High-Tech Medical Equipment: VA Has Opportunities to Improve Its Acquisition of Maintenance Services
Fast Facts
The Department of Veterans Affairs spends hundreds of millions of dollars annually to buy and maintain high-tech medical equipment like MRI machines.
Because caring for this equipment requires specialized training, the VA often buys maintenance services directly from manufacturers. It can use agency-wide contracts to do so, which reduces red tape and helps the VA get the best available price.
But some officials didn’t use these contracts because of poor guidance and resources. This resulted in spending unnecessary time awarding new contracts that didn’t get VA a better price.
Our recommendations address these issues and more.
Mobile Magnetic Resonance Machine Imaging Equipment
An MRI machine, which looks like a medical exam table positioned at the opening of a large plastic cylinder with a hole large enough for the exam table to enter.
Highlights
What GAO Found
The Department of Veterans Affairs (VA) spends hundreds of millions of dollars annually to buy and maintain high-tech medical equipment (HTME)—such as magnetic resonance imaging equipment—to deliver health care to veterans. To maintain this equipment, and help ensure its safe use, medical centers can purchase maintenance services—often from equipment manufacturers—using agencywide or stand-alone contracts. Agencywide contracts help VA leverage its buying power to obtain quality medical equipment at the best prices possible.
VA’s approach to buying HTME, uses agencywide contracts that generally support equipment maintenance. But not all regional contracting officials use these contracts when buying maintenance services and some unknowingly duplicated other officials’ work by awarding their own contracts for the services.
Example of High-Tech Medical Equipment
GAO found VA procurement guidance contained inconsistent information about whether the agency-wide contracts for HTME are mandatory when purchasing maintenance services. Additionally, regional contracting officials found the national contracting office resources for purchasing maintenance services to be unclear. Clarifying these resources and guidance on whether agencywide HTME contracts are mandatory and how to appropriately use them would reduce administrative burden and could save the government time and money.
Selected medical centers generally reported satisfaction with maintenance services, and equipment was maintained per policy. These centers generally obtained similar prices as the agencywide contracts for selected equipment. However, GAO also found instances where regional contracting officials were not efficiently purchasing maintenance services. For example, in a few instances, officials did not clearly document the services purchased or verify that the prices paid matched the prices offered through the agencywide contracts. In one case, officials paid a higher price than the agencywide contract offered for the same service. Regional contracting officials responsible for purchasing maintenance attributed these instances in part to difficulty using resources for VA’s agencywide HTME contracts, and said they plan to seek a refund for the overpayment.
Why GAO Did This Study
In fiscal year 2024, VA obligated over $608 million for the purchase of HTME and related services, including maintenance. Since 2019, VA Acquisition Management has been on GAO’s High-Risk list, partially due to challenges with VA’s acquisition approach.
GAO was asked to review how VA uses contracts to maintain HTME and whether its approach provides the needed flexibility to meet the agency’s mission. This report examines the extent to which (1) VA’s acquisition approach for purchasing HTME supports HTME maintenance and (2) the selected medical centers’ approaches to maintenance result in satisfactory and cost-effective maintenance, among other objectives.
GAO analyzed VA’s HTME strategic sourcing contracts and data for federal procurement, contract performance, and equipment maintenance from fiscal years 2022 through 2024. GAO selected a nongeneralizable sample of eight medical centers and 16 maintenance orders and contracts based on diverse geographic regions, medical center characteristics, and contracting approaches. GAO conducted site visits and interviewed relevant regional and national contracting officials.
Recommendations
GAO is making three recommendations to VA, including that VA clarify guidance and resources for using agencywide contracts to purchase HTME maintenance services. VA agreed with the recommendations and has plans to review and update its guidance and resources.
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Veterans Affairs | The Secretary of Veterans Affairs should ensure the Associate Executive Director of the National Acquisition Center evaluates how best to purchase maintenance services for radiation therapy equipment, including considering whether to modify the HTME base contracts to include these services. (Recommendation 1) |
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Veterans Affairs | The Secretary of Veterans Affairs should ensure that the Veterans Health Administration Heads of Contracting Activity determine whether HTME base contracts are designated as mandatory for purchasing HTME maintenance services and reflect this decision across agency procurement guidance to contracting officials, including updating expired HTME guidance. (Recommendation 2) |
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Veterans Affairs | The Secretary of Veterans Affairs should ensure the Associate Executive Director of the National Acquisition Center provides guidance and training to Veterans Health Administration contracting officials to facilitate effective use of the HTME base contracts, including updating its resources and identifying relevant information that regional officials should use when comparing prices and explaining how to use the center's HTME resources. (Recommendation 3) |
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
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