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Carrum Health has recently attracted nationwide attention for its approach to specialty care for large businesses, generating headlines late last year for expanding its substance use treatment offerings from opioid and alcohol use to a wide range of other drugs, including cannabis, cocaine and methamphetamine.

The company has built a name for itself with its “centers of excellence” model, which offers self-insured employers access to high-quality medical specialists in fields such as musculoskeletal, cardiology and oncology at a lower cost.

Centers of excellence are groups of doctors and medical facilities that Carrum, through its own research, deems best of class, negotiating discounts on behalf of employers.

Distinct from primary care, often called family, internal or pediatric medicine, specialties have been shown to consume a larger share of the nation’s health spending. One study estimated that 16.5% of all health care dollars went toward specialty care compared to 5.4% for primary care.

Finding ways to reduce the cost of specialty care, then, has long been seen as the key way to reduce the overall runaway cost of health care. Health management organizations, which require primary care doctors to address symptoms before referring patients to specialists, has been the main way that American medicine has tried to reduce specialty costs. But Carrum takes a different approach, negotiating high-quality care at a lower price.

It is an approach that is growing as businesses grapple with ever-higher health care costs. In October, Carrum announced that it covered 6.7 million patients in 2025, adding 3.6 million, and doubling its reach in a single year.

Though it is headquartered in San Francisco, Carrum has a strong San Diego connection. Its co-founder and chief executive, Sachin “Sach” Jain, moved here with his family in 2023.

Jain earned an MBA from the University of Chicago Booth School of Business and a bachelor’s degree in computer science from the Indian Institute of Technology in Delhi.

While the company has offices in the Bay Area and Chicago, most of its workforce is remote. Jain agreed to discuss Carrum during a recent company working retreat at the U.S. Grant Hotel in downtown San Diego.

Q: Carrum Health is based in San Francisco. How did you end up in San Diego?

A: Before San Diego, I was in the Bay Area for a decade, and that’s where we launched Carrum. Two and a half years ago, with the remote working environment, it just created an opportunity for me to live somewhere else, and I picked San Diego.

Q: So you just decided to move here because it seemed nice?

A: San Diego actually has a very special place in Carrum history. Today, we work with what we call centers of excellence providers across the country, but you need to start somewhere, right? Our very first center of excellence provider was Scripps Health. I got an introduction to the Scripps CEO, Chris VanGorder, and he was kind enough to pass along an introduction to the Scripps executive team. I got to meet some very good people who wanted to do something different in health care, and they kind of saw something in the dream we were sharing, and they raised their hands and said, “yeah, we will work with you guys.”

Q: So your first introduction to San Diego was coming down from San Francisco on work trips?

A: For the first couple of years, we would fly down here, I was living in the Bay Area at the time, and we would come in, you know, every few months to discuss what was working and what was not working, what we needed to change. Every time I’d come down here, I’m like, my heart rate goes down. It was something about the weather and the people, and so I kind of always had that in the back of my mind.

Q: Your training is in computer science. How did you end up founding a company that specializes in specialty medical care?

A: In 2009, after I finished my MBA, I took a job in the hospital revenue cycle space. They are hired by doctors to chase patients and maximize their reimbursement. Not growing up in the U.S., I was just shocked at the level of abuse, the level of just, you know, singlemindedness on how to maximize the reimbursement as opposed to thinking about how to make sure a patient has a good outcome. Today, and even 17 years ago when I was doing that job, patients have no idea who the good doctors are, whether they can trust a doctor, and, if they’re saying you need a procedure, whether you actually need that procedure. You think you have nice insurance, but after the procedure, you get a bill for the facility and a bill for the anesthesiologist and a bill for the surgeon and a bill for another surgeon you never met. When I saw how it worked, I was like, “this is just mind-bogglingly bad.” I’ve come to the U.S., the best-in-class economy, and found that healthcare here is surprisingly inefficient.

Q: How does Carrum Health try to fix that central inefficiency you observed working in health care revenue wrangling?

A: We decided that to bring the cost down in a sustainable fashion, we needed to start with quality. We needed to find the doctors who only do a procedure when it’s necessary, and when they do the procedure, the outcomes are best in class.

Q: How are you able to identify these doctors?

