Veterans Integrated Service Networks: The 18 VISNs and How Care Flows

The Veterans Health Administration organizes its hospitals and clinics through 18 regional management units called Veterans Integrated Service Networks, or VISNs. Each network oversees a cluster of VA medical centers, outpatient clinics, and specialty facilities inside a defined geographic area, sitting between VA headquarters in Washington and the roughly 1,380 individual care sites across the country.¹ For you as a patient, the VISN is the layer that ties your local clinic to the larger medical center where you go for anything your clinic can’t handle.

How the 18 Networks Are Organized

The VISN structure grew out of a mid-1990s reorganization of VA health care. Instead of running every hospital from a single national office, the VA divided the country into geographically defined networks, each responsible for coordinating care across its region.² The Veterans’ Health Care Eligibility Reform Act of 1996 arrived alongside that shift, expanding the services the VA could offer and broadening who qualified.³

VISN boundaries don’t follow state lines. They’re drawn around veteran population density and the locations of existing facilities. A single network might cover parts of several states, or in a dense area, just one. Your nearest medical center and the outpatient clinic you use for routine visits almost always sit inside the same VISN, even if you live near a state border.

The numbering runs from 1 to 23 but skips several numbers. The VA originally created 22 networks, then consolidated some over time. The remaining 18 kept their original numbers, which is why the sequence has gaps.

The Full List of VISNs

As of 2026, the 18 networks are:²

VISN 1: VA New England Healthcare System
VISN 2: New York/New Jersey VA Health Care Network
VISN 4: VA Healthcare – VISN 4
VISN 5: VA Capitol Health Care Network
VISN 6: VA Mid-Atlantic Health Care Network
VISN 7: VA Southeast Network
VISN 8: VA Sunshine Healthcare Network
VISN 9: VA MidSouth Healthcare Network
VISN 10: VA Healthcare System
VISN 12: VA Great Lakes Health Care System
VISN 15: VA Heartland Network
VISN 16: South Central VA Health Care Network
VISN 17: VA Heart of Texas Health Care Network
VISN 19: Rocky Mountain Network
VISN 20: Northwest Network
VISN 21: Sierra Pacific Network
VISN 22: Desert Pacific Healthcare Network
VISN 23: VA Midwest Health Care Network

How Care Flows Inside a VISN

Within each network, care is organized in a hub-and-spoke pattern. Major VA Medical Centers act as hubs, concentrating specialized services like neurosurgery, advanced cancer treatment, and inpatient mental health care. Smaller Community Based Outpatient Clinics and Vet Centers surround each hub and handle primary care, routine mental health visits, and preventive screenings closer to where veterans live. Nationwide, the VA operates about 170 medical centers and more than 1,190 outpatient sites of varying complexity.¹

When you need care beyond what your local clinic offers, the VISN coordinates the referral, transfers your records, and schedules you at the hub. Because every facility in the network shares administrative systems, the handoff from a small clinic to a full medical center happens without you re-enrolling or re-submitting paperwork.

Telehealth Across the Network

The hub-and-spoke model extends into virtual care. VA Video Connect lets you meet with providers through a secure video platform for concerns that don’t need a physical exam.⁴ This matters most in VISNs that cover large geographic footprints, like the Rocky Mountain Network (VISN 19) or the Northwest Network (VISN 20). Specialists from anywhere in the country can join a session, and family members or caregivers can participate. For appointments that require peripheral devices like blood pressure monitors or pulse oximeters, the VA can supply compatible equipment that syncs with the platform.

Teaching Hospitals Within the Networks

Many VA medical centers double as teaching hospitals. Under 38 U.S.C. § 7302, the VA is required to develop and maintain education and training programs for health care personnel, both to staff its own facilities and to help address national workforce shortages.⁵ The statute specifically prioritizes residency programs at VA facilities in communities designated as health professional shortage areas, with an emphasis on primary care and mental health. For patients, this means hub medical centers often have access to current treatment approaches and a deeper bench of specialists than their size alone would suggest.

Finding Your VISN and Comparing Facilities

The VA’s facility locator at va.gov/find-locations lets you search by zip code to find every medical center, outpatient clinic, and specialty office in your area.⁶ The results show which VISN each facility belongs to, along with contact information, services, and hours. This is the fastest way to identify which regional network manages your care.

Once you know your facilities, you can compare their quality. The VA publishes performance data through its Access to Care website, where you can see how individual medical centers score against community hospitals on quality measures. The same data feeds into the CMS Care Compare tool at medicare.gov, which shows star ratings and patient survey results for your VA medical center alongside non-VA hospitals in the same area.⁷ Internally, the VA uses a system called Strategic Analytics for Improvement and Learning (SAIL) to benchmark quality across its medical centers, and those outcomes factor into each facility director’s performance review.

Transferring Care Between VISNs

If you’re moving or spending extended time in another part of the country, you don’t need to re-enroll in VA health care. Enrollment is national. What you do need is to shift your care coordination to a facility in the new network. Start by telling your Patient Aligned Care Team (PACT) or specialty provider about your new location, temporary address, travel dates, and any ongoing care needs.⁸

Your provider can submit a Traveling/Relocating Veteran Consult, which triggers a coordinator at both the sending and receiving facilities to arrange the handoff. The coordinators make sure your prescriptions, scheduled treatments, and medical records transfer to the new location. The VA recommends starting this process four to six weeks before you move, especially if you rely on regular medication refills or have recurring appointments. Update your mailing address on VA.gov so billing and correspondence follow you.

VISN Leadership and Budgets

Each network is led by a VISN Director appointed under 38 U.S.C. § 7401(4), which authorizes hiring directors with demonstrated ability in medicine, health care administration, or health care fiscal management.⁹ The director’s office translates national policy from VA Central Office into day-to-day operations at the medical centers and clinics within the region. That covers patient safety metrics, staffing shortages, and services that span multiple facilities.

Funding is distributed through the Veterans Equitable Resource Allocation model, known as VERA. Rather than dividing money evenly, VERA calculates each network’s allocation based on the number of patients served, the clinical complexity of those patients, regional differences in labor costs, and supplemental funding for education, research, and high-cost equipment. Patients are classified as “Basic Care” or “Complex Care,” with conditions like spinal cord injuries, chronic mental illness, and end-stage renal disease falling into the complex tier. Networks also receive additional funding for individual patients whose annual treatment costs exceed a set threshold, which keeps a handful of very expensive cases from draining a VISN’s general operating budget.

Complaints and problems generally get resolved at the facility level through a Patient Advocate, but persistent or systemic issues can be raised to VISN leadership, because the director’s performance evaluation reflects quality metrics from every facility under their oversight.¹⁰

1
U.S. Department of Veterans Affairs. About VHA – Veterans Health Administration
2
U.S. Department of Veterans Affairs. Veterans Integrated Service Network (VISN)
3
GovInfo. Public Law 104-262 – Veterans Health Care Eligibility Reform Act of 1996
4
VA Mobile. VA Video Connect
5
Office of the Law Revision Counsel. 38 USC 7302 – Functions of Veterans Health Administration: Health-Care Personnel Education and Training Programs
6
U.S. Department of Veterans Affairs. Find VA Locations
7
U.S. Department of Veterans Affairs. VA Quality Information on Care Compare
8
U.S. Department of Veterans Affairs. VA Is With You When You Travel or Relocate
9
Office of the Law Revision Counsel. 38 USC 7401 – Appointments
10
U.S. Department of Veterans Affairs. Patient Advocate