Core Viewpoint - The Oncology Institute, Inc. (TOI) has experienced significant selling pressure, resulting in a 20.1% decline in stock price over the past four weeks, but analysts anticipate improved earnings in the near future [1] Group 1: Technical Analysis - TOI's stock is currently in oversold territory, indicated by a Relative Strength Index (RSI) reading of 25.52, suggesting a potential trend reversal [5] - The RSI is a momentum oscillator that helps identify whether a stock is overbought or oversold, with readings below 30 typically indicating an oversold condition [2][3] Group 2: Fundamental Analysis - There has been a consensus among sell-side analysts to raise earnings estimates for TOI, with a 5.2% increase in the consensus EPS estimate over the last 30 days, which often correlates with price appreciation [7] - TOI holds a Zacks Rank 2 (Buy), placing it in the top 20% of over 4,000 ranked stocks based on earnings estimate revisions and EPS surprises, indicating strong potential for a turnaround [8]

Core Insights - The Oncology Institute of Hope and Innovation (TOI) has launched a Lung Cancer Center of Excellence in Fort Lauderdale, Florida, aimed at providing advanced cancer care [1][2] - The center will be led by Dr. Edgardo S. Santos Castillero, a prominent thoracic oncologist known for his research and patient care [1][3] - TOI's mission is to enhance access to high-quality cancer care while reducing financial burdens for patients and payors [4] Company Overview - TOI was founded in 2007 and specializes in value-based cancer care, serving approximately 1.9 million patients [4] - The organization operates over 100 clinics and affiliate locations across five states, employing more than 180 clinicians [4] - TOI focuses on delivering evidence-based cancer treatments, including clinical trials and transfusions, in community settings [4] Treatment Approach - The Lung Cancer Center of Excellence aims to provide patients with access to advanced treatments and clinical trials in a compassionate environment [2][3] - The center emphasizes a whole-patient approach, integrating advanced diagnostics and innovative therapies [3] - TOI's vision includes redefining lung cancer care by combining advanced therapies with personalized treatment [4]

Company Overview - The Oncology Institute (NASDAQ: TOI) focuses on uniting cancer care practices across the United States to enhance the efficiency of oncological treatments and patient management [1] - The primary objective is to reduce costs associated with cancer care [1] Services Offered - The company provides a range of patient services aimed at improving the overall management of cancer patients [1] Industry Context - The healthcare sector is complex, and financial professionals require scientific and clinical expertise to navigate it effectively [1] - There is a growing need for strategies that bridge the gap between advanced scientific research and financial decision-making in life sciences [1]

Core Insights - The Oncology Institute of Hope and Innovation (TOI) has formed a strategic partnership with Doctors HealthCare Plans to enhance cancer care for Medicare Advantage members in South Florida [1][4] - The partnership will focus on delegated utilization management services and clinical advisory support to ensure high-quality, cost-effective cancer care [2][4] - This collaboration aims to improve patient outcomes and affordability through a data-driven approach to utilization management [4] Company Overview - The Oncology Institute, founded in 2007, specializes in value-based cancer care and serves approximately 1.9 million patients across five states [5] - TOI employs over 180 clinicians and operates more than 100 clinics, focusing on evidence-based cancer care and innovative treatment models [5] - Doctors HealthCare Plans is a Florida-based Medicare Advantage plan that emphasizes community commitment and offers extensive provider networks [6] Partnership Details - Under the partnership, TOI will implement comprehensive utilization management functions for oncology services, utilizing clinical protocols and technology-enabled workflows [2] - The collaboration includes advisory services to optimize oncology benefit design and evidence-based care pathways for providers [2] - The partnership reflects a shared commitment to advancing oncology care through improved utilization management practices [4]

Financial Data and Key Metrics Changes - The company reported a revenue of $120 million for Q2 2025, reflecting a year-over-year growth of over 20% [5] - Adjusted EBITDA loss improved to $4.1 million in Q2 2025, a $4.6 million improvement compared to the same quarter last year [6][20] - Consolidated revenue increased by 21.5% to $119.8 million compared to Q2 2024 [15] - Gross profit for the quarter was $17.5 million, a 34% increase year-over-year, with a gross margin of 14.6% [16][17] Business Line Data and Key Metrics Changes - Patient services revenue was $55.9 million, a 7% increase year-over-year, representing 47% of total revenue [16] - Pharmacy revenue reached $62.6 million, up 41% year-over-year, now constituting 52% of total revenue [16] - The pharmacy business is forecasted to grow over 35% for the full year compared to the previous year [9] Market Data and Key Metrics Changes - The company