Patients Paid The Price as VA Hospital Manipulated Metrics for Better Ratings

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The Department of Veterans Affairs has come under a lot of scrutiny and criticism for the quality of its healthcare system in recent years. One of the ways that the department tried to address some of its problems was by introducing a grading system on the performance of its hospitals and clinics about four years ago.

The VA reported that the vast majority of its facilities had improved in 2016, but there have been questions about the reliability of the metrics used by the department, and a recent report by The New York Times revealed troubling risks for patients at a small rural VA hospital in Roseburg, Oregon.

Dave Philipps, military veterans correspondent for The New York Times discusses his investigation, which found that administrators at the Roseburg hospital apparently tried to improve its ratings by deliberately limiting both the numbers and the types of patients that it admitted, along with other tactics — against the wishes of doctors.

The hospital and the VA have denied the practice, and has provided The Takeaway with the following statement:

"The New York Times story is false.

"The Roseburg VAHCS is a one-star facility, according to SAIL data. On its face, this shows there is no manipulation of data because, if the facility were manipulating data to boost its rating, wouldn't it be getting a higher score?

"The answer is that it's not manipulating data, but rather basing admissions decisions on the actual clinical capabilities of the facility.

"Roseburg VA Health Care System admits patients based on InterQual criteria, which is the industry standard for U.S. health care. All admission decisions are based on the hospital's ability to provide the care patients require and are made by clinicians, including the facility chief of staff and her clinical chiefs of service — non-clinical administrators have nothing to do with these decisions.

"At its core, the Roseburg VAHCS is primarily an outpatient center, and that's why the hospital's clinical leadership has made clear to its physicians that the facility has limited capabilities to care for patients with certain clinical conditions that are far better treated in nearby community hospitals.

"This is precisely why we're being transparent with our doctors about the conditions that the facility is unable to treat, because it's in veterans' best interests for them to be seen at other hospitals in the community with greater capabilities to deliver them the best care for those conditions.

"Secretary David Shulkin has made clear that, under his leadership, VA is going to leverage the best of the private sector with the best of VA's own clinical capabilities. And, in the case of Roseburg, which has no intensive care unit and limited surgical capabilities, we are ensuring that veterans receive the best care, whether from VA or in the community. In doing so, VA works closely with veterans and community providers to coordinate such care.

"Just as the Manchester, New Hampshire VA Medical Center is doing, Roseburg VAHCS is partnering deliberately with nearby community hospitals to deliver veterans the best possible care based on the facility's actual clinical care capabilities."

This segment is hosted by Todd Zwillich