Insight in Indian Country

REDW Advisors & CPAs

REDW Advisors and CPAs is proud to bring you the Insight in Indian Country Podcast, covering important advisory, accounting, and finance topics that impact Tribal Nations and business affairs. Gain expertise on building bright futures futures with our trusted advisors. Press play on your commute or coffee break! 

  1. OCT 3

    "Treating our patients as relatives." 💚 Building Sage Memorial Hospital's Future with Melinda White

    Send us a text Sage Memorial Hospital's journey from a four-room adobe building in 1911 to a state-of-the-art healthcare facility represents more than a century of serving the Ganado community. This episode, REDW National Tribal Practice Leader Wes Benally welcomes Melinda White, CEO of Sage Memorial Hospital, to discuss the hospital's remarkable transformation and its commitment to blending Western medicine with traditional Navajo healing practices. Melinda, who was born at Sage and returned as CEO three years ago, shares how the hospital is redefining healthcare in Indian Country—from building sweat lodges and hiring traditional healers to implementing cutting-edge technology and expanding critical services like ICU, dialysis, and elder care. She discusses workforce challenges, the importance of keeping patients close to home, and the vision for continued growth while maintaining the strong foundation of traditional values. Chapters 00:00 - Introduction and Welcome01:03 - Melinda's Background and Connection to Sage Memorial Hospital03:54 - The History: From 1911 Mission to Modern Healthcare08:47 - Incorporating Traditional Values in Modern Care12:34 - Innovation and Modernizing Healthcare Delivery15:55 - Workforce Challenges and Hiring the Right People19:49 - Patient Stories and Keeping Families Closer to Home23:16 - Measuring Success: KPIs and Quality Indicators26:55 - Vision for the Next 5-10 YearsTakeaways At Sage Memorial Hospital, traditional healing programs, including sweat lodges, medicine men/women, and future hooghan construction, are being integrated with Western medical care.The new facility achieved a complete transition to paperless operations with comprehensive electronic health records encompassing clinical and financial systems.Key expansion services include ICU, inpatient dialysis, swing beds, elder care facilities, and future plans for labor and delivery and surgical units.The hospital's core mission focuses on reducing patient transfers and keeping families closer to home, lessening the financial and emotional burden of traveling to distant facilities.Quality initiatives are measured through hospital-wide KPIs across four pillars: finance, community, people (HR), and quality.Quality Services. Quality Outcomes. REDW was honored to support Sage Memorial Hospital's transformation through our Client Advisory and Accounting Services (CAAS), Business Valuation, and Risk Advisory expertise. This journey demonstrates a powerful truth: investing in quality advisory services yields the best return. If your tribal healthcare organization is navigating growth or transformation, our team is here to help. 👉 Connect with Wes REDW Advisors and CPAs is proud to bring you the Insight in Indian Country Podcast, covering important advisory, accounting, and finance topics that impact Tribal Nations and business affairs. Thanks for listening!

    31 min
  2. OCT 2

    "It's about meeting the needs of the community." 🔄 Strengthening Revenue Cycles in Tribal Healthcare with Melissa Goad

