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The Indian Health Service (IHS) was established within the Public Health Service in 1955 in order to meet federal treaty obligations to provide health services to members of federally recognized American Indian and Alaska Native tribes.

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Introduction

Indian Health Services System Joy Upshaw Wesleyan University Indian Health Services System Overview of Indian Health Service The Indian Health Service (IHS), a federal health system, cares for 2 million of the country's 5.2 million American Indian and Alaska Native people. This system has increasingly focused on innovative uses of health information technology and telemedicine, as well as comprehensive, locally tailored prevention and disease management programs, to promote health equity in a population facing multiple health disparities. Important recent achievements include a reduction in the life-expectancy gap between American Indian and Alaska Native people and whites (from eight years to five years) and improved measures of diabetes control (including 20 percent and 10 percent reductions in the levels of low-density lipoprotein cholesterol and hemoglobin A1C, respectively). However, disparities persist between American Indian and Alaska Native people and the overall US population. Continued innovation and increased funding are required to further improve health and achieve equity (Trujillo, 2002). In the 2010 census, 5.2 million people identified themselves as American Indian or Alaska Native, representing 1.7 percent of the US population. American Indian and Alaska Native people experience poor health outcomes and have an average life expectancy that is more than five years shorter than that of the overall US population. The causes of this disparity span the life spectrum, beginning with high infant mortality rates, and include a high prevalence of chronic disease, mental health disorders, and substance abuse. The Indian Health Service (IHS) was established within the Public Health Service in 1955 in order to meet federal treaty obligations to provide health services to members of federally recognized American Indian and Alaska Native tribes. Through a network of small hospitals and outpatient health centers, the system provides health care services to approximately two million people belonging to 565 tribes, particularly those residing on federal reservations or in nearby communities. The 3.2 million members of the American Indian and Alaska Native population not served by the IHS receive care through the private sector or other public systems (the Department of Veterans Affairs, Medicaid, and Medicare) ...read more.

Middle

By 2020, the coverage gap will be closed, meaning there will be no more "donut hole," and individuals will only pay 25% of the costs of their drugs until they reach the yearly out-of-pocket spending limit. Third party reimbursements from Medicare, Medicaid, the Children's Health Insurance Program (CHIP) and private insurance will help IHS fund needed health care services. Within the Affordable Care Act, the Indian Health Care Improvement Act Reauthorization (IHCIA) helps American Indians and Alaska Natives as well. The Indian Health Care Improvement Act, which authorizes health care services for American Indians and Alaska Natives through the Indian Health Service, was originally approved by Congress in 1976 and last reauthorized in 2000. The Affordable Care Act makes the reauthorization of this law permanent and authorizes new programs within the Indian Health Service to ensure the Service is more equipped to meet its mission to raise the health status of American Indians and Alaska Natives to the highest level. The law gives IHS authority to establish expanded health care services such as mental and behavioral health treatment and prevention, long-term care services, dialysis services, facilitation of care for Indian veterans, and urban Indian health programs. This section of the law exempts a health care professional employed by a tribally operated health program from State licensing requirements if the professional is licensed in any State. It also encourages health professionals to join or continue in an Indian health program and to provide services in rural/remote areas in which a significant portion of Indians reside. The IHCIA also allows a tribe or tribal organization carrying out a program under the Indian Self-Determination and Education Assistance Act and an urban Indian organization carrying out a program under Title V of IHCIA to purchase coverage for its employees from the Federal Employees Health Benefits Program. Many tribal leaders are apprehensive that Medicaid reforms relying on managed care will channel Indian people away from Indian health care system providers and toward providers who are not as sensitive to the cultural needs of Indian patients. ...read more.

Conclusion

At the same time, health information technology systems gather data that serve as a basis for measuring performance, support clinical decisions, and assist in evaluation of internal quality improvement programs. Second, community partnership and culturally appropriate programs are of utmost importance. The experience of the Special Diabetes Program for Indians highlights the successes that can be achieved through effective collaboration between the IHS and the diverse tribal communities it serves (Daly et.al, 2009). The IHS should begin to places greater focuses on establishing collaborative practices within the community to gain better health prevention and treatment for the Native American population. Finally, addressing the multifaceted health care needs of American Indian and Alaska Native communities necessitates rethinking the care model design. This rethinking should involve a flexible approach to meeting the needs of the local community while facilitating shared knowledge across the entire system. Above all, there is a need to build on recent funding increases to achieve parity in the resources available for American Indian and Alaska Native health care delivery. In addition, developing new strategies to recruit and retain sufficient talented clinicians to care for American Indian and Alaska Native people is vital. These core ideas will be essential to promoting innovation and achieving continued breakthroughs in improving the health of the American Indian and Alaska Native people in the next decade. Organizational effectiveness can be achieved in a health care institution by focusing on healthy work environments, strategic planning and technology implementation. Also a framework needs to be assessed that is to report analyzing report and improve the overall quality of work environment in health care organizations. All of these factors reduce the operating costs and provides higher quality of patient care. From a technological perspective it is a convenient way to improve the patient's well-being, and make the nurses and doctors work easy and effective. As technology advances, the health and the quality of life of the population improves, because they can find new ways to cure diseases. Technological advancements help communication between doctors from different countries, and they can work together to discover treatments of different diseases. ...read more.

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