The VA Excellence Campaign: A Strategic Plan for Transformational Veterans Care

The Department of Veterans Affairs has a singular, sacred mission: to provide exceptional care for Veterans injured while serving our country. Today, under Secretary Collins’ leadership, the VA is embarking on bold initiatives that combine the best of government healthcare delivery with private sector innovation and technology. Secretary Collins is actively meeting with VA leaders across the nation to refocus the organization and get the VA back on target, a crucial first step in this transformative campaign. As both a combat veteran and a VA beneficiary, I’ve experienced the dedication of VA professionals firsthand and understand the tremendous potential these transformative changes hold for Veterans nationwide.

When Servicemembers risk their lives in defense of this nation, they think only of their dedication to our country, our freedoms, and their fellow Servicemembers. I know, I was there. And now, I am here, a beneficiary of the VA system, advocating for the continued evolution of Veterans care.

Campaign Mission and Intent

The VA Excellence Campaign’s mission is clear: secure the highest quality, most accessible care for our Veterans through strategic organizational transformation and aggressive technology implementation. Like any successful military operation, this campaign requires a clear plan of action. There are four interconnected “Lines of Advance”:

1) Streamlined organizational structure optimized for Veteran outcomes

2) Aggressive implementation of next-generation technology in partnership with private industry

3) Implementation of a nationwide unified scheduling system

4) Seamless integration between DoD and VA systems.

Each task builds upon the others to achieve mission success.

Understanding the Current Structure and the Opportunity Ahead

The VA’s current structure evolved from the 1995 “Vision for Change” initiative, which established Veterans Integrated Service Networks (VISNs) to better coordinate regional care. Today, 21 VISNs manage hospitals and clinics across designated geographical areas, with each VISN leadership team reporting metrics to VA headquarters in Washington, DC.

This structure has served Veterans for decades, but the healthcare landscape has transformed dramatically. Secretary Collins recognizes that the same structural framework that once promoted regional coordination now creates opportunities for improvement toward a seamless, national care experience Veterans deserve. His engagement with VA leadership at all levels demonstrates a commitment to understanding operational realities and driving meaningful change.

Consider a common scenario: A Veteran exits service at Fort Stewart, GA and relocates to Portland, OR. Upon arrival, they register with the Portland VA Health Care System, and all their care is tracked within that specific system. If they later move again, they must de-register and re-register, restarting the process. While this system enables regional accountability, it also creates artificial boundaries in what should be a unified national healthcare network.

The opportunity is clear: transform from a collection of regional healthcare systems into One VA, a truly national healthcare network where every Veteran has access to every resource, regardless of location.

Line of Advance 1: Organizational Excellence Through Integration

The first Line of Advance builds upon Secretary Collins’ leadership engagement to create a streamlined structure where each VA hospital reports to a strengthened central VA leadership, supported by national-level functions for scheduling, registration, and credentialing.

This transformation will eliminate redundant administrative layers while preserving local clinical excellence. All scheduling and registration will transition to a national system, ensuring Veterans are registered with “The VA,” not with individual facilities. Credentialing of healthcare providers will occur at a single point, shareable across all VA facilities, ending the current practice where providers undergo separate credentialing processes at each location, sometimes taking six to nine months per facility.

Industry partnership is essential here. Private sector organizations have developed sophisticated credentialing platforms used by major hospital networks nationwide. The VA should leverage these proven solutions which adapted to meet federal requirements.

Under this Line of Advance, funding for VA hospitals will be based on patient care delivered – determined through centralized registration and scheduling functions –creating transparency and avoiding misaligned incentives. Contracting functions will be modernized, with facility-level procurement supported by a centralized contracting office that maintains nationwide pricing and terms, leveraging the VA’s purchasing power while enabling rapid local response.

This is not destruction of the VA, it is strategic optimization to unleash the system’s full potential.

Line of Advance 2: Technology-Enabled Transformation Through Public-Private Partnership

Technology is the catalyst that will enable every other element of this campaign. Secretary Collins’ meetings with VA leadership must include a frank assessment of technology capabilities and deficiencies. As these strategic discussions unfold, Secretary Collins and his team should ask themselves a critical question: Do we have representatives from Service Disabled Veteran Owned Small Businesses (SDVOSBs) at the table?

