The Government Accountability Office has criticized the Veterans Affairs Department (VA) for giving bonuses to physicians when its medical centers and clinics haven’t clearly defined what the extra pay is meant for.
In at least five cases in 2011, the vague policies allowed physicians to receive bonuses between $7,500 and $10,500 even though they had been disciplined for errors ranging from leaving residents unsupervised during surgery to working without a valid license.
When asked, VA spokesperson Gina Jackson emailed this reporter some prepared statements, such as: “The VA agrees with the GAO’s assessment that more can be done to strengthen monitoring requirements and processes.”
According to the VA, giving bonuses are efforts to help the VA remain competitive with private industry salaries. Congress enacted the VA Health Care Personnel Enhancement Act in 2004, and the VA says it has used that authority to aid in efforts to recruit and retain highly skilled medical professionals in order to provide Veterans with the best possible health care.
But the House Veterans’ Affairs Committee has sharply criticized VA for awarding large performance bonuses to hospital administrators whose facilities have a history of mismanagement or negligence resulting in patient illness and, in some cases, death, according to the Army Times.
The GAO report, released Aug. 23, provided members with more ammunition for the argument that VA’s bonus and performance pay system operates independently of achievement.
GAO said VA must clarify performance pay policies to make sure they are clearly linked to “outcomes and quality.”
According to Jackson’s statement, “VA remains committed to effective oversight to ensure that performance pay and award systems are based on the achievement of clear goals and objectives that contribute to VA’s mission to serve Veterans. VA has already taken steps to strengthen the process and increase monitoring requirements so that pay and awards are supported by proper documentation of performance and meet established standards.”
“VA officials responsible for writing the policy told us that the purpose of performance pay is to improve health care outcomes quality, but this is not specified,” GAO analyst Debra Draper wrote.
According to the report, about 80 percent of the department’s nearly 22,500 providers received performance pay in fiscal 2011 and about 4,000 were given performance awards — lump-sum payments that are based on annual performance review ratings.
In fiscal 2011, the Veterans Health Administration paid nearly $150 million to doctors in performance pay, an average of more than $8,000 per provider. It gave about $10 million in performance awards, an average of $2,587 per person.
This reporter has submitted a Freedom of Information Act request for bonus records at a Texas and an Arizona Veterans Affairs Medical Center as well as comments from Senators in both states but has failed to receive a response. We the requests are honored, this reporter will publish Part II.