In a significant move that signals evolving dynamics in oncology care delivery, Thyme Care has appointed Dr. Lalan Wilfong as Senior Vice President of Value-Based Care. The appointment, announced on August 27, 2024, brings aboard a seasoned medical oncologist with 20 years of experience at Texas Oncology and extensive expertise in value-based care initiatives through McKesson Corporation and The US Oncology Network.
Transforming Oncology Care Delivery
Dr. Wilfong's transition to Thyme Care stems from his vision to fundamentally reshape oncology practice transformation. Despite progress in value-based care models, achieving the triple aim of enhanced patient experience, improved outcomes, and reduced costs has remained challenging. Thyme Care's approach has gained particular attention as CMS begins reimbursing practices for patient navigation services, addressing care management needs between appointments.
"The biggest thing I started recognizing was that the challenge of doing novel contracting the way we've historically been doing it was that payers would come up with these programs, then they would have to contract with each practice independently to execute those programs. Sometimes it worked out; many times, it didn't," Wilfong explained.
Historical Challenges in Value-Based Programs
The journey of value-based care in oncology has seen various iterations, starting with promising initiatives like UnitedHealthcare's 2013 episode payment program. This early effort, led by Dr. Lee Newcomer, revealed significant cost variations and treatment inconsistencies, with one study showing only 14 of 26 patients receiving appropriate therapy.
The landscape of value-based programs has faced persistent challenges, including the Oncology Care Model's limited success in achieving nationwide savings. Wilfong noted the recurring pattern among national payers: "Everybody wants to have value-based care. Everyone thinks we have to get away from fee-for-service and move toward novel contracting, but there's challenge after challenge after challenge [in] executing those contracts."
Thyme Care's Innovative Approach
What distinguishes Thyme Care's model is its strategy to contract nationally with payers while facilitating partnerships with multiple practices. This approach aims to simplify the execution of risk-bearing contracts and reduce administrative burden on practices.
Despite his previous skepticism of third-party entities, Wilfong was drawn to Thyme Care's distinctive methodology. "There are other entities out there doing risk bearing for payers, but they're managing it with utilization management tools or other heavy-handed approaches. One of the things I liked about Thyme Care was that they're very thoughtful about how we work with our practices; it's about incentives."
The model emphasizes reducing practice burden around care management while fostering genuine partnerships. By taking risk nationally with payers and collaborating with practices for contract execution, Thyme Care aims to address longstanding challenges in value-based care implementation.
