A recent analysis, presented at the 2022 ASCO Quality Care Symposium, shows that Thyme Care interventions reduce total-cost-of-care by $429 PMPM. Read more.

WTF Health with Bobby Green

Cancer Patient Navigation

“Cancer is different, and navigation solutions need to be specific to cancer patients.”

Jessica: Hi everybody, it's Jessica DaMassa with WTF Health—what's the future health—I am talking to the who's-who of health tech and healthcare innovation. And today we are talking to a Series A startup in the cancer navigation space. Please meet Bobby Green. He is the Chief Medical Officer and President of Thyme Care. Bobby, good to have you here.

Bobby: Great to be here Jess. Thanks.

An Introduction to Thyme Care

J: Alright, so this is really cool to me. You guys caught my eye not only because of cancer navigation, I feel like cancer is you know, obviously, a very important place where we need to do some more innovation in terms of reshaping that patient care journey. But back in October, you guys raised a Series A, and you had Andreessen money behind you. And so that always catches my eye you guys raised a $22 million Series A like I said, Andreessen, and leaving it along with Ally Corp. So I mean, why don't you introduce us to Thyme Care? Let's start out there. And then let's talk about this fundraising and what you guys are doing. So tell me about Thyme Care.

B: Great. Thanks, Jess. And thanks so much for having me here today. So the way to think about us is really as a value-based oncology solution, and we integrate with oncologists, clinicians, and people who are actually taking care of cancer patients, engage with those patients, and at the same time, partner with health plans to deliver higher-value care to their members. And it all starts as you referenced with a focus on care navigation. What that means is pairing Oncology Nurses and Care Navigators. So non-clinicians can also help cancer patients with the right technology, the right software, and the right analytics, to make sure that people with cancer the members of the health plan get to the right oncologist as quickly as possible, risk stratify them and make sure that you can identify people at risk of bad things happening ending up in the emergency room, getting admitted to the hospital and help oncologists address those things and prevent those things from happening. Addressing healthcare disparities which we see, you know, across the spectrum of people that we've been engaging with, and making sure that the treatments that people are getting aligned with their goals and that those communication channels remain open. All of these in service of trying to help health plans deliver higher-value care to their members.

Encompassing the Cancer Journey

J: Okay, so when I think of like high-value, high-touch cancer navigation, I think of like the models that have been perfected at those like big cancer centers, Mayo Clinic, MD Anderson, and those are very people-focused. So are you just basically taking what those navigators in those organizations do and adding tech to it or like unpack that a little bit more for me?

B: Yeah, so I think if you look at individual institutions' care, navigation can mean different things in different settings. So sometimes it's just focused on the time someone is diagnosed. Sometimes it is just focused on care coordination as people are going through treatment. Sometimes it might be focused on just one or two diseases. I'd say on one level, what we're doing is really encompassing the cancer journey. So going all the way from when someone's diagnosed, or even before that when someone might have a suspicion of cancer and they're talking to their primary care. Doctor about that all the way through treatment, survivorship, end-of-life issues. So the first thing I would say is it really encompasses the entire cancer journey across that whole spectrum. The second thing that I would say is that if you look at in general healthcare navigation is done today. And remember, it's done in different settings. Sometimes it's done from a health system or from a practice. Sometimes it's done by health plans. Sometimes it's done by other companies like us. We would make the argument that the sort of current model isn't working for a bunch of reasons and to your question of what's different. I think it's those things that we bring together and the different approaches. So just to sort of go through a couple of things—

The Lack of Cancer Navigation

J: A little bit more about that like what's not working with the status quo way that this is being done like give us like that the highlights here of like how this is this is not working well and how it's maybe failing patients or how it's making things more difficult for providers.

B: Yes, so I think at a core level, if you went around and talked to cancer patients, which we do and as someone who practice for 20 years and a really good practice that really tried to do these things. If you go to most cancer patients, there are still lots of gaps in their care that we would argue are due to lack of navigation. And the areas where we think that falls through is one you have to when you're navigating cancer patients actually engage with the people with cancer. So we would argue that navigation solutions really need to be high touch like that's a critically important thing. Number two, we think if you're going to do this from outside of a practice, you need to integrate, understand and have relationships with the people who are taking care of the people with cancer, right? So you have to have those integrations with the practices and with the oncologist. We think technology is not just important, but as necessary to make this successful. A lot of the solutions and a lot of what we see people using is sort of square peg round hole. And so how do you actually use technology to one enable you enable your care team to be more efficient, to make the things that are really hard or difficult or impossible to do as a care team possible and scalable, but at the same time? How do you understand who the patients are that really need your help? How do you risk stratify them? And how do you sort of complete that feedback loop so that you can not only make sure you understand who the people are but then you can tie in the interventions that are going to help. And I guess the last thing maybe I would add just is that cancer is different. So the last thing we would sort of argue is that navigation solutions for cancer patients need to be specifically for cancer patients and you can't you know, cancer is different than congestive heart failure. 

