This year, however, the award came amid allegations that the UVa Health System fraudulently billed patients, mistreated employees and retaliated against those who spoke out against the administration.

“When I hear things like, ‘The quality scores of all these hospitals are great,’ there’s no way,” said a former UVa Health executive who spoke to The Daily Progress on the condition of anonymity. “There is no way that can be true because to achieve such a result you have to focus on the very things he destroyed.”

The executive was referring to her former boss: Dr. Craig Kent, CEO of UVa Health. Kent was with UVa School of Medicine Dean Dr. Melina Kibbe, the subject of a September 5 letter of censure signed by 128 hospital doctors and medical school faculty members. The five-page document alleges the pair committed a series of “outrageous” and illegal acts and created a toxic work environment to the point of endangering patients.

Since the letter was delivered to UVA administrators, The Daily Progress has interviewed more than a dozen former and current hospital leaders and physicians and medical school faculty members, all of whom agreed to speak on the condition of anonymity, and all of whom agreed to do so UVa Health’s top priority has become “money and reputation.”

Others in the UVa community agreed with that assessment.

“Competition and the pressure to outsmart the standards of ranking systems cause administrators to lose sight of what they are really supposed to be doing,” Associate Professor Walt Heinecke, who leads the university chapter of the American Association of University Professors, told The Daily Progress. “They push people to make poor decisions, which I think is part of the problem in the hospital and in medical school.”

A significant portion of the problems described in the censure letter centered on a “culture of fear and retaliation” that Kent and Kibbe said the signatories created at UVa. The pair are accused of retaliating against those who challenged them with promotions and explicit threats.

One of the allegations in particular accuses the university of an obsession with rankings – and of doing everything necessary to achieve them.

“Ignoring valid reports of fraudulent billing and requests from senior leaders to fraudulently alter patient records to conceal adverse outcomes and increase productivity metrics,” the letter said.

In investigating allegations of fraud at the hospital, The Daily Progress interviewed several subjects who expressed concerns about the authenticity of the metrics that UVa Health administrators submit for rankings.

The former hospital executive who spoke to The Daily Progress spent nearly a decade at UVa Health before Kent’s arrival in February 2020, but left less than a year later because “I couldn’t in good conscience work for him knowing that there were no checks and balance sheets.”

“If there is high quality data being published there… no doubt he would have been fine if they had manipulated (the data),” they said.

They recalled a meeting they attended during the pandemic to discuss the amount of financial support the state was providing to hospitals. The money was distributed based on the number of patients each center treated. According to the former CEO’s statement, when Kent was told at the meeting that another, slightly larger health system in the commonwealth would receive more funding, he responded, “I don’t care what you have to do to run the numbers.” We’ll get as much money as (the other hospital).”

UVa doctors told The Daily Progress that the hospital was also able to “hide adverse outcomes and increase productivity metrics” through its clinical documentation initiative.

UVa Health, a program first mentioned by the UVa School of Medicine in April 2023, began prioritizing documenting all patient diagnoses in medical records when it came time to submit those records for external reviews. In a statement announcing its decision to adopt the practice, the medical school acknowledged that including a patient’s entire medical history could impact readings.

“One of the reasons that external benchmarks do not reflect our excellent mortality is because we do not always document and code our critically ill patients with the diagnoses necessary to accurately and comprehensively represent their high disease severity and mortality risk.” says the study announcement from the Faculty of Medicine. “This can be fixed, but it requires a partnership between our doctors who create the medical documentation and the nurses and programmers who convert that information into codes for each patient.”

However, these measures have had little to no impact on the actual treatment of sick patients, said doctors who spoke to The Daily Progress. According to these doctors, UVa Health administrators routinely pressured doctors to go back into medical records and enter diagnoses that medical staff deemed irrelevant to the treatment they were administering, even after patients had already gone home or received no care needed more.

“They just say, ‘Oh, we’re just trying to accurately reflect how sick the patient was,'” one doctor told The Daily Progress. “It has nothing to do with good patient care, patient safety or outcomes – it has nothing to do with anything. It’s about getting more money per patient, because the sicker they are, the more money you get per patient, and making patients sicker through these benchmarking programs.”

One reason UVa Health was eager to improve its metrics is that it would improve its national rankings, one doctor said, including in U.S. News & World Report and Newsweek.

The Children’s Hospital of Richmond at Virginia Commonwealth University and Inova LJ Murphy Children’s Hospital in Annandale ranked second and third, respectively, in this year’s U.S. News & World Report Best Children’s Hospital rankings. The publication also ranked eight of UVa’s pediatric specialties in the top 50 of all children’s hospitals nationwide, including neonatology, pediatric nephrology and pediatric cardiology and cardiac surgery.

“The positive reviews that come out here, actually at every hospital, are probably due to the quality of the doctors there,” said Heinecke. “I worry that administrators trying to achieve rankings will lose sight of what is best for a patient.”

The authors of the Sept. 5 letter expressed the same fear of compromised patient safety, saying the document was a “last resort out of urgent concern for our patients, colleagues, community and the University of Virginia.”

If the 128 signatories had hoped that their pleas would persuade UVa President Jim Ryan or the school’s Board of Visitors to immediately address the allegations, they were quickly disappointed. Ryan’s initial reaction was to dismiss the claims as “general and anonymous allegations of misconduct” by a small group of disgruntled teachers, typical of any organization.

Although he claimed Kent and Kibbe are the reason the university’s health system is “in the best shape it’s ever been in,” Ryan and the board have brought in the Washington, D.C.-based law firm Williams & Connolly, which serves as Such is recognized as one of the world’s leading litigation law firms that examine complaints.

Despite assurances that the company would conduct an independent audit that could provide clarity, the university has already said the results will not be made available to the public.

The Daily Progress reached out to UVa Health regarding the specific claims made by its doctors. A UVa Health representative did not respond, but UVa’s official spokesperson, Brian Coy, responded – with a prepared statement saying the university would not comment on the matter while Williams & Connolly’s review is ongoing.

“In the interest of fairness to all parties, the university will not make any further public comments while the review is ongoing,” Coy’s statement said. “We encourage all interested faculty members to participate in this independent initiative.”