A: We sift through terabytes of data, both clinical and claims. We start with public data from Medicare, etc … and we look for the signals of providers who are doing good quality work. Once we find those providers, we go have a conversation with them, and we ask them if they want to participate in our model. If they say yes, we say, “OK, now you need to give us deeper data, clinical and everything else, on 50 different metrics and those vary based on which procedure we’re talking about.”

Q: Obviously, they’re not sharing personally-identifiable information, are they?

A: Exactly. The data is anonymized, but we analyze it, and we do a lot of AI work, to make a determination, you know, among these 50 surgeons, these 10 meet our quality standards. When we do a site visit, we interview those surgeons.

Q: Doesn’t that create some friction with doctors who you don’t select?

A: In the early days, it was a challenging discussion, but where we are today, there are more providers who want to work with us than we want to put on the platform.

Q: How does this arrangement work financially for those who do participate?

A: The top-tier doctors and health systems who work with us are willing to work at risk, meaning that if anything goes wrong with a procedure, they have to cover that cost free of charge. It provides an incentive to make sure the procedure goes correctly the first time, or they will lose money. And we also ask them to give us a price at which our employers are going to realize significant savings compared to what they would pay; it’s usually about half.

Q: Why would doctors, especially those who are determined to get the best results, agree to take less?

A: We tell them, “if you work with us in this market, you will be our partner for these procedures, and you will have an opportunity to win market share for these procedures from all other health systems in this market.” The other big factor is that they never have to worry about getting paid. With some insurance providers, you know, one procedure can generate like 30 bills and it can take 180 days, if not longer in some cases, before all of the bills are settled. We provide payment right after discharge.

Q: Carrum has built centers of excellence across nearly all medical specialties, and treatment of substance use disorders is the company’s most recent foray. There was a time when drug or alcohol addiction was grounds for dismissal. Why are companies now more interested in covering this type of coverage?

A: The reality is that roughly one out of six Americans has a substance use disorder. Employers cannot afford to just leave such a large part of their workforce by the side of the road. But treatment has been difficult. Employees, due to stigma, often do not want to be treated in the communities where they live; they want to go somewhere else. In the fee-for-service world, it’s rinse and repeat for providers. A patient can become sober, but the relapse rate is very high. We did what we do to find quality providers and we went to them and said, instead of paying you per visit, we’ll just pay for the whole episode, but if the patient relapses, we will penalize you for that.

Q: You grew up and earned your undergraduate degree in India. How has your upbringing influenced your view of health care in America?

A: India has a cash pay system where the person who is delivering the care and the person who is going to pay for it directly interact with each other. There is no middleman, no insurance company. You realize that the layers of middlemen between the consumers of health care and the providers of health care are just so many here in America that it’s difficult for a patient to know who is on their side.

Featuring world, West Coast, and San Diego premieres with post-film panel discussions with filmmakers, veterans, and subject-matter experts

The GI Film Festival San Diego marks 11 years of bringing films for, by, and about the military community to the big screen. This year’s military-themed film festival takes place May 6-8, 2026, at the Museum of Photographic Arts at the San Diego Museum of Art (MOPA @ SDMA) in Balboa Park.

This year’s three-day festival will feature 15 compelling films that explore service, sacrifice, and the lived experiences of service members and veterans, while also showcasing the creativity of veterans through films that tell stories outside of the military sphere. Each screening will include a post-film panel discussion, giving audiences the opportunity to hear from filmmakers and engage directly with the stories on screen, including conversations with actors, film subjects, and subject-matter experts. These discussions reinforce the festival’s mission to create conversations, expand the definition of service, break down stereotypes, and highlight the wide variety of experiences within the military community.

Connecting Communities Through the Power of Storytelling

For more than a decade, the GI Film Festival San Diego has been a time-honored tradition, bringing together service members, veterans, military families and caregivers, filmmakers, history lovers and movie enthusiasts to celebrate the art of military storytelling through film. The festival is widely recognized not only for its carefully selected films, but also for its truthful representation of military life, its ability to foster an environment of understanding and respect, and its commitment to showcase the creativity of veterans turned filmmakers. Each year, the festival presents a diverse lineup of films that highlight the experiences of service members and veterans, as well as the challenges that often go unseen in the lives of caregivers, spouses, and military children.

