5 Ways Onsite Primary Care Benefits Tribal Organizations

Though deeply connected through tradition, culture, and resilience, many tribal communities still face unique challenges when it comes to accessing great healthcare. Between rural locations, provider shortages, cultural care gaps and more, tribal health disparities show that this population ultimately isn’t getting the care they need. But what if getting the right care was as easy as walking next door? Onsite primary care can help make that a reality. 

Barriers to Healthcare Access in Tribal Communities 

In this blog, we’ll dive into these challenges and discover five ways onsite primary care can help tribal organizations bridge the gap to better health for their people. 

Underfunded Resources 

In order to provide healthcare services to tribal communities, the federal government utilizes the Department of Indian Health Services (IHS) as the vehicle for offering care access. However, the IHS has historically been severely underfunded, addressing less than 50% of tribal healthcare needs. A significant portion of these already-limited funds are also spent on administrative overhead instead of direct patient care. As a baseline, the system itself creates gaps in care before considering the social drivers of health among the tribal population. 

Rural and Infrastructure Challenges 

Many tribal communities have trouble accessing care simply because of where people live. Over half of Native people reside in rural or small-town areas on or near reservations. With 66.5% of primary care health professional shortage areas (HPSAs) being in rural regions, this population is disproportionately affected.  At the same time, Indian Health Service facilities on average are 40 years old – three times older than most U.S. hospitals – resulting in overcrowding and limited services. These realities make it harder for people to get timely, consistent care, including their preventive needs. 

Thin Provider Base 

Even in cases when preventive care is reasonably accessible to certain tribal communities, the system is stretched thin. As of 2022, fewer than 3,000 physicians and nurses in the Indian Health Service system were currently serving the entire population, which is estimated to be 2.8 million people. With such a limited provider base, the community is facing long waits, limited appointment availability, or the need to travel long distances for basic preventive care. Many times, tribal members will resort to expensive urgent care centers and emergency rooms just to get the care they need. 

Economic Challenges 

With the rising cost of healthcare across the nation, financial barriers also play a role in limiting preventive care access for tribal communities. Native households experience poverty at double the rate of the general U.S. population. In addition, 20% of Native people under 65 were uninsured in 2022, which is the highest uninsured rate of any racial or ethnic population.  

These financial challenges can make preventive care seem out of reach and often cause delays in necessary treatment, resulting in a cycle that further widens health disparities within the Tribal community. 

Lack of Culturally Competent Care 

Building trust between primary care providers and the members they serve is critical. Many tribal communities face historic and ongoing challenges with health institutions, including differences in language, traditions, and approaches to care. Without the integration of culturally competent care, those in the community may not feel comfortable or respected in the healthcare setting, lowering engagement even when care is available.  

Onsite Primary Care for Tribal Organizations 

For tribal organizations that serve a large workforce alongside tribe members, offering dedicated onsite preventive care as part of an advanced primary care approach can address these challenges, improving both the wellbeing of their people and their bottom line. Let’s explore five ways onsite primary care helps make this possible. 

Located Right Where Tribes Need It 

When care is located just down the hall or close by in the community, members don’t have to choose between health and convenience. Onsite primary care makes it simple to prioritize wellness without the added burden of organizing additional transportation. If the member is at home or has already made it to work on the reservation, they’ve already made it to care.  

For tribal members living more rurally, onsite care right in their community means avoiding the even longer commutes to metropolitan areas. For the tribe, this convenience helps reduce delayed care among employees while also ensuring the members of the tribal community get the preventive support they need to get and stay well. 

Facilities Built for a Population’s Specific Needs 

Onsite wellness centers are designed with the specific needs of the population in mind. This includes overall size, health priorities, cultural considerations, and even how the space itself should feel. Using these design principles, the tribal community can have a sense of belonging when they visit for care. They may see familiar colors, patterns, and imagery that resonate with the local culture. These purpose-built spaces help members feel more comfortable prioritizing their care and also serve as a powerful recruitment and retention tool for the tribe as an employer. 

Dedicated Providers 

Onsite wellness centers and their providers are dedicated to an exclusive population, not the general public.  This means the workforce and tribal members can get same- and next-day appointments with little-to-no wait times when they’re ready to see their provider.  

When members aren’t delaying care due to provider availability, health issues can be treated earlier before they escalate into more costly conditions. This proactive approach translates into a healthier community and more manageable long-term healthcare costs for both them and their organization.  

Fee-for-Value, Not Fee-for-Service 

Onsite primary care providers operate on a fee-for-value healthcare model, focusing on personalized care and improving member health rather than seeing as many members as possible. This means that each member gets the time and attention they deserve, instead of rushed appointments where they may feel their needs aren’t fully addressed. Improving the member experience in this way encourages return visits and continued engagement from the population, helping to further decrease total cost of care.  

Culturally Competent Care 

Onsite primary care providers are trained to respect and honor the traditions, values, and norms of the tribal communities they serve. Even if they’re not originally from the community themselves, onsite providers are committed to delivering care that feels familiar and respectful. For tribal organizations, this demonstrates a meaningful commitment to their people – staffing providers who truly care helps build trust and strengthen community ties. 

Onsite Primary Care at Premise Health 

Onsite primary care at Premise Health offers tribal organizations a practical solution to any healthcare challenges in their communities. By meeting members where they are, investing in purpose-built facilities, and fostering meaningful, culturally conscious provider relationships, tribal organizations can support a healthier workforce and tribal community while also decreasing their healthcare spend. 

Ready to help your tribal organization get the care they need? Read more about onsite wellness centers and primary care at Premise or contact us!