Relocalizing Health with Dave Chase

Welcome to Relocalizing Health! In this episode, Dave Chase sits down with Claire Brockbank, a trailblazer in transforming healthcare costs and outcomes through community-driven strategies. From helping Colorado’s mountain towns slash exorbitant insurance prices with Peak Health Alliance to leading one of the largest union health funds in the nation at 32BJ, Claire Brockbank has proven that local communities, armed with the right data and determination, can take back control from hospital monopolies and insurance giants. 
Together, they explore the power of direct contracting, the critical role of transparency and accountability, and innovative programs like 32BJ’s $40 baby initiative. 
Listen in for practical lessons and inspiration on how you, your organization, or your community can challenge the status quo and drive real, measurable healthcare change.

Timestamps:
00:00 Addressing High Health Care Costs
04:17 Fair pricing for hospital negotiations
09:40 Using data in negotiations
12:47 Direct health care negotiations
16:13 Overcoming Challenges with Claire and 32BJ
18:37 Launching the maternity program
22:01 Addressing healthcare inequalities
23:43 Negotiating healthcare savings and impacts
26:59 Claire's leadership in health cooperatives

Claire BrockBank - https://www.linkedin.com/in/claire-brockbank-17b7901/
32BJ Health Fund - https://health.32bjfunds.org/
Learn More:
RosettaFest 2026 - https://rosettafest.org/
Health Rosetta - http://healthrosetta.org/
Nautilus - https://www.nautilushealth.org/
Kynexions - https://kynexions.com/ 
Dave Chase - https://www.linkedin.com/in/chasedave/
Podcast Website - https://relocalizinghealth.com/

Rosen Hotels & Resorts is a family hospitality company in Orlando, Florida, built by Harris Rosen, the son of immigrants who grew up on New York's Lower East Side. During the oil crisis in the 1970s, he bought a bankrupt Quality Inn on International Drive with a modest down payment and a lot of nerve. By the early 90s he had built a real company. And like every other employer in America, he was getting hammered by healthcare increases.
His workforce reflected the hospitality industry in Central Florida: a lot of immigrants, many of whom had never had access to a modern healthcare system. The traditional insurance model was punishing them with high deductibles, rising premiums, and surprise bills, in an industry where people live paycheck to paycheck.
So Rosen and his CFO, Frank Santos, now the company's CEO, asked a question almost nobody asks: what if the hundreds of millions going into bureaucracy went to caring for people instead? They converted part of an accounting office into a clinic with one part-time doctor. Their broker told them to stay in the insurance pool. Industry veterans said an employer couldn't deliver care without going broke or going substandard.
Three decades later, that accounting-office clinic is a 12,000-square-foot medical center. Rosen employees see a doctor on the clock, not on their own time. Deductibles and co-pays went down while the rest of the industry raised them. Per-employee healthcare costs run 55 percent below industry norms, sustained for thirty years. Total savings: $570 million and counting.
Rosen never kept the savings. They poured them into Tangelo Park: free preschool, free daycare, fully funded college scholarships for an entire neighborhood. High school graduation rates that used to be unacceptably low now sometimes hit 100 percent. Crime dropped 80 percent.
If a mid-sized hotel company in Orlando can build this, "we're not a healthcare company" stops being an excuse. It is just a story we tell ourselves.
Kenneth Aldrich, Rosen's clinical leader since 1998, and Carolyn Grant from Rosen's care team will be at RosettaFest 2026, July 29 to 31 in Nashville at the Gaylord Opryland. They will be in the room. So will the playbook.
Key Takeaways:
Harris Rosen bought a bankrupt Quality Inn on International Drive in Orlando during the 1970s oil crisis and built Rosen Hotels & Resorts from it
Facing a steep renewal increase in the 1990s, Rosen and CFO Frank Santos converted part of an accounting office into a clinic with one part-time doctor, against their broker's advice
That clinic is now a 12,000-square-foot medical center, built in part on fully functioning used equipment bought at 10 cents on the dollar
Employees see their doctor on the clock, get free rides to appointments, and complex health needs (60 to 72 percent of pregnancies now classified high risk) are treated as a design problem, not a liability
Rosen's opioid prescription rate runs at one-sixth the typical US employer rate, a pattern Dave Chase investigated for his book The Opioid Crisis Wake-Up Call
Healthcare costs have stayed essentially flat at the rate of inflation for three decades; per-employee costs run 55 percent below industry norms
Total savings: $570 million and counting, benchmarked against comparable Orlando hospitality employers
Employee weekly contribution is about $16.66; turnover runs at one-sixth the industry rate; workers' comp costs were cut in half
The Tangelo Park Program funds free preschool, daycare, after-school care, and fully funded college scholarships for an entire neighborhood; economist Lance Lochner measured a 7-to-1 return on the investment
The model has since spread into Parramore and the historic Eatonville neighborhood, and other Orlando employers have followed, including Second Harvest Food Bank and the School District of Osceola County, which saved $21 million in its first two years
Resources Mentioned:
The Opioid Crisis Wake-Up Call by Dave Chase
Relocalizing Health by Dave Chase: pre-order on Amazon now
RosettaFest 2026: RosettaFest.org - Rosen's clinical and care leadership will be in Nashville
Subscribe and Follow: Relocalizing Health Podcast, available on all major platforms.

