Financial Data and Key Metrics Changes - The company reported third quarter revenue of $137 million, a 23% increase compared to the previous year, driven by a 42% growth in the pharmacy business and a 13% growth in the fee-for-service business [4][14] - Adjusted EBITDA loss improved to $3.5 million, a $4.7 million improvement year-over-year, with expectations to achieve profitability in Q4 and become free cash flow positive in 2026 [5][20] - Total revenue for Q3 was $136.6 million, representing a 36.7% year-over-year growth [14] Business Line Data and Key Metrics Changes - Patient services revenue, including capitation and fee-for-service, totaled $60.2 million, accounting for 44.1% of total revenue, with a 21% year-over-year increase [15] - Pharmacy revenue reached $75.9 million, representing 55.6% of total revenue, and increased 57.4% year-over-year due to higher prescription volumes [16] Market Data and Key Metrics Changes - The company expanded its MSO network in Florida to over 200 providers and opened a new pharmacy location to serve network providers [6] - New capitation contracts signed in 2025 are expected to contribute an estimated $19 million in full-year revenue, a 29% increase compared to 2024 [6] Company Strategy and Development Direction - The company is focusing on expanding its delegated capitation model, particularly in Florida, which is expected to become its primary model across all markets [12][13] - The integration of AI into operations is anticipated to enhance performance and reduce costs, with significant operational efficiencies expected from the new AI model [7][8] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in achieving adjusted EBITDA profitability in Q4 and highlighted the strong momentum built over the past year [10][20] - The company is optimistic about the impact of recent healthcare policy changes, believing they will lower drug costs and enhance accessibility [40][41] Other Important Information - A cybersecurity incident at a key vendor temporarily affected billing for fee-for-service claims, but the company managed to minimize operational disruptions [9][10] - The company ended the quarter with $27.7 million in cash and cash equivalents, with $86 million of convertible debt outstanding [18] Q&A Session Summary Question: Can you describe the reserve for fee-for-service revenue? - The reserve was a $1.8 million adjustment that impacted adjusted EBITDA, but normalized performance was significantly better [24][26] Question: How sustainable is the first month of profitability in September? - The company expects to achieve break-even EBITDA in Q4 and anticipates positive adjusted EBITDA in 2026 [28][29] Question: What is the current PM/PM trend on new contracts? - PM/PM is dependent on market location, with most contracts having escalators for annual increases [42] Question: How will changes in payer behavior impact the business? - The overall trend towards lower-cost drugs and simplified reimbursement processes is expected to be net favorable for the company [40][41] Question: What is the outlook for new contracts and covered lives? - The company continues to see strong interest in its model and expects top-line growth to mirror previous years, with no slowdown in value-based contracting opportunities [48][49]

