Vision for Change: An Integrated Service Network

Abstract

Across the United States, technological advances, economic factors, demographic changes, and the rise of managed health care, among other things, are causing a dramatic shift away from inpatient care and a corresponding increase in ambulatory care. For the Veterans Health Administration (VHA)—the largest integrated healthcare provider in the nation—these forces are compounded by demands for downsizing its work force, cutting its costs, and shutting down facilities. At the same time, VHA, commonly known simply as “VA,” is being asked to be more responsive to those it serves and to provide better quality care.