Technology in Cancer Care

J: Alright, so I want to ask a little bit more about the tech side of this like I'm hoping you can say a little bit more. So go the next level down for us. And part of this is is you know, I'm curious how you how you're using technology to you know, help with that. Risk stratification and all those things there. And also pure curiosity on the tech side, because I see a name like Andreessen on a funding list. And I know from following other investments that Andreessen has made, they love a good platform play and they are very hot on tech first. So I mean, talk to us a little bit like, you know, take the hood off here and like let's see what's the what's underneath it. And let's talk a little bit about the technology underpinning that you have underneath all this because I do think that that's really compelling in terms of how you're approaching navigating in this way.

B: Yeah, so great question, and one thing I would do to sort of frame this Jess is I was at Flatiron health before coming to Thyme Care. 

J: Flatiron mafia—don't even talk to me about Flatiron mafia right now because we will get into that. So, folks, you need to understand that this is marriage day. This is not only Bobby from Flatiron, but other people. I'm the co-founding team here at a time-halter. I'm from Flatiron and there's Flatiron money in this so they are like the PayPal Mafia has become two tech, Flatiron mafia is now becoming to Health Tech. All right, go on Bobby, though. Tell us about the tech. 

B: Opening Pandora's box. So what you know is I think a lot of people know one of the things that Flatiron did was it said there's this thing called abstraction right? Abstracting patient charts, which is a very manual, inefficient, hard-to-do thing that wasn't scalable. And one of the major things that Flatiron did was how do you use tech to enable people to scale that? And I think there are lots of analogies there with Thyme Care. How do you use technology to enable people to actually more efficiently in a scalable way navigate cancer patients across the cancer journey in multiple care settings with multiple health plans and multiple different oncology practices? So that sort of at a high-level part partially how we think about it, I would put there are a couple areas that I would highlight. And just to your point, and Andreessen being our lead investor, technology is a critical part of what we're doing. So bucket number one is just how do you pull in multiple different data sources, data sources, from claims data from electronic health records from the interactions that you're having with patients, and how do you use that data to understand who's going to be a risk? That's risk stratification that we talked about? I would say that there are other people out there doing it. But one of the things that's critical in addition to the different data sources is how do you tie that into the interventions that you're going to make that really easy for the care team to see and interact with? identify patients, make sure they get the right follow-up, make sure that we're doing the right track and make sure that we're documenting the right outcomes with what happens to them, and you just can't do that without technology. So that sort of bucket one. Bucket two is there are a lot of thing care navigators do whether it's finding transportation for someone with cancer, whether it's coordinating care whether it's outreaching to them about symptoms, connecting them with an oncologist helping with scheduling all of these things are just hard to do without the right technology and hard to scale. Another component, which is critically important is how do you interact with the patient with the person with cancer. And this is where I think it becomes critically important. You need people like we would argue that just like you know, again, the Flatiron for example just like you can't use tech to magically abstract charts without people there. You can't navigate without people there. But it's not efficient. It's not scalable with just people and patient communication is a key component of that. So how do you communicate with patients what we're building is a tech platform and a patient-facing tech platform that is usable by people regardless of their technological skills, regardless of their access to internet because, you know, one of the things we've seen in our current engagement is there's such a large variation. Some people have smartphones, some people have flip phones, some people still have landlines, some people have internet access in the home some people don't. So how do you build a technology solution that is, works for someone who really wants to engage with a patient facing app works for someone who really finds text the easiest way but also will work for someone who can only answer a landline. 

The Value in Cancer Navigation

J: Got it. Alright and want to ask a little bit about I want to ask you to make the case for cancer care navigation in this cancer space. So I feel like we all kind of like, you know, know like that this is definitely a thing that helps improve the patient journey. It improves health outcomes, it makes everything work better, but what data can you point to specifically I mean, get us smart on this from like, from your perspective, what data are you looking at? Or what data have you seen on outcomes that really tie you know, cancer, cancer navigation with better outcomes for patients or even like reduced cost of care? I mean, tell us you know, a big picture like what you know, that we need to know in order to understand the value of this type of solution in this particular area of medicine.

