Report Examines Cancer Care Access for Native Patients

University of Oklahoma's Native Nations Center releases study on how Indian Health Service's Purchased/Referred Care program impacts cancer screening, diagnosis and treatment for tribal citizens.

Published on Mar. 7, 2026

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The University of Oklahoma's Native Nations Center for Tribal Policy Research has released a new report titled "Purchased/Referred Care and Cancer: Overview and Options for Tribal Consideration." The report, authored by tribal health care policy analyst Grace Fox, examines how the Indian Health Service's Purchased/Referred Care (PRC) program intersects with cancer care for eligible tribal citizens, including challenges around screening, diagnosis, treatment and follow-up.

Why it matters

The report highlights that cancer is an increasingly urgent public health priority in Indian Country, with American Indian and Alaska Native populations experiencing later-stage diagnoses, lower screening participation and higher mortality rates compared to the overall U.S. population. Understanding how the PRC program functions in practice is crucial, as it often serves as the bridge to specialty oncology services not available locally.

The details

The PRC program authorizes and pays for eligible care delivered by non-IHS or non-tribal providers when services are unavailable or inaccessible locally. The report provides an overview of PRC structure, eligibility requirements, notification timelines, medical-priority levels, alternate-resource coordination and funding constraints. It also includes Oklahoma-specific information, as all 77 counties in the state are designated PRC delivery areas.

  • The report was recently released in March 2026 by the University of Oklahoma's Native Nations Center for Tribal Policy Research.

The players

Grace Fox

Seminole tribal health care policy analyst at the Native Nations Center for Tribal Policy Research and author of the report.

Native Nations Center for Tribal Policy Research

A research center at the University of Oklahoma that focuses on providing research-driven analysis and policy options to support tribal leaders and communities.

Indian Health Service (IHS)

The federal agency responsible for providing health services to American Indians and Alaska Natives, including the Purchased/Referred Care (PRC) program.

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What they’re saying

“Our work at the Native Nations Center is first and foremost for tribal leaders and their communities. This report is designed to provide clear, accessible information about how the Indian Health Service's Purchased/Referred Care program works in practice and where, particularly in cancer care, delays or gaps are most likely to occur.”

— Grace Fox, Tribal health care policy analyst

“When someone is facing a cancer diagnosis, timing matters. The Purchased/Referred Care program often serves as the bridge to specialty oncology services that aren't available locally. Understanding that process – from referral to authorization to payment – can make a meaningful difference for patients and for tribal health systems.”

— Grace Fox, Tribal health care policy analyst

What’s next

The report outlines policy options for tribes to consider under the current PRC system, including self-determination and self-governance authorities, regional collaborations, and service-delivery models such as mobile screening and teleoncology.

The takeaway

This report provides crucial information for tribal leaders and health systems to better understand the PRC program's impact on cancer care access and outcomes for their communities, empowering them to identify solutions that address the unique challenges faced by Native patients.