A New Type of Collaboration for Scaling Value-Based Oncology Care
As the son of an oncologist, I saw early on the challenges individuals and their loved ones experience when faced with a cancer diagnosis. And over the 15 years, I’ve spent in a variety of roles in the oncology space, my appreciation for the complexity of the cancer care journey has only grown. I’ve watched cancer care teams overcome countless clinical, administrative, and care-coordination hurdles in delivering the compassionate, personal, high-quality care patients deserve.
And yet, patients are still overwhelmed with struggles in dealing with the confusion and emotional impact of a diagnosis, accessing timely care, organizing an array of appointments, following their treatment protocols, managing worrisome symptoms, and seeking answers to pressing questions along the way.
Value-Based Patient Navigation
I co-founded Thyme Care with an extraordinary team of clinicians, data scientists, and care delivery experts to create a better cancer care journey for patients and providers alike. Our approach combines smart technology, human support, and deep compassion for patients. We know that what we’re building has a real, tangible impact on the lives of cancer patients, which is why I’m thrilled to announce our new collaboration with AmeriHealth New Jersey which will bring additional cancer support and navigation to their members, taking a unique approach to value-based oncology care.
Our model offers an enhanced approach to cancer navigation. It builds on previous learnings from other models and navigation literature on complementing in-person care with virtual, personalized support outside the clinic. We’re helping to ensure cancer patients have access to personalized guidance, resources, education, and monitoring to better navigate their cancer journey. We provide this support from the time cancer is identified or suspected, throughout treatment, survivorship, and end of life, all with the goal of improving patient experience, addressing barriers to care, and driving better outcomes, while helping to reduce the cost of care.
Learning from the Oncology Care Model
The Centers for Medicare and Medicaid Innovation (CMMI) has just concluded their 5-year value based Oncology Care Model (OCM) and a year from now will be starting the Enhancing Oncology Model (EOM). We learned many things from the OCM, but two stood out. First, practices with the right tools and resources were able to succeed: to deliver high-value care while bending the cost curve. Second, providing the right financial incentives is critical to making these models successful. Both of these learnings have helped inform our partnerships with health plans and providers.
Success in the OCM
At a high level, the conclusion from the OCM was disappointing, as it did not show significant savings in aggregate. And that’s pretty sobering news. But if you look at the results from some individual practices, a different story emerges.
Based in Nashville, the community oncology practice Tennessee Oncology saved Medicare $5 million by investing in data analytics capabilities, establishing meaningful care navigation touch-points, and incorporating evidence-based interventions, like ePROs, into their treatment program.
Florida Cancer Specialists, another community oncology practice serving nearly 100 locations throughout Florida, was able to reduce hospital admissions by 8% and emergency room visits by 21% compared to other OCM-enrolled practices by investing in patient education, extended clinic hours, and proactive symptom management.
While these are only two examples of success in the OCM, they validate that with the right resources and infrastructure, value-based oncology can be successful in impacting outcomes, acute care utilization, and the cost of care. These case studies helped us realize that we can help others do it too, and do it at scale.
The Importance of Financial Viability
I’ve worked in oncology long enough to know that oncologists are committed to doing what’s best for their patients, but know that fulfilling this mission is impossible without financial viability. A value-based care program will not be successful, or feasible, without the right financial model. The OCM taught us that practices can be successful, but only with the right incentives; incentives that help support the technology, hiring, and work required for practice transformation.
Putting it All Together
Through partnerships with providers and health plans, we have taken these learnings and our expertise to first, provide the people and technology to enable successful and meaningful cancer navigation at scale, and second, to create a framework in which forward-looking health plans are willing to fund the investment to get this done in a way that ultimately drives value not only to them but to their members and the clinicians taking care of them.
Using Technology to Improve Care Quality
We know that providing high-quality cancer care guidance isn’t possible through technology alone. That’s why with Thyme Care, every member has a compassionate team of lay health workers and oncology nurses to virtually navigate them. Supporting our Care Team is a care delivery platform, Thyme Box, our software that enables the Care Team to provide patients with individualized education, advocacy, logistical support and monitoring throughout their treatment, in close collaboration with clinicians. Our analytics engine, Thyme Frame, identifies members, and prioritizes them by the level of risk and their specific needs to help match the right resources with the right member and interventions, all with the goal of improving outcomes.
By empowering our Care Team with the right technology and data, we can improve care quality and reduce costs in several impactful ways, specifically:
1. Proactive Symptom ManagementBy identifying and monitoring members undergoing treatment, our Care Team can quickly triage members to the right support, avoiding unnecessary ED visits and hospitalizations.
2. Improved Care AccessWe aim to reduce potential barriers to care by connecting members with needed resources such as transportation, housing, behavioral health support, grants, and more, and guaranteeing timely oncology appointments.
3. Facilitating Advance Care Planning and Goal-Concordant CareWe facilitate conversations that ensure the care a patient receives aligns with their deeply personal goals, in order to reduce unwanted care and improve quality of life.
We realize that this type of care delivery will not work without close collaboration with the doctors who are taking care of patients. Because of this, Thyme Care has established deep relationships with a network of oncology practices that continues to grow and hired a team of experts that not only understand clinical oncology but how practices and cancer centers work. We also work closely with primary care physicians (PCPs) given the key role they play in caring for cancer patients, ensuring their patients get rapid high-quality access to oncologists and that they stay in the loop, enabling them to closely monitor and manage comorbidities.
The Model that Makes All of This Work
The best care team and technology in the world can’t meet the challenge without the right financial model. Our collaboration with AmeriHealth New Jersey illustrates what is possible when you have the necessary conversations to determine what will truly drive value. Through our conversations with health plans and providers, we were able to identify the behaviors and trends that drive cost, design efficient and patient-centric interventions, and develop analyses that would show the most value to everyone involved, all while driving a better patient experience for those living with cancer.
We are confident that the time and energy we’ve put into this model will drive value for all stakeholders. And the approach can be replicated across different health plans and regions, populations, and socio-economic circumstances. Importantly, because our approach is data-based, it also offers the opportunity for constant learning and improvement.
As we continue to partner with more health plans and providers, we’ll be able to directly impact more patients by improving their access to quality care at every step and supporting their providers along the way. Cancer care is fraught with technical and human complexity. It’s time we gave cancer patients the support they deserve as they navigate their care. Now more than ever, our mission to provide a better cancer journey for all patients feels within reach.
To learn more, visit thymecare.com/health-plans.