IHS Hires Avera to Provide Telehealth in Four States; Step Closer to Medicaid Expansion?

The Indian Health Service yesterday announced that Avera Health will get $6.8 million to provide telehealth services to the nineteen Great Plains Area service units (North Dakota, South Dakota, Nebraska, and Iowa) serving seventeen tribes and 130,000 American Indians.

Avera cut its teeth on this service providing telehealth services to the Lame Deer Health Center in Montana, “the first Indian Health Service facility in the country to bring board-certified specialists into the emergency room via teleconference.” They’ll face some technical challenges: according to testimony before the U.S. Senate Committee on Indian Affairs last February, half of the Pine Ridge IHS facility lacks the wiring necessary for telehealth services.

Last January, Governor Dennis Daugaard said his Medicaid expansion task force helped push conversations along concerning increased cooperation between IHS and non-IHS providers to implement telehealth services. The IHS–Avera deal appears to show those conversations coming to some fruition.

Telehealth services could be a key part of helping our Indian residents get necessary care at IHS facilities and thus being able to bill IHS instead of traveling for care at non-IHS facilities and having to bill Medicaid. Moving American Indian care from partially state-funded Medicaid to 100% federally funded IHS is the magic budget trick necessary to make Medicaid expansion in South Dakota budget-neutral.

I know there are lots of other parts that have to move (including certain Republicans parts that Democrats need to move out of the Legislature this November), but the IHS–Avera deal appears to be one practical step toward ending South Dakota’s overlong resistance to Medicaid expansion.

6 Responses to IHS Hires Avera to Provide Telehealth in Four States; Step Closer to Medicaid Expansion?

  1. Interesting to me is that Sanford has the Medicaid Expansion in North Dakota with no relationship to telehealth in its work there. Quite a large Native population up in that North Dakota country as well. Both states have right wing governors. How does it all come together?


    South Dakota now has Avera in the drivers seat with the IHS as its reason for being there at the steering wheel. So how many more South Dakotan’s have to die in order to put this all together? What position will our lieutenant governor play in this deal? How can he represent so many interests? Well, this is South Dakota, whose gonna stop him?

  2. How does this affect Sanford’s attempt to take over the world?

  3. One state at a time Mr. Rorschach, Rome was not built in a day.

  4. I remain cynical. so a great doctor at Avera says “yes, this person needs this procedure, see this specialist, and this follow up etc.” IHS and its very unique disfunctional “committee determinations” will over rule the good doctor n shelf the patient. Or not pay for the procedure after its done. Happens every day. Wierd deal that IHS. Just does not work.

  5. I see a couple of things that might be helpful if the tools are in place where the patient is. If there is an EKG done for example, it is done in real time to be reviewed by the heart specialist who can make recommendations to the patient as well as the healthcare provider. This can save a whole lot of time for treatment. I see that Pine Ridge, as an example, is getting full fiber communications installed and should be complete now or very soon. I do not know about the other reservations as far as fiber optics installations are concerned. What is the fiber optics on Rosebud?

    If there is a specialist looking at the patient for evaluation, there should not need to be committee determinations. If the specialist at Avera says that there is a need for the patient to get a procedure done, that should be that. There would also be a record of the office visit so no one could say that they did not say what they said, it would be on record. Maybe that would make the IHS work then for the people.

  6. Ror, to be completely cynical and businesslike, I would think a $6.8M contract to provide remote service to Indians probably doesn’t match the financial and political capital to be mined from hip replacements and heart checkups for all those baby boomers and erecting big sports facilities.