Alaska Tribal Health System

The Alaska Tribal Health System (ATHS) is a diverse and multifaceted healthcare system that has developed over the last 30 years. It represents the diversity of Alaska Native people. Alaska has 229 federally recognized tribes that live across 586,412 square miles of predominantly road-less land, the underlying reason for the creation of this innovative and essential statewide health system.

Tribal health organizations in most areas are the only healthcare providers available, and there- fore serve everyone in the area regardless of race. In 2000, the ATHS served 119,241 Alaska Natives, 19 percent of the state’s population. At that time, 178 village clinics employed 468 community health aide/practitioners, although there were 32 practitioner vacancies. Alaska is the only state in which over 99 percent of health programs are managed by tribes and Native organizations. Such a large healthcare system involves sophisticated patterns of referral. Its size and reach are also reflected in its total annual budget of approximately $800 million, including federal and state funding, Medicaid and Medicare revenue, rural sanitation funding, and other smaller sources of funding.