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Continuum · Payer pitch · 2026
Virtual-first OUD episode management

Continuum

One navigator · the entire episode · paid against retention

The prescription started.
The patient stopped. We don't.

North-star metric: 90-day retention continuumhealth.care · Kentucky & Ohio · Joe Nalley
02 · The stakes
An episode nobody manages

A buprenorphine prescription is not treatment. For most patients it is the start of a countdown — and nobody is managing it.

Two-thirds of patients fall out of treatment before it works. Not because the medication fails. Because the system that prescribes does not manage the episode. Nationally, 28.4% discontinue in the first month, before the medication has time to work, and 64.6% are gone by month six. The median first episode runs 77 days1. The prescription is one touchpoint in a treatment arc that spans months. Continuum manages the arc.

National buprenorphine retention, by month

48.4%retained at 90 days1
Month 1 (after the 30-day cliff)71.6%
Month 3 (90 days)48.4%
Month 635.4%

The drop happens early. Most of the loss lands before the patient is ever stable — which is exactly the window Continuum is built to hold1.

03 · The gap
The white space

Virtual prescribing solved access. It did not solve retention.

The Peterson Health Technology Institute assessed 16 virtual SUD solutions and was clear-eyed: virtual care matches usual care, at lower cost to deliver. What it did not move was retention — 13 additional days over six months, no improvement in treatment initiation2. Access is solved. Retention is the problem still standing.

Solved · the market handled this

What virtual MAT already does

  • Same-week access to a buprenorphine prescriber
  • Permanent telehealth induction, no in-person visit required3
  • Lower cost to deliver than usual care2
Open · no shipping product owns this

What none of them manage

  • The months between induction and a stable, retained patient
  • The missed session, the missed dose, the silent disengagement
  • One accountable person across the whole episode

The existing virtual providers optimize for the prescription. The episode goes unmanaged. Continuum is built for the open problem — with the management fee at risk against 90-day retention.

04 · The retention cliff
The retention cliff

The medication starts. The patient falls off — early, and fast.

28.4%

Discontinue in the first month, before stabilization.

PubMed 38400724
48.4%

Retained at 90 days — the national baseline Continuum is measured against.

PubMed 38400724
77 days

Median time in treatment for a first episode.

PubMed 38400724
Fig. 1

Retention over the first year — national baseline vs. the managed episode

National buprenorphine retention plotted against Continuum's targeted curve. The empty space between the lines is the value.1

+23 pts
retained at 90 days vs. baseline
RETAINED IN TREATMENT

National baseline: PubMed 38400724. Continuum curve is targeted, not yet observed at scale; the 71% 90-day figure is from an illustrative pilot cohort.

05 · The model
The model

One navigator. One record. The entire episode — induction to maintenance.

Three things move retention, and none of them is a faster prescription. A named person who stays. Structured virtual care that gives the patient somewhere to be. And the medication, prescribed and managed without an in-person gate.

01 · Continuity

Named navigator

The same clinical navigator coordinates from intake through 14-month maintenance. One person, one record, one continuous relationship. Not a call center. Not a rotation.

02 · Structure

Virtual IOP

Structured virtual intensive outpatient — group and individual sessions on a schedule, with attendance tracked and missed sessions followed up inside 24 hours. The patient has somewhere to be.

03 · Medication

Buprenorphine, managed

Induction and maintenance via permanent telehealth flexibilities — no mandatory in-person visit3. The prescription is managed across the episode, not handed off after the first fill.

Fig. 2

The episode, held by one thread

Induction, virtual IOP, step-down, and maintenance — with one navigator continuous beneath every phase.

intake day 0 one named navigator — continuous across every phase Retained stable, in maintenance
06 · The outcome
The number that matters

90-day retention, measured — against a national baseline, not a brochure.

One metric governs everything: did the patient stay through 90 days. Continuum reports it against the national buprenorphine baseline and against the 65% threshold the fee is at risk on.

71% 90-day retention

Pilot cohort, illustrative. Against a 48.4% national baseline — the same number on every report Continuum produces1.

48.4%
national 90-day baseline1
+23 pts
retained patients above baseline
65%
guarantee threshold the fee is at risk on

Fig. 3

National baseline 48.4% 65% target Continuum 71% 0% 50% 100%

Every quarterly employer report runs the same comparison: the cohort's retention, the national baseline, and the threshold. No moving the goalposts.

07 · Who it's for
Who carries this

Every payer carries the OUD episode. We start where the dollars and the will line up.

An untreated or undertreated SUD case costs employers an estimated $700,000 across care, lost productivity, disability, and replacement4. The treatment exists. The retention does not. That is the buyer's open wound.

Lead · 01

Self-insured employers

They carry the $700K case directly and feel it on the next renewal. A performance fee against retention is a clean, board-legible buy.

