Organization of the VA Health Care System

The Department of Veterans Affairs provides health care to enrolled veterans through its Veterans Health Administration (VHA). The VHA is the largest administration under the VA and is separate from the Veterans Benefits Administration. The VHA is the largest health care system in the country and includes hospitals, outpatient sites, nursing homes, domiciliaries, and Vet Centers.

The Under Secretary of Health oversees the VHA. Day-to-day health care services are managed by twenty-three Veterans Integrated Service Networks (VISNs). Each network operates within a given geographic boundary, generally covering two or more states or parts of states. Within that geographic boundary, the director of the VISN is responsible for managing all VA health care facilities and services, and the VHA clinical appeals process for medical disputes that are not resolved at the medical facility level. Directors of VA medical centers (VAMCs) and outpatient clinics (Community Based Outpatient Clinics or CBOCs) reports to the VISN director in the associated geographic network.