TAHLEQUAH, Okla. — Cherokee Nation Principal Chief Chuck Hoskin Jr. signed three directives that will support increasing tribal citizens’ health care access to telemedicine, dialysis treatment and Medicare.
“Our health system leads Indian Country because we are always willing to examine ways to do better and fill gaps,” said Chief Hoskin. “Deputy Chief Warner and I are fortunate to work with members of our legislative branch and our Health Services team who work hard to keep our programs and services ahead of the curve.
Chief Hoskin’s actions direct work groups consisting of Deputy Secretary of State Canaan Duncan and Cherokee Nation Health Services leadership to examine three areas:
- Increased access to telemedicine
- Increased access to Medicare coverage
- Increased access to outpatient hemodialysis services, commonly referred to as “dialysis.”
“These three areas- telemedicine, Medicare coverage and dialysis services- are of interest to a number of Council members, which means there is an interest in these subjects among their constituents,” said Deputy Chief Bryan Warner. “Chief Hoskin’s directives to study these issues is one of many ways he and I can be responsive to the interests of Cherokee Nation citizens in health care, one of the most important Cherokee Nation programs.”
Speaker Mike Shambaugh, who requested the hemodialysis study, expressed his appreciation for the review.
“For many of our rural citizens, outpatient dialysis requires using outside providers and sometimes driving long distances,” said Speaker Shambaugh. “Before we expand into a complex area like outpatient dialysis, we need to be thoughtful and explore the best way to do so on a sustainable basis, which could mean working with partners.”
Cherokee Nation presently provides inpatient hemodialysis, but partners with a private contractor to bring outpatient dialysis to the Sallisaw area and provides support for patients accessing displays from private providers through the purchase and referred health program.
At-large council member Johnny Jack Kidwell called for a review of telemedicine and Medicare coverage as a potential way to reach more at-large citizens and increase a sense of health security among all citizens.
“Although I hear primarily from at-large citizens who look forward to more access to our health services, I know that all of our citizens stand to benefit if we can expand access to telemedicine,” said Councilor Kidwell. “Likewise, we need to examine the viability of supporting elder access to Medicare part B, C and D plans or at least assisting them with understanding and accessing those plans.”
Cherokee Nation already offers an array of telemedicine services. The work group will examine technological, regulatory and resource barriers that exist to further expansion.
With reposts to Medicare, Cherokee Nation’s health benefits coordinators work with patients to access third-party health insurance, the revenue from which is returned directly to the tribe’s health and wellness programs.
The work group will examine barriers to patients accessing plans beyond basic “Medicare A,” with those additional plans providing coverage for things such as medical equipment, home health and prescription medicine.
Cherokee Nation operates the largest tribal health system in Indian County, handling over 2 million patient visits per year. Cherokee Nation serves members of all federally recognized tribes through its network of 11 health facilities, which includes a hospital.
The work groups established by Chief Hoskin will report their recommendations to Chief Hoskin, Deputy Chief Bryan Warner and Speaker Shambaugh by July 1, 2025.
Although the work groups themselves will not change policy or add services, their recommendations will help inform future policy changes in the tribe’s health system.
“Our aim is a world class system of wellness,” said Chief Hoskin. “That takes the sort of careful and thoughtful approach to health policy reflected in these new directives.”