The Health Foundation of Central Massachusetts was formally established in January, 1999, with initial assets of approximately $60 million. These assets resulted from the sale of Central Massachusetts Health Care, Inc. (CMHC) a physician-initiated, not-for-profit health maintenance organization (HMO). The trustees of CMHC envisioned a philanthropic organization dedicated to improving the health of the people in the region as a fitting legacy to those physicians who founded and then supported the original organization in 1977. As a conversion foundation, The Health Foundation is bound to apply the assets to continue serving a similar purpose and population, or geographic area as the original HMO. 

When it converted from CMHC, the Foundation intentionally sought to retain the plan’s tax-exempt status as a 501(c)4 organization in order to retain the capacity to lobby. The Foundation’s ability to lobby has been strategically woven into its grantmaking, most notably in the Synergy Initiative, where advocacy and lobbying are expected to secure sustainability of the projects.