Why Thyme Care Succeeds Where Value-Based Care Has Fallen Short

Value-based care (VBC) has not delivered the benefits its supporters envisioned, especially in oncology. Multiple models, from commercial payers to the Oncology Care Model from the Center for Medicare and Medicaid Innovation¹ to, most recently, the Enhancing Oncology Model,² have not produced expected benefits. The reasons for failure are vast and numerous, but time and again, the oncology community has been unable to show improved outcomes for patients with cancer while simultaneously reducing cost. Many ask, how does Thyme Care, as a VBC company, continue to grow and succeed in this world? Why do we continue to forge ahead?

Whenever I start to wonder about the reason behind this, my mind always gravitates to a patient of mine who gave me the fortitude to push for a better way. She was a 70-year-old woman with metastatic non–small cell lung cancer that was strongly PD-L1 positive. I was excited to offer her treatment with immunotherapy, which had just been shown to have remarkable outcomes for this disease. At the time, useof immunotherapy was relatively new, and the American Society of Clinical Oncology had just published recommendations on toxicity management.³

At baseline, my patient was independent, traveled regularly to visit her grandkids, and had an ECOG score of 0. I saw her at week 3, where she reported mild diarrhea. I didn’t realize at that time that she minimized her symptoms, despite my questions about frequency and consistency. We forged ahead with treatment. By week 5, she was in the hospital with grade 4 diarrhea and required an intensive care unit stay for dehydration and electrolyte abnormalities. After discharge, this vibrant, self-made woman now had to give up her home and move in with her daughter. She never received therapy again. I remain pained with guilt. What if we had caught it and intervened earlier to manage her diarrhea? Would things have been different?

This is why Thyme Care has continued to succeed in VBC when other models have faltered. Our model is to take on risk with payers for patients with cancer undergoing treatment. We take on the full cost of care risk for that population and use care management and practice partnerships to manage that risk. Our company has grown in the past 2 years from managing fewer than 8000 lives to more than 85,000. We have contracted with multiple regional and national health plans, such as Aetna and Humana, as well as several at-risk primary care physician groups, such as Oak Street Health. We also now have partnerships with over 1400 oncologists, a component that is integral to our ability to drive value.

Our success stems from 3 main avenues:

Population-level clinical infrastructure. As illustrated by my patient example, what happens outside the 4 walls of the clinic is vital to improving patient care and reducing avoidable costs. Novel treatments have changed the landscape of toxicity. When I started practicing more than 20 years ago, most admissions were from toxicities such as vomiting and neutropenic fever. Now, oncologists more often see different adverse events caused by the rapid rise of targeted therapies; however, patients still suffer and are admitted for avoidable events. By focusing on population management instead of fee-for-service billing, we can focus our efforts on patients with the greatest needs instead of ensuring we have enough time per patient to enable billing for care management. Combining claims data from the payers, robust onboarding screenings, data from health information exchanges, and routine electronic patient-reported outcome (ePRO) assessments allows us to risk-stratify patients into cohorts so we can focus on issues that matter. Risk prediction modeling allows us to catch potential problems before serious consequences occur. This optimizes our workforce allocation and allows us to focus efforts on those patients with the greatest risk of poor outcomes. We have developed robust toxicity management care paths, transition-of-care programs, palliative care support, and health-related social needs assistance using a best-in-class technology-enabled product to reduce treatment-related symptom burden and avoidable hospitalizations. Members who completed Thyme Care’s ePRO program experienced a 28% relative risk reduction in emergency department (ED) presentation or inpatient admission. Eighty-three percent of patients discharged from the hospital had a coordinated follow-up visit scheduled by Thyme Care within days of discharge. Complex members who participated in Thyme Care’s readmission prevention program experienced a 30% relative risk reduction.⁴ These all drive significant savings to our health plan partners and, most importantly, are good for patients.

Deep practice alignment. We currently partner with multiple practices representing over 1400 affiliated medical oncologists. As an external company, we have the ability to partner with a wide variety of different clinics and practice types. Partnerships allow our teams to coordinate care more effectively between our care management support and the local practice care team. This collaboration allows us to manage patients together, rather than in silo, by ensuring prompt urgent care visits in the clinic for acute needs identified by our virtual care team. Thyme Care also reduces the burden on local care teams by addressing patient barriers to care as well as in-between clinic patient issues, allowing the local team to focus on the patients sitting in front of them. Additionally, we can offer unique incentive programs to practices for therapeutic interchange programs, such as biosimilar adoption, which can both improve patient care and reduce costs.

Single-point accountability for payers. Many of the payer-initiated VBC programs are difficult for payers to manage. The payer must devise an oncology VBC program and then hope individual practices will participate and succeed. This requires substantial, ongoing effort by payers and can limit the impact on their total population. Thyme Care can work in unique ways to simplify oncology VBC for our payer partners. Thyme Care works with all patients for a given payer, regardless of location or treating physician. Every patient for every payer in our at-risk population has access to our robust care management platform. By aggregating downside risk across an entire population, we reduce the variation in small sample sizes, leading to more accurate shared savings calculations.

VBC may be under attack, but the urgency behind this work remains. Although many models in the past have not shown ongoing success, we must continue to learn and adapt. Focusing on care management for all patients for outcomes that matter, working with oncologists regardless of affiliation, and ensuring savings to a payer, all while improving quality of care, has allowed Thyme Care to succeed where other models have fallen short.

I always wonder what my patient’s outcome would have been if she had access to Thyme Care. Many patients downplay adverse events when they are in front of the physician, but they are more open with other staff. Proactive outreach in the form of ePRO assessments or nurse calls can catch symptoms early, reinforce patient education, and initiate interventions such as antidiarrheals or even steroids for immunotherapy-related toxicities, which can mitigate more serious events. Tracking patients more closely between clinic visits can allow for urgent care management rather than visits to the ED and hospitalizations.⁵

With access to this support and early intervention, could we have prevented a serious outcome for my patient? I will never know. But my hope is we could have.

Author Information

Lalan Wilfong, MD, is senior vice president of value-based care at Thyme Care. A longtime medical oncologist/hematologist at Texas Oncology, he was previously senior vice president, payer and care transformation at The US Oncology Network and as vice president, value-based care and quality programs at Texas Oncology.

References

1. Trombley M, McClellan S, Chami N, et al; Abt Global. Evaluation of the Oncology Care Model: Final Report. CMS. May 2024. Accessed March 11, 2026. https://www.cms.gov/priorities/innovation/data-and-reports/2024/ocm-final-eval-report-2024-exec-sum
2. Henke R, Castro J, Chan A, et al; The Lewin Group. The Enhancing Oncology Model: First Annual Evaluation Report. CMS. August 2025. Accessed March 11, 2026. https://www.cms.gov/priorities/innovation/data-and-reports/2025/eom-1st-eval-report
3. Schneider BJ, Naidoo J, Santomasso BD, et al. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: ASCO guideline update. J Clin Oncol. 2021;39(36):4073-4126. doi:10.1200/JCO.21.01440
4. Burnett C, Ivanova J. Advancing value-based oncology through 24/7, integrated virtual cancer care. Health Care Transformation Task Force. February 2026. Accessed March 11, 2026. https://hcttf.org/wp-content/uploads/2026/02/Advancing-Value-Based-Oncology-Through-247-Integrated-Virtual-Cancer-Care-1.pdf
5. Rocque GB, Franks JA, Deng L, et al. Remote symptom monitoring with electronic patient-reported outcomes in clinical cancer populations. JAMA Netw Open. 2025;8(5):e259852. doi:10.1001/jamanetworkopen.2025.9852