Missouri Foundation for Health Medicaid Expansion Project

Understanding the Impact of Medicaid Expansion on Health Equity in Missouri

Center for Advancing Health Services, Policy & Economics Research
Project Date

June 2021 – March 2024

Type of Evaluation



Academic, Community-based, Foundation, Government, Health


The Evaluation Center and the Center for Health Economics and Policy at the Institute for Public Health at the Brown School at Washington University in St. Louis is partnering with Missouri Foundation for Health to measure the impact of Medicaid expansion in Missouri.

The project will use a mixed methods approach, using quantitative and qualitative data to assess the impact of Medicaid expansion across health systems and stakeholder groups in underserved areas of Missouri with a focus on health equity.

Project Description


Missouri Foundation for Health (MFH) is an independent philanthropic foundation whose mission is to eliminate underlying causes of health inequities, transform systems, and enable individuals and communities to thrive1. The foundation seeks to understand the impact of Medicaid expansion in Missouri.

The Center for Health Economics and Policy and Evaluation Center proposed to measure the impact of Medicaid expansion on health equity in Missouri in underserved areas. The expansion of Medicaid has great potential to reduce historic inequities facing people living in rural and urban underserved areas due to uninsurance, poverty, racism, and economic problems.

The project seeks to understand the impact of Medicaid expansion on health equity through quantitative and qualitative data.

  • Quantitative data will be used to measure the effects of the expansion of Medicaid on systems in underserved areas, focusing on the overall impact on underserved areas and the people, places and providers working in them (that is, rural and urban health hospitals and systems, clinics serving the underserved, safety net providers).
  • For the qualitative phase, the study will use a case study design to provide a holistic, in-depth understanding of the impact of Medicaid expansion on rural and urban health care systems and health inequities. Examples of stakeholder groups include health and mental health care providers, health care system administrators, and patients.

1 Missouri Foundation for Health: About the foundation, December 2021, https://mffh.org/the-foundation/

Evaluation Activities

  • Meet with partners to discuss grant, partnership and data needs.
  • Request, manage, and analyze quantitative data.
  • Develop a dashboard for quantitative data.
  • Identify sites in Missouri for qualitative data collection.
  • Develop interview guides.
  • Conduct interviews with providers.
  • Conduct listening sessions with patients. 

Our Products

  • Data interpretation sessions
  • Dashboard
  • Policy briefs
  • Annual reports
  • Journal articles
  • Presentations


Missouri Foundation for Health

Contact Person