Primary Care

Pressures are mounting on health care organizations today to provide better care while also controlling costs. Engaging people in their own health care can both result in better health outcomes for patients and ease the burden on the medical system. Discover the lessons learned, tools and best practices for moving your system from volume to value based care. Effective change management and navigating employees through change requires strategy, including communication plans, easy-to-apply methodology, and early adoption and implementation.

“Nuka represents the future of health and health care in the United States and is a model that all health systems should look to for inspiration and guidance. The Alaska Native people  have not only developed a model of improving the key health issues of their community, but demonstrate what it means to create a health system that empowers and improves the health of people and populations. I know that I will continue to deepen my study of Nuka in the months ahead as I guide my health system at Harvard to improve the health of our community.”

– Soma Stout, Vice President for Patient-Centered Medical Home Development at Cambridge Health Alliance

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Southcentral Foundation’s facility design promotes a focus on relationships, not only with customer-owners, but also between employees. More information on that program is available here:

Learn about our approach

For more than 50 years, Alaska Native people in Southcentral Alaska received their health care as “beneficiaries” of the Indian Health Service. Patients waited weeks to get an appointment or accessed the system through the emergency room. There was a disconnect between care for the mind and care for the body. Employees were not able to be creative and innovative; departments and programs acted independently.

Alaska Native and American Indian people advocated for a voice in program planning and service delivery resulting in Congress passing a federal law in favor of self-determination. This legislation opened the door for Tribes to choose ownership of the services. The Alaska Native leadership of SCF saw this as an opportunity to completely redesign the Tribal health care system in Southcentral Alaska based on Alaska Native values and needs.

By 1999, Alaska Native people were self-determined “customers” and “owners” of their Tribally managed health care, in control of decision-making and administration. Customer-owners take responsibility to make informed choices on priorities for the health care system and to work to sustain it for future generations.

What followed was a customer-driven overhaul of health care delivery, philosophy, and values. As a result, Southcentral Foundation has today what is known as the Nuka System of Care. It addresses the challenges that health care systems around the world face as to how to improve health care outcomes and customer satisfaction without skyrocketing costs.

Solutions for your organization

Southcentral Foundation’s Nuka System of Care can serve as a valuable example for organizations seeking to transform their health care systems. Being willing to implement system-wide change, engage people in their own health care, and focus on relationships can reveal benefits for both health care organizations and the people they serve.

With more than 20 years of experience developing our team-based approach, we can support your organization in helping you develop and implement processes and systems for sustainable organizational change that can be engrained in your culture. For example, systems and processes for:

  • Primary care operations such as clinic flow, roles and responsibilities, and procedures for a team-based environment
  • Workforce practices including hiring and employee learning and development
  • Continuous improvement and innovation
  • Generating strong buy-in for change
  • Building a primary care system based on the voice of the community including understanding, listening, and engaging with the community you serve
  • Facility design that promotes focus on relationships, not only with customer-owners, but also between employees and maximizes resources

How we consult

Southcentral Foundation’s Learning Institute provides consulting solutions in a variety of ways, to best meet the needs of your organization, including:

  • On-site consulting at your location
  • Customized learning experiences on SCF’s campus in Anchorage, Alaska
  • Hourly virtual consulting sessions
  • Multi-year / multi-phase contract solutions
  • Government sole sourcing / no-bid contracting
  • Curriculum design and training / workforce development customization

SCF’s Learning Institute is available to explore these solutions and more. Fill out a request to schedule your complimentary call today!

Additional Resources


Facility Design in the Nuka System of Care


From Theory to Practice: Integrated Care Teams in Action

White Paper

Discover SCF’s Approach to Medical Services, including whole system transformation story and result data