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

Just Posted

Lorraine Kuhn is seen with one of the many volleyball teams she coached. (Photo submitted by Sport Yukon)
The Yukon Sports Hall of Fame inducts the late Lorraine Kuhn

Lorraine Kuhn became the newest member of the Yukon Sports Hall of Fame for her work in growing volleyball amongst other sports

File Photo
A Yukon judge approved dangerous offender status for a man guilty of a string of assaults in 2020.
Yukon judge sentences dangerous offender to indefinite prison term

Herman Peter Thorn, 51, was given the sentence for 2020 assaults, history of violence

Crystal Schick/ Yukon News A former residential school in the Kaska Dena community of Lower Post will be demolished on June 21. Crystal Schick/ Yukon News
Lower Post residential school demolition postponed

On June 21, the old residential school in Lower Post will be demolished and new ground on a multi-cultural centre will be broken

Chief Medical Officer of Health Dr. Brendan Hanley announced 29 new COVID-19 cases on June 19 and community transmission among unvaccinated individuals. (Yukon News file)
Yukon logs record-high 29 new COVID-19 cases

F.H. Collins prom attendees and some Porter Creek Grade 9 students are instructed to self-isolate as community transmission sweeps through unvaccinated populations

Willow Brewster, a paramedic helping in the COVID-19 drive-thru testing centre, holds a swab used for the COVID-19 test moments before using it on Nov. 24. The Yukon government is reopening the drive-thru option on June 18. (Crystal Schick/Yukon News)
Drive-up COVID-19 testing opening June 18 in Whitehorse

The drive-up testing will be open from 6:30 p.m. to 9:30 p.m. everyday and increase testing capacity by 33 spots

Whitehorse City Hall (Yukon News file)
City news, briefly

A look at decisions made by Whitehorse city council at its June 14 meeting

Murray Arsenault sits in the drivers seat of his 1975 Bricklin SV1 in Whitehorse on June 16. (Stephanie Waddell/Yukon News)
Bringing the 1975 Bricklin north

Murray Arsenault remembers his dad’s Bricklin, while now driving his own

A presumptive COVID case was found at Seabridge Gold’s 3 Aces project. (file photo)
Presumptive COVID-19 case reported at mine in southeast Yukon

A rapid antigen rest found a presumptive COVID case on an incoming individual arriving at the 3Aces project

Jonathan Antoine/Cabin Radio
Flooding in Fort Simpson on May 8.
Fort Simpson asked for military help. Two people showed up.

FORT SIMPSON—Residents of a flooded Northwest Territories village expected a helping hand… Continue reading

A woman was rescued from the Pioneer Ridge Trail in Alaska on June 16. (Photo courtesy/AllTrails)
Alaska hiker chased off trail by bears flags down help

ANCHORAGE (AP)—An Alaska hiker who reported needing help following bear encounters on… Continue reading

Two participants cross the finish line at the City of Whitehorse Kids Triathlon on June 12 with Mayor Dan Curtis on hand to present medals. (Stephanie Waddell/Yukon News)
2021 Kids’ Triathlon draws 76 young athletes

Youth ages five to 14 swim, run and bike their way to finish line

NDP MP Mumilaaq Qaqqaq rises in the House of Commons, in Ottawa on May 13, 2021. THE CANADIAN PRESS/Adrian Wyld
‘Unacceptable’ that Inuk MP felt unsafe in House of Commons, Miller says

OTTAWA—It’s a “sad reflection” on Canada that an Inuk MP feels she’s… Continue reading

Lily Witten performs her Canadian Nationals beam routine on June 14. John Tonin/Yukon News
Three Yukon gymnasts break 20-year Nationals absence

Bianca Berko-Malvasio, Maude Molgat and Lily Witten competed at the Canadian Nationals – the first time in 20 years the Yukon’s been represented at the meet

Most Read