    Send us a text Revenue cycle management isn't just a back-office operation—it's a strategic tool for strengthening care delivery in Tribal communities. This episode, REDW National Tribal Practice Leader Wes Benally sits down with Melissa C. Goad, CRCR, CPA, MBA, a healthcare finance veteran with 30 years of experience spanning both payer and provider perspectives. Melissa shares her transformative journey as CFO of a 638 Tribal Healthcare Facility on the Navajo Reservation, where she led a comprehensive revenue cycle optimization initiative that delivered a tenfold return on investment. From fixing data flow challenges and reducing denials by up to a third, to implementing culturally sensitive front-end operations and embracing industry best practices, Melissa's insights offer a practical roadmap for Tribal healthcare organizations looking to maximize reimbursements and close gaps in care. Her approach? Take it layer by layer, build cross-functional teams, and remember that optimizing revenue cycles ultimately means securing the resources needed to serve the community better. Chapters ·        00:00 - Introduction and Melissa's Healthcare Background ·        02:05 - The Importance of Revenue Cycle Management ·        04:45 - Assessing Opportunities in Tribal Healthcare Settings ·        06:36 - Embracing Industry Best Practices ·        12:24 - Denials Management and Registration Challenges ·        17:37 - Data Flow and EHR Customization Issues ·        20:13 - The Power of Cross-Functional Teams ·        25:05 - Cultural Considerations in Tribal Healthcare Takeaways ·        Revenue cycle optimization is about ensuring continuity of care and honoring commitments to the community, not just financial health. ·        Tribal healthcare facilities face unique challenges including geographic isolation, staffing limitations, complex billing regulations like the All-Inclusive Rate (AIR), and often inadequate technology. ·        Starting with a thorough assessment before implementing changes prevents costly assumptions and builds a strong foundation for improvement. ·        Registration is one of the most critical points in the revenue cycle—if data starts wrong, it ends wrong. ·        Cross-functional teams that include both clinical and revenue cycle staff are essential for identifying and fixing denial patterns. ·        Cultural sensitivity in patient-facing operations, including language support and understanding Tribal-specific requirements like CBI collection, strengthens both patient experience and reimbursement accuracy. ·        Organizations can expect to see returns within 6 months of implementing systematic fixes, with some facilities achieving tenfold ROI on revenue cycle investments. Ready to Strengthen Your Revenue Cycle? Whether you're considering a 638 transition or looking to improve existing operations, connect with REDW's Tribal healthcare advisors to explore how we can help strengthen your organization's financial health and expand care for your community.  👉  Learn more about 638 Healthcare Transition Support  👉  Explore Accounting Advisory Services REDW Advisors and CPAs is proud to bring you the Insight in Indian Country Podcast, covering important advisory, accounting, and finance topics that impact Tribal Nations and business affairs. Thanks for listening!

    34 min
  3. OCT 1

    "It's fascinating and very rewarding, frankly." 💰 How 105(l) Leases Are Transforming in Indian Country with Geoff Strommer

    Send us a text The 105(l) lease program has become one of the most transformative funding mechanisms available to Tribal Nations—but it's widely misunderstood. This episode, REDW National Tribal Practice Leader Wes Benally sits down with Geoff Strommer, partner at Hobbs Straus Dean Walker, to demystify this critical provision of the Indian Self-Determination Act. Despite the name, 105(l) "leases" aren't leases at all in the traditional sense—they're funding agreements that enable Tribes to receive resources for maintaining, repairing, and even constructing healthcare and administrative facilities. Geoff, who litigated the landmark Maniilaq cases that established Tribes' rights to fully funded 105(l) agreements, shares the fascinating journey from dormant statutory provision to nearly $1 billion in total lease value across Indian Country. Learn about the three compensation methodologies, how Tribes are using projected 105(l) revenue to finance major new construction projects, and what barriers (and opportunities) exist in this evolving landscape. Chapters 00:00 - Introduction and Geoff’s Background in Tribal Law02:44 - What Are 105(l) Leases? Breaking Down the Basics06:46 - The Landmark Maniilaq Litigation Cases16:19 - Establishing Mandatory Lease Requirements17:15 - Three Compensation Methodologies Explained24:34 - Barriers and Negotiation Issues28:44 - Congressional Appropriations and Future Sustainability31:31 - Looking Forward: Financing New FacilitiesTakeaways 105(l) leases are funding agreements, not traditional leases—the federal government transfers funds to Tribes for facility maintenance and operationsThe Maniilaq litigation established that 105(l) leases are mandatory, not discretionary, and must be fully fundedThree compensation methodologies exist: fair market appraisal, hybrid appraisal, and cost reimbursementNearly $1 billion in total 105(l) lease value has been achieved across Indian Country in recent yearsTribes are now using projected 105(l) revenue streams to finance new construction projects, transforming the facilities landscapeFrom Legal Right to Financial Reality Geoff and his team at Hobbs Straus Dean Walker establish the legal framework for 105(l) leases—REDW helps you put that framework into action. Our 638 Healthcare Transition Support team guides Tribes through self-governance transitions, while our Advisory & Accounting specialists help you document costs, prepare lease proposals, and build financial packages that leverage 105(l) revenue streams for new facility construction. Ready to turn 105(l) opportunities into reality? Reach out to learn how we can help you maximize available resources.  REDW Advisors and CPAs is proud to bring you the Insight in Indian Country Podcast, covering important advisory, accounting, and finance topics that impact Tribal Nations and business affairs. Thanks for listening!

