Class of 2016

Alison MacDonald, MPA, MHCDS

Chief of Staff
Office of US Senator Jeanne Shaheen (D-NH)

Alison MacDonald is motivated by two dimes. That’s nearly the amount of every dollar the United States currently spends that goes toward health care. “We spend more than any other country per capita,” says MacDonald. “It’s a huge driver of the federal budget.” As health policy advisor to U.S. Senator Jeanne Shaheen (D-N.H.), MacDonald has worked on a range of pressing health issues—from diabetes care to transitional care for seniors to unintended pregnancy in the military.

But with health costs spiraling out of control in Washington, MacDonald finds herself increasingly pulled into the bipartisan search to control spending without negatively impacting care. Taking part in the Master of Health Care Delivery Science program at Dartmouth has helped bring those decisions down to earth. “The program brings it down to a micro level, where we can understand what a 2-percent Medicare cut really means to a hospital or physician, and what are some better ways to incentivize providers to help us achieve our goals.”

Having a laboratory of real-life doctors and hospital staff has helped MacDonald in other policy decisions as well. When fears of Ebola were sweeping Washington in October 2014, MacDonald had a vantage point few officials within the Beltway had access to. “At the same time the CDC was managing the crisis, I could talk to my study group on a Tuesday night about how their hospital systems were responding to the evolving guidelines,” says MacDonald. “It brought up insightful points. For example, when a physician goes into quarantine for 21 days, what happens to his or her patients?”

For her part, MacDonald has been able to educate her colleagues on the ins and outs of lawmaking. At the same time, the variety of perspectives she has received in Hanover have helped her in dealings with interest groups in Washington.

I already ask better questions. When a group comes in asking for higher reimbursement for x, y, or z procedure, I’m able to get into the nuts and bolts of what the costs are and how they do it, and push back a little more."