added over 50,000 capitated lives in Nevada and California through new contracts effective in Q2 [6] - An expanded capitation relationship in Nevada added 49,000 Medicaid patients, and a verbal agreement in Florida will add over 40,000 Medicare Advantage lives [7][8] Company Strategy and Development Direction - The company aims to achieve positive adjusted EBITDA in Q4 2025, driven by strong growth in pharmacy and fee-for-service businesses [6][26] - The focus is on expanding capitated partnerships and leveraging technology to enhance operational efficiency [12][26] - The company is launching three AI enablement efforts in Q3 to improve performance and cost management [13][24] Management's Comments on Operating Environment and Future Outlook - Management noted that drug cost trends are increasing, but the company is positioned to provide value to payer partners through effective cost management [44][45] - The company expects to recognize revenue from new contracts in Q4 2025, with substantial growth anticipated in Florida [47][56] - Management expressed confidence in achieving the high end of the revenue guidance for 2025, projecting $460 million to $480 million [22] Other Important Information - The company announced the retirement of its current Chairman, Richard Barish, and the election of Anne McGeorge as the new Chair [13][14] - The company is focused on improving drug margins through strategic purchasing and active formulary management [21] Q&A Session Summary Question: Can you talk about the dispensing gross margin? - The increase in gross margin is attributed to improved drug procurement and scale, with significant growth year-over-year [28][30] Question: Thoughts on drug pricing reform impacts? - Management believes the Inflation Reduction Act will be net positive for the company, benefiting both capitated and fee-for-service margins [32][33] Question: Any specific drugs impacting EBITDA? - No significant risks were identified in the current drug portfolio that would impact EBITDA negatively [36] Question: Pressure on gross patient service margin? - The pressure is primarily from capitation margins, with expectations for improvement as new contracts mature [37][39] Question: Observations on oncology spend trends? - The company noted a stable medical loss ratio despite rising drug costs, indicating effective cost management [44][45] Question: Details on new patient contracts? - The company expects substantial growth in patient lives, particularly in Florida, with projections of around 100,000 Medicare Advantage lives by year-end [57][58] Question: Clarification on fully delegated risk arrangements? - The company clarified that it takes risk for Part B oncology services and has authority over utilization management and network design [61][62]

[Part I – Financial Information](index=5&type=section&id=Part%20I%20%E2%80%93%20Financial%20Information) [Financial Statements (unaudited)](index=5&type=section&id=Item%201.%20Financial%20Statements%20(unaudited)) For the six months ended June 30, 2025, The Oncology Institute, Inc. reported total operating revenue of $224.2 million, a 16% increase year-over-year, driven primarily by a 33% growth in dispensary revenue, while recording a net loss of $36.6 million, slightly higher than the $35.4 million loss in the prior-year period, with cash and cash equivalents decreasing to $30.3 million from $49.7 million at year-end 2024, and net cash used in operating activities improving significantly to $15.2 million from $31.5 million [Condensed Consolidated Balance Sheets](index=5&type=section&id=Condensed%20Consolidated%20Balance%20Sheets) As of June 30, 2025, total assets decreased to $159.8 million from $172.7 million at December 31, 2024, primarily due to a $19.4 million reduction in cash and cash equivalents, while total liabilities remained relatively stable at $168.8 million, shifting the company's financial position from a total stockholders' equity of $3.6 million to a total stockholders' deficit of $9.0 million Condensed Consolidated Balance Sheet Summary | Financial Item | June 30, 2025 ($ in thousands) | December 31, 2024 ($ in thousands) | | :--- | :--- | :--- | | **Assets** | | | | Cash and cash equivalents | 30,292 | 49,669 | | Total current assets | 104,792 | 112,435 | | Total assets | 159,798 | 172,717 | | **Liabilities** | | | | Total current liabilities | 64,778 | 52,231 | | Long-term debt, net | 75,023 | 93,131 | | Total liabilities | 168,783 | 169,128 | | **Stockholders' Equity (Deficit)** | | | | Total stockholders' equity (deficit) | (8,985) | 3,589 | [Condensed Consolidated Statements of Operations](index=7&type=section&id=Condensed%20Consolidated%20Statements%20of%20Operations) For the three months ended June 30, 2025, total operating revenue increased by 21.5% to $119.8 million year-over-year, driven by a 40.8% surge in dispensary revenue, with loss from operations improving to $11.2 million from $16.4 million in Q2 2024, though the net loss widened to $17.0 million from $15.5 million due to a $4.0 million unfavorable change in the fair value of conversion option derivative liabilities, resulting in a six-month revenue growth of 16% to $224.2 million and a net loss of $36.6 million Condensed Consolidated Statements of Operations Summary | Metric ($ in