The Confederated Tribes’ Managed Care program, and other tribal health programs, have seen a significant savings in tribal dollars over the past few years. This is due mainly to the increased billing opportunities.
“The Affordable Care Act is working for the tribes,” said Caroline Cruz, general manager of Health and Human Services.
In recent years the tribes and IHS have focused on having as many people as possible sign up for health insurance, such as through the Oregon Health Plan, or Medicaid.
The Annual Health System report for the reservation, published by the Joint Health Commission, explains the savings the tribes have been seeing in recent years:
Managed Care saw a spending reduction of more than $2.2 million—or 43 percent— from the year 2011 to 2014 (the most recent year for which the data is available). Community Counseling saw a decrease of nearly $900,000, or about 37 percent. These savings correspond to increases in collections from outside sources.
“Since 2011, tribal collections (for health services) have doubled,” the Health Report says.
Since the Affordable Care Act took effect in 2012-13, Health and Human Services has focused on an improved billing department. Sharon Jones is the billing director. She works with Tina Bolton.
They are able to bill to outside insurance sources for services, such as at Community Counseling, that in earlier years were paid by the tribes.
The improvement has been significant since 2011, but there is room for greater savings, such as for services at CPS, Caroline says.
The Health and Human Services billing department is planning to move soon to the clinic, and they are planning to add one more person to their staff.
Housed at the clinic, the Health and Human Services billing team will have better cooperation and training opportunities with IHS billing experts.