Carrum Health Grows to 10M Covered Lives as Employers Demand Accountability Amid Arbitration and Cost Shocks

More than 70 Fortune 500 companies rely on Carrum to help combat a projected 9.2% cost increase in 2027

SAN FRANCISCO, Nov. 10, 2026 /PRNewswire/ -- Carrum Health, the leader in value-based specialty care, today announced it has grown to 10 million covered lives, winning 3.5 million new lives this year after doubling its covered lives in 2025. The growth trajectory reflects how employers are pivoting from paying for specialty care under the legacy fee-for-service model to holding providers accountable for cost and quality.

A triple squeeze on employers

• Employers keep underestimating costs: Specialty care is driving the steep increase, concentrated in hospital and physician care that tops half of U.S. health spending and grew faster than overall spending in 2024 (Centers for Medicare & Medicaid Services).¹ Employers have underestimated their costs three years running, budgeting for a 6.8% increase in 2025 and getting hit with 8.8%. For 2027, they project 9.2% before plan changes, with some industry estimates as high as 11% (Business Group on Health, Mercer, Aon, WTW).²
• Surging arbitration payouts: Payouts from independent dispute resolution (IDR), the federal process for settling out-of-network bills under the No Surprises Act, more than tripled from 2024 to nearly $15 billion in 2025, over six times what the same care would cost at typical in-network rates.³
• Costs shifting onto employer plans: With enhanced Affordable Care Act subsidies expired and $911 billion in federal Medicaid cuts ahead, hospitals make up for rising unpaid care by charging employer plans more.⁴

"Healthcare costs have outpaced inflation and GDP growth for decades, and most specialty care still gets paid in full whether it goes right or wrong," said Sach Jain, founder and CEO of Carrum Health. "CFOs can plan for high costs, but they can't plan for unpredictable ones. Our growth this year, with employers and the country's largest health plans, clearly indicates the market is done waiting for the system to fix itself."

Employers are acting on that frustration. Many have already pushed costs onto workers, with 44% of large firms raising workers' share of premiums this year (KFF).⁵ They are also tackling the cost of care itself: nearly all employers (92%) will use at least one value-based strategy by 2027, led by centers of excellence (COEs).⁶

Employers pivot to accountable specialty care

As COEs become the norm,⁶ the differences between them matter more. Three reasons employers are choosing Carrum:

• Breadth and depth across specialty care: Carrum's value-based specialty care network grew to 1,550+ COE locations in 2026, built on rigorous quality and accountability standards. The average member is 29 miles from the closest Carrum COE. The network now extends to full-spectrum musculoskeletal (MSK) procedures, cancer care, gastroenterology, general surgery, gynecology and substance use treatment.
• Built into benefits employers already use: Carrum now has 25+ partners across health plans, navigation, telehealth, digital MSK, cardiometabolic and behavioral health care, offering employers multiple ways to give members access to Carrum. They include three of the four largest national health plans, plus new partners Lyra Health for mental health and Virta Health for weight management. Most of these partners work with Carrum as their sole COE partner.
• Protection from arbitration and cost surprises: Arbitration costs tied to surgery-related care could exceed $2 billion nationwide by 2028, per federal IDR data and Carrum's employer claims analysis. Its all-inclusive rates are pre-negotiated for the entire surgical episode, including anesthesiology and radiology, two specialties driving the largest No Surprises Act payouts. These complete bundles insulate self-funded plans from the out-of-network billing gaps that trigger arbitration, unlike other COE programs that do not prevent this exposure. Under Carrum's unique model, providers also bear financial risk for outcomes with a warranty for complications and readmissions, so employers don't pay twice.

Carrum serves more than 300 employers across multiple industries, including more than 70 Fortune 500 companies, public sector employers such as state governments, and labor unions and their Taft-Hartley health funds. Public employers and union plans have less room to shift rising costs onto workers, so predictable pricing matters even more.

Impact on members

Roughly half of clients require Carrum for select procedures, and members give it consistently high Net Promoter Scores.

Carrum members pay little to nothing out of pocket for their episode of care, depending on their plan, so a major procedure doesn't come with a huge bill. They also get support from Carrum's own team: oncology nurse navigators for cancer care, licensed clinical counselors for substance use treatment, and care navigators for surgery who help members choose a COE, transfer records and book appointments by app or phone.

Cancer is now the top cost driver for 70% of employers, up from 58% a year ago.⁶ Carrum supports members through the full course of cancer care, from navigation and second opinions to treatment and survivorship. Coverage includes prohibitively expensive treatment, from chemotherapy and radiation to, now, CAR-T cell therapy, which re-engineers a patient's own immune cells to attack cancer and can be curative.

About Carrum Health
 Carrum Health's mission is to change how we pay for and deliver specialty care. We offer self-insured employers and plan sponsors a value-based specialty care solution that connects their members with a rigorously vetted network of Centers of Excellence providers. Carrum's upfront, all-inclusive bundled pricing, award-winning technology, and dedicated care navigation team help lower costs for both members and employers while delivering a superior member experience. Carrum is independently validated to reduce unnecessary procedures by as much as 30 percent, lower readmissions by 80 percent, and save employers up to 45 percent per episode of surgical care. Learn more at carrumhealth.com.

¹ Centers for Medicare & Medicaid Services, National Health Expenditures 2024 Highlights, January 2026.
² Business Group on Health, 2027 Employer Healthcare Strategy Survey, August 2026; Mercer, National Survey of Employer-Sponsored Health Plans (preliminary), September 2026; Aon, August 2026; WTW, August 2026.
³ The Wall Street Journal, July 22, 2026.
⁴ KFF, 2026; Congressional Budget Office, 2025; Mercer, September 2026.
⁵ KFF, 2026 Employer Health Benefits Survey, October 2026.
⁶ Business Group on Health, 2027 Employer Healthcare Strategy Survey, August 2026. 

Media contact:

Padma Nagappan

[email protected]

SOURCE Carrum Health