thousands) | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :--- | :--- | :--- | :--- | :--- | | **Total operating revenue** | **119,802** | **98,578** | **224,208** | **193,244** | | Patient services revenue | 55,891 | 52,461 | 108,959 | 104,914 | | Dispensary revenue | 62,573 | 44,440 | 111,866 | 84,119 | | Loss from operations | (11,211) | (16,364) | (21,122) | (34,336) | | **Net loss** | **(17,009)** | **(15,479)** | **(36,594)** | **(35,368)** | | Net loss per share, basic & diluted | (0.15) | (0.17) | (0.35) | (0.39) | [Condensed Consolidated Statements of Cash Flows](index=10&type=section&id=Condensed%20Consolidated%20Statements%20of%20Cash%20Flows) For the six months ended June 30, 2025, net cash used in operating activities significantly improved to $15.2 million from $31.5 million in the prior-year period, despite a similar net loss, driven by changes in working capital and non-cash adjustments, while net cash used in investing activities was $1.4 million, a sharp contrast to the $37.6 million provided in the prior year, and financing activities used $2.8 million, primarily for a $20 million debt repayment partially offset by $15.4 million in private placement proceeds, leading to an overall $19.4 million decrease in cash and cash equivalents Condensed Consolidated Statements of Cash Flows Summary | Cash Flow Activity ($ in thousands) | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :--- | :--- | :--- | | Net cash used in operating activities | (15,190) | (31,543) | | Net cash (used in) provided by investing activities | (1,410) | 37,564 | | Net cash used in financing activities | (2,777) | (3,085) | | **Net (decrease) increase in cash** | **(19,377)** | **2,936** | | Cash at beginning of period | 49,669 | 33,488 | | **Cash at end of period** | **30,292** | **36,424** | [Notes to Condensed Consolidated Financial Statements](index=12&type=section&id=Notes%20to%20Condensed%20Consolidated%20Financial%20Statements) The notes detail the company's business operations, significant accounting policies, and financial activities, including a Research Services Agreement with Helios to operate the Clinical Trials segment, a February 2025 debt amendment involving a $20 million prepayment and covenant removal, and a March 2025 private placement raising $16.5 million in gross proceeds, with the company concluding it has sufficient liquidity to operate as a going concern for at least one year, and providing breakdowns of revenue, debt, share-based compensation, and segment performance, showing strong growth in the Dispensary segment - On March 31, 2025, the Company entered into a Research Services Agreement with Helios CR, Inc., under which the Clinical Trials segment will be operated by Helios in a profit-sharing arrangement, which resulted in a **$2.4 million loss** from the write-off of the segment's net assets[23](index=23&type=chunk) - The company evaluated its financial condition and concluded it has **sufficient liquidity to fund operations for at least one year** from the issuance date of the financial statements, supported by a debt amendment, a private placement, and cost reduction initiatives[29](index=29&type=chunk)[30](index=30&type=chunk)[31](index=31&type=chunk) - In February 2025, the company amended its Facility Agreement, making a **$20 million partial debt prepayment** and removing a covenant that required maintaining a **$40 million cash balance**[102](index=102&type=chunk)[103](index=103&type=chunk) - In March 2025, the company completed a private placement (PIPE) resulting in **gross proceeds of approximately $16.5 million** and an associated exchange of **$4.1 million in debt for equity and warrants**[139](index=139&type=chunk) [Management's Discussion and Analysis of Financial Condition and Results of Operations](index=40&type=section&id=Item%202.%20Management's%20Discussion%20and%20Analysis%20of%20Financial%20Condition%20and%20Results%20of%20Operations) Management attributes the 21.5% year-over-year revenue growth in Q2 2025 to a 40.8% increase in dispensary revenue and a 6.5% rise in patient services revenue, with dispensary growth driven by a 102.8% increase in prescription fills, while successfully reducing SG&A expenses by 3.5% in Q2 2025 through cost discipline and operational efficiency initiatives, including planned AI pilots for automation, leading to significant Adjusted EBITDA improvement with a loss of $4.1 million in Q2 2025 compared to a loss of $8.7 million in Q2 2024, and believing it has sufficient liquidity for the next year, supported by a recent private placement, debt restructuring, and improved cash flow from operations [Results of Operations](index=42&type=section&id=Results%20of%20Operations) For Q2 2025, total operating revenue increased 21.5% to $119.8 million from $98.6 million in Q2 2024, driven by a 40.8% increase in Dispensary revenue and a 6.5% increase in Patient Services revenue, with operating expenses as a percentage of revenue decreasing from 116.6% to 109.4%, leading to an improved operating loss of $11.2 million versus $16.4 million in the prior-year quarter, aided by a 3.5% reduction in SG&A expenses due to cost discipline Operating Revenue by Category | Revenue Category ($ in thousands) | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | Change ($) | Change (%) | | :--- | :--- | :--- | :--- | :--- | | Patient