August 23, 1996

New VUMC Lobbyist ready to climb the Hill

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As the new director of Health Policy Development, Marilyn Yager will help deliver Vanderbilt's message to legislators on both the state and federal level.

New VUMC Lobbyist ready to climb the Hill

The White House's loss is Vanderbilt University Medical Center's gain, as Marilyn Yager – former deputy assistant to the President and deputy director of the Office of Public Liaison – has been named VUMC's director of Health Policy Development.

Yager succeeds Marsha Wilson, and will assist in the development of selected public policy positions in health, serve as liaison with federal health agencies and others in Washington, D.C., and assist in VUMC's relationships with those organizations that serve academic health centers directly.

She will also serve as a liaison with the Office of University Relations and General Counsel to facilitate VUMC's communication with state and federal officials, legislators and members of Congress.

The changing nature of health care delivery, combined with shrinking federal research funds, creates new challenges for VUMC and other academic health centers across the country. They are challenges Yager is eager to meet.

"Some of my goals are to maintain Vanderbilt's strong visibility on a state and federal level as a preeminent teaching facility that can be a resource for legislators on reimbursement issues, whether it's graduate medical education or Medicare or Medicaid," she said.

"Then there's the research side, not only working on behalf of Vanderbilt to maintain adequate research dollars coming to the area from the National Institutes of Health, but also making sure the priorities set by Congress and the White House fit the priorities where Vanderbilt is sending their medical research dollars."

When it comes to legislative issues that impact Vanderbilt, the key, Yager said, is to focus on the future.

"You have to constantly be looking ahead to make sure there aren't legislative barriers to the types of system changes that are being undertaken by academic health centers such as Vanderbilt in response to the changes going on in health care.

"First of all, you have to anticipate what those barriers are going to be and try to eliminate or modify those barriers at the federal level. Second, you must seek opportunities to support these system changes, whether it's through current government programs or through changes in tax law or antitrust legislation or other avenues."

Federal health care reimbursement issues will be a major focus for Yager, who foresees movement in this area starting sometime after November.

"This is a time of shrinking government reimbursement, whether it's Medicare or Medicaid. Next year is going to be a big Medicare year because, right after an election, people become braver. Both the White House and Congress will probably move to make significant cuts in Medicare reimbursement and I think all providers, particularly academic health centers, are vulnerable on that.

"I also think there are going to be a lot of changes going on in managed care and continuing merger activity among providers that will mean a great deal to Vanderbilt, and we need to have a voice in those matters.

"Making sure Tennessee's Congressional delegation understands what's happening, what the implications are and is a strong advocate on behalf of the facilities here is going to be vital."

Yager is no stranger to the world of academic medicine. Prior to her White House post – where she was the point person on health care for all groups seeking to interact with the President – Yager was director of federal relations for the Massachusetts Hospital Association. In that position, she developed policy and public affairs strategies and was senior lobbyist for the association, which represented 120 hospitals, most of them not-for-profits.

"I think there will be a number of similarities between working for Vanderbilt and working for the Massachusetts Hospital Association and even the White House. In both of those positions, I dealt with a lot of provider groups, doctors' groups, nurses' groups and others involved in the system.

"Most of my time was spent on issues that I believe are Vanderbilt's issues, such as Medicare, Medicaid – or in Tennessee's case, TennCare – medical education funding, research funding and various other issues," Yager said.

"The biggest difference for me will be that I will be representing one institution with specific issues unique to Vanderbilt. The focus will be narrowed and I look forward to the new challenges."