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June 1, 2014

Warnings on ‘gaming’ patient waits go back years

WASHINGTON — The report this week confirming that 1,700 veterans were “at risk of being lost or forgotten” at a Phoenix hospital was hardly the first independent review that documented long wait times for some patients seeking health care from the Department of Veterans Affairs and inaccurate records that understated the depth of the problem.

Eleven years ago, a task force established by President George W. Bush determined that at least 236,000 veterans were waiting six months or more for a first appointment or an initial follow-up. The task force warned that more veterans were expected to enter the system and that the delays threatened the quality of care the VA provided.

Two years ago, a former hospital administrator told senators during an oversight hearing that VA hospitals were “gaming the system” and manipulating records to make it appear that wait time standards, the criteria for awarding manager and executive bonuses, were being met.

Since 2005, the department’s inspector general has issued 19 reports on how long veterans have to wait before getting appointments and treatment at VA medical facilities, concluding that for many, sufficient controls don’t exist to ensure that those needing care get it.

For example, in October 2007, the VA inspector general told the Senate Committee on Aging that “schedulers at some facilities were interpreting the guidance from their managers to reduce waiting times as instruction to never put patients on the electronic waiting list. This seems to have resulted in some ‘gaming’ of the scheduling process.”

That’s virtually identical to language in a 2010 VA memorandum, and again in the latest inspector general’s report this week that led dozens of members of Congress to call for VA Secretary Eric Shinseki to resign. He abided by those wishes Friday, telling Obama that he had become a distraction as the administration tried to address the VA’s troubles.

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