"Many service members and veterans around the world are facing challenges that can be difficult to talk about,” says Douglas Alberto Alvarado, LCSW, U.S. Army OEF veteran, GI Film Festival San Diego advisory committee member, and lead veteran peer counselor with Courage to Call. “Whether facing financial struggles, mental health challenges, family hardships, or simply feeling homesick, every service member and veteran faces obstacles. Events like the GI Film Festival San Diego create space for those stories to be seen, heard and discussed.”

This year’s festival lineup includes themes like transitioning back to civilian life, which is explored in the documentary short "Hope… In the Aftermath of War," directed by returning filmmaker and veteran Daniel Bernardi. The film follows a soldier grappling with trauma, addiction, and fractured family ties after returning from combat, forcing her daughter to confront the quiet war unfolding at home. Other themes include the search for peace and reconciliation, which can be found in "HOME FROM THE VIETNAM WAR." The documentary feature follows a decorated U.S. veteran as he returns to Vietnam with a friend who fled the war as a child. Together, they retrace the past, confronting former enemies and long-buried memories. Another theme throughout this year’s lineup is art as a path to healing, highlighted in films like “Ugo: An Artist at War.” The documentary feature follows Maxine Giannini as she preserves her late husband’s World War II drawings, including rare D-Day sketches, using art to honor service, memory, and healing.

Providing a Platform for Veteran Voices Through Cinema

For 11 years now, the country’s premier military film festival continues to bridge the military-civilian gap by helping audiences of all backgrounds better understand what it truly means to serve. The GI Film Festival San Diego provides a unique platform for emerging filmmakers to showcase their talents, welcomes returning creators, and draws both new and returning festivalgoers year after year. The festival serves as a creative cultural space for appreciating the art of film and for understanding the present-day and historical events that shape our lives and country, while spotlighting veteran filmmakers eager to share their passion for storytelling with a community of like-minded cinephiles.

“Every year that I’ve been involved with the GI Film Festival San Diego, I’ve seen firsthand the power this event has to open dialogue and create connections,” Alvarado says. “Audience members have the opportunity to share their experiences and find someone in the room they can relate to. This film festival is more than watching military movies. It’s a celebration of community, collaboration, and camaraderie. Whether it’s your first time attending or you’re a returning guest, it creates an environment that feels like home — a place to belong, to be seen, and to be heard.”

Since 2015, the military-themed film festival has presented more than 300 films by international, U.S., and San Diego County filmmakers, drawing in diverse audiences totaling more than 14,000 guests. Additionally, throughout its history in D.C. and San Diego, the GI Film Festival has welcomed notable personalities, including documentarians Ken Burns and Ric Burns, General (Ret.) Richard Myers, former Chairman of the Joint Chiefs of Staff; the late US Senator John McCain, actors Gary Sinise, Glenn Close, Matthew Marsden, Lou Diamond Phillips, Joe Mantegna, George Takei, Virginia Madsen and Jeffrey Wright. The GI Film Festival San Diego continues to honor service and amplify veteran voices, connecting filmmakers and audiences through powerful, human-centered stories.

Ways to Attend the GI Film Festival San Diego

Film screenings at the GI Film Festival San Diego are open to the public, and tickets are now available. Attendees may purchase individual screening tickets or multi-film ticket packages. General admission is $15 per screening, or $10 for military, veterans, and KPBS members. Because some films address sensitive topics, organizers recommend attendees be at least 18 years old.

For information on the 2026 film festival, how to attend, and ways to get involved, visit GIFilmFestivalSD.org. If you’re interested in becoming a sponsor of the GI Film Festival San Diego, contact GIFilmFestivalSD@kpbs.org.

About GI Film Festival San Diego

The GI Film Festival San Diego is a multi-day showcase of films for, by and about military members and veterans. Films featured in the festival reveal the experiences of service members, veterans and their families. The festival also provides veterans and service members with an opportunity to further their creative skills.

Documentaries, shorts, narratives, and feature-length films are presented. The festival includes international and local films. Local films feature San Diego’s filmmakers, events, people, or places.

