Office of the Director

The Department of Health and Human Services Indian Health Service is a civilian sub-agency that procures contracts and administers grants to support health care delivery, public health infrastructure, and health professional training serving American Indian and Alaska Native populations. IHS operates under both federal contract and grant mechanisms, with the grant program representing the dominant funding vehicle.

IHS has awarded 8 federal contracts totaling $73.7 million in combined potential value since 2020, with $41.3 million obligated to date. Contract activity has been sparse and uneven: 2 awards in 2020, 2 in 2022, 1 in 2023, and 3 year-to-date in 2026. The most recent recorded award date is September 30, 2026. All eight prime contractors have received one award each, making the competitive landscape highly fragmented by count; however, concentration by potential value is concentrated, with Microhealth LLC and Reli Group Inc. accounting for 78% of combined potential value at $36.2 million and $21.6 million respectively. Recent awards carry a mixed set-aside profile: 25% are unrestricted competitive, 13% each are Buy Indian, Competitive 8(a), Indian Small Business Economic Enterprise, Service-Disabled Veteran-Owned Small Business, and Total Small Business designations.

IHS has awarded 1,285 federal grants totaling $4.71 billion in federal dollars obligated since 1990, representing a substantially larger funding footprint than contract activity. Grant awards have fluctuated significantly over the last five years: 165 in 2022, 342 in 2023, 87 in 2024, 59 in 2025, and 33 year-to-date in 2026. The most recent grant award closed on September 1, 2026. Recipient concentration is highly fragmented, with the top five recipients accounting for only 6% of recent awards and 6% of federal dollars. Cherokee Nation leads both by award count (11 awards, $142.6 million federal) and by federal dollars; Muscogee (Creek) Nation, Southcentral Foundation, Indian Health Council Inc., and Tuba City Regional Health Care Corporation round out the top five by dollars. The 407 distinct grant recipients indicate a broad distribution typical of direct-service and tribal-support funding. Grants are split nearly evenly between Cooperative Agreements (54% of awards) and Project Grants (46%), reflecting a mix of capacity-building partnerships and time-limited initiatives. Recent contract opportunities are not identified in current source data. Recent grant opportunities are not identified in current source data.