GEAEROSPACE
Prepared by
Joe Nalley
show your work.

Healthcare cost governance for a workforce
that just forced you to absorb the bill.

Your UAW contract locked you into five years of premium absorption. These four programs bend the curve you committed to paying for.
joe.nalley@showyourwork.health · joe-nalley.com
Confidential · Prepared exclusively for GE Aerospace · Not for distribution · June 2026joe.nalley@showyourwork.health
Joe Nalley
02
Your Workforce

53,000 employees. A near-strike.
Healthcare costs are a board-level problem.

36%
Jump in healthcare expenses reported by UAW members since 2021
UAW Local 912 / Reuters Sept 2025
53K
Global employees. Manufacturing, engineering, and production workforce.
GE Aerospace 10-K 2025
5yr
New UAW contract with GE covering "nearly all healthcare premium increases"
GE-UAW Ratification Sept 2025
$0
Net premium increase passed to union members. GE is absorbing the escalation.
UAW Contract Summary 2025
Strike
Authorization vote passed. Healthcare costs were the central bargaining issue.
Reuters / IndustryWeek Sept 2025
KY/OH
HQ Evendale, OH. Operations in Erlanger, KY. Both in our operating geography.
GE Aerospace corporate filings
Your workforce authorized a strike over healthcare costs. You absorbed the premium increases to keep production lines running. Now you need to bend the curve you just committed to paying for. The math only works if the underlying spend changes.
All figures sourced from public filings, union disclosures, and industry reporting. We verify against your claims data during pilot.02 / 12
Joe Nalley
03
The Gap

You committed to absorbing premiums.
You don't yet have the tools to earn it back.

Premium absorption without cost governance

You agreed to cover nearly all premium increases for five years. That's a fixed commitment against a variable cost base. Without pre-payment verification on high-cost claims, billing discrepancies compound year over year against a budget you can't pass through to members.

Specialty Rx at 53K lives

Smaller headcount means specialty pharmacy is a proportionally bigger cost driver. A single biologic therapy can run $80K-$150K per patient per year. Without continuation governance, patients stay on high-cost therapies past clinical utility. At your scale, 20 ungoverned specialty patients can move the annual trend line.

Manufacturing workforce behavioral health

Shift work, physical labor, high-pressure production targets. The clinical profile maps to elevated rates of depression, anxiety, and substance use. Standard EAPs offer 6-8 sessions. That covers triage. It doesn't cover residential SUD, IOP, or the chronic behavioral health episodes that drive real cost.

SUD risk in production environments

Aerospace manufacturing demands precision under physical strain. Repetitive motion injuries, back injuries from heavy component handling, and ergonomic stress create the injury-to-opioid pipeline. With operations in Ohio and Kentucky — two states with the highest OUD rates nationally — the geographic risk compounds the occupational risk.

Healthcare costs nearly shut down your production lines in September 2025. The contract bought labor peace. It didn't fix the underlying spend. The cost curve you committed to absorbing is still pointing up.
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Joe Nalley
04
The Portfolio

Four programs. Each independent.
Each designed to prove itself in 90 days.

Lead Program

Caliber

Pre-payment billing verification — advisory-only claims governance
Verifies high-cost claims (>$25K) before payment using a seven-check Billing Governance Standard — CODEVAL, DUPCHECK, RATEVAL, DURVAL, CREDVAL, SVCVAL, BUNDLEVAL. Issues a Billing Governance Certificate. Advisory-only — never denies claims, routes findings to your team. Independent of your TPA. Every dollar saved directly offsets the premium absorption commitment.
4-6% expected discrepancy rate · 10 business day turnaround · verifythebill.com
Lead Program

Cadence

Specialty pharmacy continuation governance — auditing therapies past clinical utility
Audits high-cost specialty therapies (biologics, oncology, autoimmune, rare disease) for clinical continuation appropriateness using the Cadence Governance Standard (CGS v1.1). 65,234 patients across 3 locked cohorts including NIH All of Us federal validation. 29.1% flag rate. Published in Pharmacy Times, April 2026. At 53K lives, specialty Rx is your fastest-moving cost category.
$14.3M first-cycle savings value · 55-60% Review Influence Rate · $3–6 PEPM volume-tiered
Supporting Program

Curated

Independent behavioral health navigation with readmission warranty
One named navigator per member across every BH episode — acute psych, IOP, PHP, residential SUD, eating disorders, PTSD. 13 clinical areas. Quality-scored provider database across 13 clinical areas. 30-day readmission warranty on SUD residential and acute psych. Not an EAP. Not a referral list. Episode-chain continuity.
200K+ patients managed · 80%+ residential completion · Single-digit readmission · curatedhealth.care
Supporting Program

