A Guided Walkthrough

How Continuum manages
the entire episode.

Virtual prescribing solved access to buprenorphine. It never solved retention. Here is how Continuum closes the gap — one step at a time.

The problem · the model in 4 steps · what you get · the outcome
01
The Problem

Treatment starts. Most patients stop.

Two-thirds of buprenorphine patients fall out of treatment before it works. Not because the medication fails. Because the episode goes unmanaged.

28.4% discontinue in the first month1 — before stabilization, before the medication has time to work. By six months, 64.6% are gone.1 The median time in treatment for a first episode is just 77 days.1 This is not a medication problem. It is a continuity failure: the system that prescribes does not manage the episode.

28.4%
Discontinue in month one
PubMed 38400724
64.6%
Gone by month six
PubMed 38400724
77
Median days in treatment
PubMed 38400724
0% 25% 50% 75% 100% Intake M1 M3 M6 M12 65% TARGET Continuum 73% National 35% the gap = the value
Source: PubMed 38400724.1 National 90-day retention is 48.4%. Continuum targets are projected, not observed.
02
Why It Stayed Broken

Virtual care fixed access. Not retention.

There are 16 virtual SUD solutions on the market. The Peterson Health Technology Institute assessed them 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 initiation.2 That is the honest read, and it is the whole opening.

The reason is structural. The existing virtual MAT providers optimize for prescription access. The prescription is a single touchpoint in a treatment arc that spans months, and the rest of the arc goes unmanaged. Continuum is built for the open problem — with the management fee at risk against 90-day retention.

03
The Model

Identify. Treat. Retain.

Continuum is designed to manage the episode, not just the prescription. Every member gets a named clinical navigator from intake through 14-month maintenance. Four mechanisms carry it.

1

Named navigator continuity

The same navigator coordinates induction through 14-month follow-up. One person, one record, one continuous relationship. Not a call center. Not a rotation.

2

Structured virtual IOP

9 hours per week of evidence-based programming — CBT, motivational interviewing, relapse prevention, psychoeducation. The clinical program that lives between prescriptions.

3

Buprenorphine via permanent telehealth

The DEA/HHS final rule made telemedicine buprenorphine permanent, effective 12/31/2025.3 Audio-video or audio-only. No in-person at initiation; in-person within six months, coordinated by your navigator.

4

Measured outcomes, reported to you

AUDIT-C, DAST-10, PHQ-9, and GAD-7 at intake, discharge, and 90 days. Retention metrics. Completion rates. Quarterly aggregate reporting to your benefits team.

04
The Episode Arc

One continuous thread. Five phases.

The navigator thread is continuous across all five phases. If the patient relapses at month 14, the same navigator re-engages. The episode model does not reset. It extends.
NAVIGATOR THREAD · CONTINUOUS IDENTIFY INDUCTION IOP ACTIVE STEP-DOWN MAINTAIN
The same navigator carries the member across every phase — induction through maintenance.
05
What You Get

What you do. What you get.

What you do

Almost nothing. Identify Continuum as a benefit option in your SUD communications. Provide a warm referral pathway from your EAP or care management team. That is the full implementation — no tech integration, no carrier changes, no minimum volume.

What you get

Quarterly aggregate retention and outcome reports. Navigator accountability metrics. Completion rates by episode phase. Performance-guarantee tracking. A clinical program you can point to at renewal — proof you are governing the SUD population, not just covering the prescription.

Two views make this concrete. The navigator workspace is where one named navigator runs a caseload — episode timelines, scheduled tasks, alerts that escalate when a session is missed, and clinical notes tracking COWS, UDS, and PHQ-9 over time. The quarterly employer report is what lands on the buyer's desk at renewal — referred, inducted, and retained counts, retention against target, aggregate outcome scores, and an equity check across subgroups.

06
The Outcome

Paid against retention, not prescriptions.

The fee is at risk against a single, auditable trigger: 90-day retention. The target is 65%, against a 48.4% national baseline.1 The gap between those two numbers is the value Continuum is built to capture.

The Guarantee

If retention falls below threshold, we credit the fee.

Enhanced fee-for-service with a capped performance guarantee. One trigger, one metric: retention. Bounded, auditable, not open-ended — and we publish the result either way.

65% Target
90-day retention target versus the 48.4% national baseline. The gap is the value.
Fee at Risk
Management fee credited if the threshold is not met. Continuum carries the clinical execution risk.
Published Either Way
A binding falsification criterion. If the model does not beat baseline, we say so. Public, measurable.

90 days. Measured. Fee at risk.

Kentucky launch, expanding to Ohio. Designed to prove the model on a defined population before scaling.

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Sources

1 28.4% discontinue in month one; 64.6% gone by month six; median 77 days; national 90-day buprenorphine retention 48.4%. PubMed 38400724 (2024).

2 16 virtual SUD solutions assessed; virtual care matched usual care at lower cost, adding 13 days over six months with no improvement in initiation. Peterson Health Technology Institute assessment.

3 DEA/HHS final telemedicine rule for buprenorphine access, permanent, effective 12/31/2025. SAMHSA / DEA.

Continuum's 65% and 73% retention figures are model targets, projected, not observed results. The patient arc and workspace shown are illustrative of the model, not a specific patient.