PurposeAmerican Indians and Alaskan Natives receive comprehensive health care from the Indian Health Service (IHS). To meet their needs, IHS provides tribes an opportunity to take control of their own health care development and management. During the week of May 16-18, 1989, an invitational colloquium entitled, ""Tribal Health Delivery Systems: What Does the Future Hold?"" was held in La Jolla, California. Its purpose was to introduce relevant information on different methods of financing and to provide alternatives to the delivery of health care from experts in the field.MethodsThe presenters at the colloquium addressed topics ranging from: 1) health care industry trends; 2) preferred provider organizations (PPOS) and health maintenance organizations (HMOs); 3) affiliation agreements; 4) indemnity insurance; 5) rate setting; and 6) utilization, cost and quality reviews. Also, individuals and panels were charged with describing specific case studies of workable approaches to tribal health care management. ResultsThe findings were: 1) self-determination is best signified by alternative delivery systems; 2) if tribes want to deal directly with the Health Care Financing Administration they should have the option to do so, however, there are issues that should be discussed first; 3) IHS can be of assistance to tribes looking for alternative delivery systems in numerous ways; and 4) critical demonstration projects should be funded, but if not, alternative delivery systems should still be explored regardless of funds.ConclusionThe three common themes that were derived at by the discussion groups were: 1) IHS should support a broad undertaking to educate Indian people about the alternative delivery systems and prepare people for leadership positions in the field of health care; 2) information about state-of-the-art techniques and successful outcomes should be obtained and disseminated by IHS; and 3) that IHS develop a broader view of health care possibilities and alternatives.
Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (P-02)
Wetzel RJ. Ornelas RC. Tribal health delivery systems: what does the future hold? Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (P-02) May 1989