Veterans Affairs plans to shut down three medical centers and reshape its real-estate footprint across the country. It is one part of the long-awaited plan mandated by Congress.

The VA plans to announce its recommendations for the Asset and Infrastructure Review (AIR) Commission on Monday.

On Thursday, Denis McDonough, VA secretary, previewed the recommendations during a seminar hosted by the RAND Epstein Family Veterans Policy Research Institute. The plan calls for closing three VA hospitals, bringing the total number of institutions from 171 to 168.

According to McDonough, the changes will improve veterans' overall quality of care while also modernizing the agency to keep up with broader trends.

We accept that health care has evolved with these recommendations, and VA needs to lead the charge. As a result, he said, VA facilities will be built with veterans and VA employees in mind.

Also in the plan is a new VA across the country.

It's not official yet, but Military Times first reported Wednesday that the VA is closing 170 of its outpatient clinics around the country and building 255 new clinics and community living facilities.

According to McDonough, the recommendations would enable about 150,000 veterans to obtain primary health care and nearly 375,000 veterans to receive specialty care in an outpatient setting.

"VA is here to stay," she said. This is not a retreat on VA's part, and our ability to provide world-class health care will be strengthened due to this doubling down. Although McDonough acknowledged that markets would change, she said, "we are staying in every market.".

The AIR Commission process has drawn comparisons with the Base Realignment and Closure (BRAC) process that the Pentagon went through, but McDonough dismissed it.

It was established to close DoD facilities and reduce the DoD footprint. He said it's to keep VA as the best health care provider countrywide. It is a modernization effort to enhance the effectiveness of our facilities by moving away from outdated, out-of-date facilities into facilities that reflect the needs of our Veterans in the 21st century, according to him.

According to the AFG's president, the VA's plans will "destroy large segments of their health care system."

"By closing VA facilities, veterans will be forced to rely on private, for-profit healthcare. They will experience long wait times and lack unique expertise and integrated services only found within the VA," Kelley stated.

McDonough says evolving health care practices mean the VA doesn't need as many inpatient beds as it did 50 years ago or even a decade ago.

He said a hip replacement in the 1990s, for example, would leave most patients in the hospital "for weeks", but now the average stay is just 24 hours.

As part of this plan, the VA is also seeking to concentrate its infrastructure in areas where service demand is more significant.

For example, McDonough explained that the VA plans to build a new medical center in the Southeast because the veteran population is expected to grow by 25% in one local market. The demand for long-term care services is expected to increase by 87 percent.

McDonough said the veteran population in one market in the Northeast has been shrinking for decades and will drop another 18% over the next ten years.

The VA plans to close one of its VA medical centers in the area and instead replace it with new facilities, including a community living center and a community-based outpatient clinic (CBOC).