In an effort to bolster data and boost performance measures, managers pushed staffers to create ways that delivered minimum amounts of care to veterans while increasing the number of patients seen for mental health-related services, according to testimony from Nicolas Tolentino, former administrator at the VA Medical Center in Manchester, N.H.
Tolentino participated in a hearing in front of the Senate Veterans’ Affairs Committee in April after a VA inspector general report found that the VA exaggerated how quickly mental care was provided to veterans.
Tolentino disputes the VA’s claim that 95% of veterans who seek mental health treatment receive care within 14 days. To that end, only 64% of veterans are treated within 14 days while an estimate of 94,000 patient appointments wait almost six weeks on average before treatment begins, according to the report.
The VA’s main issues are performance measurement and care delivery. That statement was reiterated by William Schoenhard, the VA’s deputy under secretary for health, saying that: “We fully embrace that our performance measurement system needs to be revised.”
Regardless, the pressure to meet performance metrics might lead to providers attempting to circumvent the system, or, as Tolentino put it, “gaming the system.” Although the scenario of providers attempting to get ahead is likely to remain, every organization that decides to incent providers must measure and incent based on the right initiatives, said Kerry McDermott, senior policy director at West Health Policy Center in Washington, D.C., adding that organizations “get the system they incent for.”
The VA is working to resolve mental health problems and is cooperating with investigators. Additionally, the organization has begun hiring more staff. Specifically, 1,600 mental health workers and 300 support staff are expected to be added.