Contract Health Care - Office of Managed Care

Contract Health Care Services available through any Indian health care facility in the Oklahoma Area of the US/PHS Indian Health Service (IHS) are funded from a specific IHS budget pool outside of facility operations. Therefore, they are also managed and accounted for distinct from facilities operations funding. Three different entities are currently responsible for administration of contract health care in and around the Cherokee tribal jurisdictional service area (TJSA): Cherokee Nation, Creek Nation and the IHS.

The Cherokee Nation Health Service is responsible for the administration of contract services as indicated by the map below, and the function is performed from the Office of Managed Care.

When eligible patients of the Cherokee health system require specialty care that is not directly available from the clinic or hospital where they receive basic services, referrals can be made outside the network of facilities. The Cherokee Nation Health Service contracts with over 250 specialty care physicians and/or family facilities for a variety of tertiary care ranging from specialized radiology and other screening to orthopedics and cardiology. More than 20 district disciplines are represented in the "micro-network" of contract providers.

Not all specialty (or 'tertiary') care needed by our patients can be paid for by the system. Because the budget can not accommodate every need of every patient for tertiary care, medical priorities have been established for determining which referrals can be authorized for payment. Additionally, the level of available funds fluctuate with the amount of needs presented. In other words, some services can be paid for at times when they can not be at others, depending on how much of the contract health funding has been expended at a particular point in the budget cycle. This can be confusing to patients, but every effort is made to assist the patients in meeting their health care needs, even when our resources can not pay.