B: Yeah, so it's interesting you ask that because I think if you go back ten or, and I'll talk a little bit more about examples before, if you go back ten years or, let's just say a decade maybe a little bit longer. There are multiple studies that have been published that show that a variety of interventions, whether it's work that's come out of Stanford, showing that lay health workers can keep people out of the hospital and the IDI through care, navigation, whether it can reduce inappropriate care at the end of life, a lot of great work that was done out of the university. of Alabama, Birmingham, looking at their care navigation program showing reduced costs, better outcomes work from Sloan Kettering showing that just simply having patients respond to patient-reported outcomes, which I would sort of put in the care navigation like can improve outcomes can improve survival like the landscape is almost sort of littered with these really good studies that have been done showing that this stuff works. And if you go look around at what cancer patients are getting those types of interventions and those types of navigation, it's a small minority and it's not happening. You know, I sort of envision it as I mean a lot of the work that came out of Sloan Kettering looking at the PRL and the work Ethan Bash did there. Imagine if you develop the drug at an institution and said, Wow, this drug really works and it increases survival, but no one's ever going to be able to use it out of this institution. That's what sort of happened with navigation. It's used in these pockets and places, but how do you scale that and how do you make that available to everyone? And that's, in a lot of ways, one of the big problems that we're trying to solve.

J: Talk to me about your clients then, so like, Who are you selling this to? And I specifically want to hear also about the relationship that you have with Clover Health. So Medicare Advantage plan and he has piloted your solution with them. I mean, talk to me about the clients or Thyme Care and how what you've learned through your partnership with Clover sets you up to like, take better care of other Medicare Advantage type populations or work more effectively with payers moving forward.

Partnership With Clover Health

B: Yeah. So um, so we've been in partnership with Clover since the spring, I'm responsible for navigating their cancer population. It's been an incredible partnership. We've learned a ton. I would say, you know, just doing the work of navigating and building the technology along it has been just critically important to have the opportunity to do that. I think that you know, we've learned it's hard. Cancer navigation is hard. But I don't think anyone I don't think any of us were surprised by that. I've been and I'm almost embarrassed to say this, a little bit surprised at Clover has a relatively underserved population and their MA plan, and I'm almost a little bit surprised, or at least I was initially by the magnitude of difficulties and access to care. That population has difficulties with transportation, need for financial assistance, all of these things, which, you know, fortunately, we built out a navigation model that's able to help with them, but sort of learning what a big component of that was going to be I think has been super helpful. Medicare Advantage populations are in some ways different than commercial populations. We have another we started another partnership with one of the practices that we work with a navigating their population for a health plan as well. That's a commercial population. I think one of the take homes from that has been while there are differences, there are more common there. There more commonalities and differences. When you go from a Medicare Advantage to a commercial plan, at least in cancer, that sort of cancer expertise, carries you obviously, more comorbidities and stuff that requires more coordination in the Medicare population as well. And you know, listen, we are a startup so the partnership with Clover has taught us a lot about navigating health plans, and how to work collaboratively how to integrate, you know, Clover has a lot of solutions that they offer for their membership and how to integrate with those and work with them and not step on toes has also been another great learning for us. 

What's Next for Thyme Care?

J: Okay, so you might be a startup but you are a well-funded startup. So talk to us a guess about what's next for you guys. You raise $22 million with this series A and we like what's on tap within the near term and in the long term, and what do you guys going to do with this funding to scale up?

B: So yeah, so it's a great question. It's what we're excited about. I think I would put it in a couple of different buckets just so one is regional growth is really important for us. So right now we're navigating across the state of New Jersey and so growth in that tri state area, we call it sort of establishing network density is super important for a bunch of reasons. Flatiron. Sorry. for that. You can imagine as we go into practices, the higher percentage of a practices population that we are able to navigate, the better right so it makes it just easier for the practice. It's more meaningful for practice. So while it's not exclusively focused on regional growth, that is an area where we're really working hard to expand our health plan footprint in the regional area. And that includes from a Medicare Advantage perspective that includes from a commercial perspective, that includes direct contracting which we think is a really interesting opportunity to expand what we're doing in cancer care, a big push to expand the oncology practices that we work with, as well as other clinicians, so coordination with primary care physicians, engaging them and helping them with their cancer members. We think is critically important. We just hired someone to lead that program who's a primary care physician, which we're really, really excited about as well. And then as you sort of look down the road, we think there's a great opportunity here with employers as well. To your question before about health systems, we do think that there are ways that we can help help health systems in navigation. And we started to have discussions there, as well as some really interesting possibilities with life science companies,

J: Well, the life science companies love to keep our eye on this, Bobby, thank you so much. It's been a pleasure to chat with you and it's exciting to hear where you guys are headed. So thanks for the introduction to Thyme Care. It's exciting to hear this different tech-enabled take that you're taking on the cancer journey and really across all oncology except for peds. Right, and just I want to throw that in there real quick. 

B: Yes, it's right now a focus on adult oncology.

J: Very cool. Well, you will have to check back in with us and let us know how things are going as you guys scale up. And make inroads into other areas of the country and into other areas of health care, working with those provider groups and working with those life sciences companies. That's very interesting to me. We'll check back in with you, Bobby, but thank you so much for taking the time today.

B: Thank you, Jess. Really appreciate it.

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