Included Health has teamed up with Carrum Health to embed specialty care into Included Health’s alternative health plan, the companies announced on Tuesday.
Included Health provides virtual and in-person care, navigation and care coordination and 24/7 support for clinical and administrative needs. Its alternative health plan launched in February and is centered around primary care and provides costs upfront.
Through the new partnership, Carrum’s Centers of Excellence network will be integrated into Included Health’s alternative health plan. Included Health will identify when members require specialty care — including surgeries, cancer care and substance use disorder treatment — via primary care visits, communication through the app and claims data, and then refer them to Carrum for care.
After treatment, Carrum will transition the member back to Included Health.
The partnership comes as employers battle rising healthcare costs, with specialty care driving almost 50% of spending.
“What we see is that oftentimes, individuals, when they are touching the healthcare system, they just don’t know what to do,” said Matthew Eurey, chief commercial officer at Carrum Health. “Included has built a really great solution to help them to navigate all the pitfalls and the things that can go wrong, but employers see that a lot of their spend is coming from specialty care. … In order to help employers to bend the cost curve, we wanted to work with [Included] where we could take their great offerings, their great navigation capabilities, and be that outlet of support when life is happening in its trickiest moment.”
Included Health echoed these comments, stating that the company chose Carrum as a partner due to its ability to provide high-quality care while reducing costs.
“We want to make sure that we’re bringing the best healthcare to our clients, making sure that we are bringing them partners who can both continue to increase that quality and those outcomes, but also really help on that total cost of care piece, and a lot of that cost is driven by specialty care. … Carrum has done an exceptional job identifying high-quality providers who are able to deliver that in a value-based care way, and that then brings down the total cost of care, so that our employers can have a more sustainable way of delivering benefits to their employees,” said Dr. Ami Parekh, chief health officer at Included Health.
To track the success of this partnership, the companies will measure patient engagement, whether members are seeing improved outcomes and whether this lowers the total cost of specialty care, according to Parekh.
By working with Carrum Health, Included ultimately hopes to “raise the standard of healthcare for everyone,” Parekh added.
“We think really highly of Carrum and what they built when it comes to helping members get to high-quality specialty care that can lead to a more sustainable cost structure for purchasers, and I think this partnership is the start of that,” she said. “It is the start of bringing higher quality, more efficient specialty care to large populations.”
This partnership comes shortly after Included Health’s July announcement that it plans to acquire Firefly Health, a primary care and health plan provider. The deal will accelerate Included Health’s alternative plan strategy for employers, the company previously told MedCity News.
Photo: metamorworks, Getty Images
