I went to the Lake of the Ozarks area a year ago, and was on US 54 through the area. It's a hybrid of controlled access and at-grade intersections... but for the most part, it's controlled-access.
There is one intersection that is creating a lot of buzz.
http://www.komu.com/news/issues-unsettled-for-key-largo-intersection-in-osage-beach/
http://articles.ky3.com/2012-04-25/modot-plans_31401317
http://lakeexpo.com/news/lake_news/article_48c1d52c-727a-11e2-9269-001a4bcf887a.html (http://lakeexpo.com/news/lake_news/article_48c1d52c-727a-11e2-9269-001a4bcf887a.html)