SDVOSBs represent a unique and invaluable resource. These companies are led by Veterans who understand both the mission and the operational challenges firsthand. They bridge the gap between military culture and private sector innovation. They have skin in the game, literally. Many SDVOSB leaders rely on VA care themselves and are deeply invested in solving the problems that impact their fellow Veterans. Excluding them from strategic planning discussions means losing crucial perspectives and proven capabilities.

The question is simple: Why can Amazon or Walmart track inventory worldwide with a button click, while Veterans can’t seamlessly access care across the VA system? The answer isn’t capability, it’s execution. The technology exists today to create One VA.

Strategic Technology Priorities:

Cloud Computing Implementation: The VA must fully embrace FedRamp-certified cloud service providers. The notion that VA patient data requires unique protection beyond HIPAA and HHS standards is outdated. Private healthcare systems like Columbia Presbyterian protect millions of patient records using commercial cloud infrastructure. SDVOSBs specializing in cloud migration and cybersecurity have successfully implemented similar transformations for major healthcare systems and government agencies. The VA should partner with certified cloud providers, particularly SDVOSBs with proven track records, to deliver secure, scalable, cost-effective infrastructure that enables real-time data access nationwide.

Industry Innovation Integration: Private companies, including numerous innovative SDVOSBs, are developing breakthrough medical solutions, scheduling platforms, telehealth technologies, and operational software. The VA must create agile evaluation and procurement processes to rapidly implement solutions that work. SDVOSBs bring unique advantages: they combine technical expertise with intimate knowledge of VA operations and Veteran needs. This is where Veterans benefit most from private sector partnership, not by outsourcing care, but by integrating best-in-class technology and innovation.

Electronic Health Record Optimization: Modern EHR systems must provide seamless information flow between facilities, enabling any provider at any location to access complete patient histories instantly. SDVOSBs have successfully implemented interoperability solutions for complex healthcare networks and understand the unique challenges of government IT modernization.

Telehealth Expansion: Technology enables expert specialists in Wisconsin to treat Veterans in New Mexico via telehealth. One VA means every Veteran has access to every specialist, regardless of geography. Many SDVOSBs, including the Valor Network, have pioneered telemedicine platforms specifically designed for government healthcare delivery, demonstrating that Veteran-owned companies can deliver world-class technical solutions at scale.

Real-Time Operational Transparency:  Modern analytics platforms can provide leadership with real-time visibility into operations, quality metrics, wait times, and resource utilization, enabling rapid problem-solving and eliminating the reporting delays that have historically masked problems. SDVOSBs specializing in data analytics and business intelligence can implement these solutions rapidly and cost-effectively.

Provider Management and Workforce Analytics:  Secretary Collins has observed that many VA physicians are tired, a critical observation that demonstrates the kind of situational awareness necessary for effective leadership. However, this observation demands deeper examination. In the military, when leaders notice fatigue among troops, they immediately assess the operational tempo, deployment schedules, and overall mission demands. The same leadership principle applies here.

The reality is that many VA physicians are indeed fatigued, but not solely from their VA responsibilities. A significant number of VA physicians work additional jobs after completing their VA shifts, moonlighting at private hospitals, emergency rooms, or private practices. This raises fundamental questions that Secretary Collins and his leadership team must address:

Does VA leadership have situational awareness of physicians outside employment?  In the military, commanders maintain accountability for their personnel and understand their commitments. Service members cannot simply take on outside employment without approval and awareness from their chain of command. The question is whether VA physicians are required to request permission or notify their leadership about additional employment that may impact their readiness, performance, and ability to serve Veterans.

Is there a formal approval process?  If physicians are working 40+ hours at the VA and then working additional shifts elsewhere, leadership needs to know. This isn’t about restricting physicians’ rights to supplemental income, it’s about ensuring patient safety, physician wellbeing, and maintaining the quality of care Veterans deserve. Fatigue-related medical errors are well-documented in healthcare literature. A physician working a full VA shift followed by an overnight ER shift elsewhere may not be operating at peak performance the following day when treating Veterans.

