Clinicians at an Oregon VA hospital say that administrators cherry-pick patients for admissions to manipulate care-quality scores, according to a new report.
The New York Times interviewed a number of staffers at Roseburg Veterans Administration Medical Center and found through those conversations and a review of documents that the hospital began to cherry-pick patients in 2016, and since then its star rating has increased from one to two stars.
By choosing to transfer the sickest patients to other local facilities or not admit them at all, the hospital was able to boost metrics and leadership bonuses at the expense of patient safety, a group of physicians said in a letter sent to a correspondent at the NYT.
Clinicians currently on staff told the publication that the improved scores cover up issues like massive turnover in primary care that can endanger patients.
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The VA released its 2017 star ratings in late October, and the data suggests that few of its one-star hospitals have made significant improvements. Fourteen facilities earned a one-star rating last year, and the majority also did in 2016.
The Department of Veterans Affairs' health system has also been under intense scrutiny over the past several years following a nationwide scandal in 2014, which revealed that some veterans faced extremely long waits for care. Since then, it's been reported that for more than 15 years, VA hospitals hired doctors with revoked licenses and that a number of medical centers have failed to report potentially dangerous clinicians.
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Administrators at Roseburg disputed the clinicians' accounts. Director Doug Paxton told the newspaper that it was not turning away certain patients to boost its quality metrics, but did admit that the hospital was being more selective with admissions.
"The numbers are indicators of the quality of care for veterans, so, sure, we're worried about the numbers," Paxton said. "But if you improve the care to veterans, in turn your numbers are going to improve. That's the bottom line."