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The Veterans Health Administration (VHA) paid about $828 million in recruitment and retention incentives from 2020 to 2023, but the process for providing an estimated $340.9 million of that was not “effectively governed” according to a recent US Department of Veterans Affairs (VA) Office of Inspector General (OIG) investigation.
About one-third of incentives were missing forms or signatures, or lacked sufficient justification, for the payments to about 130,000 VHA employees. In the report, the OIG notes the VHA has faced “long-standing challenges related to occupational shortages,” adding that a shortage occupation designation does not mean there are actual shortages at a facility.
“Most shortage occupations continue to experience annual net growth and are not critically understaffed in most facilities,” the report says.
More than 85% of incentive monies in 2022 and 2023 were paid to employees in occupations on staffing shortage lists. OIG estimated the VHA paid incentives to 38,800 employees (about 30%) where the award justification could not be verified or was insufficient.
Amplified by the COVID-19 pandemic and the PACT Act, the need to recruit and retain employees peaked in 2021, when record numbers of health care workers left their jobs. An October 2021 survey of 1000 medical professionals found nearly 1 in 5 health care workers quit during the pandemic, with most citing stress and burnout, and an additional 31% were considering quitting. When the PACT Act was signed into law in August 2022, it created thousands of newly benefits-eligible veterans.
In May 2022, the VA reported it needed to hire 52,000 employees annually for the next 5 years to keep up. In response, the VA released a 10-step plan to support recruitment and retention, focusing on raising wages when possible and finding other incentives when it wasn’t (ie, relocation bonuses or greater flexibility for remote work). The OIG report acknowledged the pandemic exacerbated VHA’s recruitment and retention challenges.
By 2024, the VA had not only reduced employee turnover by 20% over the prior 2 years, but had also exceeded its hiring goals. The VHA workforce grew by 7.4% in fiscal year 2023, its highest rate of growth in > 15 years.
VA officials must retain the documentation for incentives for 6 years so the process can be reconstructed if necessary. However, the OIG report noted “numerous instances” where documentation couldn’t be produced and therefore could not determine whether the incentives complied with policy.
The report also identified 28 employees who received retention incentive payments long after their award period had expired. The VA paid about $4.6 million for incentives that should have been terminated. The VA reported that it is pursuing debt collection for 27 of the 28 employees.
Only if the “identified weaknesses” are addressed will the VHA have assurance that incentives are being used effectively, the OIG said. Its recommendations included enforcing quality control checks and establishing accountability measures. The OIG also recommended establishing oversight procedures to review retention incentives annually, recertify them if appropriate, or terminate them.
The Veterans Health Administration (VHA) paid about $828 million in recruitment and retention incentives from 2020 to 2023, but the process for providing an estimated $340.9 million of that was not “effectively governed” according to a recent US Department of Veterans Affairs (VA) Office of Inspector General (OIG) investigation.
About one-third of incentives were missing forms or signatures, or lacked sufficient justification, for the payments to about 130,000 VHA employees. In the report, the OIG notes the VHA has faced “long-standing challenges related to occupational shortages,” adding that a shortage occupation designation does not mean there are actual shortages at a facility.
“Most shortage occupations continue to experience annual net growth and are not critically understaffed in most facilities,” the report says.
More than 85% of incentive monies in 2022 and 2023 were paid to employees in occupations on staffing shortage lists. OIG estimated the VHA paid incentives to 38,800 employees (about 30%) where the award justification could not be verified or was insufficient.
Amplified by the COVID-19 pandemic and the PACT Act, the need to recruit and retain employees peaked in 2021, when record numbers of health care workers left their jobs. An October 2021 survey of 1000 medical professionals found nearly 1 in 5 health care workers quit during the pandemic, with most citing stress and burnout, and an additional 31% were considering quitting. When the PACT Act was signed into law in August 2022, it created thousands of newly benefits-eligible veterans.
In May 2022, the VA reported it needed to hire 52,000 employees annually for the next 5 years to keep up. In response, the VA released a 10-step plan to support recruitment and retention, focusing on raising wages when possible and finding other incentives when it wasn’t (ie, relocation bonuses or greater flexibility for remote work). The OIG report acknowledged the pandemic exacerbated VHA’s recruitment and retention challenges.
By 2024, the VA had not only reduced employee turnover by 20% over the prior 2 years, but had also exceeded its hiring goals. The VHA workforce grew by 7.4% in fiscal year 2023, its highest rate of growth in > 15 years.
VA officials must retain the documentation for incentives for 6 years so the process can be reconstructed if necessary. However, the OIG report noted “numerous instances” where documentation couldn’t be produced and therefore could not determine whether the incentives complied with policy.
The report also identified 28 employees who received retention incentive payments long after their award period had expired. The VA paid about $4.6 million for incentives that should have been terminated. The VA reported that it is pursuing debt collection for 27 of the 28 employees.
Only if the “identified weaknesses” are addressed will the VHA have assurance that incentives are being used effectively, the OIG said. Its recommendations included enforcing quality control checks and establishing accountability measures. The OIG also recommended establishing oversight procedures to review retention incentives annually, recertify them if appropriate, or terminate them.
The Veterans Health Administration (VHA) paid about $828 million in recruitment and retention incentives from 2020 to 2023, but the process for providing an estimated $340.9 million of that was not “effectively governed” according to a recent US Department of Veterans Affairs (VA) Office of Inspector General (OIG) investigation.
About one-third of incentives were missing forms or signatures, or lacked sufficient justification, for the payments to about 130,000 VHA employees. In the report, the OIG notes the VHA has faced “long-standing challenges related to occupational shortages,” adding that a shortage occupation designation does not mean there are actual shortages at a facility.
“Most shortage occupations continue to experience annual net growth and are not critically understaffed in most facilities,” the report says.
More than 85% of incentive monies in 2022 and 2023 were paid to employees in occupations on staffing shortage lists. OIG estimated the VHA paid incentives to 38,800 employees (about 30%) where the award justification could not be verified or was insufficient.
Amplified by the COVID-19 pandemic and the PACT Act, the need to recruit and retain employees peaked in 2021, when record numbers of health care workers left their jobs. An October 2021 survey of 1000 medical professionals found nearly 1 in 5 health care workers quit during the pandemic, with most citing stress and burnout, and an additional 31% were considering quitting. When the PACT Act was signed into law in August 2022, it created thousands of newly benefits-eligible veterans.
In May 2022, the VA reported it needed to hire 52,000 employees annually for the next 5 years to keep up. In response, the VA released a 10-step plan to support recruitment and retention, focusing on raising wages when possible and finding other incentives when it wasn’t (ie, relocation bonuses or greater flexibility for remote work). The OIG report acknowledged the pandemic exacerbated VHA’s recruitment and retention challenges.
By 2024, the VA had not only reduced employee turnover by 20% over the prior 2 years, but had also exceeded its hiring goals. The VHA workforce grew by 7.4% in fiscal year 2023, its highest rate of growth in > 15 years.
VA officials must retain the documentation for incentives for 6 years so the process can be reconstructed if necessary. However, the OIG report noted “numerous instances” where documentation couldn’t be produced and therefore could not determine whether the incentives complied with policy.
The report also identified 28 employees who received retention incentive payments long after their award period had expired. The VA paid about $4.6 million for incentives that should have been terminated. The VA reported that it is pursuing debt collection for 27 of the 28 employees.
Only if the “identified weaknesses” are addressed will the VHA have assurance that incentives are being used effectively, the OIG said. Its recommendations included enforcing quality control checks and establishing accountability measures. The OIG also recommended establishing oversight procedures to review retention incentives annually, recertify them if appropriate, or terminate them.
