The Department of Veterans Affairs is providing more health care and benefits than ever before. But it’s also faced some growing pains in getting its budget and workforce to keep up with its mission.

The VA faced its share of challenges in 2024 and is likely to pick up new priorities under the incoming Trump administration. Here’s a recap of the top stories facing the VA this year:

More appointments, more benefits for veterans

The VA provided a record 127.5 million health care appointments to veterans in fiscal 2024 — a 6% increase over the previous year. It also delivered $187 billion in benefits to 6.7 million veterans and survivors in FY 2024. It processed more than 2.5 million disability benefit claims — a 27% increase over last year’s record.

“It’s not just more care. It’s better world-class care, and it’s better health outcomes for veterans than in the private sector,” VA Secretary Denis McDonough said at the National Press Club in October. “It’s not just more benefits, it’s faster, more accessible benefits we’re delivering by meeting vets where they are, rather than expecting them to come to us.”

Workforce keeping up with growing workload

The Veterans Health Administration grew its workforce to historic levels in recent years. VHA pursued a “net-zero growth” model for its workforce this year after the agency hired more than 61,000 employees in FY 2023 — its fastest rate of growth in 15 years.

VHA, however, plans to keep growing its workforce in fiscal 2025. Under Secretary for Health Shereef Elnahal said supplemental funding in FY 2025 would allow VHA to increase its headcount by 5,000 employees — compared to its peak staffing in mid-June, when it had a record 400,000 total employees.

Budget shortfalls

Congress approved a $3 billion supplemental in September to avoid delays in paying disability benefits and veterans and their survivors. But lawmakers have yet to address a multi-billion-dollar shortfall in the VA’s FY 2025 health care budget.

The VA told lawmakers this summer that VHA would need an additional $12 billion before the end of the fiscal year. But officials recently cut that estimate by nearly half, after they told lawmakers that a shortfall in its health care budget wasn’t as severe as earlier estimates showed.

Under Secretary for Health Shereef Elnahal said in a recent interview that the PACT Act, which expands eligibility for VA health care and benefits to veterans exposed to toxic substances during their military service, has “significantly increased demand in our system.”

EHR reboot

The VA put all future deployments of its new Electronic Health Record on hold in April 2023 but is getting ready to resume deployments in mid-2026.

The department is planning to resume its rollout of a new Electronic Health Record in mid-2026, after spending a year and a half to address problems at sites already using it.

The VA announced it would begin EHR pre-deployment activities in the coming weeks, with plans for a mid-2026 launch of the Oracle-Cerner EHR at four VA facilities in Michigan — Ann Arbor, Battle Creek, Detroit and Saginaw.

The VA’s inspector general office reported in September that between October 2020 and March 2024, the Oracle-Cerner EHR experienced 826 “major performance incidents” — including outages, performance degradations and incomplete functionality.

What’s new for VA in 2025?

The VA is getting an extensive list of changes to how it delivers health care and benefits, now that Congress passed sweeping year-end legislation.

The Sen. Elizabeth Dole 21st Century Veterans Health Care and Benefits Improvement Act Congress passed before the end of the year requires the VA to develop a plan to expand same-day scheduling for medical appointments.

The Dole Act requires each VA physician, podiatrist, optometrist and dentist to receive an annual pay evaluation, and would give the VA more flexibility to offer pay awards, as well as recruitment, retention and relocation bonuses to these health care workers.

Among its provisions, the Dole Act would expand pay flexibilities for some VA health care workers, and would allow the VA to provide backpay to health care workers who exceed pay caps between January 2006 and December 2017.

The bill would allow the VA to waive pay limitations for up to 300 personnel, “if deemed necessary for the recruitment or retention of critical health care personnel.”

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