Humana Expands Value-Based Oncology Care Through New Agreement with Thyme Care
Humana (NYSE: HUM) has announced a new value-based care partnership with Thyme Care to enhance cancer care support for eligible Medicare Advantage members. The collaboration aims to provide comprehensive oncology services through 24/7 virtual care navigation and data-driven insights.
The program is now available to eligible Humana Medicare Advantage members in seven states: Michigan, New York, Illinois, Indiana, Tennessee, Pennsylvania, and New Jersey. Key services include:
- 24/7 virtual care navigation with dedicated oncology care teams
- Community support for resources like financial assistance and transportation
- Coordinated care between oncologists, primary care physicians, and specialists
The initiative focuses on reducing care gaps, minimizing unnecessary expenses, and providing comprehensive support for cancer patients while managing treatment complexities and costs.
- Expansion into value-based oncology care across 7 states
- 24/7 virtual care navigation system implementation
- Potential cost reduction through care coordination and early intervention
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Insights
Humana's new value-based oncology care agreement with Thyme Care represents a strategic expansion of its alternative payment model approach into high-cost cancer care, potentially addressing a significant expense category within its Medicare Advantage business.
This partnership targets the economics of cancer treatment, which typically accounts for 7-10% of total healthcare spending but with substantial variability in costs and outcomes. By implementing proactive care navigation and early interventions, Humana could realize several financial benefits:
- Reduced acute care utilization through better symptom management and care coordination
- Lower pharmacy costs via provider-led interventions
- Decreased out-of-network leakage by coordinating between specialists
- Improved risk adjustment accuracy through better documentation
The timing is particularly relevant as Humana faces Medicare Advantage rate pressures and increased competition. This program could enhance Humana's Medicare Advantage star ratings through improved member satisfaction and clinical outcomes, potentially qualifying for quality bonuses that significantly impact revenue.
While requiring upfront investment, the ROI could be substantial—similar oncology care management programs have demonstrated 15-20% reductions in total cost of care while improving quality metrics. The seven-state implementation suggests a measured rollout approach to test effectiveness before broader deployment.
This initiative aligns with Humana's broader strategy of differentiating its Medicare Advantage offerings through enhanced care management capabilities, particularly important as the company works to rebuild membership following recent challenges in this segment.
Humana's oncology care partnership with Thyme Care addresses a critical gap in cancer treatment delivery by implementing a proactive, high-touch support system that extends well beyond traditional medical visits. From a clinical perspective, this model targets several key failure points in conventional cancer care:
- Symptom management between appointments, when patients often deteriorate and end up in emergency departments
- Medication adherence challenges that compromise treatment efficacy
- Care fragmentation between specialists that leads to contradictory advice and duplicative testing
- Social determinants that directly impact survival rates and treatment completion
The 24/7 virtual navigation component is particularly valuable for reducing preventable hospitalizations, which occur in 30-50% of cancer patients and significantly increase mortality risk. Early symptom recognition and intervention by oncology-specialized nurses can prevent complications from becoming life-threatening emergencies.
The program's emphasis on pharmacy interventions addresses the financial toxicity of cancer treatments, where out-of-pocket costs frequently lead to treatment abandonment. Studies show 25-30% of cancer patients don't fill prescriptions or take lower-than-prescribed doses due to cost concerns.
The data-driven approach enables risk stratification to identify patients who need more intensive support, particularly during high-risk periods like treatment transitions or after hospital discharge. This precision in resource allocation is essential for scalability and sustainability.
While promising, successful implementation will require careful integration with existing oncology practices and alignment of incentives across the care continuum. The true measure of success will be whether this program can demonstrate improvements in both clinical outcomes (survival, functional status) and patient-reported quality of life measures.
Cancer is the second-leading cause of death in
"Receiving a cancer diagnosis is a pivotal moment that requires the right care and support," said Humana Medical Director Dr. Bryan Loy. "As a leader in value-based care, we are excited to team up with Thyme Care to ensure our members have access to comprehensive, high-touch oncology services."
Humana Medicare Advantage members who are eligible for the program in
- 24/7 virtual care navigation: Thyme Care’s dedicated Care Team, comprised of oncology nurses, nurse practitioners, social workers, and resource specialists, provides clinical and non-clinical support in between appointments, including medication guidance and symptom management, urgent care support, chronic condition management, and access to palliative care support.
- Community support beyond the clinic: a localized team proactively identifies needs and connects members to community-based resources, including financial assistance, transportation to and from their appointments, food assistance, or access to stable housing.
- Care coordination between providers: Thyme Care coordinates seamlessly with a member’s oncologist, primary care physician, and other specialists to ensure everyone has the right information at the right time to make informed care decisions.
“Navigating a cancer diagnosis can feel like a maze for patients and their loved ones or caregivers. Between getting up to speed on their medical diagnosis to coordinating between specialists and learning to manage their symptoms and side effects, the experience can often feel lonely and isolating. Thyme Care surrounds patients with dedicated support to guide them through this journey, which aligns perfectly with Humana’s commitment to provide access to high-quality, patient-friendly care,” said Thyme Care President and Chief Operating Officer Brad Diephuis, MD. "We're proud to work with Humana as they expand their value-based care strategy into oncology and bring comprehensive cancer support to more people who need these critical services.”
About Humana
Humana Inc. is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell health care services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
About Thyme Care
Thyme Care is the leading value-based care enabler, collaborating with payers and providers to transform the experience and outcomes for individuals living with cancer. The company partners with health plans, employers and risk-bearing providers to assume accountability for enhanced care quality, improved health outcomes, and reduced total cost of care. Thyme Care's approach combines a technology-enabled Care Team and seamless integration with more than 800 oncologists in Thyme Care Oncology Partners, creating a hybrid collaborative care model that guides and supports the entire patient journey. Thyme Care empowers oncologists nationwide through purpose-built tech, advanced data analytics, and virtual patient engagement, driving better care and outcomes in value-based arrangements. Thyme Care is a founding member of CancerX, and is backed by leading investors. To learn more about how Thyme Care is enabling the shift to value-based care in oncology, visit www.thymecare.com.
Other providers are available in the Humana network.
Provider may also contract with other Plan Sponsors.
View source version on businesswire.com: https://www.businesswire.com/news/home/20250226867807/en/
Media Contacts
Lisa Dimond
Humana Corporate Communications
832-330-4702
ldimond@humana.com
Kimberly Dreisinger
Thyme Care Communications
kimberly@thymecare.com
Source: Humana Inc.
FAQ
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