Health Care Access and Quality for New York Veterans Provided by the U.S. Department of Veterans Affairs and Community Care: Volume I, Understanding the Impact of Proposed Policy Changes

The U.S. Department of Veterans Affairs (VA) serves approximately 9 million veterans each year, including more than 300,000 living in New York. Traditionally, VA has delivered health care to enrolled veterans in its own facilities. Over the past decade, options for veterans to receive health care that is paid for by VA but delivered by private-sector providers have increased substantially under the VA Community Care program (“Community Care”). Under this program, enrolled veterans may be eligible for Community Care if they have care needs that are not available within VA or if VA care is not available that meets VA's drive-time, wait-time, or quality standards. Proposed policy changes aim to relax existing eligibility standards or remove them entirely. This analysis examines the present landscape of both VA and Community Care services in New York to understand how increasing eligibility for Community Care may affect access to and the quality of care for New York veterans.

Issue

As of this writing in late 2025, numerous policy changes affecting Community Care have been proposed over the past few years. While some aim to overhaul and improve oversight and ensure quality, many others ultimately aim to expand the circumstances under which VA enrollees may be eligible for Community Care, including by adding covered services, relaxing drive-time or wait-time standards, or opening or closing VA facilities. Expanding eligibility generally aims to improve geographic access, timeliness, and/or the quality of care that veterans receive, although whether it will accomplish these aims is unclear. Increasing utilization of Community Care by veterans in New York is potentially concerning, as a 2018 RAND report found that, among all health care providers in New York, only 2 percent were “ready” to provide high-quality care for veterans (Tanielian et al., 2018). A 2024 RAND report assessing the needs of recently separated veterans in New York found that 60 percent indicated a preference for receiving Community Care, indicating that increasing eligibility may significantly increase Community Care utilization (Ringel et al., 2024).

Approach

We used a combination of publicly available information on veterans, facility locations, wait times, and quality measures to describe and visualize the state of VA care and Community Care for veterans in New York as of this writing in November 2025. Using this information, we discuss how the proposed policy changes may affect access to and the quality of VA care and Community Care for veterans in New York.

Key Findings

• Geographic access to VA care is limited in New York. We estimate that 47 percent of New York veterans live within a 30-minute drive of a VA health care facility (VA medical center or outpatient clinic), although 87 percent live within a 60-minute drive. Access to VA primary care within a 30- or 60-minute drive varies substantially across New York, with coverage gaps mostly in northern, rural regions.
• Private-sector providers who are contracted to care for veterans as part of VA's Community Care Network (CCN) expand New York veterans' geographic access to care, although some gaps remain. We estimate that 17.1 percent of veterans in New York do not live within a 30-minute drive of either VA or a CCN primary care provider.
• Wait times for established patients are relatively short in New York VA facilities, but new patients face long wait times for appointments in many specialties and facilities. The average wait time for a VA primary care appointment in New York is 4.3 days for established patients and 20.0 days for new patients, while average mental health care appointment wait times are 4.8 days for established patients and 26.4 days for new patients. Wait times are typically longer for specialty care services. Analogous recent data for CCN providers are not publicly available in New York, and published data on wait times for CCN and private-sector providers in New York have mixed results.
• Comparisons of hospital quality data for New York VA hospitals and community hospitals (not necessarily CCN providers) showed that VA facilities consistently provide better or similar care quality on outpatient care quality measures, patient-centeredness of care, and emergency department (ED) timeliness. There is more variation in the quality of inpatient care, with some New York VA facilities performing better and others worse than the community hospitals on some measures of care, although there are not clear trends.

Implications

• Proposed policy changes to expand veterans' eligibility for Community Care may moderately increase geographic access to care. Expanded eligibility could potentially reduce drive times for veterans who live less than 30 minutes (for primary care and mental health care) or 60 minutes (for specialty care) from a VA facility, because veterans who live beyond these distances are already eligible for Community Care.
• Proposed policy changes to expand veterans' eligibility for Community Care have unclear implications for the timeliness of care, as recent data for CCN provider wait times are not available. New patients may have long wait times for care both inside and outside VA across specialties.
• Proposed policy changes to expand veterans' eligibility for Community Care have mixed implications for health care quality. As New York VA facilities consistently provide better or similar care quality than private-sector facilities on outpatient care quality measures, patient-centeredness of care, and ED timeliness, it is likely that patients will receive worse care quality with respect to these measures. However, as performance of New York VA facilities is mixed with respect to inpatient care quality, implications for care quality are unclear and vary by facility.
• Assessments of the impact of proposed policy changes are limited by available data. We recommend that VA release Community Care network, wait-time, and expenditure data on its Open Data Portal and that New York State consider implementing wait-time reporting requirements for health care plans. Public availability of these data is a critical first step to building simulation models to assess whether Community Care eligibility expansions translate into meaningful access for veterans.