High-Tech Medical Equipment: VA Has Opportunities to Improve Its Acquisition of Maintenance Services

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.