Avel Ecare LLC

Avel Ecare LLC, doing business as Avel Ecare Pharmacy, is a foreign-owned, for-profit telemedicine provider based in Sioux Falls, South Dakota that delivers virtual healthcare services to federal agencies as a prime contractor on 121 awards with no subcontract footprint. The vendor operates exclusively on a full-and-open, non-set-aside basis and competes as a standard commercial provider across all recent federal work.

Avel Ecare's service portfolio centers on firm fixed-price telehealth delivery to tribal healthcare facilities across the Great Plains region, encompassing virtual care delivery, tele-emergency support, specialty clinic consultations, behavioral health services, diagnostic ultrasound examinations, and sexual assault nurse examiner (SANE) services. The vendor's capability work is represented across 111 awards under the General Medical and Surgical Hospitals NAICS and 113 awards under the Medical-Managed Healthcare PSC. Representative prime awards include a $30.8 million single-award IDIQ with the Indian Health Service for Great Plains Area telehealth support services running through July 31, 2027; a $5.2 million sole-source definitive contract with IHS for telehealth bridge services to Billings Area Service Unit locations in Montana (December 2025 through June 2026, later extended through December 2026); and a $5.1 million definitive contract with IHS for area-wide telemedicine services for the Billings Area IHS Bridge (April 2025 through December 2025). Task orders under the master IDIQ vehicle range from approximately $21 thousand to $1.3 million and cover multiple tribal healthcare facilities in South Dakota, North Dakota, and Minnesota, with individual orders typically supporting specific service units or hospitals for periods ranging from one month to twelve months.

Customer concentration is acute and singular. The Department of Health and Human Services Indian Health Service accounts for 114 of 121 awards (100% coverage) with $66.5 million in combined potential value, making it the overwhelming customer base. The remaining five awards distribute across the Bureau of Indian Education (three awards, $101 thousand), the Department of the Air Force (two awards, $37 thousand), and the Department of the Army and South Dakota Army National Guard (one award each, $37 thousand total). This concentration reflects Avel Ecare's specialization in serving tribal healthcare infrastructure across the IHS system rather than diversification across federal healthcare customers.

Vehicle position is tightly channeled through a single master contract. The vendor holds 109 task orders under the Indefinite Delivery Contract 75H70622D00023 (the IHS Great Plains Area Telehealth Support Services IDIQ) with a combined potential value of $25.1 million. This single vehicle represents the dominant ordering channel for federal customer engagement, with task orders issued by IHS service units throughout the Great Plains region since the July 26, 2022 IDIQ award.

Activity has grown from 18 awards in 2022 to 39 in 2023, contracted to 23 in 2024, recovered to 28 in 2025, and stands at 13 awards so far in 2026 (through August 13). Combined potential value across all 121 awards totals $66.7 million, with $35.7 million (54%) obligated to date. The recompete cliff poses material exposure: 11 awards with combined potential value of $9.1 million reach ultimate completion within the next twenty-four months, representing renewal risk on existing task order work with IHS tribal healthcare facilities.

The vendor has no named subcontract footprint and operates solely as a prime contractor. Recent modifications to delivered work indicate ongoing task order closeouts and de-obligations of excess funds, typical of the IHS's monthly or quarterly task order issuance cadence against the master IDIQ. Avel Ecare's federal footprint is concentrated, specialized, and dependent on sustained IHS ordering against a single master vehicle; the vendor does not appear to hold positions on government-wide acquisition contracts, agency-wide BPAs, or GSA vehicles, nor does it subcontract to major federal prime contractors.