VA launches Veterans Health Administration reorganization

WASHINGTON - The Department of Veterans Affairs today 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.

VA has briefed Congress of its intent and will provide official congressional notification tomorrow. In early 2026, the department will announce precise organizational and personnel changes, which will take place over the next 18-24 months.

Multiple independent reviews from VA's Inspector General, the Government Accountability Office and others have underscored the need for reorganizing VHA. Those reviews highlighted governance weaknesses and how the organization's management structure is rife with middle managers who have overlapping responsibilities, slowing decision making and creating unnecessary burdens to serving Veterans.

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 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 - not bureaucracy - and result in more defined roles and faster decision-making for all VHA employees.

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."

Background on Why VHA Needs Reorganization

"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." - Government Accountability Office, September 2016

"VHA does not have an effective oversight process for ensuring and assessing the progress of VISNs and VAMCs in meeting VHA's strategic goals and objectives." - Government Accountability Office, Oct. 21, 2016

"This review highlights that the VISN organizational structure lacked clearly defined roles and standardized responsibilities and did not ensure accountability…" - VA Office of Inspector General, March 31, 2025

"…weaknesses in VA's governance and oversight have affected many aspects of program performance and operations." - VA Office of Inspector General, Semiannual Report to Congress, April 1-Sept. 30, 2023

"The OIG concludes that governance, with respect to staffing models, could be improved." - VA Office of Inspector General, Aug. 19, 2021

Regional Networks Need Improved Oversight and Clearly Defined Roles and Responsibilities - Government Accountability Office, June 19, 2019

"…the Commission strongly recommends a new [VHA] governance model…" - Commission on Care, June 30, 2016