Engaging community members and patients to understand their perspectives and inform organizational and systems change is critical to advancing health equity. Beyond guiding quality improvement strategies that are more responsive to patient needs, building accountable relationships with communities served can help bridge gaps in trust between health care organizations and historically marginalized communities that have resulted from long-standing bias, stigma, and racist practices within the health care system. There is a clear association between higher levels of community engagement with local health care organizations and improved health outcomes.

Southcentral Foundation’s (SCF) innovative Nuka System of Care is a relationship-based and customer-owned approach that provides care to approximately 70,000 Alaska Native and American Indian people in Southcentral Alaska, including many with complex health and social needs. The Nuka System of Care places relationships with their patients — who they refer to as “customer-owners” — at the center of care delivery.

The Better Care Playbook spoke with two SCF leaders to learn how SCF’s approach to customer-owner engagement has evolved over the years and the role it plays in improving care and advancing equity across their system. Karen McIntire has worked at SCF for 26 years, currently serves as Vice President of Workforce and is also a customer-owner within the health system. Steve Tierney, MD, a family physician by training, serves as Senior Medical Director of Quality Improvement and Chief Medical Informatics Officer at SCF.