Abstract Robert Ross, the President and CEO of The California Endowment, reflects on foundations choices for public policy and systems change, the involvement of The California Endowment in efforts to expand health care access through the Affordable Care Act, and the foundation’s 10-year...

As foundations work to leverage their philanthropic assets to achieve greater social impact, there is a keen interest in designing strategies that create transformative rather than incremental change. This paper is an effort to provide a conceptual overview that will enable foundations to better...