VA memo warned of ‘gaming strategies’

A Department of Veterans Affairs (VA) memorandum written four years ago warned that “inappropriate scheduling practices” were being used at some VA medical facilities “in order to improve scores on assorted access measures.” These practices were sometimes referred to as “gaming strategies.”

The document, dated April 26, 2010, was written by William Schoenhard, who then served as VA’s deputy under secretary for health operations and management.

“This memo clearly shows that VA’s Central Office (VACO) has long-known about these gaming strategies at some of its facilities, yet has done nothing to effectively eliminate such practices,” said Daniel M. Dellinger, national commander of The American Legion. “What has allegedly been happening at Phoenix and other VA hospitals nationwide was happening in 2010.

“What corrective actions did VA take four years ago? What corrective actions has it ever taken to get rid of this problem? The fact that VA management knew about this and has done nothing about it is precisely why The American Legion has called for VA Secretary Eric Shinseki’s resignation.”

The memo discussed what VA facilities were doing to make it appear they were providing timely access to veterans for their medical care: “Example: as a way to combat Missed Opportunity rates, some medical centers cancel appointments for patients not checked in 10 or 15 minutes prior to their appointment time. Patients are informed that it is medical center policy that they must check in early and, if they fail to do so, it is in the medical center’s right to cancel that appointment. This is not patient-centered care.”

The American Legion contacted officials at VACO on May 20, asking them to comment on the significance of the Schoenhard memo and what had been done to address a serious systemic problem. VA officials have yet to respond.

Click here to see the nine-page memo, which lists several specific scheduling practices to avoid.


  1. Whenever you hang some money out for grabs, there is always those that find ways to cheat it other peoples expense. Paying a bonus for doing your job is gambling with some ones life in this case. Can them all, and hire some vets to do an honorable job.
  2. Maybe he was waiting because he and his family are struggling just to get by. Another vet
  3. This is the tip of the iceberg. The VA has a long, long history of problems. There are good VA facilities and there are horrible ones. The problem lies in the administration of the system and lack of accountability within the VISNs, which are nothing more than fiefdoms. A change in management and personnel policies would rectify many of the issues.
  4. There is an elephant on the in the living room and nobody sees it. If there is, "No Punishment For Failure" what in gods heaven makes you think thieves are going to stop stealing? They steal even when there IS punishment. J. H. Christ.
  5. I think all those responsible for this despicable behavior should be given doses of fatal diseases, loaded onto a decommissioned ship, taken out to the middle of the pacific and set adrift to die slow and painful deaths!
  6. This has been going on for some time. In reading through the 9-page memo above, several of the examples were dated 2008. Apparently the methods were mature then. Was there budget for oversight at any time, in either administration?
  7. All of us Veterans are SCREWED. I have now been waiting for a cancer screening from the Tucson VA for 2 years. My Wife/Caregiver was so upset she now has an appointment for my cancer screening on the out side medical care. I hope and pray it's not Cancer. However, if it is, I promise heads will roll for lack of care and under the Federal TORT Law, I can prove they neglected my care. Want to know something else? I went to the VA to get records and some were not there. I have those records in a safe place. But it is odd the ones I needed from the Tucson VA. Were not available. Smell a Rat? Stay Tuned, its going to get a lot worse. Its not just Phoenix folks.
  8. I'll be darned, I swore and I argued that there was no veteran stupid enough to wait and die whilst waiting for a VA appointment. You proved me wrong! AND even worse it took your wife/caregiver to finally make an outside appointment. You were just going to wait and wait just yo prove your point, what ever that was. Thanks for proving me wrong!!
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