An internal VA report just confirmed what many of us knew: only 45% of veterans surveyed feel their healthcare experience was “excellent” or “very good”. Frankly, that’s a failing grade. Secretary Collins is now pushing a complete overhaul of VA healthcare metrics to fix this, because that number reveals a huge gap between the care we deliver and the care vets actually deserve. So what’s really changing, and how will we know if it’s working?
Key Takeaways
- Secretary Collins is ditching old volume-based metrics and will now judge VA healthcare effectiveness using patient-reported outcomes and direct qualitative feedback.
- The VA’s target is to raise the “excellent” or “very good” healthcare experience rating from the current 45% to at least 65% by the end of 2027 by making specific program changes.
- New mandatory post-appointment digital surveys and larger veteran focus groups are being rolled out to get real-time insights into what’s working and what’s broken.
- This new data will directly control how money and training are doled out, so that funding is spent on the things veterans themselves say they need.
The Shift from Volume to Value: A New Measurement Philosophy
For years, the Department of Veterans Affairs (VA) has been obsessed with metrics that look good on a spreadsheet but miss the entire point of patient care. In his recent speech at the National Veterans Affairs Council meeting in Washington D.C., Secretary Collins finally said it out loud: we need to stop just counting appointments and start understanding the veteran’s journey and outcome. The VA’s own 2025 Annual Report bragged about an average wait time of 21 days for primary care, but that number tells you nothing about what happened when the veteran finally got in the room. This focus on process metrics always seemed to crowd out the actual quality of the care itself.
I’ve worked with veterans’ advocacy groups for over a decade, and I hear the same story constantly. The frustration isn’t about the wait, it’s about being rushed, ignored, or treated like a number during the visit. These new metrics are designed to hit that problem head-on by making patient experience scores a core performance indicator. The conversation is changing from “did the veteran get an appointment?” to “did they feel heard, and did their health actually get better?”
Beyond Wait Times: Measuring the Patient Experience Index
The biggest change coming from Secretary Collins’s office is the new Patient Experience Index (PEI). This isn’t just another survey. As detailed in the Federal Register notice from January 15, 2026, the PEI combines multiple data points to get a real picture of the experience. It measures the clarity of provider communication, how easy it is to deal with VA bureaucracy, the perceived empathy of the staff, and how confident the veteran feels in their treatment plan. Instead of a single “were you satisfied” question, veterans will answer a series of questions that dig into these specific areas.
The goal they’ve set is to raise the overall PEI score by 15% across all VA facilities by Q4 2027. This is a massive reorientation of what “success” looks like for a VA facility. Now, a clinic with amazing wait times but terrible PEI scores will get flagged for intervention just as fast as one with long waits. Accountability is shifting to the quality of the human interaction and the health outcome, not the speed of the transaction. It’s about time.
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The Impact of Integrated Mental Health & Primary Care
Mental health services are also getting a metric overhaul, specifically around integration with primary care. For too long, mental health has been stuck in its own silo, forcing vets to get separate referrals and make more appointments, which is a terrible model for people who are already struggling. A 2024 RAND Corporation study proved the point, finding that veterans in integrated care programs had a 25% higher rate of adherence to their treatment plans than those stuck in the old referral system. Secretary Collins’s team is clearly paying attention to that data.
So the new metrics will track the rate of successful integration. They’ll measure things like the percentage of primary care visits that include a mental health screening, how many clinics have mental health professionals physically working alongside primary care docs, and (most importantly) what veterans themselves report about how easy it was to get that support. The target is ambitious: have 80% of all VA primary care clinics offering embedded mental health services by mid-2027, and see a 10% jump in vets reporting they can easily access it. This ensures the service isn’t just available, but actually working for people.
Financial Incentives and Staff Training Realigned
Here’s the part that will actually make this happen: they’re changing how people get paid. Performance bonuses for VA facility directors and staff used to be tied to throughput, how many people you can push through the system. Now, a big slice of those incentives will be linked directly to the Patient Experience Index and specific outcome measures like lower readmission rates or improved functional status. This is exactly the kind of thing the Government Accountability Office (GAO) report on VA performance incentives has been pushing for.
When you tie a director’s bonus to how veterans feel about their care, you’re going to see a rapid change in priorities. It’s a tough pill for some to swallow, and I expect some pushback, but it’s the only way to force real change. To support this, the VA is also pouring money into new training on empathetic communication, cultural competency, and trauma-informed care. They plan to get 90% of patient-facing personnel trained by Q3 2026, giving staff the tools they need to actually succeed under this new system.
Challenging Conventional Wisdom: Why “Efficiency” Isn’t Enough
The old thinking was that an “efficient” healthcare system is one with short waits and high throughput. That’s not a bad thing, but for veteran care, it misses the point entirely. The VA gets hammered in the press over wait times, which leads to calls for privatization, but just processing vets faster isn’t better care. Sometimes, it just makes them feel more alienated from the system that’s supposed to be helping them.
I’ve seen it firsthand. The positive impact of a single good interaction on a veteran’s health is enormous. A 15-minute appointment where a doctor actually listens and shows respect can do more good than a dozen 5-minute appointments that just check boxes on a form, no matter how “efficient” that looks on paper. What is the real cost of that efficiency? The new metrics from Secretary Collins finally get this. They acknowledge that healing is a human process, not just a clinical one. Putting a veteran’s subjective experience first might not make sense to a business consultant, but it might be the one thing that gets them to trust the VA and stick with their care.
By focusing on patient experience and real-world feedback, the VA has a chance to build a system that actually works for the people it was designed to serve, building trust and delivering care that matters.
What is the primary goal of Secretary Collins’s new VA healthcare metrics?
They’re meant to shift the VA’s focus away from just counting patients and appointments toward a complete evaluation of the patient experience and actual health outcomes, forcing a higher standard of empathetic care.
What is the Patient Experience Index (PEI) and what does it measure?
It’s a new, complete metric that ditches simple satisfaction surveys to measure factors like provider communication, how easy it is to get services, staff empathy, and a veteran’s confidence in their own treatment plan.
How will mental health services be impacted by the new metrics?
They’ll be measured on their successful integration into primary care settings. The VA will track things like how often mental health screenings happen in a regular checkup and how easy veterans say it is to access those services.
Are there changes to staff incentives under the new system?
Yes. A large portion of financial incentives for VA staff and directors will now be tied to the Patient Experience Index and concrete health outcomes, not just on how many patients they see.
Why is the VA moving away from solely focusing on wait times?
Because the VA now recognizes that efficiency alone is not quality care. This new approach accepts that the qualitative aspects of a veteran’s journey, feeling heard and respected, are a far better indicator of success.
