The Indian Health Service (IHS) oversees the provision of healthcare services to 1.9 million American Indians and Alaska Natives from 562 recognized tribes across 35 states. The Innova planning process engaged local community tribal leadership in planning healthcare delivery, facilitated Area offices’ understanding of tribal needs and priorities, and provided the federal agency with comprehensive data on Native healthcare service demand. By engaging these three key stakeholders in the process, The Innova Group secured crucial community based support for implementing 331 detailed local-level health service delivery plans. Summaries of these plans quantify area demand for staffing, space, and funding in ways that had previously been impossible, greatly clarifying planning priorities and the budget development process.