VA launches Veterans Health Administration reorganization

The Department of Veterans Affairs (VA) on December 15 announced its intent to reorganize the management structure of the Veterans Health Administration (VHA), with the goals of improving health care for Veterans, empowering local hospital directors, eliminating duplicative layers of bureaucracy and ensuring consistent application of VA policies across all department medical facilities.

In a press release, the VA says Congress has been briefed on its intent and will continue to provide official congressional notification and that early in the New Year, the department will announce precise organizational and personnel changes, which will take place over the next 18-24 months.

The VA says that the need for reorganization of the VHA has been underscored by multiple independent reviews from VA’s Inspector General, the Government Accountability Office (GAO), all highlighting governance weaknesses and how the organization’s management structure is rife with management that has overlapping responsibilities, slowing decision making and creating unnecessary burdens to serving Veterans.

Back in September, 2016, the GAO reported:

“Recent internal and external reviews of Veterans Health Administration (VHA) operations have identified deficiencies in its organizational structure and recommended changes that would require significant restructuring to address, including eliminating and consolidating program offices and reducing VHA central office staff.” The following month, the GAO then assessed that the VHA did not have an effective oversight process for ensuring and assessing the progress of VISNs and VAMCs in meeting VHA’s strategic goals and objectives.

Earlier in 2025, the VA Office of Inspector General said of its review that the VISN organizational structure “lacked clearly defined roles and standardized responsibilities and did not ensure accountability….”

The VHA’s reorganization will incorporate this feedback by reducing duplicative management layers and putting the right people in the right places without reducing staff. As part of the reorganization:

-VHA Central Office will have the responsibility for setting policy goals and conducting financial management, oversight and compliance.

-Operations Centers and Veterans Integrated Service Networks (VISNs) will take policy direction from VHA’s Central Office to develop operational, quality and performance standards that will guide VA’s more than 1,300 medical facilities.

These changes will result in clearer guidance and more decision-making authority for VA Health Care Systems, which deliver health care through more than 170 medical centers and nearly 1,200 outpatient sites of care.

Staffing and operations at VA medical centers and clinics will not be changing as part of this reorganization.

VHA’s reorganization will better position the organization to focus on care delivery and result in more defined roles and faster decision-making for all VHA employees.

According to the press release, 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.

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