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Do For-Profit Schools Help in the Health Care Industry?

Today Campus Progress’ parent organization, the Center for American Progress, released a report (PDF) and held a panel discussion that examined the needs of the job market in the growing health care industry and its relationship to for-profit schools that offer programs to train students for this industry. The report carefully examined some of the needs of the health care industry and how for-profit schools could help fill that need. But the report found that the for-profit industry falls short of fulfilling the greatest needs in health care.

Most notably, nursing is an extremely high-demand industry. According to Bureau of Labor Statistics projections of job openings in the health care industry, registered nurses will have the highest demand in the next ten years, with a need for more than 1 million new registered nurses projected. Two factors contribute to the increase in the number of jobs needed in the nursing industry: the Affordable Care Act will increase coverage for an estimated 30 million Americans, requiring more medical professionals overall; and aging baby boomers who need more medical care will require more labor-intensive nursing care over time.

 “But for-profit schools contribute relatively few nursing graduates to the field,” the report says. For profits graduated roughly 150,000 students in registered nursing (RN), but this supply is still only 7 percent of the total number of degrees awarded in nursing. A licensed practical nurse or (LPN) or nursing aid might be a good candidate for advancing through an RN program, but for-profits also only graduate a small proportion of LPN students. Non-profit schools still supply the vast majority of both LPN (80 percent) and nursing aid (89 percent) students.

This could be because nursing is a highly intensive and expensive training program and many for-profit schools, with an eye on the bottom line, target more online-only and less labor intensive programs. In fact, in the medical industry, for-profit schools graduate the highest number of students in the medical assistant field, training nearly 88 percent of medical assistants in this country. These are entry-level administrative jobs that have a relatively low demand in health care job projections when compared with high-need fields of nursing and home health care.

The second highest number of health related for-profit students, 10 percent, participate in massage therapy programs, a low demand profession.

But the bigger issue with for-profit schools isn’t just a mismatch between the programs for-profits offer and the demands of the growing health care industry. There’s some evidence to suggest that some schools advertise their programs with promises of high salary, career advancement, and flexible training schedules.

But while some for-profit schools do a good job of helping graduates advance professionally, students sometimes discover only after completing a program that their training wasn’t properly accredited and they are therefore unable to sit for the required licensing exam. Other students take on far more debt than they can realistically pay back on a medical assistant salary, which is typically in the neighborhood of $30,000 to $35,000. Job advancement is less certain, usually based more on on-the-job experience and willingness to pursue more higher education. Furthermore, some training programs require clinical training, which is less flexible and doesn’t lend itself to distance learning. [Full disclosure: Campus Progress’ advocacy arm supports regulations that would increase accountability of for-profit programs. In addition, this  author has written pieces critical of the for-profit education industry in the past.]

The CAP report offers several recommendations, including offering more incentives to for-profit schools to offer high-demand career training. Federal grants intended to incentivize training in science and technology should also include incentives for training high-need health care fields, the report recommends.

The report also advises for-profit schools to offer better career counseling so students are aware of which industries are in highest demand; as well as to provide students with statistical information about the quality of the program (like default rates on loans and job placement) at least 10 days before a student enrolls in classes. But providing good information so students can make better choices may not be enough.

“I always get wary when we talk about student choice,” said Kevin Kinser, a professor at the University of Albany who studies for-profit and career college programs, at the CAP event.  “For most students there isn’t much of a choice.” He mentioned that students are often choosing between one or two schools in the geographic area that offer programs they are interested in.

There are, of course, ways that for-profit schools are in a good position to provide needs in the health care industry. Jeff Strohl, director of research at the Georgetown Center for Education and the Workforce, pointed out that for-profits might have the flexibility to offer re-training and on-the-job credentialing instruction. As the health care industry becomes more regulated, he says, there will be a greater need for employees keeping licenses up to date. “People need to take certification tests again and again,” Strohl said. For profit schools could help fill that need.

Still, the report makes clear that there are challenges that the for-profit industry and the regulators at the Department of Education need to meet to align students more closely with the demands of a growing industry. Students need not just good information, but good programs to make appropriate choices about higher education.

Kay Steiger is the editor of CampusProgress.org.

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