Whitehorse General Hospital in Whitehorse on Feb. 14, 2019. A report by an independent panel that reviewed the Yukon’s health and social system says that by adopting the Nuka System of Care, the territory could reduce hospital visits and stays and save nearly $19 million per year in costs by 2035. (Crystal Schick/Yukon News file)

Yukon should adopt Alaska’s Nuka healthcare model, review panel recommends

The independent panel that spent more than a year reviewing the Yukon’s health and social programs and services is urging the territory to look across the border and adopt a healthcare model created in Alaska.

The award-winning Nuka System of Care, created and administered by the non-profit, Alaska-Native-owned Southcentral Foundation in Anchorage, is lauded throughout the five-person panel’s 200-plus-page final report, Putting People First.

The report, released to the public last week, contains 76 recommendations on how to improve the territory’s health and social system, with a focus on improving experiences for both patients and providers as well as making operations and delivery more efficient.

“The panel looked at a number of different models of organization and delivery and we were very much impressed with the Nuka Model of Care that’s operated by the Southcentral Foundation in Alaska,” panel member Gregory Marchildon told media during a press conference on May 13.

“And we took some of the lessons from that model of care and adapted them into the Yukon context.”

The Nuka model currently provides “medical, dental, behavioural, traditional and health care support services” to more than 65,000 Alaska Natives in Anchorage and the Anchorage area, according to the Southcentral Foundation’s website.

One of its key components is providing what it calls its “customer-owners” with primary care — for example, access to a family doctor or nurse — in order to mitigate the possibility of more serious health issues arising later.

The model also emphasizes, among other things, the importance of ensuring services are culturally appropriate, centring patients’ wants and needs when creating care plans, building long-term relationships between patients and care providers, building a team of care providers around patients and short wait times for appointments.

According to Putting People First, between 2000 and 2017, the number of hospital stays by Southcentral Foundation customer-owners dropped by 36 per cent. Visits to the emergency department also dropped by 40 per cent during the same timeframe; according to the report, the Yukon could save nearly $11 million per year in hospital costs if it were to see similar reductions.

That would amount to a decrease of more than 10 per cent, or $267, for every Yukoner.

“With hospital use expected to grow over the coming years as the population grows and ages, the potential savings grow as well,” the report continues, projecting that by 2035, a 10 per cent reduction in spending would work out to nearly $19 million saved.

“Yukon will be able to use these funds to offset increased costs in other areas associated with the implementation of the Nuka model of care, especially in the area of primary health care,” the report says.

Part of the costs of adapting the Nuka model to the Yukon include a complete restructuring of how healthcare is administered in the territory.

Instead of the Department of Health and Social Services funding, regulating, administering and delivering programs and services, the panel is recommending the government create an arm’s length public organization, Wellness Yukon, to handle administration and delivery.

“These would be services across the health continuum starting with primary care … (as well as) hospital care, long-term care, home and community care, medical evacuation and medical transportation, chronic disease management and so on,” Marchildon told reporters.

“It would also be responsible for measuring, monitoring and evaluating performance in terms of outcomes, satisfaction, quality and cost.”

Yukoners would also see primary care become “the centre of the health care universe,” with each Yukoner assigned to a primary care team that would help coordinate their care throughout the “health care continuum,” including specialized or Outside hospital care.

“What this means is that Yukoners can expect that they will have contact with a group of providers not just the first time they get sick, but continually,” Marchildon said.

“… This marks a pretty big change from the traditional referral model and it’s one of the reasons in Alaska, they’ve been able to achieve so much in terms of improving satisfaction, improving the quality of care, improving the outcomes and actually over time, in reducing costs.”

Primary care teams, which would operate through both community health centres and hubs, would be responsible for anywhere between 1,200 to 1,400 Yukoners. The teams would be led by either a doctor or nurse practitioner and also include medical assistants — a new component to Yukon health care — that come from the communities themselves.

