Assignment Overview
The Veterans Health Administration

From the U.S. Department of Veterans Affairs website (, the following sheds light on this giant organization.

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Facts about the Department of Veterans Affairs:

The Department of Veterans Affairs (VA) was established on March 15, 1989. It succeeded the Veterans Administration and has responsibility for providing federal benefits to veterans and their dependents. Headed by the Secretary of Veterans Affairs, the VA is the second largest of the 14 Cabinet departments and operates nationwide programs of health care, financial assistance, and national cemeteries.
Of the 48.9 million veterans currently living, more than three of every four served during a war or an official period of hostility. About a quarter of the nation’s population, approximately 81 million people, are potentially eligible for VA benefits and services because they are veterans, family members of veterans, or survivors of veterans.
The responsibility to care for veterans, spouses, survivors, and dependents can last a long time. The last dependent of a Revolutionary War veteran died in 1911. The War of 1812’s last dependent died in 1946, and the Mexican War’s in 1962. About 547 children and widows of Spanish-American War veterans still receive VA compensation or pensions.
In the fiscal year of 2019, the VA estimated spending was $198.6 billion, which was an increase of $12.1 billion from fiscal year 2018.
Medical Care

VHA operates one of the largest health care systems in the world and provides training for a majority of America’s medical, nursing, and allied health professionals. Roughly 60 percent of all medical residents obtain a portion of their training at VA hospitals; and VA medical research programs benefit society at-large.
The VA health care system has grown from 54 hospitals in 1930 to 1,600 health care facilities today, including 144 VA Medical Centers and 1,232 outpatient sites of care of varying complexity.
To receive VA health care benefits, most veterans must enroll. More than 20 million veterans are enrolled in the VA health care system as of October 2015. When they enroll, they are placed in priority groups or categories to help VA manage health care services within budgetary constraints and to provide quality care to those enrolled.
Some veterans are exempted from having to enroll, although all veterans are encouraged to enroll to help VA plan its health care needs and provide better preventive and primary services. Veterans who do not have to enroll include veterans with a service-connected disability of 50 percent or more, veterans who were discharged from the military within one year but have not yet been rated for a VA disability benefit, and veterans seeking care for only a service-connected disability.
VA manages the largest medical education and health professions training program in the United States. VA facilities are affiliated with 107 medical schools, 55 dental schools, and more than 1,200 other schools across the country. Each year, about 81,000 health professionals are trained in VA medical centers. More than half of the physicians practicing in the United States have had part of their professional education in the VA health care system.
VA’s medical system also serves as a backup to the Defense Department during national emergencies and as a federal support organization during major disasters.
Since 1979, VA’s Readjustment Counseling Service has operated Vet Centers, which provide psychological counseling for war-related trauma, community outreach, case management and referral activities, plus supportive social services to veterans and family members. There are 206 Vet Centers.
Since the first Vet Center opened, approximately 1.6 million veterans have been helped. Every year, the Vet Centers serve over 126,000 veterans and handle at least 900,000 visits from veterans and family members.
Vet Centers are open to any veteran who served in the military in a combat theater during wartime or anywhere during a period of armed hostilities. Vet Centers also provide trauma counseling to veterans who were sexually assaulted or harassed while on active duty.
VA provides health care and benefits assistance to more than 100,000 homeless veterans each year. While the proportion of veterans among the homeless is declining, VA actively engages veterans in outreach, medical care, benefits assistance, and transitional housing services. VA has made more than 300 grants for transitional housing, service centers, and vans for outreach and transportation to state and local governments, tribal governments, and non-profit community and faith-based service providers.
Programs for alcoholism, drug addiction, and post-traumatic stress disorder have been expanded in recent years, along with attention to environmental hazards.
Indispensable to providing America’s veterans with quality medical care are more than 94,754 volunteers in VA’s Voluntary Service who donate more than 13 million hours of service each year to bring companionship and care to hospitalized veterans.
Case Assignment
Read the following article:

VA U.S. Department of Veterans Affairs. (2018). Department of Veterans Affairs FY 2018-2024 strategic plan. Online: Department of Veterans Affairs.