services | 55,891 | 52,461 | 3,430 | 6.5% | | Dispensary | 62,573 | 44,440 | 18,133 | 40.8% | | Clinical trials & other | 1,338 | 1,677 | (339) | (20.2)% | | **Total operating revenue** | **119,802** | **98,578** | **21,224** | **21.5%** | - The increase in dispensary revenue was primarily due to a **102.8% increase** in the number of prescription fills, offset by a **30.6% decrease** in average revenue per fill[206](index=206&type=chunk) - Selling, general and administrative (SG&A) expenses **decreased by 3.5%** in Q2 2025 compared to Q2 2024, reflecting cost discipline and operational efficiency, with the company planning to launch AI pilots for prior-authorization and denial automation to further improve efficiency[211](index=211&type=chunk) [Key Business Metrics](index=45&type=section&id=Key%20Business%20Metrics) Management uses key metrics including the number of clinics, lives under value-based contracts, and Adjusted EBITDA to evaluate performance, with the company operating 80 clinics and managing 1.9 million lives under value-based contracts as of Q2 2025, and Adjusted EBITDA, a non-GAAP measure, showing significant improvement with a loss of $4.1 million for the three months ended June 30, 2025, compared to a loss of $8.7 million in the same period of 2024, driven by higher revenue and lower operating expenses Key Performance Indicators | Metric | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | | :--- | :--- | :--- | | Clinics | 80 | 87 | | Lives under value-based contracts | 1.9 million | 2.0 million | | Adjusted EBITDA ($ in thousands) | (4,089) | (8,709) | Adjusted EBITDA Reconciliation | Reconciliation to Adjusted EBITDA ($ in thousands) | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | | :--- | :--- | :--- | | Net loss | (17,009) | (15,479) | | Depreciation and amortization | 1,805 | 1,518 | | Interest expense, net | 1,870 | 2,119 | | Share-based compensation | 752 | 3,387 | | Changes in fair value of liabilities | 4,040 | (3,120) | | Other adjustments | 4,513 | 2,274 | | **Adjusted EBITDA** | **(4,089)** | **(8,709)** | [Liquidity and Capital Resources](index=47&type=section&id=Liquidity%20and%20Capital%20Resources) The company asserts it has sufficient liquidity to fund operations for at least one year, supported by its cash balance of $30.3 million as of June 30, 2025, a March 2025 private placement that raised $16.5 million, and a February 2025 debt amendment that removed a restrictive cash covenant, with cash flow from operations improving by $16.4 million for the first six months of 2025 compared to the prior year due to better working capital management, and material future cash requirements including debt service of $94.1 million and operating lease payments of $32.7 million - The company concluded it has **sufficient liquidity for at least one year**, citing its cash balance, a recent private placement raising **~$16.5M**, a debt amendment removing a **$40M cash covenant**, and improved operational cash flow[223](index=223&type=chunk)[224](index=224&type=chunk)[225](index=225&type=chunk) - Net cash used in operating activities **improved by $16.4 million** for the six months ended June 30, 2025, compared to the same period in 2024, primarily due to better working capital management and non-cash adjustments[229](index=229&type=chunk)[233](index=233&type=chunk) Material Cash Requirements | Material Cash Requirements (Total) | Amount ($ in thousands) | | :--- | :--- | | Convertible note (principal & interest) | 94,105 | | Operating leases | 32,738 | | Deferred acquisition and contingent consideration | 143 | | Other (finance leases, D&O insurance) | 407 | | **Total** | **127,393** | [Quantitative and Qualitative Disclosures About Market Risk](index=52&type=section&id=Item%203.%20Quantitative%20and%20Qualitative%20Disclosures%20About%20Market%20Risk) The company's primary market risks are interest rate risk, inflation risk, and impairment risk, with interest rate risk considered minimal due to the short-term nature of its cash holdings, while inflation poses a risk by potentially increasing the costs of drugs, labor, and other business expenses faster than forecasted, and impairment risk relates to the potential for writing down goodwill or intangible assets if economic conditions worsen, interest rates rise, or reporting units underperform - The company identifies its main market risks as **interest rate risk, inflation risk, and impairment risk**[257](index=257&type=chunk) - **Inflation is a key concern** as it can increase costs for drugs, labor, and administration, potentially causing the company to use cash faster than planned[259](index=259&type=chunk) - There is a **risk of goodwill or intangible asset impairment** if reporting units underperform, the economy enters a recession, or interest rates continue to rise[260](index=260&type=chunk) [Controls and Procedures](index=52&type=section&id=Item%204.