Revenue Growth - For the three months ended September 30, 2025, total operating revenue increased by 36.7% to $136.564 million compared to $99.901 million in the same period of 2024[209]. - Patient services revenue for the three months ended September 30, 2025, was $60.195 million, reflecting a 21.0% increase from $49.752 million in the prior year[209]. - Dispensary revenue for the three months ended September 30, 2025, rose by 57.4% to $75.895 million, up from $48.210 million in the same quarter of 2024[209]. - Total operating revenue for the nine months ended September 30, 2025, was $360.772 million, a 23.1% increase from $293.145 million in the same period of 2024[209]. Expenses and Costs - Total operating expenses for Q3 2025 were $144.6 million, an increase of 27.1% from $113.8 million in Q3 2024[213]. - Patient services costs increased by 17.7% in Q3 2025, primarily due to rising intravenous drug costs, while clinical payroll costs decreased by 1.8%[214]. - Dispensary costs rose by 97.7% in Q3 2025 due to a significant increase in the number of prescriptions filled, despite a 20.4% decrease in average prescription costs[215]. - Selling, general and administrative expenses were 18.5% of total operating revenue for the three months ended September 30, 2025, compared to 26.7% in the same period of 2024[208]. - Selling, general and administrative (SG&A) expenses decreased by 4.5% in Q3 2025 to $25.4 million, attributed to cost discipline and operational efficiency[216]. Profitability and Loss - The company reported a net loss of 12.2% for the three months ended September 30, 2025, compared to a net loss of 16.2% in the same period of 2024[208]. - The net loss for the nine months ended September 30, 2025, was $53.1 million, a slight increase of 3.1% from $51.5 million in the same period of 2024[227]. - Adjusted EBITDA for Q3 2025 was $(3.46) million, a 57.8% improvement from $(8.20) million in Q3 2024[226]. Cash Flow and Liquidity - As of September 30, 2025, the company had cash and cash equivalents of $27,658 and an accumulated deficit of $263,911, with a net loss of $53,098 for the nine months ended September 30, 2025[229]. - The company improved cash flow from operations by approximately $2,904, a 9% reduction in cash used compared to the same period in the prior year[231]. - Net cash used in operating activities decreased to $27,820 for the nine months ended September 30, 2025, compared to $30,724 in the prior year, reflecting a 9% improvement[236]. - The company expects sufficient liquidity to fund operations for at least one year from the issuance date of the financial statements[232]. - Cash provided by accounts payable and accrued expenses increased by $1,027 for the nine months ended September 30, 2025, due to cash management initiatives[240]. Market and Operational Insights - The number of fills in the dispensary increased by 97.7% for the three months ended September 30, 2025, contributing to the revenue growth despite a 20.4% decrease in average revenue per fill[211]. - The number of clinics remained stable at 80, while the number of markets expanded to 22 from 14 in the prior year[222]. - The company anticipates continued increases in selling, general and administrative expenses due to costs associated with being a public company and business growth[206]. Financial Instruments and Risks - Interest expense for the nine months ended September 30, 2025, increased by 47.9% to $9.36 million compared to $6.33 million in the prior year[219]. - The fair value of conversion option derivative liabilities increased by $5.98 million in Q3 2025 due to a rise in stock price[220]. - Total material cash requirements over the next five years are estimated at $125,380, including $93,227 for convertible notes and $31,667 for operating leases[241]. - Inflation has increased costs for drugs and clinical trials, potentially leading to faster depletion of cash reserves[266]. - Impairment risk is assessed annually, with potential economic disruptions and rising interest rates posing threats to goodwill and intangible assets[267]. Revenue Recognition - The transaction price for FFS arrangements is variable, based on patient encounters and provider costs, with revenue recognized only when significant reversal of cumulative revenue is unlikely[252]. - Revenue for dispensed prescriptions is based on fee schedules set by PBMs, with DIR fees impacting the transaction price[256]. - Clinical research contracts are recognized as a single performance obligation, with revenue invoiced periodically based on trial progress[257].

