Veterans Health Care: Better Communication Needed to Integrate Management of Medical Facility and Community-Based Care

Why This Matters

Since 2014, veterans who face challenges accessing timely health care at Veterans Health Administration (VHA) medical facilities have been increasingly referred to community providers to receive care.

As part of an organizational reform to address its progressively complex processes, VHA created the Office of Integrated Veteran Care (IVC) to improve coordination and provide seamless access to care.

GAO Key Takeaways

IVC combined oversight of the management of VHA medical facility and community care into one office. The office established national priorities and initiatives, such as expanding a new process for specialty care appointments. It is also responsible for developing national policy for VHA's regional networks and medical facilities to guide implementation of initiatives to enhance access to care at medical facilities.

IVC has made several changes to its organizational structure and priorities since it was established. In May 2025, officials said further changes are on hold as the Department of Veterans Affairs undergoes reorganization and workforce reduction that may affect IVC. Congressional stakeholders have raised questions about the potential effects on veteran health care delivery.

The frequent changes have affected officials' ability to carry out the initiatives at some facilities. They reported that IVC did not clearly communicate changes to its organizational structure, and they did not always know where to seek guidance. They also reported that communication was often one-way, and their input was not solicited when making changes. Clear two-way communication will help officials effectively implement initiatives to ensure veterans access timely care.

VHA Organizational Chart as of January 2025

How GAO Did This Study

We evaluated VHA's efforts against selected leading agency reform practices identified in prior GAO work. We reviewed documents and interviewed VHA officials from national-level offices, three regional networks, and three medical facilities on IVC's organizational structure and planned changes.