Veterans Benefits and Services totals about $326 billion in FY2024, going through the Department of Veterans Affairs. The two biggest pieces are direct disability compensation payments to about 6 million veterans with service-connected disabilities (~$130B — the largest single recipient pool) and the Veterans Health Administration (~$115B), which runs 170+ VA medical centers and 1,000+ outpatient clinics staffed by VA employees rather than contractors.
Other significant lines: Community Care via the MISSION Act (~$25B), which pays outside hospitals and clinics — including HCA, CommonSpirit, and other major systems — when the VA can't deliver care in-house; Post-9/11 GI Bill education benefits (~$11B); and VA home loan, insurance, and burial programs.
On the contractor side, the VA's biggest tech bet is Oracle Health (formerly Cerner) modernizing the EHR system to replace the legacy VistA platform. Other notable contractors include Leidos (claims processing IT), Optum (Community Care network management), Maximus (disability claims examination), and McKesson + Cardinal Health (pharmaceutical distribution to VA's mail-order pharmacy, the largest in the US).