"We pay them a $2,500 flat fee for the time that they spend with the patient and make that recommendation for no surgery. If you don't, then you've wasted their time." - Matt Eurey
Most of healthcare is paid for volume, so employers end up paying for surgeries that never needed to happen. When RAND studied Carrum Health's data, about 30% of surgeries were avoided once the first step was checking whether the patient actually needed one.
Matt Eurey ran benefits at Lowe's, which spent about a billion dollars a year on healthcare. He explains how Carrum pairs bundled prices with surgeon-held warranties and charges nothing per employee per month. He also covers why more than half of Carrum's new buyers last year made the program mandatory, and how the model extends to cancer and substance use disorder.
If surgical and specialty claims are driving your trend, this is the episode for you. Tune in.
Thank you to our 2026 sponsors!
ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/fully-insured-vs-self-funding-with-paretohealth-spencer-podcast/?utm_source=youtube&utm_medium=referral&utm_campaign=SelfFundedwSpencer to learn more.
Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more.
Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more.
Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com.
Chapters:
(00:00:00) Intro: Paying Surgeons Not to Operate
(00:00:20) Meet Matt Eurey and Carrum Health
(00:01:56) How Carrum Decides if Surgery Is Appropriate
(00:05:34) Rooting Out Perverse Incentives
(00:07:01) Running Benefits for 225,000 at Lowe's
(00:13:26) The Early Days of Care Navigation
(00:18:49) Why Matt Joined Carrum
(00:20:50) What Value-Based Care Actually Means
(00:26:33) Why Carrum Doesn't Use Benchmarks
(00:28:44) Zero PEPM: How Carrum Gets Paid
(00:30:28) Mandated vs. Voluntary Programs
(00:37:01) Can This Become the Standard?
(00:41:01) How Claims Flow Back to the TPA
(00:43:17) The Member Experience, Start to Finish
(00:49:03) Cancer and the Two-Year Warranty
(00:51:45) Substance Use Disorder Care in Hours
(00:56:14) Why Carrum Added Cancer and SUD
(00:59:44) Why Wouldn't an Employer Do This?
(01:01:33) What's Next for Carrum
(01:03:10) What Happens If We Don't Fix Costs
(01:05:08) Closing Thoughts
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