Innovative Economic Opportunities
for Tribal Health Care Centers

With Indian Self-Determination and Education Assistance Act (P.L. 93-638) authority and under the Indian Health Care Improvement Act (IHCIA), tribal organizations have a unique opportunity to ensure an accessible and appropriate network of health care providers for their tribal members, while building a business that benefits the tribal community.

This class is designed for tribes operating a P.L. 93-638 health care contract or for those tribes considering health care as a business opportunity. From this hands-on class, tribes will conceptualize a culturally-appropriate and community-responsive network of care; identify key supports, including other tribes; learn best practices for contracting care with medical groups and independent providers; and frame health care as a business, an employer and a resource for their communities.

T O P I C S   C O M I N G   S O O N!
Capping Costs
  • Building relationships with medical groups and MCOs
  • Seizing opportunities under PPACA
  • CMS addendums and Section 206 of the IHCIA
  • Procured/Referred Care (formerly CHS) program design
Growing the Health Care Business
  • Forward-funded health systems with revenue opportunities:
    • Maximizing Medicaid and Medicare enrollment and billable moments
    • Marketing and outreach
    • Medicaid expansion
  • Educating the workforce (billers, benefits coordinators)
  • Payment for service (full-cost recovery)
  • Third-party revenue goal setting
Leveraging Federal Funding and Federal Status
  • Exploring target populations:
    • Section 813 of the IHCIA (reach others)
  • Getting paid:
    • Section 206 of the IHCIA
    • CMS addendums - compelling payment without the commitment
  • Looking for the opportunity:
    • Health insurance exchanges (insurance products, payment strategies and billing opportunities)
    • Tribal organization advantages (HRSA funding, business beyond health care)
    • Higher revenue for higher quality
  • Health care compliance (from the front door to the bottom line)
  • Medicare/Medicaid conditions for participation
  • Quality care standards
  • Third-party revenue expenditure
Building Credibility
  • Tribal cooperatives (business building and resource sharing)
  • Payment strategies (a customer and a provider)
  • Quality improvement plan
  • Tribal opportunities

*Topics subject to change.

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