Medicaid Managed Care and School Health Services: Early Lessons & Opportunities

April 22, 2024

To better understand the role of Medicaid managed care in school health programs, Healthy Schools Campaign launched a project with Aurrera Health Group to explore how four states – California, South Carolina, Tennessee and Washington – have or are actively working to carve school health services into Medicaid managed care.

The project sought to answer two key questions:

● What is the experience of states that have carved school health services into their Medicaid managed care delivery system or are currently working on doing so?
● How have school districts and MCOs partnered to support student health and connect school health services to Medicaid managed care?

This issue brief summarizes the project methodology, general findings across the four states, the status of managed care and local education agency (LEA) partnerships in each of the states, and recommendations for developing and enhancing the connection between school health and Medicaid managed care.

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School Medicaid Guidance: What Advocates and State Policymakers Need to Know

October 17, 2023

In May 2023, the Centers for Medicare and Medicaid Services released new school Medicaid guidance affirming that states have flexibility in their school-based Medicaid program to allow school districts to bill Medicaid for health services delivered to all Medicaid-enrolled children.

This brief answers key questions about the guidance and highlights what policymakers and advocates need to know — and how to get involved — to ensure states are best positioned to leverage federal opportunities increasing children's access to the services they need.

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Download: School Medicaid Guidance: What Advocates and State Policymakers Need to Know

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Schools Are Key to Improving Children’s Health: How Illinois Can Leverage Medicaid Funds to Expand School Health Services

September 25, 2020

Key opportunities exist for education, healthcare and public health sectors to improve both health and education outcomes by focusing on school-based health services. This brief addresses the opportunity in Illinois to expand on Medicaid-funded health services delivered within a school by school nurses and other district-employed providers.

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PDF: Schools Are Key to Improving Children’s Health: How Illinois Can Leverage Medicaid Funds to Expand School Health Services