So… once again we find the government doing dumb things with our money with no oversight.
The upshot of this one is that the CA government apparently decided to incentivize doctors to review disability claim cases quickly by giving them a flat-fee payment for each case reviewed (what is called a “spiff” in the retail world…) on top of their normal salaries.
San Diego Union-Tribune Story – “Bonuses stop for state disability doctors” – April 22nd, 2013
Actually a great idea, I think one of the dysfunctional aspects of our government is we have no performance-based incentive programs involved in it, wish we could do things like this more often. However in typical government fashion they put this in place with apparently no mechanism for monitoring it and making sure it’s working correctly.
As anyone who’s ever managed incentive based plans knows, it’s critical that you build the plan to create as few openings for abuse as possible in the beginning, then monitor it on an ongoing basis because we know no plan is perfect, and there will always be people looking for ways to game the system. And finding them, no matter how well you think you planned it from the beginning.
Apparently in this case this has been on auto-pilot since 1996.
Also apparently they have no internal reporting that would have flagged particular consultants for review, likely Dr. Paxton (the subject of this article.)…
How would I have done it? Easy – set up a periodic audit system, where someone in a supervisory position picked random samples of the consultants work to review. Then set up reporting so if one consultant were billing at rates outside the norms, the audit process kicked in a little more frequently for them.
If this consultant truly was managing such exceptionally efficient performance and maintaining the same accuracy level as the other consultants while doing many times their caseload, more power to him. He may deserve every penny he got. But we don’t know that – or at least nothing in this article indicates any audit process exists.
One issue not brought up in this article. If we make an assumption that Dr. Paxton is not giving sufficient time to review each case, then he could have either have denied valid claims or approved invalid claims. If he denied valid claims, I’m sure that would have shown on someone’s radar. Many people with denied claims may just go away, but I suspect a significant portion would have fought the denial.
On the other hand, if his default behavior was to approve unjustified claims, no one would have complained, would they? Everyone feels their claim is justified, so the approval would just be seen as validation of what they already knew.
The end result, however, is more financial drain to the state, in the form of disability payments to people who did not truly qualify…
Another thing to build into the oversight reporting – a comparison of claim approval/denial rates between consultants. If someone deviates from the normal averages, again – increase the audit frequency.
Missing from this Watchdog article is the name of the person responsible for managing this program, and the name of that person’s boss.
In private industry, if my job was to manage a program like this and it was found I had let it run with such loose controls for 17 years, I would likely be fired. In government, I’m sure nothing will happen. There is no consequence to incompetence in government.
Matter of fact, I’m sure next we’ll hear how we need to pay above average wages and benefits “so we can get the best and brightest into government.” Sure. I’m sure the guy in charge of this program is one of those.
Truly stupid government.