF Health News on a distribution—not destination—model.
KFF Health News is a core line item in our operating budget. It is also editorially independent with regard to story ideas and content, but otherwise operates like all of our other programs with its mission, strategy, budget, and personnel decisions made by me and ultimately, our Board. KFF Health News is now the largest health policy newsroom in the country, producing a wide range of journalism for print, radio, and television, from explanatory stories to features and deep investigations. These focus on systemic problems, not busting bad actors in health care or government. We now operate several regional bureaus and desks, including in rural areas, the Midwest, California, the Midwest and the South—all to fill health journalism needs.
Overall, we produce about two thousand products a year. Almost every product, except our editorially independent KFF Health News stories, which are vetted through our editorial process, is an organizational product that often includes contributions from experts from multiple teams.
Our next program will focus on disinformation in health. The impact of mis- and disinformation is now pervasive. It distorts policy debate, further polarizes the country, and as we saw with disinformation about COVID vaccines, can even kill. It is now not enough for us to be in the business of producing good information, we also have to actively counter disinformation in health, and we are designing a program to do that. As this new program demonstrates, we are always changing and adapting at KFF.
Several years ago, we lowered the rate at which we spend from our endowment to about 5.5 percent annually to maintain the real value of our spending power and assets over time. We spent at a much higher rate while we were building a new organization and now want to sustain what we have built. Our endowment is just above $800 million.
When we lowered our payout rate to a more typical level, we changed our financing model. We now support ourselves about 70 percent from our endowment and 30 percent from external funds, which mostly come from foundations and some individual donors, including a recent major gift from MacKenzie Scott to expand our work across KFF on health equity. We use external funds chiefly for the incremental costs of mission-critical projects we could not otherwise undertake.
That’s KFF in a nutshell. We’re an integrated information organization playing a special role on the national health care scene, with no delusions about how hard it is to do that. We keep changing and evolving as an organization and would rather make mistakes than stand pat. Since we operate our own programs, if something isn’t working as planned, we can adapt and fix it. We change constantly to try to be more effective. We love the work, and along the way, we have created a family of colleagues who truly enjoy working together and are devoted to our unique mission. In health policy, we know the challenges will keep coming but we’re ready.