Learn More:
RosettaFest 2026 - https://rosettafest.org/
Health Rosetta - http://healthrosetta.org/
Nautilus - https://www.nautilushealth.org/
Kynexions - https://kynexions.com/ 
Dave Chase - https://www.linkedin.com/in/chasedave/
Podcast Website - https://relocalizinghealth.com/

In the late 1990s, the Alaska Native Medical Center was a tuberculosis sanatorium turned healthcare facility where elders described themselves not as people, but as numbers. One elder remembered it clearly: "I was number 24601. My newborn daughter was 24602. When my aunt passed, they gave her number to another baby."
That was the system April Kyle grew up in. She avoided that hospital as a child because going was a horrible experience. Six-hour waits were normal. Six-week appointment backlogs were standard. The worst health outcomes in the United States.
April Kyle now runs it.
What happened between those two realities is one of the most documented, most studied, most awarded healthcare transformations in the world. People fly in from Singapore, Sweden, and across the globe to understand how the Southcentral Foundation and the Alaska Native community it serves built the Nuka System of Care, a model so far ahead of conventional medicine that it has won the Malcolm Baldrige National Quality Award twice. The only healthcare organization in America to do so.
This episode tells that story. Not the awards. The ownership. The decision to stop calling people patients and start calling them customer-owners. The moment a new nurse leader said we were going to see anyone who needs care the same day and her colleagues thought leadership had lost their minds. Within six months it was just how things worked.
Emergency room visits down 45 percent. Hospital admissions down 53 percent. Specialist use down 65 percent. Quality scores went from the bottom fifth percentile to the 75th and often the 90th percentile. Childhood immunization at 93 percent. Diabetes complications down 25 percent. Customer-owner and employee satisfaction both hovering around 95 percent. Total cost running 20 to 30 percent below national averages. In Alaska. In one of the most expensive geographies in the country.
And over half the employees are now Alaska Native people. The health system became an engine of community wealth building.
April Kyle is flying from Alaska to RosettaFest 2026 in Nashville, July 29 to 31, to share this story in person. She will be in the room.
Key Takeaways:
South central Foundation serves 70,000 Alaska Native people across an area the size of Sweden
The transformation began when the community took ownership of a system that had been poorly serving them
The single most powerful shift: they stopped using the word patient and started calling everyone a customer-owner
Dr. Douglas Eby, Chief Medical Officer: "When you're a patient, things are done to you. When you're a customer, you have a choice. When you're an owner, you have control."
April Kyle's leadership philosophy: "I'm not the expert at what services should be delivered. I need to be an expert at how to be driven by the community."
Same-day access for anything achieved within six months of committing to it, from a six-week waitlist
They spend 10 times the usual amount on training, coaching, and mentoring
ER visits down 45 percent, hospital admissions down 53 percent, specialist use down 65 percent
Quality scores from the bottom fifth percentile to the 75th to 90th percentile
Total cost 20 to 30 percent below national averages despite Alaska's high-cost geography
The community decides: mammogram scheduling was moved from fall to February because the women of one island community said so, and they were right
Copying the tactics is easy. Copying the ownership model is what most systems cannot do.
April Kyle joins the main stage at RosettaFest 2026 in Nashville
Resources Mentioned:
Relocalizing Health by Dave Chase: pre-order on Amazon now
South central Foundation and the Nuka System of Care: southcentralfoundation.com
RosettaFest 2026: RosettaFest.org April Kyle joins the main stage
Previous Relocalizing Health podcast interview with April Kyle: search the feed
Subscribe and Follow:
Relocalizing Health Podcast — available on all major platforms.
Learn More:
RosettaFest 2026 - https://rosettafest.org/
Health Rosetta - http://healthrosetta.org/
Nautilus - https://www.nautilushealth.org/
Kynexions - https://kynexions.com/ 
Dave Chase - https://www.linkedin.com/in/chasedave/
Podcast Website - https://relocalizinghealth.com/

Welcome to another episode of Relocalizing Health! This week, Dave Chase sits down with Allison Duncan, founder of Anau Health and architect of transformative maternal health models, to explore why the current U.S. maternity system is failing women by design and how we can radically improve it. From her eye-opening journey mapping world-class maternal care in Brazil to building community-driven solutions in Pickens County, South Carolina, Allison Duncan shares powerful insights about the cost, human toll, and missed opportunities in our current system. Together, they discuss how integrating social care with clinical support, rethinking payment structures, and harnessing local leadership can revolutionize birth outcomes and create brighter futures for mothers, babies, and communities everywhere. If you care about the future of healthcare and want to learn what it takes to reclaim maternal health from the ground up, you won’t want to miss this conversation!