%20Controls%20and%20Procedures) Management, including the CEO and CFO, evaluated the company's disclosure controls and procedures and concluded they were effective as of June 30, 2025, with no material changes to the company's internal control over financial reporting during the quarter, while acknowledging the inherent limitations of any control system, noting it can provide only reasonable, not absolute, assurance of achieving its objectives - Based on an evaluation as of June 30, 2025, the Chief Executive Officer and Chief Financial Officer concluded that the company's disclosure controls and procedures were **effective**[261](index=261&type=chunk) - **No changes occurred** during the quarter ended June 30, 2025, that have materially affected, or are reasonably likely to materially affect, the company's internal control over financial reporting[262](index=262&type=chunk) [Part II – Other Information](index=54&type=section&id=Part%20II%20%E2%80%93%20Other%20Information) [Legal Proceedings](index=54&type=section&id=Item%201.%20Legal%20Proceedings) The company is **not currently involved in any legal proceedings that would have a material adverse effect** on its business, financial condition, or results of operations[266](index=266&type=chunk) [Risk Factors](index=54&type=section&id=Item%201A.%20Risk%20Factors) **No material changes** have been made to the risk factors described in the Annual Report on Form 10-K for the year ended December 31, 2024[267](index=267&type=chunk) [Other Information](index=54&type=section&id=Item%205.%20Other%20Information) During the quarter, a director by deputization, M33 Growth I L.P., adopted a Rule 10b5-1 trading plan for the sale of up to 3 million shares of common stock, and subsequent to the quarter end, on August 13, 2025, the company entered into At-the-Market (ATM) Sales Agreements to sell, at its option, up to $15 million of its common stock - On June 12, 2025, director M33 Growth I L.P. adopted a **Rule 10b5-1 trading plan for the sale of up to 3,000,000 shares of common stock** through May 18, 2026[271](index=271&type=chunk) - On August 13, 2025, the company established an At-the-Market (ATM) offering program, allowing it to **sell up to $15 million in common stock** through agents BTIG, LLC and B. Riley Securities, Inc[272](index=272&type=chunk) [Exhibits](index=55&type=section&id=Item%206.%20Exhibits) This section lists all exhibits filed with the Form 10-Q, including certifications from the Principal Executive Officer and Principal Financial Officer, and interactive data files (XBRL), also referencing previously filed documents such as the merger agreement, corporate bylaws, and various warrant and debt agreements

Press Release Overview [Introduction](index=1&type=section&id=Introduction) The Oncology Institute, Inc, (TOI) announced its Q2 2025 financial results and reaffirmed its full-year 2025 guidance - The Oncology Institute, Inc, (NASDAQ: TOI) reported financial results for the three months ended June 30, 2025[1](index=1&type=chunk) - TOI is one of the largest value-based community oncology groups in the United States[1](index=1&type=chunk) [CEO Commentary](index=1&type=section&id=CEO%20Commentary) The CEO highlighted strong Q2 revenue growth driven by the pharmacy business and new capitated lives, reinforcing confidence in 2025 guidance - Achieved over **20% year-over-year revenue growth** in Q2 2025[2](index=2&type=chunk) - Pharmacy business grew over **40% year-over-year**, and over **50,000 new capitated lives** were added to the value-based business[2](index=2&type=chunk) - Expanding partnerships in Florida and Nevada are expected to significantly increase covered lives[2](index=2&type=chunk)[5](index=5&type=chunk) - Confidence in achieving revenue at the **high end of 2025 guidance** and **Adjusted EBITDA positivity** by year-end 2025[2](index=2&type=chunk) Highlights [Recent Operational Highlights](index=1&type=section&id=Recent%20Operational%20Highlights) Q2 operational achievements included fee-for-service revenue growth, record pharmacy performance, expanded capitated partnerships, and key executive appointments - Fee-for-service revenue grew **10%** over Q2 2024, driven by momentum in new markets[5](index=5&type=chunk) - Retail Pharmacy and Dispensary set fill records, contributing **$62.6 million in revenue** and over **$11 million in gross profit** in Q2 2025[5](index=5&type=chunk) - Planned expansion of existing fully delegated capitated partnership with Elevance into two new counties in Central Florida, potentially doubling covered lives[5](index=5&type=chunk) - Welcomed Dr, Jeff Langsam as Chief Clinical Officer and Kristin England as Chief Administrative Officer[5](index=5&type=chunk) [Second Quarter 2025 Financial Highlights](index=1&type=section&id=Second%20Quarter%202025%20Financial%20Highlights) TOI reported a 21.5% increase in Q2 2025 consolidated revenue, a 34.4% rise in gross profit, and a 53.1% improvement in Adjusted EBITDA loss **Q2 2025 Financial Highlights (YoY Comparison):** | Metric | Q2 2025 (Millions) | Q2 2024 (Millions) | Change (%) | | :-------------------------- | :------------------ | :------------------ | :--------- | | Consolidated Revenue | $119.8 | $98.6 | 21.5% | | Gross Profit | $17.5 | $13.0 (calculated from Statement of Operations) | 34.4% | | Net Loss | $(17.0) | $(15.5) | 9.7% | | Basic & Diluted EPS | $(0.15) | $(0.17) | 11.8% (improvement) | | Adjusted EBITDA | $(4.1) | $(8.7) | 53.1% (improvement) | | Cash & Cash Equivalents (as of June 30, 2025) | $30.3 | N/A | N/A | Financial Outlook and Guidance [Fiscal Year 2025 Guidance](index=1&type=section&id=Fiscal%20Year%202025%20Guidance) The company reaffirmed its full-year 2025 guidance for revenue, gross