Hospital medicine in the Veterans Health Administration: Strengths, opportunities, and future directions.

The Veterans Health Administration (VHA) is America's largest integrated health care system, serving 9.1 million enrolled veterans annually in 1,380 inpatient and outpatient healthcare facilities.1 VHA aims to provide high-quality, holistic, and veteran-centered care. This mission-driven approach has produced notable, unique strengths, including comprehensive service delivery with a strong emphasis on care quality, safety, and continuity customized to the specific needs of the patients it serves.2 However, structural, operational, and policy-related issues increasingly threaten VHAs ability to fully achieve its mission. In this perspective, we will highlight some key strengths of VHA clinical care, emerging threats relevant to hospital-based care delivery, and propose actionable strategies to support sustained excellence for hospitalized veterans.