Timestamps:
00:00 Exploring maternal care issues
07:15 Challenges in Indigenous Maternal Healthcare
09:17 Innovative maternity care in Brazil
11:55 Rising Risks in Pregnancy and Birth
16:51 Addressing maternal mortality causes
20:00 Cost of NICU and preterm births
22:01 Reducing preterm birth costs
26:09 Finding a local design partner
27:55 Helping women achieve economic independence
33:37 Redesigning healthcare payment models
35:34 Introducing Strong Mama, Strong Babies
38:01 Issues in Payment Model

Learn More:
RosettaFest 2026 - https://rosettafest.org/
Health Rosetta - http://healthrosetta.org/
Nautilus - https://www.nautilushealth.org/
Kynexions - https://kynexions.com/ 
Dave Chase - https://www.linkedin.com/in/chasedave/
Podcast Website - https://relocalizinghealth.com/

Welcome to a special series within Relocalizing Health as we count down to RosettaFest in Nashville, July 29 to 31. Each one of these is a quick look inside the book and the communities that inspired it. Real places, real numbers, real people who decided to stop waiting for someone else to fix healthcare and just built something better themselves.
If you don't have your ticket to Nashville yet, go grab it at RosettaFest.org. This is where the people in these stories will actually be in the room with you.
Here's more about today's special episode
Phifer Incorporated is a family-owned manufacturing company in Tuscaloosa, Alabama. About 1,200 employees. They make aluminum, fiberglass, and polyester screening — the window screens in your home, the sun-shading fabric on your lawn furniture. They are also the last remaining made-in-USA manufacturer in their category.
And they figured out something most Fortune 500 companies still have not figured out about healthcare.
This episode is the story of Russell DuBose, VP of HR at Phifer, who refused to treat healthcare like a force of nature he could not touch. He looked at the glide path the company was on in the mid-2010s and saw a future where benefits became unaffordable to the plan and the people on it. So he did what any manufacturing leader would do. He treated it like a supply chain problem and applied the same lean six sigma rigor he would to any production deficit on the factory floor.
What followed was a seven-year roadmap, a zero-cost-share on-site clinic, direct contracts with the best providers, a transparent pharmacy, nurse navigation, scholarships for employees' kids, summer enrichment programs, childcare support for working families, and five straight years of essentially flat healthcare spending. The Plan Grader score went from 37 to 74. Retirement readiness climbed more than 20 points.
And then a benefits decision at a screen manufacturing plant in Tuscaloosa turned into a national voice. Russell testified before the House Energy and Commerce Committee on ERISA and chairs the Alabama Employer Healthcare Consortium, helping spread the model to other employers across his region and state.
If a 1,200-person manufacturer in Alabama can do this, the excuse that you are not big enough stops being a reason. It is just a story we tell ourselves.
Russell DuBose is a co-leader of the Employer Track at RosettaFest 2026, July 29 to 31 in Nashville at the Gaylord Opryland. He will be in the room. So will the playbook.
Key Takeaways:
Phifer Inc. is the last remaining made-in-USA manufacturer in their screening category
Russell DuBose reframed healthcare as a supply chain problem and applied lean six sigma rigor to it
The 2017 read of The CEO's Guide to Restoring the American Dream gave him the blueprint
First Plan Grader score was 37 out of 100. Most employers start between 5 and 17.
The Phifer Cares Clinic opened in 2019 with zero cost share for advanced primary care. Within months it was running at 88 percent daily capacity with 58 percent of eligible members actively using it
Five straight years of flat healthcare spending through inflation and high-cost cancer claims
Savings reinvested: scholarships for employees' kids (100-plus students to college), summer enrichment for hundreds of children, eliminated pharmacy co-pays for 1,700-plus patients, childcare support for 250-plus working families
Plan Grader improved from 37 to 74
Russell testified before the House Energy and Commerce Committee on ERISA
He chairs the Alabama Employer Healthcare Consortium
Resources Mentioned:
Health Rosetta Plan Grader: healthrosetta.org
Nautilus Health Institute: open-source tools and frameworks
Relocalizing Health by Dave Chase: pre-order on Amazon now
RosettaFest 2026: RosettaFest.org — Russell DuBose is a co-leader of the Employer Track
Learn More:
RosettaFest 2026 - https://rosettafest.org/
Health Rosetta - http://healthrosetta.org/
Nautilus - https://www.nautilushealth.org/
Kynexions - https://kynexions.com/ 
Dave Chase - https://www.linkedin.com/in/chasedave/
Podcast Website - https://relocalizinghealth.com/