Southcentral Foundation in Alaska: Person-Centered Integrated Primary Healthcare Case Study

Eesha V. Desai, Sarah Dannin, June-Ho Kim and Asaf Bitton

Chapter 12 in People-Centered Integrated Primary Healthcare System Development in Asia and Beyond, 2025, pp 375-399 from World Scientific Publishing Co. Pte. Ltd.

Abstract: The Southcentral Foundation is a tribally governed Indian Health Service system based in Anchorage, Alaska, that has developed an innovative, long-term approach to people-centered integrated Primary Healthcare (PCIPHC) and health system transformation. Called the Nuka System of Care, the system is customer-owned and centered on relationships with primary care teams delivering culturally appropriate integrated care.The shift to Southcentral Foundation’s people-centered model began by empowering individuals receiving care by making them “customer-owners’’ and involving them in decision-making. This involvement ensured a more responsive health system and improved patient satisfaction, emphasizing the significance of inclusivity and patient agency in strong people-centered integrated primary healthcare.The implementation of care teams, aligned with performance targets and regular reviews, significantly improved efficiency, access, and accountability in PCIPHC delivery. Multidisciplinary teams, guided by clear goals and a mission-driven approach not only enhanced coordination but also reduced wait times, ensuring more comprehensive and timely care for an often marginalized tribal population. Additionally, a systematic approach to empanelment by these teams enabled effective PCIPHC.An outcome- and metrics-driven PCIPHC system with supportive data and information technology systems was able to reduce hospitalization, improve access to same-day appointments, and attain high clinical recognition as a patient-centered medical home, underscoring the effectiveness of these reforms. This demonstrates the significance of data-driven, mission-aligned strategies in achieving substantial health improvements and system-wide success.Altogether, the Southcentral Foundation employs a variety of integration strategies, including integration across health services, integration with community traditions, and integrated data management systems to provide high-quality, person-centered primary care, which enables better clinical, patient-reported, and clinician-reported outcomes.

Keywords: Primary Healthcare; Primary Care; People Centeredness; Integrated Healthcare; Health System; Health Financing; Health Economics; Healthcare Delivery; Health Policy; Public Policy; Universal Health Coverage; People-Centered Integrated Primary Healthcare; People-Centered Integrated Healthcare; Integrated People-Centered Delivery System (search for similar items in EconPapers)
JEL-codes: H51 I11 I15 I18 O53 (search for similar items in EconPapers)
Date: 2025
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