Community colleges are leaving more than $115 million on the table annually in Medicaid funding that they could use to support student health and basic needs, according to a new study.
Only 3% of community colleges bill Medicaid for services, even though 84% offer health services that are likely eligible for Medicaid reimbursement, says a new report that examines the extent to which Medicaid is serving and can serve as a significant regular funding source to support the health services resources available to community college students. That funding could serve as many as 5 million community college students, it says.
Researchers reviewed 1,017 U.S. community colleges and examined what health services they offer, participation in and reimbursement from the Medicaid program, and barriers to their participation in Medicaid. The report was done by Mile 2 Consulting and EduOptimists with funding from the Kresge and ECMC foundations.
Just 50 community colleges have an active National Provider Identification number, meaning that the college had previously registered with the Center for Medicare and Medicaid Services in order to be able to bill Medicaid for services, according to the analysis. Just 32 of them have received any amount of reimbursement since 2018, with 29 of them in California.
Services eligible for reimbursement
Medical clinics and providers — including those run, employed or contracted by community colleges — can receive reimbursements from Medicaid for eligible health services they provide, including psychological services, counseling, nursing services, physical therapy, case management and more, the report says. It estimates that community colleges could collectively receive $52 million for Medicaid reimbursement for mental health and behavioral health sciences and another $20 million for reimbursements for first aid, immunizations, health assessments and diagnostics. Another $8.5 million could come from reimbursements for sexual and reproductive health and health planning services provided by the colleges.
The report also lists 60 community colleges with the highest estimated revenue potential from Medicaid reimbursements, led by California’s Los Rios Community College District ($2.6 million), Dallas College ($1.8 million) and Houston Community College ($1.8 million). The researchers developed a dashboard to dive into institutional and state reimbursement projections.
Addressing the barriers
So what’s keeping community colleges from tapping Medicaid? About 45% of surveyed community college administrators said they were not aware that billing was an option, according to the report. About 38% cited not having the capacity to manage the Medicaid billing process, with 21% saying the process is too complex. Seventeen percent said their providers don’t have the right types of licenses or certifications to bill Medicaid, and 14% replied the process to become a registered Medicaid provider is too complex.
Researchers took a closer look at barriers in California and found that state policy often prevents colleges from partaking in Medicaid reimbursements. For example, K-12 schools are primarily designated for Medicaid reimbursements for school-based services, making it difficult for colleges to get reimbursements.
The report also provides recommendations for various stakeholders to increase community colleges’ participation in Medicaid. Colleges, for instance, should create partnerships with state Medicaid agencies to review eligibility requirements, analyze potential revenue and seek technical support. State Medicaid agencies can explicitly recognize higher education institutions to participate, track and publish data on Medicaid participation by community colleges, and they can convene communities of practice to allow colleges to learn and network with each other.