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.