Lead · 02

Medicaid MCOs

KY and OH carry heavy OUD burden and weak retention. A managed-episode vendor paid on retention fits the value-based mandate directly.

Then

Commercial health plans

Same clinical gap, larger book. A regional plan without internal SUD episode capability is the natural second meeting.

Then

Stop-loss carriers

They underwrite the tail risk of the unmanaged episode. Retention that holds is a loss-ratio story they already price.

08 · The economics
Contract structure

One trigger. Retention. The fee is at risk against it.

No basket of soft metrics, no attribution argument. A single performance trigger the buyer already cares about, measured against a published national baseline.

Trigger 90-day buprenorphine retention. One number. Clears 65%, the fee is whole; below it, credit is owed.
Baseline 48.4% national. The published buprenorphine 90-day rate — the same figure on the website, the sample report, and this deck1.
Cap 10% of the management fee at risk against the threshold. The downside is bounded and disclosed up front.
Contract $700K–$950K annual managed-services engagement, scoped to cohort size, launching in Kentucky and Ohio.

A buyer's first objection to outcome vendors is attribution. We removed it.

Retention at 90 days is observable, the patient is either in treatment or not. The baseline is public. The threshold is in the contract. There is nothing to argue about at true-up, which is exactly why the fee can sit on it.

Why a guarantee, not a promise: a vendor only puts the fee at risk when it believes the model holds. The structure is the claim.
09 · The operator
THE OPERATOR
JN
Joe Nalley
Founder & CEO, Cadence, LLC

Built by someone who has carried the books this lives on.

Joe Nalley works across the medical and behavioral books that an OUD episode runs through — today as Staff Vice President of Carelon Growth (Elevance Health). Continuum is designed from that seat: the place where retention either holds or quietly becomes someone else's claim.

Across a career in managed care he has served more than 200,000 patients through population health and care management programs. He has built and shipped the patient-facing and payer-facing systems that hold an episode together — the navigator workflow, the accountability dashboard, and the quarterly report that puts retention next to the national baseline.

The result is a model that reads correctly to a payer because it was written by one: a single trigger, a published baseline, and a fee that stands behind the number.

200,000+
patients served across a managed-care career
1
performance trigger — retention
KY & OH
launch markets
10 · What's built
Already standing

This is a model with the machinery built, not a thesis on a napkin.

01 · The product

Navigator workflow, live

The named-navigator model, virtual IOP structure, and accountability dashboard are built and documented — the operating system the episode runs on.

02 · The proof artifact

Quarterly employer report

A complete reporting format that puts cohort retention against the 48.4% national baseline and the 65% threshold, with navigator-accountability and 42 CFR Part 2 compliance built in.

03 · The ask

First two markets

One pilot cohort in Kentucky, one in Ohio. Performance-backed from day one, so the buyer's first dollar is already at risk on the number.

11 · The ask
The ask

One cohort. One number.
The fee stands behind it.

We are placing the first Continuum cohorts in Kentucky and Ohio. The buy is a managed-services engagement, $700K–$950K, with the fee at risk against 90-day retention. We want one payer or employer willing to be measured.

If retention is the problem you keep paying for, the conversation is short: pick the cohort, name the threshold, and let the number settle it.

What a first meeting decides

  • The cohort — size, market, and member source
  • The threshold — the 65% retention bar the fee sits on
  • The baseline — the published 48.4% national rate, in writing
  • The term — pilot length and the quarterly report cadence
continuumhealth.care · Kentucky & Ohio
12 · Sources & notes
Sources & methodology

Every external number on these slides, cited.

National retention figures are observed and published. The Continuum 71% 90-day figure is from an illustrative pilot cohort and is labeled as such wherever it appears; the year-one curve in Fig. 1 is targeted, not yet observed at scale.

  1. National buprenorphine retention — 28.4% discontinuation in month one, 48.4% retained at 90 days, 64.6% gone by month six, median first episode 77 days. PubMed 38400724 (2024). pubmed.ncbi.nlm.nih.gov/38400724
  2. Peterson Health Technology Institute, assessment of virtual SUD solutions — care matches usual care at lower delivery cost; +13 days retention over six months, no improvement in treatment initiation across 16 solutions assessed (2024). phti.org
  3. Permanent telehealth flexibilities for buprenorphine induction without a mandatory in-person visit — DEA / SAMHSA telemedicine prescribing rules for controlled substances (2024–2025). deadiversion.usdoj.gov
  4. Per-case employer cost of untreated substance use disorder, estimated $700,000 across healthcare, lost productivity, disability, and replacement; SUD costs U.S. employers an estimated $438B annually. Avalere Health (2025). avalere.com
Continuum · Cadence, LLC dba Continuum · continuumhealth.care Pitch deck · 2026 · figures current as of build
Continuum One navigator. The entire episode. Paid against retention.