Abstract/Letter from the Secretary: The Department of Veterans Affairs (VA) is committed to providing excellent care and benefits to our Nation’s Veterans. We continue to serve over 9 million Veterans who served through periods of peace and conflict to include WWII, the Korean War, and Vietnam, as well as the Gulf Wars. We anticipate that many more Veterans will require VA care and services in the future. I intend to ensure that VA will be there to serve them and their families. VA provides many types of care and benefits tailored to Veterans that are not available in the private sector. In addition to providing some of the best overall high-quality healthcare in the country, VA delivers exceptional care in polytrauma, spinal cord injury and rehabilitation, prosthetics, traumatic brain injury, post-traumatic stress treatments and other behavioral health programs. VA plays a critical role in preparing our Nation’s doctors and nurses – 70 percent of whom train at VA facilities. And we lead the Nation in innovation, with VA research having contributed to the first liver transplant, development of the cardiac pacemaker, advancements in treatments for Post Traumatic Stress Disorder, cutting-edge prosthetics, and many other medical breakthroughs. We also lead the Nation in providing access to healthcare through telehealth. But we have much more work to do. As VA moves forward with its modernization efforts, we will incorporate Veterans’ input to build a system that works best for them — a customer- and clinically-driven system. In order to do that, we must build a VA that competes successfully with the private sector. If we maintain the status quo, VA will fail, and Veterans will be put at risk. VA faces many challenges that require a fundamental change to the way we think and operate to competitively serve our Veterans. To ensure our success, VA will focus resources on foundational services that Veterans need most, and leverage Federal partners, community providers, and private partners to offer care and services where needed. This will provide Veterans access to the best of both VA and the private sector. We do not want Veterans to choose VA because they have no other choice; we want them to choose VA because we perform well for Veterans and their families. When we uphold high standards of care and services, equal to or better than the private sector, they will choose us as their provider. Our disability system must be reformed. We need a system that promotes wellness and recovery rather than disincentivize them. We will modernize our systems and process for claims and appeals to ensure Veterans receive decisions quickly and are empowered to make informed choices about their benefits. VA must continue to invest in ground-breaking research that contributes to the quality of life for Veterans — and for all Americans. We also need to modernize our procurement and information technology services, continue our investments in 21st century technology, like telehealth to increase access to care, and better leverage our existing infrastructure while teaming up with private partners to invest in state-of-the-art facilities. This strategic plan focuses on the positive outcomes we will achieve in partnership with our Veterans and builds on the improvements we have made, and will continue to make, on behalf of Veterans and their families everywhere.

The following requirements/questions will be assessed:

Using information provided in Appendix A-Appendix D of the Department of Veterans Affairs FY 2018-2024 strategic plan, how would you assess the internal strengths and weaknesses of the VHA?
Based upon your assessment of the strengths and weaknesses, discuss two areas of the VHA’s organizational structure that need to be changed to improve access and quality of care.
Assignment Expectations
Your references and citations should be consistent with APA style.
Your response should be based on scholarly material, such as peer-reviewed articles, white papers, technical papers, etc. Do not include information from non-scholarly materials such as wikis, encyclopedias, (or similar websites).
Your response should incorporate the objectives of the module with the requirements of this assignment.
Use information from the modular background readings as well as any good-quality resource you can find. Cite all sources and provide a reference list at the end of your paper.
Length: 6 pages minimum, not including the Title page.


Health organizations are very large and complex. If you make a quick list of all the departments, facilities, and personnel of even a small hospital, you will immediately see that it is quite a mosaic. It can be mind boggling to evaluate a major hospital or a network of health care services.

Therefore, this course cannot encompass all the fine details of each organization. It is up to you to “transform” the generalities to a specific field or organization.

Required Reading
Alagoz, E., Chih, M.-Y., Hitchcock, M., Brown, R., & Quanbeck, A. (2018). The use of external change agents to promote quality improvement and organizational change in healthcare organizations: A systematic review. BMC Health Services Research, 18(1), 42. Read pp. 1-4.

Baum, N., Brockmann, E. N., & Lacho, K. J. (2016). Strategic planning: A practical primer for the healthcare provider: Part I. The Journal of Medical Practice Management, 31(6), 371. Read pp. 371-373.

Braithwaite, J., Herkes, J., Ludlow, K., Testa, L., & Lamprell, G. (2017). Association between organisational and workplace cultures, and patient outcomes: Systematic review. BMJ Open, 7(11), e017708. Read pp. 1-6.

Edwards, J., Ketchen, D., & Harrison, J. P. (2014). Mastering strategic management – 1st Canadian edition (1st ed.). Online: BCcampus. Review section 24 of Chapter 4.

Kapoor, R., Tan-Koi, W. C., & Teo, Y.-Y. (2016). Role of pharmacogenetics in public health and clinical health care: A swot analysis. European Journal of Human Genetics, 24(12), 1651-1657. Read pp. 1-6.

Valeau, P., Willems, J., & Parak, H. (2016). The effect of attitudinal and behavioral commitment on the internal assessment of organizational effectiveness: A multilevel analysis. VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations, 27(6), 2913-2936. Read pp. 1-6.

Van Durme, T., Macq, J., Anthierens, S., Symons, L., Schmitz, O., Paulus, D., . . . Remmen, R. (2014). Stakeholders’ perception on the organization of chronic care: A SWOT analysis to draft avenues for health care reforms. BMC Health Services Research, 14(1), 179. Read pp. 1-6.

For the Case Assignment

VA U.S. Department of Veterans Affairs. (2018). Department of Veterans Affairs FY 2018-2024 strategic plan. Online: Department of Veterans Affairs.

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