Continuum

Virtual-first OUD/SUD treatment with buprenorphine and navigator continuity
Delivery-anchored virtual MAT program. Buprenorphine via permanent DEA telehealth pathway. Named navigator manages full episode — intake through stabilization through step-down. Built for the injury-to-opioid pipeline in manufacturing. 42 CFR Part 2 compliant. KY and OH operations — your geography.
9/week IOP standard · 42 CFR Part 2 compliant · Fee-first, earning into risk · continuumhealth.care
Each program operates independently. Adopt one, two, or all four. No bundling requirement. No platform lock-in.
04 / 12
Joe Nalley
05
Caliber · Claims Verification

You committed to absorbing premiums.
Every billing error comes out of that commitment.

Pre-payment, not post-payment

Standard claims audits catch errors after you've already paid. Caliber verifies before the check clears. Seven-check Billing Governance Standard applied to every claim above $25K. The discrepancy is caught before it becomes an overpayment you have to chase.

Advisory-only

Caliber never denies a claim. It issues a Billing Governance Certificate with findings and routes them to your benefits team. You decide what to do. We don't touch the payment — we verify the bill. Independent of your TPA, your PBM, your carrier.

The math for GE

At 53K employees plus dependents, high-cost claims above $25K flow through daily. At a 4-6% discrepancy rate — the industry norm per OIG and AHLA data — that's millions in preventable overpayments annually. Every dollar recovered is a dollar that offsets the premium absorption you committed to in September.

Seven-Check Billing Governance Standard
CODEVAL — Coding accuracy verification
DUPCHECK — Duplicate charge detection
RATEVAL — Rate/fee schedule validation
DURVAL — Duration and utilization review
CREDVAL — Credential and licensure check
SVCVAL — Service documentation match
BUNDLEVAL — Unbundling and modifier audit
4-6%
Expected discrepancy rate on high-cost claims
OIG / AHLA / MGMA
10 days
Standard turnaround. 5 days for short-hold TPAs.
$3-5
PEPM tiered by population
+ performance guarantee
For GE Aerospace: Caliber is the fastest path to offsetting the premium absorption commitment. Every discrepancy caught before payment is pure margin recovery.05 / 12
Joe Nalley
06
Cadence · Specialty Pharmacy

29.1% of specialty patients flagged
for continuation past clinical utility.

At 53,000 employees, your specialty pharmacy book is smaller in absolute terms — but proportionally larger as a cost driver. A single biologic therapy running $120K per year on a patient who no longer needs it is invisible in a 500K-life plan. In yours, it moves the trend. Cadence governs the continuation decision — not whether to start therapy, but whether it should keep going.
The Evidence
01
65,234 patients across 3 locked cohorts. Including NIH All of Us — federal-scale validation.
02
29.1% flag rate. Nearly 1 in 3 high-cost specialty patients flagged for continuation review.
03
55-60% Review Influence Rate. More than half of flagged cases result in changed therapy decisions.
04
$14.3M first-cycle savings value across 4 drug classes. Published in Pharmacy Times, April 2026.
Why GE Aerospace

You just locked in a 5-year commitment to absorb premium increases. Specialty pharmacy is the fastest-growing line item in employer health spend — 50% of total drug costs for many self-insured plans, driven by a fraction of members.

At your scale, 50-100 specialty patients on therapies past clinical utility can represent $4-12M in annual spend that shouldn't be there. Cadence identifies those patients, flags them for review, and gives your medical director the evidence to act. CGS v1.1 covers biologics, oncology supportive care, autoimmune, and rare disease.

29.1%
Flag rate across 65,234 patients in 3 locked cohorts
Cadence Governance Standard v1.1
$14.3M
First-cycle savings value, 4 drug classes
Pharmacy Times, April 2026
06 / 12
Joe Nalley
07
Supporting Programs

Two more programs. Same pilot structure.
Same 90-day proof window.

Curated · Behavioral Health

Manufacturing stress doesn't stop at six sessions.

Shift work, production targets, physical fatigue. Your workforce carries a clinical profile that maps to elevated BH utilization — depression, anxiety, substance use, PTSD. Standard EAPs offer triage. Curated provides one named navigator across every BH episode for the life of enrollment. 13 clinical areas. 30-day readmission warranty on SUD residential and acute psych.

