Beyond Navigation: Thyme Care Ready for Heavy Lifts to Make Value-Based Care Work

When it was founded in July 2020, Thyme Care’s early focus in cancer care was patient navigation. By the fall of 2023, the company was serving more than 3000 patients¹ and had research to show that its technology-driven navigation and support services brought a $594 cost reduction per patient per month, compared with a control group.²

Bobby Green, MD | Image credit: Thyme Care

That was at the time of Thyme Care’s $60 million capital raise¹; by July 2024, a new $95 million round of financing and a new investor, Concord Health Partners,³ publicly signaled that Thyme Care has much bigger things in mind. The company plans to expand things it has been working on, such as reducing pharmacy waste⁴ and reducing administrative burdens with data analytics.⁵ It is looking to improve the referral processes among oncology practices, primary care groups, and health plans. Thyme Care’s model differs from others in that the company deeply integrates itself into its partner practices to find efficiencies—and does so while assuming 2-sided risk,³ meaning that creating better patient experience, quality, and waste reduction provides the payoff.

It also attracts investors, including Concord. “We’ve been intentional about trying to find the right people to partner with,” Bobby Green, MD, an oncologist who is cofounder, president, and chief medical officer at Thyme Care, said in an interview. Each of the company’s investors has offered a balance of support while challenging the start-up, he said, and Concord “was just a really nice addition.”

“Traditionally, their focus is identifying and supporting health care companies that are building solutions that address the things we’re focused on—affordability, quality, access to care. And so, I think in many ways, it was real alignment along the vision,” Green said. “They also have a lot of strategic relationships throughout the ecosystem and potential partners for us in the future.”

Providers in oncology are increasingly under pressure to operate in risk-based payment models, whether a commercial plan or Medicare’s Enhancing Oncology Model (EOM), which recently made changes to attract more providers.⁶

Service delivery is offered through its Thyme Care Oncology Partnerships (TCOP), described as “operating as an extension of the practice.”³ These partnerships allow Thyme Care to perform some of the most challenging tasks to make value-based care work: the company provides the virtual navigation as well as data and analytics services to reduce administrative burden. A year ago, the company unveiled Thyme Box, a value-based oncology care management platform that sorts data from payers, electronic health records, and other sources to recommend personalized interventions. Thyme Box is powered by a mechanism that can allow risk-bearing entities to shift from fee-for-service to value-based care.⁵

More than 800 oncologists were enrolled in these partnerships³ when Thyme Care announced the hiring of Lalan Wilfong, MD, one of the best-known leaders in value-based care, who has experience in Medicare’s Oncology Care Model (OCM) and the current EOM.

Controlling Costs
Success in payment models means improving quality and bringing down the total cost of care. Thyme Care has produced evidence that its navigation model can do this; now, the quest is on to move into other areas known to drive up the cost of cancer care. One of those strategies involves provider-led therapeutic interventions.

“If you look at the spend buckets in oncology, there’s acute care, end-of-life related issues, which are important, but as I think everyone knows, drugs are a big part of oncology spend,” Green said. With drugs accounting for 70% of the cost of cancer care, no strategy to control the total cost of care can overlook drugs.⁷

“What we really thought was important was to think about how to tackle that drug spend, but in a way that was collaborative with oncologists and not confrontational…. If I put on my oncologist hat, most of the way that drug costs get controlled in oncology tends to be very abrasive with the oncology community, and then not collaborative,” he said.

A key lesson from the past decade—from the OCM and other models, and now the EOM, Green said—is that oncologists want to be part of value-based care arrangements, and they want incentives to deliver that value. Thyme Care sees itself as being able to help practices access value-based arrangements more easily, Green said. “We view this as an opportunity.”

Specifically to the EOM, he said, the company has spent the past year working with oncologists across the American Oncology Network, which has allowed Thyme Care to develop sophisticated analytics for both health-related social needs screening—an EOM requirement—and predictive analytics. A chronic complaint about the former OCM is that practices did not get back performance data in a timely manner, so they could not correct problems in close to real time to avoid ongoing penalties.

Thyme Care believes it has corrected for this, Green said. “We’ve spent a lot of time building out the data analytics, the predictive analytics, and the actuarial work that will enable us to understand how we’re doing sooner than later, which I think informs a lot of things, including how you actually get better in the program,” he said.

Primary Care: The Next Frontier?
What’s next? Green said he is excited about improving the referral process between primary care physicians and oncologists. This area has been a major concern among oncology practices in recent years, partly because some payers now control their own primary care practices.⁸

The referral process “is something [where] we think there is a lot of room for improvement, and there’s a lot of opportunity to help primary care doctors find high-value oncology practices,” Green said. Some of the value of TCOP is seen here, as these partnerships seek to improve the referral process and ongoing coordination between primary and oncology care.

Green describes improving that “scary time” from the moment a primary care physician says, “I think you need to see an oncologist,” to getting that patient an appointment. At times, a patient may not have a confirmed diagnosis, he said, and primary care practices need help “getting over that barrier that sometimes happens of patients not being able to get into an oncologist because they haven’t had the biopsy. Yet, there are actually lots of circumstances where it’s appropriate.”

In recent months, Green has had many conversations with practices, and when he asks, “Are you willing to see patients early in the cancer journey before they’ve had a biopsy? I mean, uniformly, the answer is, ‘Of course. That’s what we do.’ ”

With palliative care, it is a similar story. He noted that the value of palliative care was a theme of the most recent meeting of the American Society of Clinical Oncology, including a clinical trial presented at the plenary session.⁹

“Early palliative and supportive care is key. That was a big take-home message—the fact that you can deliver palliative care effectively by telehealth.”

Patient experience and cost savings do not have to compete in palliative care. “There’s a real tailwind there for the oncology community,” he said.

“One of the core beliefs we have here is that value-based care is good for patients, and oncologists want to participate in value-based care arrangements,” Green said. “So, the more that we can partner with, whether it’s health plans or other risk-bearing entities, [such as] risk-bearing primary care groups, the more…we feel that that is not only good for patients, but it also brings more value-based opportunities to oncology practices.”

References
1. Rice I. This startup just raised $60 million to help cancer patients navigate their care. Forbes. August 21, 2023. Accessed September 30, 2024. https://www.forbes.com/sites/indiarice/2023/08/21/this-startup-just-raised-60-million-to-help-cancer-patients-navigate-their-care/
2. Mullangi S, Worland SC, Dharmarajan K, et al. Reduction in cancer spending due to patient navigation. JCO Oncol Pract. 2023;19(suppl 11):557. doi:10.1200/OP.2023.19.11_suppl.557
3. Thyme Care closes $95M series C to fuel cancer care affordability. Thyme Care. July 16, 2024. Accessed September 30, 2024. https://www.prnewswire.com/news-releases/thyme-care-closes-95m-series-c-to-fuel-cancer-care-affordability-302197293.html
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6. Caffrey M. CMS reopens EOM with payment boost, extends model to 2030. Am J Manag Care. 2024;30(Spec 7):SP499.
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8. Abelson R. Corporate giants buy up primary care practices at rapid pace. The New York Times. May 8, 2023. Updated May 12, 2023. Accessed September 30, 2024. https://www.nytimes.com/2023/05/08/health/primary-care-doctors-consolidation.html
9. Greer JA, Trotter C, Jackson V, et al. Comparative effectiveness trial of early palliative care delivered via telehealth versus in person among patients with advanced lung cancer. J Clin Oncol. 2024;42(suppl 17):LBA3. doi:10.1200/JCO.2024.42.17_suppl.LBA3