In 2020, Luis Martinez received an unexpected and devastating diagnosis of stage four kidney failure — the result of undiagnosed
"I was in a spiral," says Martinez, a network engineer who lives in Arizona. "I was referred to Mayo Clinic, and the psychologists there told me, 'Look, in order for you to get on a transplant list, you must be at a healthy weight. Not only that, for the transplant to work, it's better to be at a healthy weight that can be maintained, rather than having something else keeping you in that same position where you have hypertension and diabetes.'"
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Since no amount of dieting and exercise had worked in the past, he looked into bariatric surgery, only to find out it was not fully covered through his standard insurance. Out-of-pocket costs for the procedure can reach tens of thousands of dollars, and Martinez prepared himself to cash out his
But his employer, national security and technology company Peraton, offered another option through Carrum Health, a value-based Centers of Excellence platform that connects members with top healthcare providers across the U.S. who specialize in chronic conditions, including bariatric care. The only cost Martinez would incur was his deductible, which was $750.
"They said, 'You're going to have to go to California to get it done, but we'll help you with the travel and the hotel and anything else that you might need to get this surgery taken care of,'" says Martinez.
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Top quality, comprehensive care
Part of the initial process was seeing a psychologist and nutritionist, and over the next few months, Martinez worked with a patient care specialist at Carrum, part of their "white glove" approach, to make sure all information from these specialists, as well as his medical history, was sent ahead to the surgery team in California. Once there, he was blown away at the preparation and care taken to ensure a smooth experience.
"They had an entire medical team waiting for me [that] knew about my entire health history," he says. "Not only did they have the bariatric surgeon there, they had a nephrologist there, they had a cardiac surgeon there, even the director of the medical center was there to make sure that I was OK. They really treated me, my wife and my son like their own family. I am so grateful for that."
Carrum's model of working directly with highly-rated healthcare providers allows them to offer bundled, upfront pricing to plan sponsors. This, along with provider payment being based on outcome, helps reduce overall healthcare costs for employers and employees. As workers are leaning more on benefits leaders for help when it comes to finding cost-effective quality care, enabling access to an offering like this — and covering the expense — sets employers apart, says Brent Nicholson, Carrum's cofounder and chief growth officer.
"[It's] an opportunity to say, 'I'm not just going to put a health plan and a PPO network together and then leave it up to the employees to figure it out themselves,'" he says. "[Instead, we] put together a benefits portfolio, help you understand where to go, and make it stress free and remove the financial toxicity as much as [possible]."
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Providing peace of mind for employees
Martinez had his surgery in January 2024, and following its success, is now on dialysis while he
Adding Carrum to its benefits lineup has allowed Peraton to steer its employees away from care based on convenience, and toward that which provides better overall outcomes for both them and the company, says Bernadette Long, Peraton's senior director of benefits. Peraton has a Carrum landing page just for company employees to streamline the information process.
"Getting [employees] into centers of excellence in the country was definitely top of mind, and doing so in a way that they have a high touch, easy to use process with constant support was also important in making that decision," she says. "Lastly, I'd be remiss if I didn't call out the cost. It's definitely a big reason — the contribution to the long-term predictability of spend, having the final payments, leveraging transparency, and ultimately reducing the overall spend that the company has. It also impacts our employees and their family members as their spend is lowered at the same time."
For Martinez, who just celebrated his 10-year anniversary with the company, access to this benefit has solidified his belief in Peraton's commitment to his health and wellness.
"I'm so happy that I'm able to get out there and talk about this, because what Carrum and Peraton have done for me as an employee and for my family is very important," he says. "The loyalty I have for Peraton is immense. I cannot explain how grateful I am."
Luis Martinez's National Kidney Register page:
