Mission And Service Delivery Structure
VA’s mission is to serve America’s veterans (individuals who have been honorably discharged from U. S. military service) in three major areas: health care, which is coordinated by the Veterans Health Administration (VHA); socioeconomic support and assistance, coordinated by the Veterans Benefits Administration; and burial services, coordinated by the National Cemetery Administration.
VHA operates the largest health care system in the nation, encompassing 172 hospitals, 132 nursing home care units, 40 domiciliaries, and over 600 outpatient clinics. VHA also contracts for care in non-VA hospitals and in community nursing homes, provides fee-for-service visits by non-VA physicians and dentists for outpatient treatment, and supports care in one hundred state veterans homes in forty-seven states.
Since 1995, VHA has undergone a major reorganization. There are twenty-two regional Veterans Integrated Service Networks (VISNs), each comprised of from five to eleven facilities. The VISN, rather than the individual medical center, is the basic planning and budgetary unit of health care delivery in the new VHA structure. VISNs are responsible for providing a coordinated continuum of care for veterans treated in each network of facilities and for supporting research and health profession education activities. Key domains of health care value in which VISN performance is measured include access to care, quality of care, patient satisfaction, patient functional status, and cost-effectiveness.
In addition, VHA has shifted from an inpatient, hospital bed-based system to outpatient, primary, and ambulatory care. There is increased emphasis on noninstitutional settings such as outpatient clinics, home-based services, and other ambulatory and community-based venues.