Golden Hammer: No work and all pay at VA makes watchdog sick

If you didn’t do a job, would you still get paid?

That’s what federal investigators fear is happening at the Veterans Affairs Department’s network of health care providers, with the government paying millions of dollars for work that might not be getting done, or giving thousands to doctors who leave in the middle of surgery or make patients wait for hours.

Almost 80 percent of the VA’s nearly 22,500 medical providers receive payment from the department based on their performance, a grand total of $150 million in 2011. But an investigation by the Government Accountability Office found the “goals” that providers must meet to receive the pay often have little to do with providing health care for veterans.

Plus, no one at the VA is checking to see whether the providers are meeting the goals before they get paid, Congress’ chief watchdog said.

Because the Veterans Health Administration, which oversees the providers, doesn’t review the set objectives, “it cannot have reasonable assurance that the goals established make a clear link between performance pay and providers’ performance,” the GAO said.

The issue is raising bipartisan ire on Capitol Hill.

“This is irrefutable proof of what we’ve known for quite some time: that in many cases, VA’s performance pay and bonus system has absolutely nothing to do with performance,” said Rep. Jeff Miller, a Florida Republican who chairs the House Veterans’ Affairs Committee. “In light of these disturbing findings, [VA] Secretary [Eric K.] Shinseki owes it to America’s veterans and American taxpayers to conduct a top-to-bottom review of VA’s performance appraisal system.”

The ranking member on the committee, Rep. Michael Michaud, Maine Democrat, was one of the lawmakers who requested that GAO look into the matter. He said he was “very disappointed” with the findings.

“The examples cited in the report are disturbing,” he said. “It is clear to me that too often those who do not perform above and beyond are reaping rewards they do not deserve.”

For handing out millions of dollars in taxpayer money without even checking to see whether work was being completed — and likely hurting veterans in the process — the Veterans Affairs Department wins this week’s Golden Hammer, a distinction given by The Washington Times to examples of fiscal waste and money mismanagement.

Some of the “goals” set for providers included attending staff meetings, serving on various committees and publishing articles, investigators said.

Officials at the VA said they agreed that oversight and organization of the performance pay was too lax. They are working to create guidelines to ensure that performance goals center on serving veterans.

“The intent of performance pay is to ensure and improve the quality of care through the achievement of specific goals and objectives,” according to a response from the VA.

But the GAO found problems beyond simple oversight: Performance pay was awarded to five providers against whom the VA was taking disciplinary action.

One provider was practicing without a license. Then there was a surgeon who left an operating room and let medical students finish the surgery unsupervised. A third refused to treat patients waiting in an emergency room, leading to waits of more than six hours.

“This is stunning to me and a slap in the face to veterans,” Mr. Michaud said.

Yet these providers still were paid a total of $45,000. The problems were discovered in just four VA medical centers, meaning there could be hundreds of similar problems at the VA’s other 148 medical centers that the GAO has yet to investigate.

In fact, over the course of their investigation, the GAO did not find a single provider who was not paid — no matter what their performance was. About 20 percent of VA providers received performance-based awards and bonuses worth $10 million total, investigators said.

The House Veterans’ Affairs Committee is planning a Sept. 9 hearing to look into reports that medical providers are still being paid despite causing serious harm.

“Despite the fact that multiple VA Inspector General reports have linked a number of veteran deaths to widespread mismanagement at VHA facilities, the department has consistently given executives who presided over these events glowing performance reviews and cash bonuses of up to $63,000,” a committee press release said.