Financial Performance - Consolidated revenue for Q3 2025 was $136.6 million, a 36.7% increase from $99.9 million in Q3 2024[4] - Fee-for-service revenue grew by 13% compared to Q3 2024, driven by organic growth in Florida and Oregon[4] - Retail Pharmacy and Dispensary generated $75.9 million in revenue and $12.8 million in gross profit during Q3[4] - Total operating revenue for Q3 2025 was $136,564,000, a 36.6% increase from $99,901,000 in Q3 2024[23] - Net loss for Q3 2025 was $16,504,000, compared to a net loss of $16,113,000 in Q3 2024, reflecting a 2.4% increase in losses[23] Adjusted EBITDA - Adjusted EBITDA for Q3 2025 was $(3.5) million, an improvement from $(8.2) million in Q3 2024[4] - Adjusted EBITDA for the nine months ended September 30, 2025, was $(12,555,000), an improvement from $(27,847,000) in the same period of 2024[23] - The company expects Adjusted EBITDA of approximately $0 to $2 million in Q4 2025[5] Cash and Assets - Cash and cash equivalents stood at $27.7 million as of September 30, 2025[4] - Cash and cash equivalents decreased to $27,658,000 as of September 30, 2025, down from $49,669,000 at the end of 2024[22] - Total assets decreased to $163,619,000 as of September 30, 2025, from $172,717,000 at the end of 2024[22] Liabilities and Receivables - Total current liabilities rose to $65,580,000 as of September 30, 2025, up from $52,215,000 at the end of 2024, reflecting increased operational costs[22] - Accounts receivable increased to $59,639,000 as of September 30, 2025, compared to $48,335,000 at the end of 2024, indicating improved revenue collection[22] Company Updates - The company updated its full-year 2025 revenue guidance to $495 to $505 million, up from the previous guidance of $460 to $480 million[3] - The company welcomed Kristin England as the new Chief Administrative Officer to oversee operations and technology strategy[4] - The company is leveraging AI to enhance operational efficiencies and improve patient experience[6] Operational Activities - The company reported a net cash used in operating activities of $(27,820,000) for the nine months ended September 30, 2025, compared to $(30,724,000) in the same period of 2024[24] - The number of lives under value-based contracts remained stable at 1.9 million for both Q3 2025 and Q3 2024[21] - The company issued 2,695,000 shares for options exercised during the nine months ended September 30, 2025[24]

Core Insights - The Oncology Institute, Inc. (TOI) reported strong financial results for Q3 2025, with consolidated revenue of $136.6 million, a 36.7% increase from $99.9 million in Q3 2024, and a net loss of $16.5 million compared to a net loss of $16.1 million in the prior year [3][4][20] - The company updated its full-year 2025 guidance, raising revenue expectations to between $495 million and $505 million, while Adjusted EBITDA guidance was adjusted to a loss of $11 million to $13 million [3][4] - TOI's fee-for-service revenue grew by 13% year-over-year, driven by organic growth in Florida and Oregon, and the retail pharmacy and dispensary segment set records with $75.9 million in revenue [4][5] Financial Performance - Consolidated revenue for Q3 2025 was $136.6 million, up from $99.9 million in Q3 2024, while gross profit increased to $18.9 million, a 31.7% rise [4][20] - The net loss for Q3 2025 was $16.5 million, slightly higher than the $16.1 million loss in Q3 2024, with basic and diluted loss per share improving to $(0.14) from $(0.18) [4][20] - Adjusted EBITDA for Q3 2025 was $(3.5) million, an improvement from $(8.2) million in Q3 2024 [4][20] Operational Highlights - The company signed several new in-network MSO providers in Florida and opened a new pharmacy location in the state [4][5] - TOI welcomed Kristin England as the new Chief Administrative Officer, focusing on enterprise operations and technology strategy [4][5] - The company reported a total of 80 clinics and 22 markets, maintaining the number of lives under value-based contracts at approximately 1.9 million [4][17] Guidance and Outlook - TOI expects Adjusted EBITDA of approximately $0 to $2 million in Q4 2025, reflecting a positive outlook for the remainder of the year [3][4] - The updated guidance for 2025 reflects the company's confidence in achieving revenue and profitability growth, despite potential risks in the operating environment [3][4]

Core Insights - The partnership between Ascertain and The Oncology Institute aims to create "near-touchless" administrative workflows to reduce manual interactions between providers and payers [1][2] Group 1: Partnership and Technology - Ascertain's Unified Payer Portal (UPP) is an AI-powered automation module designed to streamline payer-related tasks for outpatient oncology visits [2] - The implementation of the UPP was completed in just eight weeks, showcasing the adaptability of Ascertain's technology and the strength of the partnership [3] Group 2: Operational Efficiency - Since the deployment in September 2025, the automation has reduced authorization submission time by over 80% at pilot sites, saving hundreds of staff hours weekly [4] - The initiative is projected to generate up to $2 million in operating expense savings in 2026 as it scales across all authorization types [4] Group 3: Company Background - Ascertain specializes in automating complex administrative workflows in healthcare using agentic AI, replacing manual tasks with intelligent automation [6] - The Oncology Institute, founded in 2007, focuses on delivering value-based cancer care and operates over 100 clinics across five states, serving approximately 1.9 million patients [7]

