School-based health care and Medicaid

Offering healthcare services to kids in schools, known as school-based health care, is a worthy investment, with the potential to improve future health and education outcomes for Ohio students.

School-based healthcare services are meeting critical needs of children and families across the state. In recognition of the connections between health and academic performance, school districts and policymakers are increasingly seeing the value of providing healthcare services in schools. Yet, financial sustainability can be a challenge, and offering these services can be administratively burdensome for schools and their healthcare provider partners. 

In 2014, the federal government increased flexibility for states to cover school-based health services for students enrolled in Medicaid (more than 703,000 students in Ohio). The new HPIO policy spotlight explores the opportunities this federal policy change presents for Ohio to leverage Medicaid reimbursement to improve the health and well-being of students. 

Connections between health and academic performance

Acute and chronic health challenges, such as asthma and dental pain, are common reasons for school absences. During the 2022-2023 school year, nearly 4 in 10 (38.6%) children enrolled in Medicaid were chronically absent, meaning they missed more than 10% of instruction time. This was more than double the rate of their peers not enrolled in Medicaid (18.2%). Offering health services in schools can improve students’ health and prevent them from missing school to access services elsewhere.

Conclusion

Providing a wider array of health services in schools can lead to better health and education outcomes for Ohio students, especially among those in underserved groups. Twenty-six other states have expanded Medicaid reimbursement for school-based healthcare services beyond students with an individualized education program (IEP). By paying the non-federal share, these states are investing in their students’ health and learning, while also experiencing boosts in federal revenue.

When considering changes to its Medicaid in School program, Ohio can take advantage of the Medicaid School-Based Services Technical Assistance Center and apply for future federal grants. Throughout this journey, strong statewide support and collaboration will be critical. Regardless of challenges along the way, school-based health care is an evidence-informed investment for Ohio.