Southcentral Foundation

Developed by Alaska’s Southcentral Foundation, the Nuka System of Care (“Nuka”) is recognized as one of the world’s leading models of health care redesign. It is also the name given to Southcentral Foundation’s whole health care system, which provides medical, dental, behavioral, traditional and health care support services to more than 65,000 Alaska Native people.

Nuka is built upon the simple, yet revolutionary belief that the relationship between the primary care team and the patient (known as the customer-owner) is the single most important tool in managing chronic disease, controlling health care costs, and improving the overall wellness of a population. Recognizing that individuals are ultimately in control of their own lifestyle choices and health care decisions, Nuka focuses on understanding each customer-owner’s unique story, values and influencers in an effort to engage them in their care and support long-term behavior change.

The focus on relationships extends beyond health care delivery. To ensure whole system transformation, each key work system was redesigned – including workforce development, compliance, human resources and finance – to ingrain an organization-wide focus on relationship-building and shared decision-making.


A Native Community that enjoys physical, mental, emotional and spiritual wellness.


Working together with the Native Community to achieve wellness through health and related services.


SCF’s operational principles provide guidance from customer-owners when improving systems and/or developing new programs or services. Our mission and goals emphasize working together with individuals, families and the community, which means our systems and services are built on RELATIONSHIPS. We believe that multidimensional wellness can only occur effectively in a relationship-based system of care designed by and for the customer-owner, when, where and how they want it.


Organizations from around the world have realized Alaska Native people are on to something and are willing to invest their time and resources in learning from Southcentral Foundation and the successes of the Nuka System of Care.

Collaborations have included:

  • Alaska Regional Health Corporations
  • Cherokee Indian Health Authority
  • First Nations Health Authority (Canada)

*Not a complete list of collaborations

2011 and 2017 winner of the Malcolm Baldrige National Quality Award

Southcentral Foundation is a 2011 and 2017 winner of the Malcolm Baldrige National Quality Award, the highest presidential honor for performance excellence. This award reflects the hard work and dedication of the over 2,300 employees who work at SCF, as well as the high quality of the health care system built and operated by Alaska Native people.


SCF’s Nuka System of Care experienced a dramatic decrease in ER visits after transformation – 36 percent from January 2000 to 2015. In addition, primary care visits continue to decrease – a 25 percent decrease from 2008 to 2015.

By improving the overall health of the population, SCF’s Nuka System of Care slowed health care spending dramatically. Between 2004 and 2009, annual per capita spending on hospital services grew by only 7 percent while primary care spending remained below the national index.

What does the word Nuka mean?

Nuka is an Alaska Native word used for strong, giant structures and living things.

What is the Nuka System of Care?

SCF’s Nuka System of Care is a relationship-based, customer-owned approach to transforming health care, improving outcomes and reducing costs. The Nuka System of Care is very unique and receives increasing national and international recognition for its effectiveness.

How can SCF’s Nuka System of Care help my organization?

Any health care organization – regardless of where they are on the value-based payment spectrum – can benefit from the operating principles and systems on which the Nuka System of Care is built. For example, the Nuka System of Care can serve as a model for integrated health systems or accountable care organizations engaged in system redesign around a strong primary care platform or those already engaged in risk-based payor contracts. Other providers will benefit from incorporating Nuka System of Care principles and systems – such as robust behavioral health services, team-based care, and data-driven management tools – as they develop population health strategies and prepare for value-based reimbursement.

Why should I attend a Nuka conference?

The Nuka conferences are ideal for anyone interested in learning best practices from a health care system that has reduced cost, improved health outcomes and increased customer and employee satisfaction.

Participants have included:

  • Executive leadership
  • Directors
  • Managers
  • Direct Client / Patient Services
  • Specialists
  • Board Members / Owners
  • Coordinators
  • Consultants
  • Analysts / Associates
  • Administrative Support
  • Interns / Fellows
  • Instructors / Educators
  • Researchers

You should consider attending if you:

  • Are seeking proven solutions, best practices and tools to address challenging organizational issues in this rapidly changing industry
  • Would like to see a vision for the future of health care
  • Are interested in learning new skills
  • Would like to network with other health care organizations

What is Core Concepts?

Core Concepts is a required training for all Southcentral Foundation employees, as it provides foundational tools to build relationships. Employees learn communication tools that underline respect and empathy with peers and customer-owners.

What is SCF’s financial model?

SCF has been operating with the key elements of a successful Accountable Care Organization (ACO) for more than 15 years. In fiscal year 2015, 49% of SCF’s income was through third-party payments, 43% was through a grant with the Indian Health Service, and 5% was through grants. While SCF has access to non-traditional sources of revenue, it is important to understand that it also faces unique challenges, including providing services to a population with some of the country’s highest rates of chronic disease, poverty and trauma-induced mental health concerns. By improving population health, Nuka has slowed spending dramatically. Between 2004 and 2009, annual per capita spending on hospital services grew by only 7% while primary care spending remained below the national index.





75th - 90th




James Segura

James Segura

Chairman, 2004-present; Director, 1982-present
Charles Anderson

Charles Anderson

Vice Chairman, 2005-present; Director, 2003-present
Charles Akers

Charles Akers

Director, 2008-present
Karen Caindec

Karen Caindec

Secretary/Treasurer, 2008-present; Director, 2004-present
Roy M. Huhndorf

Roy M. Huhndorf

Director, 1995-present
Dr. Terry Simpson

Dr. Terry Simpson

Director, 2003-present
Loretta J. Throop

Loretta J. Throop

Director, 2008-present


Katherine Gottlieb, MBA, DPS

Katherine Gottlieb, MBA, DPS

Doug Eby, MD, MPH

Doug Eby, MD, MPH

Vice President of Medical Services
Kevin Gottlieb, DDS

Kevin Gottlieb, DDS

Vice President of Resource & Development/Chief of Staff
April Kyle

April Kyle

Vice President of Behavioral Services Division
Lee Olson, CPA

Lee Olson, CPA

Vice President of Finance/Chief Financial Officer
Michelle Tierney, PhD

Michelle Tierney, PhD

Vice President of Organizational Development & Innovation
Ileen Sylvester, MBA

Ileen Sylvester, MBA

Vice President of Executive & Tribal Services