The New York Times

The Department of Veterans Affairs announced Thursday it would replace the director of its medical center in Roseburg, Douglas Paxton. He had come under fire in recent weeks for limiting the number of patients the center admitted in an effort to improve its dismal performance rating, according to doctors at the hospital.

“There are times that facility leadership needs to change in order to usher in a new approach that will demonstrate we are committed to delivering results for veterans,” Dr. Carolyn Clancy, executive in charge of the Veterans Health Administration, said in a statement.

The Roseburg Veterans Administration Medical Center, a rural Oregon hospital that for years had ranked near the bottom of the veteran health care system, saw its rating rapidly improve under Paxton. But doctors said that improvement — in a rating system measured on a scale of 1-5 stars — was driven largely by strategic tweaks to health care practices to boost performance measures, even when they left veterans worse off.

One approach was to turn away more veterans against doctors’ wishes. Fewer patients meant fewer bad outcomes.

The Veterans Affairs Department said it was not rethinking its performance metrics, despite their apparent vulnerability to manipulation. But it also announced Thursday what it called “an aggressive new approach” to take over management of low-performing hospitals like Roseburg in an attempt to head off similar problems.

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