The idea is that the assistants, with additional training and education, would eventually become nurses, nurse practitioners or doctors themselves, Marchildon explained, joining the system while having “a much closer connection to the communities and a much more enduring connection to the communities than what is currently the situation.”

“So this is very much looking to the long-term to change the basic dynamic,” he said.

The primary care teams would then be linked to “polyclinics,” based in larger hubs, that offer more specialized care like midwifery and dietician services or respiratory therapy. The polyclinics would “flow” any patient information back to that patient’s primary care team to ensure a continuity in care.

“So this marks a pretty big departure from the system,” Marchildon said. “It means a system (that) is … much more directed both by Yukoners and by the members of the primary care teams than right now, in which, basically, you don’t have that kind of continuity and coordination that you could have through this new system.”

Contact Jackie Hong at jackie.hong@yukon-news.com

Yukon health and social services

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

d
Wyatt’s World

Wyatt’s World for March 5, 2021.

g
Yukonomist: School competition ramps up in the Yukon

It’s common to see an upstart automaker trying to grab share from… Continue reading

The Yukon government responded to a petition calling the SCAN Act “draconian” on Feb. 19. (Yukon News file)
Yukon government accuses SCAN petitioner of mischaracterizing her eviction

A response to the Jan. 7 petition was filed to court on Feb. 19

City councillor Samson Hartland in Whitehorse on Dec. 3, 2018. Hartland has announced his plans to run for mayor in the Oct. 21 municipal election. (Crystal Schick/Yukon News file)
Councillor sets sights on mayor’s chair

Hartland declares election plans

Whitehorse RCMP will provide internet safety training due to an uptick of child luring offences. (iStock photo)
RCMP hosting internet safety webinars for parents and caregivers

The webinars will take place on March 23 and 25

Chief Medical Officer of Health Dr. Brendan Hanley receives his first dose of the COVID-19 vaccine from Public Health Nurse Angie Bartelen at the Yukon Convention Centre Clinic in Whitehorse on March 3. (Crystal Schick/Yukon News)
State of emergency extended for another 90 days

“Now we’re in a situation where we see the finish line.”

The Yukon government says it is working towards finding a solution for Dawson area miners who may be impacted by City of Dawson plans and regulations. (Joel Krahn/Yukon News file)
Miner expresses frustration over town plan

Designation of claims changed to future planning

Team Yukon athletes wave flags at the 2012 Arctic Winter Games opening ceremony in Whitehorse. The 2022 event in Wood Buffalo, Alta., has been postponed indefinitely. (Justin Kennedy/Yukon News file)
2022 Arctic Winter Games postponed indefinitely

Wood Buffalo, Alta., Host Society committed to rescheduling at a later date

Crews work to clear the South Klondike Highway after an avalanche earlier this week. (Submitted)
South Klondike Highway remains closed due to avalanches

Yukon Avalanche Association recommending backcountry recreators remain vigilant

RCMP Online Crime Reporting website in Whitehorse on March 5. (Haley Ritchie/Yukon News)
Whitehorse RCMP launch online crime reporting

Both a website and Whitehorse RCMP app are now available

A man walks passed the polling place sign at city hall in Whitehorse on Oct. 18, 2018. The City of Whitehorse is preparing for a pandemic-era election this October with a number of measures proposed to address COVID-19 restrictions. (Crystal Schick/Yukon News file)
City gets set for Oct. 21 municipal election

Elections procedures bylaw comes forward

A rendering of the Normandy Manor seniors housing facility. (Photo courtesy KBC Developments)
Work on seniors housing project moves forward

Funding announced for Normandy Manor

Tom Ullyett, pictured, is the first Yukoner to receive the Louis St-Laurent Award of Excellence from the Canadian Bar Association for his work as a community builder and mentor in the territory. (Gabrielle Plonka/Yukon News)
Tom Ullyett wins lifetime achievement award from the Canadian Bar Association

Ullyett has worked in the Yukon’s justice ecosystem for 36 years as a public sector lawyer and mentor

Most Read