Are current policies enforced?  The VA likely has policies governing outside employment, but are they enforced? Does leadership actively track and approve secondary employment, or is this happening without proper oversight? Secretary Collins’ team needs clear situational awareness: Who is working where, when, and how much? This information is essential for workforce planning, quality assurance, and patient safety.

What does this reveal about compensation and culture?  If physicians routinely need secondary employment to meet their financial obligations, this signals either inadequate compensation or a cultural expectation that has become normalized but shouldn’t be. The VA must offer competitive compensation that allows physicians to focus their professional energy on Veterans rather than requiring additional employment to maintain their standard of living.

Modern workforce management platforms can track provider schedules, credentials, work hours, and performance metrics in real-time. These systems, commonly used in large healthcare networks, enable leadership to maintain situational awareness about physician workload, fatigue risk, and outside employment. Implementing such systems would give Secretary Collins and his team the visibility they need to ensure physicians are rested, focused, and dedicated to Veteran care. A centralized credentialing and provider management system would enable proper tracking of physician work hours and outside employment, protecting both physicians and patients.

Secretary Collins and his team should implement clear policies requiring disclosure and approval of outside employment, establish maximum work-hour guidelines consistent with patient safety standards, and ensure leadership at all levels maintains accountability for physician wellness and readiness, just as military commanders do for their troops.

The SDVOSB Imperative:  As Secretary Collins shapes his leadership team and advisory groups, the absence of SDVOSB representation should raise immediate red flags. These businesses aren’t just contractors, they’re stakeholders with lived experience, technical expertise, and unwavering commitment to the mission. When planning sessions occur without SDVOSB voices, the VA loses access to some of its most qualified and motivated problem-solvers. Secretary Collins should ensure that SDVOSBs are not merely vendors but strategic partners in this transformation.

The partnership between VA expertise, SDVOSB innovation, and broader private sector capabilities will create a healthcare delivery model that exceeds purely privatized care, which faces its own challenges with profit motives and insurance company limitations.

Line of Advance 3: Unified National Scheduling, Eliminating Barriers to Access

Building on organizational integration and technology implementation, Line of Advance 3 establishes a revolutionary nationwide scheduling system. This represents one of the most tangible improvements Veterans will experience.

The Vision: When Veterans separate from service, they register with “The VA,” not a specific facility. They gain immediate access to scheduling resources across every VA hospital nationwide. If Centers of Excellence exist for specific treatments, Veterans are automatically connected to those resources.

How It Works:

National Scheduling Centers: Veterans call a national number and reach trained schedulers with real-time visibility into appointments nationwide. If a Veteran needs urgent psychological care, schedulers immediately provide options, local VA appointments, telehealth appointments, or private sector appointments coordinated by the VA, all while the Veteran is on the phone.

Digital Scheduling Platform: Younger Veterans comfortable with technology can access an online portal to view and book appointments across the entire VA system, including telehealth options. SDVOSBs have developed sophisticated patient engagement platforms that could be adapted for VA-wide deployment, creating user experiences comparable to commercial healthcare apps.

Coordinated Care, Not Privatized Dumping: The system coordinates with credentialed private providers when appropriate, ensuring continuity of care rather than disconnected outsourcing.

Metric Integrity: National scheduling eliminates the perverse incentives of the current system. Success metrics shift from “appointments made” to “Veterans treated successfully.”

Private industry partners, including SDVOSBs with healthcare IT expertise, bring proven scheduling technologies used by major healthcare networks. Companies like Epic, Cerner Oracle, and specialized healthcare scheduling platforms have solved these problems for large integrated delivery networks. The VA should leverage these solutions, working with SDVOSBs who can customize platforms for Veterans’ unique needs and provide implementation expertise informed by military experience.

This transformation isn’t just possible, it’s overdue and entirely achievable with today’s technology and the right partners.

Line of Advance 4: Seamless DoD-VA Integration, Honoring the Transition

The final Line of Advance eliminates the artificial boundary between DoD and VA systems, ensuring continuity of care precisely when Veterans need it most. Secretary Collins’ commitment to getting the VA back on track must include prioritizing this critical integration.

The Current Gap: Injured Servicemembers face bureaucratic obstacles exactly when they deserve streamlined support. Medical records don’t automatically transfer from DoD to VA. Disability determinations require lengthy claims processes after separation. These delays cost Veterans health outcomes and cost taxpayers money through preventable complications.

