Arizona VA Facility Manipulated Wait Times and Cashed In
The VA Office of Inspector General (OIG) released its findings from a review of the Ocotillo Primary Care Clinic, a facility in the Southern Arizona VA Health Care System (SAVAHC). The OIG investigated the clinic based on a complaint from a former employee who alleged that “managers improperly directed scheduling staff to zero out patient wait times” and physicians were able to cash in because wait times are one of the variables that determine their bonuses.
The Veterans Health Administration (VHA) calculates wait times based on “how long a veteran has to wait for an appointment from the date they wish to be seen (desired date).” The schedulers at Ocotillo, under the direction of their managers, manipulated wait times by making appointment dates and desired dates one in the same.
The OIG reviewed 5,802 appointments scheduled at Ocotillo from December 2013 through August 2014 and uncovered that 4,409 (76 percent) of the appointment dates were adjusted to reflect that the patients’ desired dates were the same as the scheduled dates. The OIG also reviewed scheduling data for 4,855 appointments scheduled from October 1, 2015 through March 31, 2016, and discovered that 2,212 (46 percent) of 4,855 appointments had been altered to adhere to VHA regulations; media coverage of manipulated wait times at Phoenix VA facilities might be responsible for the improvement.
The auditors also probed the complainant’s allegation that physicians cashed in on the unethical practice of manipulating wait times because wait times factor into bonuses; the OIG substantiated the complainant’s claim. The OIG discovered that the “wait-time goals were based on a physician’s ability to see patients within either 7 or 14 days of the patients’ desired dates.” The managers made sure that the physicians did not get penalized for wait times by engaging in the unethical practice of amending scheduling data. The physicians received an average bonus of $28,521, with approximately 15 percent related to waiting times. A lot of people would dismiss the bonuses as a non-issue because the money is not that much compared to the trillions wasted by the federal government, but the VA personnel who manipulated wait times and the physicians who reaped a benefit from it are public servants employed by taxpayers to provide quality medical care to veterans; it is a colossal issue.
The OIG should be commended for revealing unethical and criminal activities by VA bureaucrats, but it intentionally fails at motivating the proper authorities to take action against the perpetrators. The OIG’s recommendations for Ocotillo are the usual; make sure staff follow policies and procedures. The following is an example of a customary OIG recommendation:
- We recommend the VA Desert Pacific Healthcare Network Director review the training records of all SAVAHCS schedulers to ensure their training is compliant with Veterans Health Administration scheduling policy.
The OIG never recommends any disciplinary action. The managers at Ocotillo must be terminated, but it won’t happen.
The people who work for the VA are members of a public union, which presents a barrier to terminating incompetent, unethical, criminal staff, so the first step to repairing the VA health care system is to damage the union. Congress must pass legislation that either prohibits federal government employees from being union members or provides the bureaucrats at the top of the VA org chart carte blanch for discharging any and all personnel and hold them accountable.