Film screenings are followed by discussions with filmmakers, actors, documentary subjects, and/or subject-matter experts. The festival presents awards in multiple categories, honoring excellence in filmmaking. The festival is organized and produced by KPBS in partnership with the Film Consortium San Diego.

The 2026 GI Film Festival San Diego is funded in part by Creative Forces®: NEA Military Healing Arts Network, an initiative of the National Endowment in partnership with the U.S. Departments of Defense and Veteran Affairs. Creative Forces Community Engagement Grant program is managed by Mid-America Arts Alliance.

Official sponsors of the 2026 festival are the USAA Educational Foundation, Scatena Media Group, Singleton Schreiber, AMC Networks, Dexcom, The Elizabeth Hospice, US Bank and Verizon. Additional support is provided by the California Film Commission, National University, Navy League San Diego and Southwestern College.

KPBS is a member of the San Diego Veterans Coalition and the San Diego Military Family Collaborative.

About Film Consortium San Diego

The Film Consortium San Diego is a social venture that stimulates film and television production in the region and increases networking, employment, education, funding and distribution opportunities in film, television and new media. The Film Consortium hosts and organizes the annual San Diego Film Awards, San Diego Film Week, and Film Summit.

About KPBS

KPBS connects, reflects and serves all of our communities with trusted programming and dialogue. KPBS delivers this content to more than 1.3 million audience members weekly via multiple platforms, including television, radio, and digital media. As a public service of San Diego State University, education is a core value – from children’s programming to community discussions on important issues our region is facing, to local news coverage. KPBS provides stories that make us think, help us dream, and keep us connected. For more information, visit kpbs.org.

The following film lineup is listed in alphabetical order:

SAN DIEGO, CA — The U.S. Supreme Court Monday blocked California school policies that prohibit teachers from sharing students' preferred gender identities with their parents, a ruling that stemmed from a lawsuit originally filed by two Escondido middle school teachers.

In a 6-3 decision, the justices lifted a stay on a San Diego federal judge's ruling that barred the policies. The 9th U.S. Circuit Court of Appeals had stayed U.S. District Judge Roger Benitez's order from last December, pending appeal.

Elizabeth Mirabelli and Lori Ann West, who worked at Rincon Middle School, sued over policies that prevented teachers and other school employees from informing parents if their child might be transgender or gender nonconforming. Such information would include whether the child is using different pronouns or gender-specific names at school.

The plaintiffs -- which later came to include multiple parents -- challenged the policies on religious grounds, while attorneys for the state argued students whose gender identities are shared with their parents could face "substantial harm," particularly if those students are living in unsupportive home environments. Keeping such information private protects students from potential discrimination, abuse and harassment, the state argued.

The Supreme Court wrote in its ruling, "These policies likely violate parents' rights to direct the upbringing and education of their children."

Regarding the state's arguments focused on protecting vulnerable children, the ruling said its injunction "also permits the state to shield children from unfit parents by enforcing child-abuse laws and removing children from parental custody in appropriate cases."

Justices Sonia Sotomayor, Elena Kagan and Ketanji Brown Jackson dissented, and in her opinion, Kagan wrote that the court's ruling came too rashly, with a decision rendered without oral argument or allowing the 9th Circuit to issue a ruling on the case's merits.

"The Court is impatient: It already knows what it thinks, and insists on getting everything over quickly," Kagan wrote.

Kagan added that the "thorny legal issues" presented by the case could eventually show that the plaintiffs should be granted relief, but she wrote that the court had concluded the case without examining all the relevant facts.

The California Attorney General's Office could not immediately be reached for comment regarding Monday's ruling.

Peter Breen, head of litigation at Thomas More Society, a conservative law firm that represented the plaintiffs, said in a statement, "No more can bureaucrats secretly facilitate a child's gender transition while shutting out parents. California built a wall of secrecy between parents and their own children, and the Supreme Court just tore it down. This groundbreaking ruling will protect parents' rights to raise their children as they see fit for years to come."

— City News Service

and last updated 7:02 PM, Mar 03, 2026

SAN DIEGO (KGTV) – Lanes have been reopened following a deadly semi-truck crash and fire in Mission Valley Tuesday morning.

The incident was reported just after 6 a.m. on southbound I-805 at the transition to Interstate 8, according to the California Highway Patrol.

