VA Aims to Spend More Than $36 Billion in Community Care Payments
The US Department of Veterans Affairs (VA) paid community-based health care institutions > $36 billion in fiscal year 2025 as part of the 2018 VA MISSION Act. Health care organizations in Texas, Florida, California, North Carolina, Ohio, Tennessee, Pennsylvania, Georgia, Michigan, and Arizona received the most payouts.
Congressional discussions about extending support further into more community care have been ongoing. Some lawmakers emphasize the importance of giving veterans more health care options, while others remain concerned about the impact of the Veterans Health Administration. Money has also been a continued part of the discussion, particularly with saving for veterans vs spending taxpayer dollars without sufficient accountability.
In January, the VA revealed a plan to expand community care for veterans by purchasing $1 trillion in private health services over the next decade. VA Assistant Secretary for Management and Chief Financial Officer Richard F. Topping described how the plan sought to create a nationwide network of clinicians (ie, doctors, dentists, and pharmacists) managed by third-party administrators, based on frameworks such as Medicare and “the best of state models.” He also cited a new partnership between the VA and Centers for Medicare & Medicaid to cover veterans who use both for health care. Topping emphasized that the VA had consulted governmental bodies and industry sources to identify successes to emulate, lessons learned, and “pain points” to avoid.
Demand for non-VA medical services has risen annually in the years since the MISSION Act was passed, Topping said; > 40% of veterans received at least some of their care from private doctors in 2025.
“Veterans overwhelmingly want choice,” he said. “Most importantly, veterans want health care choices that meet them where they are.”
Some of the contracts with third-party administrators signed in 2018 are due to expire. Topping said VA’s new contract terms with private-sector health plans and clinicians will ensure the department maintains control over quality and delivery.
“While community care is an important option for many veterans, VA is also spending record amounts of funding on direct care — a record high $101 billion was spent on direct care in FY 2025, when VA completed a record high 82,083,918 direct care appointments, up 4.1% from FY 2024,” VA touted in a June press release.
From December 2025 to May 2026, the VA solicited proposals for a potential 10-year, $700 billion multiple-award contract to provide Community Care Network services and resources through an established network of licensed health care practitioners. The contract, expected to be awarded in August, could cover 9.1 million enrolled veterans across all states and territories.