Continuation Intelligence Engine
Upload your specialty pharmacy claims. See what governance would find.
| Column | Description |
|---|---|
| member_id | De-identified member identifier |
| drug_name | Medication name (e.g., semaglutide 2.4mg, adalimumab 40mg) |
| therapy_category | GLP-1, biologic, behavioral, or oncology |
| monthly_cost | Monthly therapy cost in dollars |
| duration_months | Total months on therapy |
| last_reassessment_months | Months since last formal clinical reassessment |
| has_pa | Y or N. Is there a prior authorization on record? |
| dose_changes | Number of dose changes during therapy |
| lab_results_available | Y or N. Are recent lab results documented? |
| comorbidity_count | Number of documented comorbidities |
Which CGS v1.1 triggers fire across your population. A member can trigger multiple flags.
Flagged members by therapy category.
Members with 2+ triggers, sorted by annualized cost.
| Member | Drug | Monthly Cost | Duration | Triggers |
|---|
Directional estimates using Cadence Cohort 1 reference parameters. Not a savings guarantee.
GSV (Governance Signal Value) quantifies the economic shape of what governance makes visible. TAF-weighted by outcome type: Adjust 0.25, Taper 0.50, Switch 0.30. Blended TAF: 0.3458. RIR applied at 60% (Cohort 1 measured). 92% review completion rate. GSV is not a savings projection.
This is what a governance cycle would examine. No clinical determinations have been made. No member data was transmitted. The triggers identify where structured review is warranted.
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One 90-day cycle. Your population. Measured results.