A Department of Veterans Affairs task force is considering a plan to reorganize the 171 VA hospitals into 27 community-based networks.
Each network would be overseen by a chief executive officer who would have more flexibility in managing the hospitals' resources.
The CEOs would be accountable to network boards of directors composed of veterans, employees, unions, suppliers and others affected by VA hospitals, according to sources familiar with the discussions of an internal VA task force.
The 30-person task force is preparing to make such a recommendation, which would allow the local network executives to consolidate resources, particularly in administration of the hospitals, and dedicate more to veterans' healthcare, the sources said.
Such a structure could, for instance, eliminate long waits for treatment, the sources said. If veterans needing immediate care must wait a long time for an appointment at a nearby VA hospital, the hospital could send the veterans to another facility in the VA network where the waits are shorter or to a private provider with which the network has a contract.
The plan also would eliminate the need for hospital administrators to get approval from the VA central office in Washington before making even minor changes, as well as do away with the four-region management structure.
The VA's health undersecretary, Kenneth Kizer, M.D., convened the task force earlier this month to develop a restructuring plan. Dr. Kizer said he wanted draft recommendations completed by the end of the month, with formal recommendations presented early next year.
VA spokesman Terry Jemison said last week the task force members had come up with "areas of consensus" but had not made a formal recommendation. He declined to comment further.
Richard Fuller, director of health policy program development for the Paralyzed Veterans of America, said he had not been told of the task force's proposal. But he added that his organization is one of many that has suggested giving the local VA hospitals more freedom to manage healthcare delivery.
The VA hospital system "drastically needs to be decentralized," Mr. Fuller said.