VFW Welcomes VHA Restructuring Initiatives

In December, VA Secretary Doug Collins and House Veterans' Affairs Committee Chairman Mike Bost signaled their alignment on reforming the Veterans Health Administration's (VHA) structure, a decision for which VFW has long advocated.

With the current VHA comprising 18 Veterans Integrated Service Networks (VISNs), VFW representatives believe the structure is flawed, often resulting in poor oversight, unequal and improper policy implementation and inconsistent outcomes for veterans.

"When the VISN structure was introduced in the 1990s, it was supposed to offer oversight and accountability to the VA health care system," VFW Washington Office Executive Director Ryan Gallucci said. "Unfortunately, what started as a modest quality control mechanism quickly ballooned into an unwieldy bureaucracy that numerous Inspector General reports show is where accountability often went to die. It is clear to the VFW that the current system of 18 networks - numbered one through 23 - is overdue for reform, and we thank Secretary Collins, Chairman Bost and the committee for moving to deliver consistent, integrated care across VA."

For years, VFW has voiced concerns about the shortcomings of the VHS structure, including three separate Congressional hearings last year.

The first of those came in January 2025, when a VFW employee highlighted her journey to access appropriate and timely mental health care, and how, in doing so, she experienced delays and roadblocks due to a VISN's misinterpretation of the 2018 MISSION Act. This led then-VFW Commander-in-Chief Al Lipphardt to point out the issue during VFW's annual legislative presentation to the joint House and Senate Veterans' Affairs Committees in March 2025.

Finally, in July 2025, another VFW employee spoke to the challenges of navigating maternity care in the community, as well as the roadblocks created by miscommunication and lax quality controls.

After hearing these personal anecdotes, VA announced in December the overhaul of its system of Community Care Networks (CCN), which enables veterans to receive care in the community when facing excessive wait times, when medical services are not available at VA, or when it is otherwise in their best medical interest. Currently, VA oversees five CCNs and plans to reduce that number to two, further eliminating bureaucratic barriers to veterans receiving the best care VA and its community care partners have to offer.

"The VFW has been consistent for more than a decade that community care is part of VA care - yet since the earliest days of the Choice Program and now the MISSION Act, we have seen fits and starts with how VA gatekeeps community care referrals across the enterprise," Gallucci said. "We hope that as VA revamps its CCNs, we can achieve seamless integration of care, whether it is delivered through direct VA providers or VA's community partners - once and for all burying the unrealistic boogeyman of privatization that has stymied modernization."

This article is featured in the 2025 March/April issue of VFW magazine and was included in the Washington Wire section.