How It Works · A Guided Tour

What happens when
someone is struggling.

A plain walkthrough of how Curated works — the gap most plans live with, the model in four steps, what an employer actually gets, and the warranty that stands behind it.

1 · The gap 2 · The model 3 · What you get 4 · The outcome
Step 1 · The Gap
Someone you cover is struggling. What happens next is nobody's job.

A member calls the number on the back of their card. They get a list. Nobody vetted those programs on outcomes. Nobody checks whether the level of care matches the clinical need. Nobody follows up 30 days later to see if it worked. They aren't failing to seek care — they're being routed into a system that can't receive them.

72%
of inactive behavioral health providers should never have been listed in the directory
HHS OIG, 2025 — ref 1
15%+
30-day behavioral health readmission rate, and nobody warranties it
AHRQ HCUP — ref 2
47.2%
of adults with mental illness received any treatment at all
SAMHSA NSDUH, 2023 — ref 3
Step 2 · The Model

Vet. Route. Measure.

Four moves close the gap between where the member is and where they need to be.

01

Vet programs on measured outcomes

Every facility in the network is credentialed on clinical outcomes, not just licensure — completion rates, readmission rates, 90-day sustained engagement. Programs that can't demonstrate results don't get in. Continuum is the first named SUD node inside the network: virtual buprenorphine continuity, vetted on retention, routed to like any other program.

Outcome-based credentialing
02

Assign one licensed navigator

A licensed clinical navigator is assigned at intake and matches the member to the right program at the right level of care. She confirms program fit, coordinates the referral, monitors engagement, and briefs the next program at every transition — no gap, no repeated intake. Not a call center. Not rotating staff. One person per member, for as long as they're covered.

One navigator, permanent
03

Price the episode, not the session

Care is sold as a bundled episode with a single price set before treatment begins — warranty reserve included. Centers of excellence replaced per-procedure billing with bundled pricing years ago; Curated applies the same model to behavioral health. The member pays nothing at the point of care.

Bundled episode · $0 member cost-share
04

Measure the outcome — then warrant it

Every episode is tracked to outcome: 30-day readmission, 90-day engagement, program completion, with PHQ-9 and AUDIT-C captured at intake, discharge, and 90 days. Then Curated stands behind the routing with a 30-day readmission warranty. Accountability is the difference between a fee and a warranty.

Measured · warranted
One Continuous Record

One member. One navigator. Three programs.

A walkthrough of a single episode chain — 174 days, seven events, one navigator who never resets. Watch the PHQ-9 depression score fall as the chain holds together.

D0
Day 0 · Intake

Routed to Curated, navigator assigned

Worsening depression and alcohol use. Navigator M.R. assigned at intake.

PHQ-9 · 22/27
D3
Day 3 · Placement

Matched to dual-diagnosis residential

Curated-vetted residential, ASAM Level 3.5. Bundle price locked before care begins.

D14
Day 14 · Check-in

Two-week clinical review

Engaging in group therapy. Medication adjustment working.

PHQ-9 · 16/27
D32
Day 32 · Transition

Residential discharge → IOP begins

Same-day transition. No gap, no new navigator, no repeated intake. M.R. briefs the IOP team.

PHQ-9 · 12/27
D84
Day 84 · MAT

IOP discharge → MAT begins

Third program, same navigator, same continuous record.

PHQ-9 · 8/27
D174
Day 174 · 90-Day Outcome

Sustained recovery

Employed, stable. No readmission. The warranty never had to trigger.

PHQ-9 · 5/27
PHQ-9 22 → 5. One navigator the whole way.

This chain is illustrative. It represents the designed care model — the names, scores, and timelines are not historical patient data.

Step 3 · What the Buyer Gets

Built for self-funded employers.

No per-session surprises. The warranty protects the plan. The dashboard shows every active episode.

$4–$7 PEPM

Access, volume-tiered

Platform, risk stratification, and navigator assignment. Member cost-share is $0 at the point of care.

Per episode · bundled

One price, set up front

A single bundled price for the episode chain, warranty reserve included, locked before care begins.

Live dashboard

Episode-chain visibility

Your benefits team sees every active episode and its phase, plus quarterly outcome reporting — PHQ-9, AUDIT-C, completion, and readmission.

Shared savings

Gain-share on outcomes

Curated earns when outcomes improve against your baseline — aligned incentives, not a flat fee with no accountability.

Step 4a · The Warranty

If a navigated member is readmitted within 30 days,
we pay.

Not a performance guarantee buried in a rider. A contractual warranty, reserved on our books, triggered by claims data — on SUD residential and acute psychiatric, the two categories where routing quality has the most measurable impact. Our margin depends on getting the routing right.

Step 4b · The Outcome

Care that someone is accountable for.

The member got one navigator who stayed. The programs were vetted on results, not just licensure. The price was set before care began. The outcome was measured — and warranted. That is the whole model: someone is finally responsible for what happens next.

References

1 HHS OIG, "Many Medicare Advantage and Medicaid Managed Care Plans Have Limited Behavioral Health Provider Networks and Inactive Providers," OEI-02-23-00540, 2025. Of inactive behavioral health providers, 72% should not have been listed in the directory at all.

2 Heslin KC, Weiss AJ. "Hospital Readmissions Involving Psychiatric Disorders, 2012." HCUP Statistical Brief #189. AHRQ, 2015.

3 SAMHSA, "National Survey on Drug Use and Health," 2023. Among adults with mental illness, 47.2% received treatment.

4 NCQA, "Behavioral Health Quality Measurement," 2024. HEDIS measures FUH and FUM remain core benchmarks. Curated outcome reporting includes PHQ-9, AUDIT-C, program completion rate, 30/90-day readmission rate, and navigator engagement metrics.

Sarah's episode chain is illustrative — it represents the designed care model, not historical patient data.