    35 min
  4. SEP 22

    "People are keeping a close eye on HR in Indian Country." 👁️‍🗨️ Navigating Employee Voice & Cultural Competency with Taryn Reynolds & Jessica Goodfox

    Send us a text Employee voice is transforming HR practices across Indian Country, creating both opportunities and challenges for Tribal organizations. This episode, REDW National Tribal Practice Leader Wes Benally welcomes Taryn Reynolds, MSL, THRP II, and Jessica Goodfox, THRP, TMP, from REDW's Human Resource Consulting team to discuss the heightened focus on HR accountability, proper documentation practices, and the unique cultural considerations that shape Tribal workplace policies.  From developing bereavement policies that honor four-day traditional burial practices to managing investigations in close-knit communities where "everyone knows everyone," Taryn and Jessica share practical insights for HR professionals navigating these complex dynamics. They also preview their upcoming presentations at the NNAHRA Conference, including executive coaching for HR practitioners and compensation clarity sessions. Whether you're a seasoned HR professional or a new manager dealing with employee relations for the first time, this conversation offers valuable guidance on documentation best practices, cultural competency, and leveraging external expertise when needed. Chapters 00:00 - Introduction and Welcome02:04 - The Rise of Employee Voice in Indian Country HR07:17 - Top Three Things for New Managers10:22 - Cultural Competency Beyond Buzzwords13:21 - NNAHRA Conference Experience and Networking16:38 - What to Expect at NNAHRA 2025Takeaways Employee needs and investigations are increasing across Indian Country, requiring proper documentation and legal complianceHR professionals should document employee interactions immediately and avoid promising complete confidentiality during investigationsCultural competency in Tribal HR means aligning policies with traditional practices, such as four-day bereavement periods for burial ceremoniesThe NNAHRA Conference provides transformative networking opportunities and professional development for Tribal HR professionalsExternal HR consulting can help remove bias and provide objective investigation services in close-knit Tribal communitiesResources Learn how to design effective compensation strategies amid ongoing financial uncertainty in our latest blog, “Navigating Compensation: Creative Strategies Amid Uncertainty” | READ MOREDownload our FREE white paper, “Addressing Pay Compression: Strategies and Best Practices” | LEARN MORENNAHRA'S 29th Annual Conference - September 29 - October 1 - Pechanga Resort Casino REDW's Human Resource Consulting team will be front and center at NNAHRA’s 29th Annual Conference with presentations on executive coaching and compensation clarity, plus our popular booth featuring chair massages and great swag. Stop by to learn how REDW can support your Tribal organization's HR needs. | Connect with REDW at NNAHRA REDW Advisors and CPAs is proud to bring you the Insight in Indian Country Podcast, covering important advisory, accounting, and finance topics that impact Tribal Nations and business affairs. Thanks for listening!

    21 min
  5. 11/21/2024

    "We're still here, we're thriving." 🌟 Native American Heritage Month with Taryn Reynolds, MSL, THRP II

    Send us a text Wesley Benally welcomes Taryn Reynolds, MSL, THRP II, to the Insight in Indian Country Podcast. Taryn is a proud member of the Osage Nation and Human Resources Consultant at REDW Advisors & CPAs. With a rich background spanning 13 years in tribal government, she shares her unique perspective on blending traditional values with progressive governance in tribal organizations. In their conversation, Taryn emphasizes how protecting sovereignty extends beyond language preservation into organizational policies. Taryn illustrates how tribal communities can be both progressive and traditional, challenging the "that's how it's always been done" mentality while honoring cultural values. Her message resonates with a powerful truth: Native communities aren't just surviving – they're thriving and creating sustainable futures for generations to come. Chapters 00:00 - Introduction and Personal Background03:19 - Cultural Identity in Professional Practice08:27 - Understanding Tribal Sovereignty and HR14:31 - Progressive Approaches to Tribal Governance19:44 - Sources of Inspiration and Mentorship25:14 - Vision for Future Tribal Leaders28:08 - Reflections on Native American Heritage Month30:17 - Closing Thoughts on Ambition and LeadershipREDW Advisors and CPAs is proud to bring you the Insight in Indian Country Podcast, covering important advisory, accounting, and finance topics that impact Tribal Nations and business affairs. Thanks for listening!

    34 min

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About

REDW Advisors and CPAs is proud to bring you the Insight in Indian Country Podcast, covering important advisory, accounting, and finance topics that impact Tribal Nations and business affairs. Gain expertise on building bright futures futures with our trusted advisors. Press play on your commute or coffee break! 

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