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GOVERNANCE PLATFORM

Nobody governs what happens
after the approval.

Authorization governs initiation. Nobody governs what follows — continuation, routing, or billing accuracy.
One portfolio for every renewal conversation.
65,234 patients measured Published methodology Three independent cohorts

Three structural gaps.
One governance layer.

Authorization decides whether care starts. Nobody governs what happens between the first dose and the renewal. Three products. Three layers. Each generates a governance certificate — documenting what happened, what it cost, and whether it worked.

At renewal, the portfolio replaces anecdotes with evidence. Not a report. A certified governance record.

Governance requires independence. The entities that process, pay, and profit from claims cannot certify their own accuracy. The same company that manages the pharmacy benefit cannot govern continuation. The same company that routes the referral cannot measure the outcome. That structural separation is the moat.

Three gaps. Three governance layers.
Each with its own data.

Every product generates a certificate. Together, they form the only portfolio that documents what happened between authorization and renewal.

showyourwork.health
Cadence
Continuation governance for specialty pharmacy
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ustekinumabvalid
secukinumabflagged
tofacitinibvalid
vedolizumabflagged
Cadence

Specialty pharmacy continuation governance. Three independent cohorts. Published methodology.

65,234
Patients validated
3
Independent cohorts
29.1%
Flag rate (primary cohort)
$13.9M
Governance signal value
Learn more
curatedhealth.care
curated
Care this serious has to be curated.
94%
COMPLETION
1
NAVIGATOR
30d
WARRANTY
curated

Episode-based behavioral health with outcome measurement at intake, discharge, and 90 days. 30-day readmission warranty.

1
Navigator. Every episode.
13
Clinical areas
$0
Member cost
30-day
Readmission warranty
Learn more
verifythebill.com
caliber
Seven checks. Before payment.
CPT/ICD alignment
Modifier validation
Unit count audit
Fee schedule match
Duplicate detection
Bundling review
Place of service
caliber

Independent pre-payment billing verification. Seven checks during the TPA hold window. Advisory-only.

4-6%
Billing inaccuracy (OIG)
7
Verification checks
$0
TPA integration
Pre-pay
Before payment
Learn more

Three certificates. One portfolio.
The renewal conversation that doesn't exist yet.

Cadence Governance Certificate
$13.9M GSV
30,734-patient primary cohort. 29.1% flag rate on continuation therapies refilling without documented clinical justification.
Curated Governance Certificate
90-Day Outcomes
Per-episode outcome data. Readmission warranty. Bundled pricing with no balance billing. Every referral tracked from intake to follow-up.
Billing Governance Certificate
$416K Prevented
Modeled overpayment prevention. Pre-payment coding verification. Charge-level accuracy audit before the claim is paid.
Governance Portfolio
Q1 2027
Illustrative
Gross savings identified $13.9M
Primary cohort 30,734
Episodes with 90-day data 100%
Readmission warranty claims Covered
Overpayment prevented $416K
Pre-payment verification 100%

Three cycles. Three certificates. One portfolio.

1
Each product runs its governance cycle independently.
Cadence reviews continuation. Curated manages episodes. Caliber verifies claims. No integration between them. No shared infrastructure. Each operates on its own data, its own standard, its own timeline.
2
Each cycle produces a governance certificate.
Documented evidence of what was measured, what was found, and what it cost. Sealed. Auditable. Independently verifiable.
3
At renewal, the portfolio replaces anecdotes.
One document. Three governance layers. Every claim documented. The renewal conversation shifts from "what are you doing about costs" to "here's what we governed and what it found."

What it costs. What it governs.

Each product stands alone. The value compounds when you run all three — one portfolio conversation at renewal.

Cadence
~$5 PMPM
Governed specialty members
Governs continuation on therapies refilling without documented justification. $13.9M signal identified in primary cohort. ~$300K annual at 5,000 specialty members.
Curated
Per episode + PEPM
Bundled behavioral health
Governs routing and outcomes for every behavioral health episode. 90-day measurement. 30-day readmission warranty. ~$775K annual at scale.
Caliber
Per claim verified
Pre-payment governance
Governs billing accuracy before payment. Seven checks during the TPA hold window. $416K modeled prevention. ~$700K annual at scale.
Combined Platform Economics
~$1.8M
Three governance layers. One client. One renewal portfolio.
Modeled Year 2 revenue. Cadence prices per governed specialty member (~5K within a larger population). Curated and Caliber price per member (10K and 15K respectively). Year 1 at pilot pricing is lower.
Lead with Caliber
Start with billing. No clinical change required, no network disruption. Caliber's modeled overpayment prevention covers the investment in year one. Then introduce continuation governance. Then episode routing.
First employers launching now.
Cadence DURA study complete and published. Curated provider contracts in progress. Caliber pilot scoped. First full-portfolio client targeted for Q1 2027.

The platform deck. The methodology.
The full thesis.

Joe Nalley
Joe Nalley
Founder — Cadence + Curated + Caliber

Six high-acuity clinical books at a top-three national payer. Oncology, MSK, CHF, maternity, autoimmune, dementia. Founded and sold ClearBill, a billing integrity platform that returned $9.2M to payers. CEO of a multi-service health system through acquisition — 200,000 patients, 13 locations.

Built the programs. Managed the risk. Designed the governance layer for each.

One conversation.
Three governance layers.
Your next renewal.

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What does governance look like
at your population?

Adjust the sliders. The calculator models each product independently, then combines them into a single portfolio ROI.

5,000 25,000 100,000
10% 18% 30%
$10M $100M $500M
50 200 500
Cadence
Continuation Governance
Specialty members 4,500
Flagged (25%) 1,125
Reviewed (92%) 1,035
RIR (60%) 621
$4.2M
Governance Signal Value
~$5.00 PMPM
Caliber
Billing Governance
Annual claims spend $100M
High-cost claims (20%) $20M
Inaccuracy rate (5%) $1.0M
Prevention rate (82.5%) 82.5%
$825K
Prevented Overpayment
~$38 per claim verified
Curated
Episode Governance
Annual episodes 200
Avg episode cost $18,500
Savings rate (25%) 25%
$925K
Episode Savings
~$3.08 PEPM
Combined Portfolio Governance
$5.95M
Total Governance Value
$450K
Estimated Annual Cost
13.2x
Combined ROI
Three governance layers. One portfolio document at renewal. Values are illustrative based on published methodology and modeled assumptions.