profit, Adjusted EBITDA, and Free Cash Flow, expecting to reach the high end of the revenue range **Full Year 2025 Guidance:** | Metric | Range | | :---------------- | :------------------- | | Revenue | $460 to $480 million | | Gross Profit | $73 to $82 million | | Adjusted EBITDA | $(8) to $(17) million | | Free Cash Flow | $(12) to $(21) million | - The Company believes it can reach the **higher-end of the revenue guidance range** for 2025 due to strong revenue growth in the first half of the year[6](index=6&type=chunk) [Q3 2025 Outlook](index=2&type=section&id=Q3%202025%20Outlook) TOI anticipates a Q3 2025 Adjusted EBITDA loss between $(2.5) million and $(3.5) million **Q3 2025 Adjusted EBITDA Outlook:** | Metric | Range | | :-------------- | :-------------------------- | | Adjusted EBITDA | $(2.5) to $(3.5) million | Company Information [About The Oncology Institute, Inc.](index=3&type=section&id=About%20The%20Oncology%20Institute%2C%20Inc.) TOI is a leading provider of value-based cancer care in community settings, operating over 100 clinics and serving approximately 1.9 million patients - Founded in 2007, TOI provides highly specialized, value-based cancer care in community settings[10](index=10&type=chunk) - Serves approximately **1.9 million patients** with cutting-edge, evidence-based care, including clinical trials and transfusions[10](index=10&type=chunk) - Operates over **100 clinics** and affiliate locations across five states with over 180 employed and affiliate clinicians[10](index=10&type=chunk) [Webcast and Conference Call](index=3&type=section&id=Webcast%20and%20Conference%20Call) The company hosted a conference call and webcast on August 13, 2025, to discuss its Q2 results, with replay details available - Conference call held on Wednesday, August 13, 2025, at 5:00 p,m, (Eastern Time) to discuss second quarter results and management's outlook[7](index=7&type=chunk) - Access details for the live call, replay (available until August 20, 2025), and webcast via the Investor Relations section of TOI's website[8](index=8&type=chunk)[9](index=9&type=chunk) [Forward-Looking Statements](index=3&type=section&id=Forward-Looking%20Statements) The report contains forward-looking statements subject to risks and uncertainties, and the company disclaims any obligation to update them - Press release contains forward-looking statements, which are not historical facts and are subject to risks and uncertainties[11](index=11&type=chunk) - Actual events and circumstances may differ materially from assumptions, and TOI does not undertake any obligation to update these statements[11](index=11&type=chunk) Non-GAAP Financial Measures [Explanation of Non-GAAP Measures](index=4&type=section&id=Explanation%20of%20Non-GAAP%20Measures) TOI uses Adjusted EBITDA and Free Cash Flow as supplementary non-GAAP measures to evaluate performance and facilitate peer comparisons - TOI uses **Adjusted EBITDA** and **Free Cash Flow** as non-GAAP metrics to assess operational and financial performance, plan future periods, and compare with similar companies[4](index=4&type=chunk)[12](index=12&type=chunk)[14](index=14&type=chunk) - **Free Cash Flow** is defined as net cash flow provided by (used in) operations plus cash paid for interest, less capital expenditures, useful for understanding cash available for strategic initiatives[13](index=13&type=chunk) - **Adjusted EBITDA** is defined as net (loss) income plus depreciation, amortization, interest, taxes, non-cash items, share-based compensation, goodwill impairment charges, change in fair value of liabilities, unrealized gains or losses on investments, and other specific adjustments[15](index=15&type=chunk) [Free Cash Flow Reconciliation](index=5&type=section&id=Free%20Cash%20Flow%20Reconciliation) Free Cash Flow for the first six months of 2025 improved by 54.1% to $(14.6) million, driven by reduced net cash used in operations **Free Cash Flow Reconciliation (Six Months Ended June 30):** | Metric (in thousands) | 2025 | 2024 | Change ($) | Change (%) | | :------------------------------------------ | :--------- | :--------- | :--------- | :--------- | | Net cash and cash equivalents used in operating activities | $(15,190) | $(31,543) | $16,353 | 51.8% | | Cash paid for interest | $2,158 | $2,224 | $(66) | (3.0)% | | Purchases of property and equipment | $(1,536) | $(2,436) | $900 | 36.9% | | **Free Cash Flow** | **$(14,568)** | **$(31,755)** | **$17,187** | **54.1%** | [Adjusted EBITDA Reconciliation](index=5&type=section&id=Adjusted%20EBITDA%20Reconciliation) Adjusted EBITDA loss improved significantly by over 53% for both the three and six-month periods ending June 30, 2025 **Adjusted EBITDA Reconciliation (Three Months Ended June 30):** | Metric (in thousands) | 2025 | 2024 | Change ($) | Change (%) | | :-------------------------- | :--------- | :--------- | :--------- | :--------- | | Net loss | $(17,009) | $(15,479) | $(1,530) | 9.9% | | Depreciation and amortization | $1,805 | $1,518 | $287 | 18.9% | | Interest expense, net | $1,870 | $2,119 | $(249) | (11.8)% | | Non-cash addbacks | $2,222 | $(69) | $2,291 | (3,320.3)% | | Share-based compensation | $752 | $3,387 | $(2,635) | (77.8)% | | Changes in fair value of liabilities | $4,040 | $(3,120) | $7,160 | (229.5)% | | **Adjusted