Healthcare certificate programs vary widely in return on investment

Getting a job in the medical field seemed like a good fit for Kayla Hales. The 25-year-old from North Royalton has some health issues. Other family members do, too. Seeing a friendly face at a front desk or exam room of a doctor's office eased their fears over the years.

Plus, she heard a phrase that feels like a familiar one in Northeast Ohio: It's a good career move.

"My parents always say there will always be jobs in healthcare," she said.

So after high school and stops at Cuyahoga Community College and Bryant and Stratton College, she completed the 39-week medical assisting program at Polaris Career Center. She now has one of the multitude of healthcare jobs in the region — but it's certainly not one of the most financially lucrative ones.

Northeast Ohio is a medical mecca. Healthcare is one of the biggest drivers of the local economy. The sector has the most jobs as well as the greatest number of openings, per a 2020 Team NEO report.

Opportunities extend far beyond top-of-mind options like being a doctor or nurse. Many healthcare positions don't require an advanced degree. Community colleges and for-profit colleges offer loads of two-year degrees and even shorter-term credentials in everything from sports massage to medical coding.

But a recent analysis of federal data shows that some healthcare credentials don't have much, if any, long-term economic payoff.

Third Way, a think tank, examined data from the federal government about what graduates of thousands of programs earned two years after getting their credential or degree. The bulk of those with bachelor's and associate degrees see a return on their investment five years or less after graduating.

Yet 53% of students who graduate from a certificate program never get any economic return, when compared with what a high school graduate earns.

And healthcare fields — despite the public perception of job growth — have some of the widest range of outcomes.

"The discrepancy has always been there," said John Cordova, program director of allied health at the nonprofit Futuro Health. "It goes back to the 'us and them' type of thing. The more education you have, the more you're 'us.' The less education you have, the more you're 'them.' "

Take Tri-C, for example. It offers two tracks in the allied health field. Graduates in the diagnostic, intervention and treatment professions lane spend $5,144 on the program.

Two years after graduation, median earnings came in at about $52,000, per Third Way's analysis. That's nearly $30,000 more than a high school graduate earns in Ohio.

The course catalog is full of other options that sound similar, including medical assisting. It also falls under the allied health umbrella. It costs the same amount of money as the diagnostic track. Two years after graduation, though, those who completed this program made only about $8,000 more than a high school graduate.

Scan the websites of various institutions' medical assisting information pages, and you'll notice that many tout the growing demand for jobs in that particular field. That's true, according to the U.S. Bureau of Labor Statistics. But most don't add an additional line detailing the median pay of $17.23 an hour.

At Polaris, Hales' alma mater, graduates of its medical assisting program reportedly earned about $2,000 less than those with only a high school diploma. Third Way's analysis finds there's no return on investment for that program at that institution.

Leaders at Polaris have seen the data. It surprised them. They've gone to local hospitals and pushed for higher wages.

"We've been rather frank about starting salaries and what an entry level medical assistant should be paid," said Karen Rayk, the adult education director at Polaris.

For many, the decision to enter this field centers on a desire to help others or to use the job as a stepping stone to other positions like nursing, according to Amy Hrouda-Traum, who teaches in Polaris' medical assisting program. She's never had anyone leave the program after conversations about potential salaries.

"Many students tell me it's not about money," she said. "It's about being happy in a lifelong career, not just a job they do not enjoy."

That particular offering at Polaris has a net price of about $7,700. It's far more expensive at other places, including Fortis College. The for-profit institution has outposts in Cuyahoga Falls, Centerville, Cincinnati and Westerville.

Its medical assisting program's net price is about $22,000, yet those who completed the program made $1,300 less than those who only have a high school diploma.

"We're just honest with people about the industry and how much you can make as a general rule," said Brian Parker, president of the Cuyahoga Falls campus. "And people choose to do that."

Students know they're training for entry-level positions, he said, adding that the college's website is clear in laying out relevant information, including its 56% graduation rate for first-time students. Parker said the college's marketing efforts are run by its corporate arm.

The way colleges talk isn't decided by accident. Institutions nationwide spent a reported $730 million on advertising in 2017. It's especially pronounced at for-profit schools. The Brookings Institution reported finding those places spent $400 on advertising for each student, far more than the $48 at private and the $14 at public colleges.

Offerings aren't decided based on chance, either. Kelly Reinsel, dean of health and public services at Stark State College, said decisions there are rooted in community needs. Conversations with local employers helped form the decision to shift the medical assistant program from an associate's degree to a one-year certificate.

"What they were saying is, 'We need more MAs (medical assistants), how can you get them out faster? But we still want them to have the academic rigor, we want them to be as ready as they are when they come out of your two-year program,' " she said.

The shift will also allow students to tap into different financial resources, like scholarship money earmarked strictly for short-term certificates. Stark State officials looked at post-grad wages, too.

There wasn't a difference, Reinsel said, between whether someone had an associate's degree in medical assisting versus a certificate.

The salary uptick emerged for those who passed a national certified medical assistant exam. Not all programs are approved through accrediting bodies, and this discrepancy is more pronounced at for-profit colleges.

The Cleveland Clinic partners with both for-profit and nonprofit colleges to offer students externships and internships. It's an educational opportunity, of course, but also gives the hospital system a chance to expand its workforce pipeline.

While Mari Knettle, director of the center for health sciences, stresses the hospital system has successful relationships with all types of institutions, the Clinic's list of approved partnerships tends to skew more toward nonprofit colleges.

"In many cases, the not-for-profit institutions have the accreditation that we're looking for; they provide a lot of support to the students while they are with us," said Knettle. "We don't want to have a situation where students are left hanging out to dry."