200K+
Patients managed across BH episodes
80%+
Residential completion rate
Readmission warranty · $3-7 PEPM · curatedhealth.care
Continuum · Substance Use

Ohio and Kentucky. The geography speaks for itself.

Ohio ranks 5th nationally in opioid overdose deaths. Kentucky ranks 4th. Your two largest operational footprints sit in the two states most affected. Continuum delivers virtual-first MAT with buprenorphine via permanent DEA telehealth pathway. Named navigator from intake through step-down. 42 CFR Part 2 compliant. Built for exactly this geography.

$9,000+
Average employer cost per SUD episode without early intervention
SAMHSA / Milliman 2024
4th/5th
KY and OH national ranking for opioid overdose deaths
CDC WONDER 2024
Virtual MAT · Fee-first · continuumhealth.care
Curated and Continuum are independent of Caliber and Cadence. Adopt any combination. Each proves itself on your data.
07 / 12
Joe Nalley
08
The Pilot

Healthcare costs nearly shut down
your production lines. You need proof,
not another vendor promise.

Your workforce authorized a strike over healthcare costs nine months ago. You absorbed the premium increases to keep the lines running. That bought time. It didn't fix the underlying spend. We don't ask you to trust us — we ask you to measure us. 90 days. Your claims data. Your baseline. Your scorecard. If we don't move the numbers, you walk away with the analysis and owe us nothing beyond the pilot fee.

Scope

Defined population. Caliber runs against your full high-cost claims flow. Cadence runs against your specialty pharmacy book. Curated and Continuum pilot on segments you select.

Timeline

90-day measurement window. Claims-verified outcomes, not self-reported surveys. Baseline established from your prior 12 months. Outcomes measured against your own history, not an industry average.

Guarantees

Performance guarantees active from pilot day one. Cadence includes a performance guarantee on review influence rate. Curated warranties apply during pilot. Our platform fee is at risk from the first navigated member.

Exit

If it doesn't work, you walk. No termination fee. No penalty. No lock-in. You keep the data, the baseline analysis, and the scorecard. The 90 days were free intelligence either way.

The Scorecard
Every pilot produces a claims-verified scorecard at day 30, 60, and 90. Metrics are agreed before launch — not after we see the results. You define success. We measure against it. The scorecard is the decision document for full deployment.

Caliber: discrepancy rate, prevented overpayment, turnaround time
Cadence: flag rate, review influence rate, therapy modification rate, projected savings
Curated: readmission rate, completion rate, cost per episode, navigation engagement
Continuum: treatment retention, MAT adherence, ED utilization, return-to-work
Why This Matters Now
You signed a 5-year contract absorbing premium increases. That commitment started in October 2025. The cost curve hasn't bent yet. Every month without governance is a month where the gap between what you committed to pay and what you can actually sustain gets wider.

Three things you learn in 90 days that you can't learn any other way:
1. Whether your specialty pharmacy book has continuation waste — and how much
2. Whether your high-cost claims carry billing discrepancies — and at what rate
3. Whether a vendor will put their own fee at risk against their own performance
The pilot isn't the beginning of a sales cycle. It's the end of one. Either the numbers move or they don't. That's the whole conversation.
Pilot pricing: PEPM at standard rates. No setup fees. No implementation charges. Warranties and guarantees active from day one.08 / 12
Joe Nalley
09
Unit Economics

What the 90 days cost.
What we expect them to return.

ProgramPEPMAnnual (est.)Primary Lever
Caliber$3-5$160-400KPrevented overpayment
Cadence$3–6$160-640KContinuation waste removal
Curated$3-7$160-560KReadmission + completion
ContinuumPer patientVariableED diversion + retention
Illustrative: ~53K employees + dependents (~80K covered lives est.)
Pilot: start with one or two programs, measure on your data
PEPM tiers by volume — Cadence includes performance guarantee
We publish the economics honestly. If the modeled savings don't exceed the program cost in the expected case, we say so. The remainder buys governance, guarantees, and risk transfer.
Caliber ROI Signal
At a 4% discrepancy rate on claims >$25K, a self-insured plan at 80K covered lives typically sees $1.5-4M in preventable overpayments annually. Caliber's PEPM is a rounding error against the recovery. Every dollar recovered offsets the premium commitment.
Cadence ROI Signal
29.1% of specialty patients flagged across 65,234 patients in the study. At GE's scale, even 30-60 specialty patients continuing past clinical utility at $80-150K per year represents $2.4-9M in addressable waste. The PEPM pays for itself on the first modified therapy.
Portfolio Discount
Two or more programs: 15–20% combined PEPM discount. Three or more: 20–25%. Single scorecard, single data feed, one vendor relationship across all programs.
All economics verified against your claims data during pilot. We don't model in a vacuum.09 / 12
Joe Nalley
10
Competitive Position

What we do that your current
vendors structurally can't.

