#USA #San Francisco #Carrum Health #Specialty Care #Centers of Excellence

Carrum Health's Major Expansion

Carrum Health, a leader in value-based Centers of Excellence (COE) for specialty care, has announced a groundbreaking expansion of its network. This strategic move places approximately 90% of Americans within a mere 50-mile radius of one of its over 1,000 centers. The expansion is designed to enhance access to high-quality specialty care, which now encompasses a range of services that account for around 40% of employers' medical expenditures.

The intricate nature of specialty care has increasingly demanded solutions that provide not only access but also quality, integrity, and transparency in treatment. Carrum Health has consistently maintained its reputation as a quality leader in the COE sector, utilizing its C.A.R.E. framework as a foundational aspect of this expansion. This framework underlines several principles:

1. Curated Quality Standards: Carrum imposes the most stringent quality protocols on facilities and physicians, ensuring that only the top 10% of providers are included in its network.
2. Focus on Appropriateness: Unlike traditional models that may prioritize profitability, Carrum incentivizes medical providers to recommend the most appropriate treatment plans tailored to each patient's needs.
3. Risk-Bearing Providers: Carrum is the first COE solution to link provider payments directly to patient outcomes across various treatment avenues, including surgeries and cancer care.
4. End-to-End Transparency: Employers can access clear, upfront information regarding the provider network and pricing, eliminating the uncertainty often associated with medical billing.

As healthcare costs skyrocket, with an anticipated additional 8% rise this year, the push for effective care solutions has intensified. Currently, specialty care represents a significant portion of employer healthcare expenditures, prompting nearly half of employers to consider adopting COEs to maintain costs and improve patient outcomes. According to Ellen Kelsay, President and CEO of the Business Group on Health, many employers in recent surveys have expressed their need for refined solutions that can manage escalating healthcare expenses while still delivering quality care.

Carrum's successful expansion while upholding its esteemed quality standards demonstrates its commitment to innovatively addressing the complex needs of the healthcare marketplace. The company has thoughtfully adjusted its COE model for various specialties, offering Premium COEs for complicated procedures, such as CAR-T cell therapy with complete bundled payments to ensure patient accountability. Moreover, local COEs are tailored for more routine treatments like colonoscopies, emphasizing ease of access for patients within their communities.

In detailing Carrum's newly launched service categories, it becomes evident that the expansion now encompasses:

• - Gastroenterology: Essential screenings and procedures like colonoscopies and endoscopies.
• - General Surgery: Offering a range of abdominal surgeries, including non-emergency appendectomies and gall bladder removals.
• - Gynecology: Procedures such as hysterectomies and fertility-preserving surgeries.
• - Pain Management: Prioritizing preventive care to reduce the need for invasive interventions.
• - Urology: Addressing both male and female specialized needs.
• - Ear, Nose, and Throat (ENT): Covering surgeries for conditions like deviated septum and tonsillectomies.

These offerings build on Carrum's existing specialties in musculoskeletal, bariatric, and cardiovascular care, alongside its innovative strategies in cancer treatment and substance use disorders. This holistic approach now effectively covers nearly the complete landscape of specialty care, significantly impacting healthcare expenses for employers.

According to Christoph Dankert, Carrum's Chief Network Officer, there is a pressing demand among employers for comprehensive solutions tailored to member needs that offer high-quality specialty services. By pioneering the COE model across diverse specialties, Carrum Health melds localized access with nationally recognized standards of excellence, reinforcing its status as a thought leader in value-based specialty care across the U.S.

About Carrum Health: The mission of Carrum Health is to innovate how specialty care is paid for and delivered. For self-insured employers, Carrum provides a value-based COE solution, connecting their members with a rigorously vetted network of specialty providers. With all-inclusive pricing, award-winning technology, and dedicated care navigation, Carrum effectively reduces unnecessary procedures, lowers readmissions, and saves employers substantially on surgical care episodes. Discover more at carrumhealth.com.