EBITDA** | **$(4,089)** | **$(8,710)** | **$4,621** | **(53.1)%** | **Adjusted EBITDA Reconciliation (Six Months Ended June 30):** | Metric (in thousands) | 2025 | 2024 | Change ($) | Change (%) | | :-------------------------- | :--------- | :--------- | :--------- | :--------- | | Net loss | $(36,594) | $(35,368) | $(1,226) | 3.5% | | Depreciation and amortization | $3,589 | $3,007 | $582 | 19.4% | | Interest expense, net | $7,440 | $4,103 | $3,337 | 81.3% | | Non-cash addbacks | $2,059 | $(108) | $2,167 | (2,006.5)% | | Share-based compensation | $2,210 | $7,474 | $(5,264) | (70.4)% | | Changes in fair value of liabilities | $7,392 | $(3,120) | $10,512 | (336.9)% | | **Adjusted EBITDA** | **$(9,198)** | **$(19,651)** | **$10,453** | **(53.2)%** | - Non-cash addbacks for the three and six months ended June 30, 2025, primarily included a **$2,398 thousand write-off** of net assets from the Clinical Trials segment[19](index=19&type=chunk) Key Business Metrics [Key Business Metrics Summary](index=5&type=section&id=Key%20Business%20Metrics%20Summary) As of Q2 2025, TOI operated 80 clinics in 20 markets, serving 1.9 million lives under value-based contracts **Key Business Metrics (as of June 30):** | Metric | 2025 | 2024 | | :-------------------------------- | :--- | :--- | | Clinics | 80 | 87 | | Markets | 20 | 14 | | Lives under value-based contracts (millions) | 1.9 | 2.0 | **Key Financial Metrics (Three & Six Months Ended June 30):** | Metric (in thousands) | Q2 2025 | Q2 2024 | YTD 2025 | YTD 2024 | | :-------------------------- | :-------- | :-------- | :--------- | :--------- | | Net loss | $(17,009) | $(15,479) | $(36,594) | $(35,368) | | Adjusted EBITDA | $(4,089) | $(8,709) | $(9,198) | $(19,650) | Consolidated Financial Statements (Unaudited) [Consolidated Balance Sheets](index=6&type=section&id=Consolidated%20Balance%20Sheets) Total assets decreased by 7.5% to $159.8 million as of June 30, 2025, while the company's stockholders' equity shifted to a deficit **Consolidated Balance Sheet Highlights (in thousands):** | Metric | June 30, 2025 | December 31, 2024 | Change ($) | Change (%) | | :-------------------------- | :-------------- | :---------------- | :--------- | :--------- | | Cash and cash equivalents | $30,292 | $49,669 | $(19,377) | (39.0)% | | Total current assets | $104,792 | $112,418 | $(7,626) | (6.8)% | | Total assets | $159,798 | $172,717 | $(12,919) | (7.5)% | | Total current liabilities | $64,778 | $52,215 | $12,563 | 24.1% | | Long-term debt, net | $75,023 | $93,131 | $(18,108) | (19.4)% | | Total liabilities | $168,783 | $169,128 | $(345) | (0.2)% | | Total stockholders' equity (deficit) | $(8,985) | $3,589 | $(12,574) | (350.4)% | [Consolidated Statements of Operations](index=7&type=section&id=Consolidated%20Statements%20of%20Operations) Q2 2025 operating revenue grew 21.5% to $119.8 million, and loss from operations improved, though net loss slightly increased due to non-operating items **Consolidated Statements of Operations Highlights (in thousands, Three Months Ended June 30):** | Metric | 2025 | 2024 | Change ($) | Change (%) | | :-------------------------- | :--------- | :--------- | :--------- | :--------- | | Patient services revenue | $55,891 | $52,461 | $3,430 | 6.5% | | Dispensary revenue | $62,573 | $44,440 | $18,133 | 40.8% | | Total operating revenue | $119,802 | $98,578 | $21,224 | 21.5% | | Loss from operations | $(11,211) | $(16,364) | $5,153 | (31.5)% (improvement) | | Total other non-operating loss (income) | $5,929 | $(885) | $6,814 | (769.9)% | | Net loss | $(17,009) | $(15,479) | $(1,530) | 9.9% | | Basic & Diluted EPS | $(0.15) | $(0.17) | $0.02 | (11.8)% (improvement) | **Consolidated Statements of Operations Highlights (in thousands, Six Months Ended June 30):** | Metric | 2025 | 2024 | Change ($) | Change (%) | | :-------------------------- | :--------- | :--------- | :--------- | :--------- | | Total operating revenue | $224,208 | $193,244 | $30,964 | 16.0% | | Loss from operations | $(21,122) | $(34,336) | $13,214 | (38.5)% (improvement) | | Total other non-operating loss (income) | $15,603 | $1,032 | $14,571 | 1411.9% | | Net loss | $(36,594) | $(35,368) | $(1,226) | 3.5% | | Basic & Diluted EPS | $(0.35) | $(0.39) | $0.04 | (10.3)% (improvement) | [Consolidated Statements of Cash Flows](index=8&type=section&id=Consolidated%20Statements%20of%20Cash%20Flows) Net cash used in operating activities for the first half of 2025 decreased significantly, though the overall cash position declined by $19.4 million **Consolidated Statements of Cash Flows Highlights (in thousands, Six Months Ended June 30):** | Metric | 2025 | 2024 | Change ($) | | :------------------------------------------ | :--------- | :--------- | :--------- | | Net cash used in operating activities | $(15,190) | $(31,543) | $16,353 | | Net cash (used in) provided by investing activities | $(1,410) | $37,564 | $(38,974) | | Net cash used in financing activities | $(2,777) | $(3,085) | $308 | | Net (decrease) increase in cash and cash equivalents | $(19,377) | $2,936 | $(22,313) | | Cash and cash equivalents at end of period | $30,292 | $36,424 | $(6,132) | - **Significant decrease in net cash used in operating activities**, primarily due to improved net loss adjustments and changes in operating assets and liabilities[26](index=26&type=chunk) - Shift from cash provided by investing activities in 2024 (due to sales of marketable securities) to cash used in 2025, with purchases of property and equipment remaining consistent[26](index=26&type=chunk) Contacts [Contacts Information](index=8&type=section&id=Contacts%20Information) The report provides contact details for media and investor relations inquiries - Media contact: Daniel Virnich, MD, danielvirnich@theoncologyinstitute,com, (562) 735-3226 x 81125[27](index=27&type=chunk) - Investor relations contact: ICR Strategic Communications, investors@icrinc,com[27](index=27&type=chunk)