Dimension
Your PBM
Your TPA
Standard EAP
Show Your Work
Specialty Rx governance
PA and step therapy. No continuation audit.
Not in scope
Not in scope
CGS v1.1. 65,234 patients. 29.1% flag rate. Published.
Claims verification
Not in scope
Post-payment. Audits their own work.
Not in scope
Pre-payment. 7-check BGS. Independent. Advisory-only.
BH depth
Not in scope
Not in scope
6-8 sessions. Referral.
13 clinical areas. Full episode chain. Warranty.
SUD treatment
Not in scope
Not in scope
Rehab referral
Virtual MAT. Buprenorphine. Named navigator. KY/OH.
Cost guarantee
Rebate reporting
Processing SLAs
Engagement metrics
Provider-held delivery warranty. Platform fee at risk. The only vendor in the category that warrants outcomes.
Pilot terms
Annual contract
Multi-year
Annual contract
90 days. Walk-away. No penalty.

We don't replace your PBM, TPA, or EAP. We fill the gaps they weren't designed to fill — with programs that prove themselves on your claims data before you commit.

10 / 12
Joe Nalley
11
The Team

Built from the payer seat.
Designed for the employer buyer.

Joe Nalley
Joe Nalley
Founder & CEO

15 years building healthcare organizations and governance structures. Specialty risk products at a Fortune 25 payer — maternity, MSK, oncology, CHF — across millions of commercial members. Direct visibility into how payers price, manage, and lose money on the exact episodes these programs address.

Built and scaled a 13-location health system (BH, SUD, MAT, primary care, surgical center, community hospital). 30,000+ patients. Exited. Founded ClearBill — $9.2M returned to payers in the first six months. Exited. The programs in this deck aren't concepts — they're built on the same architecture, sold to the same buyer, governed by the same standards.

Cadence: 65,234 patients · 3 independent cohorts · NIH federal validation · Published in Pharmacy Times
M.S. Applied Behavioral Analysis, Northeastern · joe-nalley.com
Platform
7 Products Built and Published
Curated, Continuum, Waybright, Caliber, Cadence, Compass, Covenant — each with its own site, canon, and governance standard. Same infrastructure. Same employer buyer.
Publication
Pharmacy Times, April 2026
Cadence study published in a peer-reviewed pharmacy journal. 65,234 patients. 29.1% flag rate. $14.3M first-cycle savings value. Not a white paper — a published finding with locked cohorts and federal validation data.
Capital
Founder-Led, Capital-Backed
Active capital conversations with healthcare-focused investors. Employer pilots are the proof points. Every signed pilot validates the model and accelerates deployment.
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Joe Nalley
12
Next Steps

One conversation. One pilot.
90 days of your own data.

We're in your backyard. Evendale to our office is a local meeting.
This isn't a cold call from a coast — it's a neighbor with proof.

Week 1-2

Introductory call. Identify which programs fit. Agree on pilot population and scorecard metrics.

Week 3-4

Claims data review. Baseline analysis. Pilot agreement signed. No setup fees.

Day 1-90

Programs live. Scorecards at day 30, 60, 90. Warranties and guarantees active throughout.

Day 91

Decision. Scorecard in hand. Continue, expand, or walk away. No penalty either way.

Timing
Pilot can launch within 30 days of agreement. No implementation timeline. No technology integration required for initial deployment. Claims data feed is the only prerequisite. A one-page pilot term sheet is available on request.
The Clock Is Running
The 5-year contract started in October 2025. You're eight months into absorbing premium increases with no new tools to bend the cost curve. Every month without claims governance and specialty pharmacy oversight is a month where the gap between your commitment and your spend gets wider. The next UAW negotiation is already on the calendar. The data you bring to that table matters.
Start Here
We recommend starting with Caliber (claims verification) and Cadence (specialty pharmacy governance) — fastest ROI, directly offsets premium absorption, lowest integration burden. Add Curated and Continuum in wave two once the scorecard proves the model.
joe.nalley@showyourwork.health · joe-nalley.com · showyourwork.health
Confidential · Prepared exclusively for GE Aerospace · Not for distribution · June 202612 / 12