The Affordable Care Act (ACA) has extended health insurance coverage to nearly seventeen million people, the majority of which has come through the expansion of Medicaid for low-income individuals. Consequently, this has increased the demand for primary care visits and psychiatry appointments nationally. Despite the projected increase, the distribution of that demand will not be uniform across states, as only 31 states and the District of Columbia have decided to expand Medicaid coverage. The potential strain on behavioral health providers, delivery systems, and public programs will differ based on whether a state chose to expand Medicaid.

This project will help inform our understanding of how workforce capacity differs between states that have expanded Medicaid and those that have not. We will propose the following questions:

  1. What barriers and challenges have organizations in expansion states faced as they face increased utilization?
  2. What lessons can be drawn from successful organizations?
  3. Are successful organizations employing innovative, team-based care models
  4. What have state policymakers done to encourage organizations to achieve workforce capacity, including changes to telehealth and scope of practice requirements?