Core Insights - The Oncology Institute, Inc. (TOI) reported a strong financial performance for Q2 2025, achieving over 20% year-over-year revenue growth, primarily driven by a 40% increase in pharmacy business and the addition of over 50,000 new capitated lives [2][4][5] - The company is expanding its partnership with a major health plan in Florida, which is expected to double the number of lives covered under this payor [2][5] - TOI reaffirms its full-year 2025 revenue guidance of $460 to $480 million and anticipates achieving Adjusted EBITDA positivity by the end of 2025 [4][6] Financial Highlights - Consolidated revenue for Q2 2025 was $119.8 million, a 21.5% increase from $98.6 million in Q2 2024 [5][24] - Gross profit for the same period was $17.5 million, reflecting a 34.4% increase [5][24] - The net loss for Q2 2025 was $17.0 million, compared to a net loss of $15.5 million in Q2 2024 [5][24] - Adjusted EBITDA improved to $(4.1) million from $(8.7) million year-over-year [5][24] Operational Developments - The company expanded its fully delegated capitated partnership with Elevance into two new counties in Central Florida, which is expected to significantly increase the number of lives under its management [5][6] - TOI welcomed new executives, including Dr. Jeff Langsam as Chief Clinical Officer and Kristin England as Chief Administrative Officer, to enhance its operational capabilities [5][6] Key Metrics - The number of clinics remained stable at 80, while the number of markets increased to 20 from 14 year-over-year [21] - Lives under value-based contracts were approximately 1.9 million, consistent with the previous year [22] Cash Position - As of June 30, 2025, TOI had cash and cash equivalents of $30.3 million, down from $49.7 million at the end of 2024 [23][25] - The company reported a net cash outflow from operating activities of $15.2 million for the first half of 2025, a significant improvement from $31.5 million in the same period of 2024 [25][26]

Core Points - Richard Barasch will retire as Chairman of The Oncology Institute, effective August 12, 2025, and will be succeeded by Anne McGeorge [1] - Anne McGeorge has over 35 years of experience in healthcare financial advisory and previously led Grant Thornton LLP's Global Health Care and Life Sciences Practice [2] - The Oncology Institute aims to provide exceptional oncology care and has a mission to advance value-based cancer care in community settings [5] Company Overview - The Oncology Institute, Inc. was founded in 2007 and is one of the largest value-based oncology groups in the United States [5] - The organization serves approximately 1.9 million patients and operates over 100 clinics across five states [5] - The company employs over 180 clinicians and is focused on delivering evidence-based cancer care, including clinical trials and transfusions [5]

Core Insights - Topicus.com Inc. reported a total revenue of €372.0 million for Q2 2025, marking a 20% increase from €311.2 million in Q2 2024, with organic growth contributing 5% [4][8] - Net income for Q2 2025 rose to €41.5 million, a 54% increase from €26.9 million in the same quarter of 2024, translating to €0.31 per diluted share compared to €0.21 [5][8] - The company completed acquisitions totaling €210.3 million in cash consideration, with an estimated total consideration of €240.8 million including deferred payments [8] Financial Performance - Total revenue for the first half of 2025 reached €727.6 million, an 18% increase from €617.8 million in the first half of 2024 [4] - Net income for the first six months of 2025 was €111.6 million, up from €55.2 million in the same period of 2024, resulting in €0.85 per diluted share compared to €0.43 [5] - Cash flows from operations (CFO) for Q2 2025 were negative €14.9 million, a decrease from positive €8.8 million in Q2 2024, while CFO for the first half of 2025 increased to €256.5 million from €236.3 million [6][24] Cash Flow and Investments - Free cash flow available to shareholders (FCFA2S) was negative €16.7 million for Q2 2025, down from negative €3.8 million in Q2 2024, but increased to €145.0 million for the first half of 2025 from €130.1 million [7][10] - The company reported cash and cash equivalents of €249.3 million at the end of Q2 2025, compared to €233.7 million at the end of Q2 2024 [24] Acquisitions and Growth Strategy - Topicus completed acquisitions for a total cash consideration of €210.3 million, with deferred payments estimated at €30.5 million, indicating a strong focus on growth through acquisitions [8] - The company experienced organic growth of 5% and 4% for Q2 and the first half of 2025, respectively, highlighting the importance of both acquisitions and organic expansion in its growth strategy [4]