Core Insights - Topicus.com Inc. reported a total revenue of €387.9 million for Q3 2025, marking a 24% increase compared to €312.2 million in Q3 2024, primarily driven by acquisitions and organic growth of 3% [4][6] - The company experienced a net loss of €120.9 million in Q3 2025, a significant decline from a net income of €38.0 million in the same quarter of 2024, largely due to a €221.7 million expense related to the investment in Asseco [5][6] - Cash flows from operations increased by 53% to €48.4 million in Q3 2025 compared to €31.7 million in Q3 2024, while free cash flow available to shareholders rose by 114% to €22.3 million [6][7] Financial Performance - Total revenue for the first nine months of 2025 reached €1,115.5 million, a 20% increase from €930.0 million in the same period of 2024 [4] - The net loss for the nine months ended September 30, 2025, was €9.3 million, compared to a net income of €93.3 million for the same period in 2024 [5] - Cash flows from operations for the nine months increased by 14% to €304.9 million compared to €268.0 million in 2024 [7] Cash Flow and Investments - Free cash flow available to shareholders for the nine months ended September 30, 2025, increased by 19% to €167.5 million from €140.7 million in 2024 [7] - The company completed acquisitions for a total cash consideration of €11.4 million, with deferred payments estimated at €7.8 million, leading to a total consideration of €19.2 million [6] Shareholder Metrics - The net loss per share for Q3 2025 was €0.94, compared to earnings of €0.28 per share in Q3 2024 [5][6] - The weighted average shares outstanding for Q3 2025 were 83,338,874, slightly up from 82,912,026 in Q3 2024 [17]

Core Viewpoint - The Oncology Institute, Inc. (TOI) will release its third quarter 2025 financial results on November 13, 2025, followed by a conference call to discuss the results [1]. Financial Results Announcement - The financial results will be announced after market close on November 13, 2025 [1]. - A conference call will take place on the same day at 5:00 p.m. Eastern Time [1]. Conference Call Access - The conference call can be accessed by phone at 1-877-407-0789 for domestic callers and 1-201-689-8562 for international callers [2]. - A replay of the call will be available two hours after the call ends, accessible at 1-844-512-2921 for domestic and 1-412-317-6671 for international callers, with a passcode of 13756737 [2]. - The replay will be available until November 20, 2025 [2]. Company Overview - The Oncology Institute, founded in 2007, specializes in value-based community oncology care, serving approximately 1.9 million patients [4]. - TOI operates over 100 clinics and affiliate locations across five states, employing more than 180 clinicians [4]. - The company focuses on delivering advanced, evidence-based cancer care, including clinical trials and transfusions [4].

Group 1 - The stock price of Oncology Institute has increased by 1,130% through October 16, significantly outperforming major technology stocks like Nvidia and Tesla, which gained 35.4% and 6.2% respectively, while Apple saw a decline of 1.2% [1][8] - Oncology Institute, founded in 2007, offers a variety of cancer care services, including physician care, infusions, radiation, pharmacy services, and clinical trials, aiming to operate under value-based contracts that incentivize cost-effective, high-quality healthcare [4][5] - The company operates in 16 markets across five states and has experienced rapid revenue growth, with a 21.5% increase in second-quarter revenue to $119.8 million, although it reported an operating loss of $11.2 million, which is an improvement from the previous year's loss of $16.4 million [5][6] Group 2 - The future prospects for companies like Oncology Institute that enhance cost-effectiveness and improve outcomes in the U.S. healthcare system are promising, but it remains uncertain when or if the company will achieve profitability [6] - Despite the significant stock price increase, there are recommendations to consider other investment opportunities, as Oncology Institute was not included in a list of the 10 best stocks identified by The Motley Fool Stock Advisor [7][8]

