Purpose:

This study was conducted to answer the question, “In a post-COVID, post-Medicaid expansion healthcare environment, who doesn’t get what type of care, and why?”

Recognizing that healthcare workforce shortages in the aftermath of a global pandemic, expansion of eligibility of MO HealthNet, and Medicaid unwinding have impacted the community health infrastructure and community health data, the board of directors of KCMS Foundation called for updated data to inform decision making for our program services and with our community’s stakeholders. The findings and recommendations in this report are intended to support program development, community collaborations, and advocacy for systems change in the Metro Care catchment area of Clay, Platte, and Jackson Counties in Missouri. The Kansas City Medical Society Foundation’s Metro Care program has seen significant shifts in patient need and access to care since 2020. Yet, we knew that local emergency departments were not empty; we knew that there was a lack of access to care driving increasing ED utilization. This report will drive our program development and community engagement. We hope that it can be similarly useful for our partners and collaborators.

Key Takeaways:

• After Medicaid expansion (2021-2023), emergency department visits increased in Clay, Jackson, and Platte Counties, particularly among those with Medicaid
• Lack of reliable transportation, housing, complicated Medicaid application and renewal processes, and wait times were the most common barriers patients face when accessing healthcare according to frontline social service workers
• Recommendation include:
• Expand referrals and outpatient specialty care
• Invest in case workers, insurance navigators, and community health workers
• Increase care options for the people without insurance
• In areas with lower socioeconomic status, prioritize interventions that address economic barriers to healthcare, medication access, after-hour clinics, telehealth, mobile health units, and same-day primary care visits

Disclaimer: This report was underwritten by REACH Healthcare Foundation. This research was supported by REACH Healthcare Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of REACHHealthcare Foundation.