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Screwed-up bonus payments are at the heart of the VA scandal

Vox, June 2, 2014
The best-intentioned health care policies don't always lead to the best outcomes for patients. This is one problem at the core of the Veterans Affairs' scandal: administrators received financial bonuses keeping wait times short. The aim of those bonuses was to incentivize good behavior: If there's money to be made in getting patients seen quickly, the reasoning goes, then hospitals will focus on reducing wait times. Instead, those extra bonuses appear to have incentivized bad behavior. They gave administrators an incentive to do something easier than improving health care: falsify records to make it look like wait times were shorter, and still net bonus payments.