Assessment of Strategies to Promote Cost and Management Efficiencies in Tribal and Contract Health Service Programs

摘要

In the face of rapidly increasing health care costs, and to enhance tribal self-determination, the Indian Health Service (IHS) has been exploring the use of alternative methods of providing and managing health care. The alternatives are designed to contain costs, and provide coordination among often fragmented health care services while maintaining the quality of health care services. On a limited basis, the IHS has supported projects including the purchase of Health Maintenance Organization (HMO) services on the part of the Pascua Yaqui, and local administrative services for the Suquamish, under a Third Party Administrator Contract. Under contract to the IHS, Support Services, Inc. (SSI) conducted this assessment as the first in a two-phase effort to analyze information about: the feasibility of applying managed health care techniques to selected tribal and Contract Health Services administered or contracted by the IHS, the data needed to plan and develop alternative methods of health care delivery, and the risks, benefits, and cost-efficiency of the alternative methods deemed to be feasible.