Governance Platform
Three structural gaps in employer healthcare.
One platform built to govern each.
One platform built to govern each.
Same buyer. Same renewal. Three independent layers that produce one portfolio.
Joe Nalley — Founder
Platform Overview — April 2026
The Problem
Three corridors in employer healthcare
that nobody governs.
that nobody governs.
Continuation
The prescription was approved. It refilled for a year. The continuation was never governed.
$97-156B ungoverned annual spend
Routing
The member needed care. They were sent wherever. Nobody measured whether it worked.
The wrong program is a routing failure
Billing
The claim was processed. It was about to be paid. No one verified the bill.
$1 spent recovering $0.25
Authorization governs the gate. What happens after is unmonitored.
02
Cadence
Structured governance for high-cost
therapy continuation.
therapy continuation.
IDENTIFY
CGS triggers flag patients for review. Population-level scan.
→
REVIEW
Independent clinical reviewer. Subspecialty matched. Advisory-only.
→
DOCUMENT
Sealed artifact. Immutable audit trail. Configuration fingerprint.
→
CERTIFY
Governance Certificate. Stop-loss ready. Board-ready evidence.
65,234
Patients validated
three independent cohorts
three independent cohorts
60%
RIR — trajectory
change identified
change identified
$13.9M
Governance signal
value across 34,500 members
value across 34,500 members
25-29%
Flag rate. Convergent
across all populations.
across all populations.
showyourwork.health · CGS v1.1 · $4.50-6.00 PMPM
03
Curated
One navigator. Every episode.
For as long as they're covered.
For as long as they're covered.
Independent BH care network. Licensed navigators match members to vetted programs. Bundled episode pricing. Outcome measurement at intake, discharge, 90 days. One navigator across every episode for as long as they're covered.
1
Navigator. Every episode.
For as long as you're covered.
For as long as you're covered.
13
Clinical areas. Crisis
to recovery to monitoring.
to recovery to monitoring.
$0
Member cost.
Zero. Always.
Zero. Always.
30-day
Readmission warranty.
SUD residential + acute psych.
SUD residential + acute psych.
curatedhealth.care · $4-7 PEPM · The independent BH network
04
Caliber
Measure twice.
Independent pre-payment claims verification. High-cost claims verified during the TPA's existing 14-60 day hold window. Seven checks by external credentialed reviewers. Billing Governance Certificate. Advisory-only.
4-6%
Documented billing
inaccuracy (OIG, AHLA, MGMA)
inaccuracy (OIG, AHLA, MGMA)
7
Verification checks.
Every claim above threshold.
Every claim above threshold.
$0
TPA integration.
Claims extract only.
Claims extract only.
$416K
Prevented overpayment.
Per 15K-life employer (modeled).
Per 15K-life employer (modeled).
verifythebill.com · BGS v1.0 · $2-5 PEPM
05
The Governance Portfolio
The renewal conversation that doesn't exist yet.
Stop-loss carriers price risk on what they can verify. This portfolio replaces assumptions with three documented artifacts — one per layer.
CADENCE
$13.9M
Governance signal value
across 34,500 governed members
across 34,500 governed members
CURATED
90 days
Post-episode outcome data
per member, per episode
per member, per episode
CALIBER
$416K
Prevented overpayment
per 15K-life employer
per 15K-life employer
One portfolio. The underwriter sees specialty pharmacy governed, behavioral health episodes measured, and claims accuracy verified. That is a different risk profile.
06
Platform Economics
One employer, three layers, zero incremental acquisition cost.
~$300K
Cadence alone
(Year 2 / ~5K governed members)
(Year 2 / ~5K governed members)
~$775K
Curated alone
(Year 2 / 10K lives)
(Year 2 / 10K lives)
~$700K
Caliber alone
(Year 2 / 15K lives)
(Year 2 / 15K lives)
~$1.8M
Triad
(same employer)
(same employer)
Acquire the employer once and layer all three. Each product stands alone. The portfolio is additive, not contingent.
Cadence revenue per governed specialty member (PMPM), not per total employee. Curated and Caliber priced per employee (PEPM). Employer sizes vary. All figures are Year 2 modeled estimates.
Pilot sequencing: Lead with Caliber — simplest value prop, fastest ROI. Caliber opens the door, then you introduce the other two layers.
Currently onboarding. First employer partners launching Q3 2026. SUD residential and claims verification first.
07
Joe Nalley
Founder, Cadence + Curated + Caliber
The Founder
Built the programs. Managed the books.
Then built the layer that was missing.
Then built the layer that was missing.
- 200,000+ patients. 80%+ residential completion. 90%+ IOP. Acquired by a national BH company.
- CEO, GetWell Health System: BH, primary, urgent, pain, lab, imaging, surgery, hospital
- Top-five national payer, six high-acuity clinical books. Both sides of the table.
- Three structural gaps. Saw them from inside. Built the governance layer for each.
08
The layer your plan is missing
across every high-cost corridor.
across every high-cost corridor.
Specialty pharmacy, behavioral health, billing accuracy — three corridors, no oversight. One conversation.
09