Provider capacity during Medicaid expansion and a public health emergency.

Objectives: To assess the capacity of Medicaid providers to take on new patients during a time of unprecedented growth in program enrollment due to Medicaid expansion and the COVID-19 public health emergency.

Study design: We conducted a survey of Medicaid providers in Missouri in 2023 about their patient load and capacity to accept new patients.

Methods: We recruited 141 Missouri Medicaid providers through probability sampling and 109 additional providers through convenience sampling for a total sample size of 250, representing 0.8% of all Medicaid providers in Missouri. Our survey was informed by semistructured interviews with 15 providers conducted earlier in the year. We analyzed results using sample percentages with 95% CIs.

Results: As expected, a large majority of respondents reported that their patient load had increased since 2021. Nonetheless, 53% (47%-59%) reported that they personally had the capacity to take on additional patients, and 70% (65%-75%) reported that their larger practice had the capacity to do so. We found no evidence that these responses differed between large metropolitan areas and other areas of the state. Majorities also reported that their practices either had recently hired additional personnel (both staff and providers) or planned to do so, and substantial percentages reported other capacity-expanding changes.

Conclusions: Our results suggest that the health care system in Missouri can accommodate even historic growth in Medicaid enrollment and patient loads without compromising access to care as perceived by providers. Further research is needed from the patient side and focused on rural areas.