The Department of Veterans Affairs (VA) has announced plans to reorganize the management structure of the Veterans Health Administration (VHA). The aim is to improve health care for veterans, empower local hospital directors, remove redundant layers of bureaucracy, and ensure consistent application of VA policies across all medical facilities.
Congress has been briefed on this initiative, with official notification scheduled for tomorrow. The department expects to announce specific organizational and personnel changes in early 2026. These changes will be implemented over the following 18 to 24 months.
The decision follows several independent reviews by the VA’s Inspector General and the Government Accountability Office (GAO), which have pointed out weaknesses in VHA governance. These reviews identified issues such as overlapping responsibilities among middle managers that slow down decision-making and create obstacles in serving veterans.
According to the reorganization plan, the VHA Central Office will focus on setting policy goals and managing financial oversight and compliance. Operations Centers and Veterans Integrated Service Networks (VISNs) will develop operational, quality, and performance standards based on guidance from the Central Office. This new structure is intended to provide clearer direction and greater decision-making authority for VA Health Care Systems, which include more than 170 medical centers and nearly 1,200 outpatient sites.
There will be no changes to staffing or operations at VA medical centers and clinics as a result of this reorganization. The initiative does not involve reducing staff levels at VHA, nor does it anticipate significant changes in overall staffing once complete.
VA Secretary Doug Collins said: “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. 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.”
Several reports have called for structural reforms within VHA:
- A September 2016 GAO report stated that recent internal and external reviews identified deficiencies in VHA's organizational structure requiring significant restructuring.
- An October 2016 GAO report found that VHA lacked an effective oversight process for ensuring progress toward strategic goals.
- A March 31, 2025 review by the VA Office of Inspector General noted that VISN structures lacked clearly defined roles and standardized responsibilities.
- The VA Office of Inspector General’s semiannual report covering April to September 2023 highlighted how weaknesses in governance affected program performance.
- An August 19, 2021 OIG report suggested improvements could be made regarding governance related to staffing models.
- A June 19, 2019 GAO report emphasized the need for improved oversight and clearer roles within regional networks.
- On June 30, 2016, the Commission on Care recommended a new governance model for VHA.
The planned reorganization seeks to address these findings by clarifying roles within VHA leadership while maintaining its workforce dedicated to veteran care.