Summary of The Oncology Institute Conference Call (October 08, 2025) Company Overview - **Company Name**: The Oncology Institute (NasdaqCM:TOI) - **Industry**: Oncology Care - **Market Size**: U.S. oncology care spending exceeds $200 billion annually, with a significant growth trend driven by oncology drug costs [2][3] Core Points and Arguments - **Value Proposition**: The Oncology Institute is the largest value-based oncology care provider in the U.S., focusing on delivering clinically excellent care to underserved populations while bending the cost curve [4][5] - **Patient Base**: The company manages risk for over 2 million patients across various product types, including Medicare Advantage and managed Medicaid [4] - **Cost Management**: The Oncology Institute aims to reduce overutilization in oncology care by adhering to NCCN compliant practices, which can significantly lower costs [5][12] - **Unique Positioning**: Unlike competitors that do not employ physicians, The Oncology Institute employs clinicians, allowing for better control over care delivery and cost savings [9][10] - **Clinical Trials Access**: The company provides access to clinical trials for economically underserved populations, enhancing patient care options [11] Financial Performance - **Revenue Growth**: The company has achieved a 41% revenue CAGR over the past 18 years, with a focus on transitioning from unprofitability to profitability [17][25] - **Path to Profitability**: The Oncology Institute is guiding towards adjusted EBITDA break-even in Q4 2025, driven by value-based contracts, growth in the dispensary segment, and improved clinical productivity [18][19][25] - **Revenue Segmentation**: Revenue is derived from patient services (medical and radiation oncology), dispensary (Part D drugs), and other segments, with Part D drugs contributing significantly to overall margins [20][21] Market Expansion and Future Growth - **Current Operations**: The Oncology Institute operates in five states, with plans for further expansion in markets with high Medicare Advantage penetration [13][15] - **Growth Strategy**: The company is focused on filling capacity in existing markets before aggressively pursuing new territories, ensuring profitability and cash flow stability [29][30] Patient Outcomes and Satisfaction - **Financial Toxicity**: The Oncology Institute addresses the financial burden of cancer care, helping to lower out-of-pocket costs for patients significantly [27][28] - **Patient Satisfaction**: High levels of patient satisfaction are reported, with the company tracking KPIs related to clinical outcomes and patient experience [28] Additional Insights - **Competitive Landscape**: The Oncology Institute differentiates itself from fee-for-service aggregators and other value-based care models by providing a full suite of services and maintaining a focus on community-based care [10][12] - **Future Opportunities**: The company is receiving interest from payers in new markets, indicating potential for future growth while maintaining a focus on existing operations [29][30] This summary encapsulates the key points discussed during the conference call, highlighting The Oncology Institute's unique position in the oncology care industry, its financial trajectory, and its commitment to patient care and satisfaction.

Core Insights - Small-cap stocks are gaining significant attention, with some stocks in the iShares Russell 2000 ETF experiencing massive gains this year, outperforming larger-cap stocks like Nvidia and Palantir [1][2]. Small-Cap Performance - The iShares Russell 2000 ETF has increased by 11.2% this year, although it still lags behind the S&P 500 [2]. - On September 18, the Russell 2000 index reached an all-time high for the first time since March 15, 2021, ending a streak of 967 trading days without a new high, which is the second longest in the index's history [3]. Notable Small-Cap Stocks - The Oncology Institute (TOI) has seen a remarkable rise of 1,064% this year, increasing from 31 cents to $3.60 per share [3]. - Better Home & Finance (BETR) and ThredUp (TDUP) also performed well, with gains of 602.6% and 578.1% respectively [7]. - ThredUp is valued at over $1.1 billion and is expected to lose 24 cents per share this year, yet its stock price has risen to $9.44 [5]. Market Dynamics - Many small-cap stocks started the year with low share prices, leading to substantial percentage increases with even small dollar gains [3]. - The average stock in the Russell 2000 index now trades for $37 per share, indicating a shift in market dynamics as small stocks rally [6].