VA plans to overhaul nation’s largest integrated health care system

(The Center Square) – The Department of Veterans Affairs plans to reorganize the management structure of the Veterans Health Administration, the nation’s largest health system, to improve care.

The goal is to empower local hospital directors and eliminate duplicative layers of bureaucracy across all the administration’s 1,380 medical facilities. VA officials plan to announce details in early 2026, including organizational and personnel changes. Those changes are expected to take place over the next two years.

“The current VHA leadership structure is riddled with redundancies that slow decision making, sow confusion and create competing priorities,” VA Secretary Doug Collins said in a statement. “In other words, when everyone’s in charge of everything, no one’s in charge of anything.”

Staffing and operations at medical facilities won’t change, but the reorganization will include giving the VHA Central Office the responsibility to set policy goals and conduct financial management, oversight and compliance. Operations Centers and Veterans Integrated Service Networks, or VISNs, will take policy direction from VHA’s Central Office to develop operational, quality and performance standards.

“Under a reorganized VHA, policymakers will set policy, regional leaders will focus on implementing those policies, and clinical leaders will focus on what they do best: taking great care of Veterans,” Collins said.

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House Committee on Veterans’ Affairs Chairman Mike Bost, R-Ill., said he supports the undertaking.

“I support the intent of Secretary Collins’ plan to break new ground and restructure the agency to meet the needs of today and tomorrow’s veterans, their families, and their survivors. Change can be a good thing. Veterans and their families gave us a clear mandate last November that business as usual is not cutting it and we must cut through the bureaucracy, remove the red tape, and push VA forward,” Bost said in a statement. “Congress looks forward to working with my friend, Secretary Collins, and the entire Trump administration in the coming weeks and months to learn more about the implementation of this plan to ensure it does one thing: benefit veterans.”

Reviews from VA’s Inspector General, the Government Accountability Office and others have underscored the need for reorganizing VHA.

“This initiative is not a reduction in force or an attempt to reduce staffing levels at VHA, and VA does not expect a significant change in overall staff levels once it’s complete,” according to the agency.

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