McDougall has worked closely with three other DHMC employees, as well as numerous national and state trade organizations, to pool information to bring to Congress, he said.
"There have been five different health care reform bills and we've been involved in each of them," McDougall said. "We've let it be known the parts that can be improved upon and the parts that we think are a priority."
DHMC researchers, as well as faculty and staff at Dartmouth Medical School, hope to play a role in the research and initiatives resulting from health care reform, McDougall said.
McDougall cited 764 potential instances in the Senate version of the health care reform bill in which major administrative decisions may be made after the legislation itself is passed. These are areas in which DHMC and DMS have the chance to become involved in health care reform, he said.
"Of the 764 [instances], I think we're interested in about 300," he said. "There's the potential for some wonderful opportunities for us."
Programs that interest DHMC lobbyists include a value-based purchasing program in the proposed legislation.
The program would reward hospitals that operate more efficiently and meet a set of performance benchmarks, rather than simply reimbursing for reported spending.
DHMC would likely receive financial benefits from the program, if implemented, McDougall said.
DHMC lobbyists are also pushing for a program in which the U.S. Secretary of Health and Human Services would award grants and contracts to fund the development, improvement and expansion of systems to measure patient care quality, according to McDougall. Dartmouth institutions would have a better chance of winning such contracts because of Dartmouth's leadership in developing metrics for care delivery, he said.
"Having [College President Jim Yong] Kim's background and his expertise is very important," he said. "I also think that the Dartmouth Institute for Health Policy has been doing things that the bill is attempting to do for 30 years, so there's a lot in the bill that has its foundation right here at Dartmouth, Dartmouth-Hitchcock [Medical Center] and Dartmouth Medical School."
McDougall said DHMC's lobbying efforts include opposing excessive federal budget cuts and providing legislators with information about the potential negative repercussions of proposed legislation.
"Almost all of the legislation that we see is well intended, but well-intended bills can have unintended consequences," he said.
Brown's victory in Massachusetts has been a "game-changer" for debate over the health care bill, McDougall said. He noted that lobbyists will have a better sense of where the bill is going after President Barack Obama addresses the nation in his State of the Union address Wednesday.
"The present situation is that everything is up in the air," he said.
McDougall said the bill will likely be passed, but only after extensive modification to make it more attractive to moderate and conservative legislators.
In the proposed health care legislation, health care providers agreed to make significant reductions in what they charge for health care in exchange for expanded coverage of the uninsured. However, professionals at DHMC believe the agreement is favorable only if 96 percent of the 46 million uninsured Americans become covered, according to McDougall.
DHMC receives information to guide its specific policy proposals from various health organizations, including the Association of American Medical Colleges, the American Medical Association, the American Heart Association and the National Association of Children's Hospitals and Related Institutions.
"Our concern is that there will be the cuts, but not the coverage," McDougall said, adding that he and his colleagues are lobbying to make sure both coverage and medical spending are addressed in the bill.
McDougall also said that he hopes changes to health care reform include increased transparency, and that the results of the Massachusetts election show how important this issue is to the American public.
"I think that there needs to be more transparency in the whole process," McDougall said. "When you have 4,400 pages of legislation, it's very difficult for the public to understand what's really in there."
Brown won the Massachusetts Senate seat left vacant after the death of Democratic Sen. Ted Kennedy. The loss shifted the balance of power in the Senate, leaving Democrats with only 59 Senators in favor of the current health care reform bill. Sixty votes will be needed to end debate on the final version of the bill and bring the legislation to a floor vote.
