Audit: The VA's poor policies created perverse incentives

A new Veterans Affairs audit shows a significant number of workers have tampered with patient wait times.

Thirteen percent of staff were instructed to schedule appointments without regard to a patient's desired date, which could indicate an attempt to falsify records.

The report backs up the idea that what went wrong at the VA was a story of perverse incentives

At least one instance of the practice was detected in 64 percent of the surveyed VA facilities. The survey, however, did not determine whether these activities were intentionally fraudulent behavior.

The audit also acknowledged that the VA's goal of seeing patients within two weeks of a desired appointment date "was simply not attainable given the ongoing challenge of finding sufficient provider slots to accommodate a growing demand for services."

The report also criticized other complications and technicalities in the VA scheduling system, many of which have been known for years.

The report backs up the idea that what went wrong at the VA was a story of perverse incentives. The VA gave bonus payments for seeing patients in a timely manner. But when local VA officials realized they couldn't meet the goal, they manipulated the electronic data reported to the VA to hide patients who weren't being seen so quickly.

The audit evaluated 138 of the more than 150 VA hospitals nationwide. The rest of the VA's expansive network will be audited in the second phase of the investigations.

In the meantime, the VA said it will reevaluate its policies to move away from a system that was clearly unrealistic in the first place.

Will you support Vox’s explanatory journalism?

Most news outlets make their money through advertising or subscriptions. But when it comes to what we’re trying to do at Vox, there are a couple reasons that we can't rely only on ads and subscriptions to keep the lights on.

First, advertising dollars go up and down with the economy. We often only know a few months out what our advertising revenue will be, which makes it hard to plan ahead.

Second, we’re not in the subscriptions business. Vox is here to help everyone understand the complex issues shaping the world — not just the people who can afford to pay for a subscription. We believe that’s an important part of building a more equal society. We can’t do that if we have a paywall.

That’s why we also turn to you, our readers, to help us keep Vox free. If you also believe that everyone deserves access to trusted high-quality information, will you make a gift to Vox today?

One-Time Monthly Annual

$5/month

$10/month

$25/month

$50/month

Other

$

Yes, I'll give $5/month

Yes, I'll give $5/month

We accept credit card, Apple Pay, and Google Pay. You can also contribute via