VA Dialysis Pilot: Increased Attention to Planning, Implementation, and Performance Measurement Needed to Help Achieve Goals

VHA oversees VA’s health care system, which includes 153 VAMCs organized into 21 VISNs. Each VISN is charged with the day-to-day management of the VAMCs within its network. VA Central Office decentralized its budgetary, planning, and decision-making functions to the VISN offices in an effort to improve accountability and oversight of daily facility operations. However, VA Central Office maintains responsibility for monitoring and overseeing both VISN and VAMC operations.