Across 2025 and 2026, three converging forces have made osteopathic physicians the natural pipeline for VA Community Care expansion: VA’s accelerating reliance on community care (now ~40% of veteran medical visits and 30% of the medical care budget), the structural fit between osteopathic philosophy and chronic-pain / musculoskeletal / behavioral health care that veterans disproportionately need, and the unique compliance positioning of DOs in the federal/state legal seam around medical cannabis. For DOs considering whether to expand into VA Community Care or operate the two-hat model, the pipeline math has never been more favorable.
The community care expansion you should know about
VA Community Care has grown from $14.8 billion in FY2018 to roughly $48 billion in the FY2026 budget — a structural shift that reflects both veteran preference for community-based care and VA’s inability to meet wait-time, drive-time, and service-availability standards in many regions. The Veterans Healthcare Policy Institute has documented that referrals have grown 15-20% per year. Community care now represents about 40% of veteran medical visits and 30% of the medical care budget, up from below 20% a decade ago.
The growth creates a direct demand signal for community providers. VA needs more credentialed CCN providers — particularly in primary care, behavioral health, musculoskeletal/orthopedic care, and chronic pain management. These are clinical areas where osteopathic training is a strong fit.
Osteopathic medicine’s emphasis on holistic care, musculoskeletal manipulation, and integrative approaches aligns closely with what veterans most often need from community care: chronic pain that hasn’t responded to opioid-based treatment, mobility limitations from service-related injuries, behavioral health concerns that benefit from a whole-person approach, and integrative options that complement (rather than replace) VA-side care. DOs also are positioned to operate the two-hat model — bringing the state cannabis evaluation pathway into the same provider relationship.
The CCN Next Generation opportunity for new entrants
The CCN Next Generation procurement explicitly intends to broaden the vendor base. VA officials have stated the IDIQ structure is designed to attract not just the large national health insurers but also regional and smaller-scale operators. For DOs in regions currently under-served by community care infrastructure, the Next Generation transition creates an opening to enter the network through TPAs that may have stronger regional or specialty focus than the current Optum/TriWest structure.
Award announcements are expected mid-to-late 2026. The first task orders will look similar to current operations, but VA plans to layer in value-based payment models — beginning with episode-based payments for lower-extremity joint replacements. DOs who enter CCN now, build their veteran patient panel, and develop competency in outcomes documentation will be positioned for the value-based payment models when they roll out.
The April 23 DEA order’s relevance for DOs
The DEA’s Schedule III order doesn’t change the two-hat model’s structure, but it changes its operating environment in ways that matter for DOs evaluating entry. Schedule III recognition of state-licensed medical cannabis means: research access is broader, Section 280E tax burden is lifted for state-licensed operations, and federal recognition of state programs is established for the first time.
For a DO weighing whether to add the state cannabis evaluation hat to an existing CCN practice (or vice versa), the federal compliance environment is more navigable than it was 12 months ago. The June 22 expedited DEA registration window and the June 29 hearing on broader rescheduling are inflection points. The Veterans Equal Access Act — if enacted — would change the relationship between VA care and state cannabis evaluation in ways that further validate the two-hat model.
The five reasons DOs should consider Mendry now
Mendry’s two-hat compliance architecture is documented and battle-tested. DOs joining gain access to the framework rather than building it from scratch.
Mendry’s directory connects DOs to veterans actively seeking veteran-aware providers — both for CCN-authorized care and state cannabis evaluation.
Mendry’s directory model is membership-based ($20-$50/month tiers). No per-lead fees, no per-appointment charges, no pay-for-referral arrangements.
Tier 2 and Tier 3 memberships include podcast and content opportunities. DOs build authority and reach through educational content rather than direct marketing.
Mendry doesn’t store PHI, doesn’t prescribe, doesn’t sell products, doesn’t complete state paperwork. The platform sits cleanly in the educational/connection space — no compliance overlap with the DO’s own clinical practice.
Veteran demand + community care expansion + DEA Schedule III opening + DO clinical fit + Mendry’s compliance-clean platform = the strongest pipeline alignment for DOs serving veterans in over a decade.
- Confirm CCN credentialing status — currently credentialed with Optum (Regions 1-3) or TriWest (Regions 4-5)?
- If your state has a medical cannabis program, evaluate state-license requirements for evaluations
- If state-licensed, file DEA registration application before June 22, 2026 for expedited review
- Establish the four-separation compliance architecture (records, billing, consents, encounter docs)
- Prepare for CCN Next Generation transition — credentialing packet ready, transition lead identified
- Track Veterans Equal Access Act in FY2026 VA appropriations
- Watch June 29 DEA hearing for broader rescheduling implications
- Consider Mendry directory listing for veteran-aware patient access (mendry.org/members-directory)
- Engage healthcare attorney for annual compliance review of two-hat architecture
- Plan for 2026 HIPAA Security Rule update — encryption, MFA, vulnerability scans
Medical cannabis remains legally complex, but demand is growing fast. Veterans are actively searching for providers who can educate, listen, and guide them through integrative care options. By joining Mendry’s directory, DOs position themselves ahead of competitors who either avoid cannabis entirely (missing veterans who want it discussed) or overstep compliance rules (risking their license). Mendry offers the middle path: compliant, educational, trusted. The 2026 federal cannabis policy environment makes that middle path more navigable than ever.
Veterans Healthcare Policy Institute — Community Care Spending Crisis (February 2026)
Federal News Network — VA readies massive contract for veterans’ private sector health care
Mendry — Why Providers Choose Mendry (live mendry.org content)
U.S. Department of Justice — Schedule III order (April 2026)