There’s not much predictability in healthcare costs, as anyone who’s ever shopped around for elective surgical procedures knows. Depending on geography, hospitals, physicians and insurance plans, the costs can vary widely for patients — who also worry about which option delivers the best outcome. Then there are the bills that roll in afterward for the costs you thought were covered but aren’t, the calls with the insurance company begin, and the consumer experience is only further degraded from here.
Carrum Health is working on solving this problem for self-insured employers, who want to lower their health benefits expense while improving the overall health and productivity of their employees. Carrum’s approach to systematically reducing the unreasonably high costs of common procedures while transforming the patient experience is why we decided to invest. Today, for every dollar spent by self-insured employers on health benefits, about 30 cents are spent on payment administration under the antiquated fee-for-service model. Carrum Health is approaching this problem with a recognition that fee-for-service (and quantity over quality) is crippling healthcare.
What appealed to us was Carrum Health’s combination of improved service for employers and members, intelligence gleaned from healthcare outcomes (the digital oil) and predictable costs. The company offers a concierge experience for members, connecting them to top doctors and hospitals. And bundled payments deliver self-insured employers the lower and predictable cost that’s lacking in much of healthcare.
Founded in 2014, Carrum Health’s mission is to bring common sense to healthcare with a bundled-payment model that’s mutually beneficial for providers, employers and their employees. The company offers bundled payments for planned surgical procedures, including musculoskeletal, cardiovascular and bariatrics.
Through its platform, Carrum Health is currently serving more than 400 self-insured employer groups, ranging in size from less than 1,000 to more than 180,000 employees. The company primarily focuses on the western United States, and is scaling nationally by adding more national employers.
Founder and CEO Sach Jain is a successful entrepreneur and a healthcare industry insider. He was previously a management consultant for Booz & Company, focusing on value-based care models — specifically, bundled payments.
Jain and the company have received multiple national awards and recognitions, including being honored as the winner of 2017 Harvard Business School-Harvard Medical School Health Acceleration Challenge. A committee of 24 clinicians, healthcare professionals, and academics specializing in health care and innovation evaluated participants over 15 months and picked Carrum as the winner because of its solution’s impact on cost and quality, scalability of the model and actual evidence of value delivered.
A handful of large progressive employers, such as Walmart, Boeing and Lowe’s Home Improvement, had originally set-up home-grown Center of Excellence programs. After that, a handful of players, including employer consortium groups, domestic medical tourism companies and carriers, started offering their own version of Center of Excellence solutions. In the absence of any standardization, the cost to set-up and run these programs is high, while employee adoption continues to be a challenge. None of the players has a technology and analytics platform to make the model scalable and more effective. Carrum’s Bundled Payment SaaS Platform is a leapfrog in this space and is akin to what Netflix has proven to be to the old service-oriented Blockbuster model.
Data is said to be the digital oil powering our future, and it has the capability of driving better care and predictability of outcomes. Carrum offers a continuum of data that makes the entire system more effective. By analyzing how employers are spending money on healthcare benefits, Carrum can curate the highest demand procedures for their members. Additionally, by leveraging predictive analytics to identify and engage employees who are on path to a surgical episode, Carrum significantly improves the program utilization. In turn, outcome data offers healthcare providers additional insight on how to keep improving service qualitatively and cost-effectively.
Minding the Traction Gap
We strategically invest in companies that are within the Traction Gap so we can help them during that critical time between launching a minimum viable product (MVP) and achieving minimum viable traction (MVT), on their way to scaling. With hundreds of thousands of covered lives, we invested in Carrum Health at MVP. The company is progressing well and now is in between minimum viable repeatability (MVR) and MVT.
We’re big believers in using technology to improve the care experience, expand access and lower costs. Private-sector companies, like Carrum Health, are building platforms that connect technology to healthcare outcomes and have a real impact on human lives. Carrum has a highly experienced team, a SaaS platform, and the passion and experience to succeed. Using predictive analytics to help employers lower healthcare costs, while ensuring members are getting quality healthcare, is a win-win scenario. We’re convinced that Carrum has discovered a formula for success and will lead the way in reshaping our nation’s approach to healthcare, one organization at a time.