The Solution: With current technology, there is no viable reason for this gap to exist.

Implementation Steps

Automatic Medical Record Transfer: DoD electronic health records automatically migrate to VA systems upon separation, with Veterans’ electronic health history immediately available to VA providers. SDVOSBs with expertise in health information exchange and interoperability have successfully connected disparate healthcare systems and can accelerate this integration.

Pre-Separation Disability Determinations: Initial disability evaluations occur before separation, with determinations ready upon transition. Veterans requiring ongoing treatment move seamlessly into VA care without gaps.

Integrated Transition Clinics: Joint DoD-VA transition clinics, already piloted in some locations, should expand nationwide, ensuring hand-off of care rather than cold handoff of paperwork.

Technology Backbone: Modern health information exchanges enable secure, real-time sharing between DoD and VA systems. This technology is proven and operational, it requires organizational will and resource allocation. SDVOSBs specializing in government health IT have the security clearances, technical capabilities, and mission understanding to implement these solutions rapidly.

Claims backlog disappears for combat-injured Veterans who receive determinations before separation. Only Veterans who develop service-connected conditions later would file traditional claims – which is a manageable volume if handled efficiently through modernized digital systems developed in partnership with SDVOSBs that understand claims processing from both sides.

The Path Forward: A National Treasure, Modernized

The Department of Veterans Affairs is indeed a national treasure. We need this institution, and it must evolve to provide care worthy of Veterans who volunteered to protect our freedoms. We enjoy our way of life, our security, opportunity, and freedom, because of our military. We owe these men and women more than gratitude; we owe them exceptional care.

Secretary Collins’ direct engagement with VA leadership across all levels signals a recognition that transformation requires top-down commitment and bottom-up input. As Secretary Collins conducts these crucial meetings and shapes the VA’s strategic direction, the composition of his advisory circle matters enormously. If Service Disabled Veteran Owned Small Businesses are not represented in these strategic discussions, Secretary Collins and his team should pause and ask why. SDVOSBs represent the intersection of military experience, entrepreneurial innovation, and technical expertise, exactly the combination needed to drive this transformation.

This transformation will challenge entrenched interests related to employment, contracts, and funding. But we have reached an inflection point. Incremental change is insufficient. The choice before us isn’t between government care and privatized care, it’s between the status quo and transformation.

With these changes, the VA will emerge as a powerhouse of medical excellence, combining government stability and mission focus with private sector innovation and agility, particularly the mission-driven innovation of SDVOSBs, delivering care that exceeds profit-driven private healthcare constrained by insurance company limitations.

Conclusion: Mission Success Defined

Mission success means every Veteran receives the highest quality care, wherever and whenever they need it. It means seamless transition from military service to Veterans care. It means technology that enables rather than hinders. It means leadership that maintains true situational awareness, understanding not just what challenges exist, but why they exist and who is accountable. It means One VA, unified in purpose, empowered by innovation, and uncompromising in its commitment to those who served.

Secretary Collins began the crucial work of getting the VA back on target through direct engagement with leadership at all levels. This campaign plan provides a strategic framework to guide that effort. As Secretary Collins builds his team and shapes strategy, ensuring SDVOSB participation isn’t just good policy, it’s mission-critical. These Veteran-owned businesses bring unique capabilities, unwavering commitment, and proven track records. They deserve a seat at the table, and the VA needs their expertise.

The American people rely on our military to protect us into the next century. Our military must know with absolute certainty that if they are injured in that service, their nation will provide exceptional care delivered by physicians who are properly supported, adequately compensated, and not compromised by fatigue from excessive outside employment. Secretary Collins has demonstrated his commitment to this mission. Now we must execute with the same precision, commitment, and relentlessness our Veterans demonstrated in uniform.

The campaign begins now. Success requires the right strategy, the right leadership, the right partners, including those who have already proven their dedication through both military service and business excellence, and most importantly, the situational awareness to understand what’s really happening on the ground and the courage to address it.

The post The VA Excellence Campaign: A Strategic Plan for Transformational Veterans Care appeared first on Small Wars Journal by Arizona State University.