The Choctaw Nation Health Services Authority provides rural health care across 11.7 counties and over 8 million acres in southeastern Oklahoma. They operate 41 clinics and hospitals, seeing over 544,000 patient encounters annually with a budget of $108 million. They have expanded the use of telemedicine to increase access to specialists, initially facing obstacles in specialist buy-in and appropriate clinic setups, but now partnering with various universities and hospitals to provide remote services like radiology, cardiology, neurology, and behavioral health. They continue working to improve primary care access and care coordination across tribal health systems.