Cynthia Helba and Kathy Langwell, Westat, and Jo Ann Kauffman, Kauffman and Associates, Inc., prepared this Draft Final Report. W. Sherman Edwards and Brian Colhoff, Westat, Victor Paternoster, Kauffman and Associates, Inc., Janet Sutton, Project HOPE Center for Health Affairs, and Frank Ryan, project consultant, made substantial contributions to the study. We would like to thank the members of the Technical Working Group for their assistance and thorough reviews of draft reports throughout the study. In addition, we are grateful to the Tribes/Tribal organizations that volunteered to participate in site visits that were conducted for the study, including: Bois Forte Band of Chippewa, Choctaw Nation, Hopi, Little Traverse Bay Band of Odawa Indians, Port Gamble S’Klallam Tribe, and the Yukon-Kuskokwim Health Corporation. Several individuals at the Indian Health Service also contributed generously of their time and provided assistance with data review activities. Finally, we would like to thank Andy Rock and Tom Hertz, OASPE/DHHS Task Order Managers for the project, who provided valuable guidance and insights throughout the project.