Details on what led to the crash were unclear, but the collision was followed by a fire that fully engulfed the semitruck — which was hauling almonds — at the freeway transition.

CHP officials added, “A combination of diesel and oil entered a storm drain. The spill did not affect any nearby waterways.”

The big rig's driver, who was not identified, died at the scene, according to CHP officials.

CHP Officer Sal Castro said, “The big rig was fully engulfed in flames when our officers arrived on scene. They did locate the big rig fully engulfed as a result of the crash … no other injuries to other drivers, just what appears to be property damage only.”

Brandi Munday told ABC 10News her car was parked below the freeway where the incident occurred. The crash and fire sent almonds raining down on her vehicle.

“I look on the bridge and there's literally like this mushroom cloud of smoke, like black smoke, and fire and flames,” Munday said. “When I came to move my car, there [were] literally almonds falling down it, like grazing my head.”

The nuts scattered all over her car, with some pieces smashing her engine and leaving a big dent – damage that Munday said will be expensive to fix.

Southbound I-805 lanes in the immediate area were closed for several hours due to the emergency response and clean-up.

The CHP San Diego Area is investigating the circumstances that led to the crash and fire.

CHP officials stated, “It is unknown if alcohol and/or drugs were a factor in the crash. A toxicology report is pending through the San Diego County Medical Examiner’s office.”

Copyright 2026 Scripps Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

A crucial Mountain West showdown is on tap tonight. San Diego State (19-11, 13-5) has been the class of the MWC in recent seasons. Even during a ‘down’ year, the Aztecs have what it takes to win another conference title. Standing in their way on Tuesday is Boise State (18-11, 10-8). The Broncos, while flawed, have proven they can take down quality opponents.

Boise State enters tonight as 1.5-point favorites (-105) over San Diego State. The total is set at 144.5 points on DraftKings Sportsbook. Here’s a college basketball pick, preview and prediction for Tuesday’s game between the Aztecs and the Broncos.

San Diego State vs. Boise State prediction, preview

As is almost always the case, San Diego State makes its mark on defense. The school ranks 16th in adjusted defensive efficiency on KenPom. That includes the nation’s seventh-best block percentage (15.7%) and eighth-best non-steal turnover percentage (9.5%). With that being said, this unit might not be operating at 100%. Aztecs guards Miles Byrd and BJ Davis are both listed as questionable to play tonight. Together, the pair have combined for nearly three steals per game. That’s without mentioning their stellar contributions on offense, as well.

If both or even one of Byrd or Davis sit out, it would leave SDSU in a predicament. The only other player on this roster averaging double-digit points is leading scorer Reese Dixon-Waters (12.6 PPG). However, one strength the Aztecs do possess is their depth. Ten different players are currently putting up at least 5.0 points per game. Expect more touches for defensively-minded center Magoon Gwath in this one. The big man has accounted for 8.8 points, 4.3 rebounds and 1.6 blocks this season.

San Diego State isn’t the only school dealing with injury uncertainty. Boise State forward Preston Carmichael is questionable to suit up tonight. Still, unlike their opponents, the Broncos are equipped to sustain some losses in the front court. Six different players in this rotation are listed as at least 6’7″. Unsurprisingly, that height has had a major impact on the glass. BSU owns a 54.1% total rebounding percentage, 23rd-best in college basketball. In comparison, the Aztecs sit at 129th (50.5%).

With that being said, the Broncos aren’t exactly a juggernaut. The program ranks 96th in college basketball with a 113.4 offensive rating. A team-wide 34.2% three-point percentage places them at eighth among all 12 Mountain West schools. Still, this is a fairly versatile offense. Four different Boise State players have accounted for at least 11.9 points per game. A name to watch is Drew Fielder, who currently leads the MWC with a 53.8% field goal percentage. He’s averaging 13.9 points and 5.6 rebounds per game.

When these rivals last met on January 3rd, San Diego State pulled out a dramatic 110-107, three-overtime victory. For two schools that pride themselves on defense, don’t expect another shootout. On the road, it’s already a tough challenge for the Aztecs. The potential absences of Byrd and/or Davis makes it difficult to trust the visitors. Back Boise State tonight as slight favorites at home.