The Oncology Institute(TOI) - 2025 Q2 - Quarterly Results

Press Release Overview 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] - TOI is one of the largest value-based community oncology groups in the United States[1] CEO Commentary 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] - Pharmacy business grew over 40% year-over-year, and over 50,000 new capitated lives were added to the value-based business[2] - Expanding partnerships in Florida and Nevada are expected to significantly increase covered lives[2][5] - Confidence in achieving revenue at the high end of 2025 guidance and Adjusted EBITDA positivity by year-end 2025[2] Highlights Recent Operational Highlights 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] - Retail Pharmacy and Dispensary set fill records, contributing $62.6 million in revenue and over $11 million in gross profit in Q2 2025[5] - Planned expansion of existing fully delegated capitated partnership with Elevance into two new counties in Central Florida, potentially doubling covered lives[5] - Welcomed Dr, Jeff Langsam as Chief Clinical Officer and Kristin England as Chief Administrative Officer[5] Second Quarter 2025 Financial Highlights 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 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] Q3 2025 Outlook 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. 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] - Serves approximately 1.9 million patients with cutting-edge, evidence-based care, including clinical trials and transfusions[10] - Operates over 100 clinics and affiliate locations across five states with over 180 employed and affiliate clinicians[10] Webcast and Conference Call 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] - Access details for the live call, replay (available until August 20, 2025), and webcast via the Investor Relations section of TOI's website[8][9] Forward-Looking Statements 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] - Actual events and circumstances may differ materially from assumptions, and TOI does not undertake any obligation to update these statements[11] Non-GAAP Financial Measures Explanation of Non-GAAP Measures 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][12][14] - 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] - 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] Free Cash Flow Reconciliation 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) | $17,187 | 54.1% | Adjusted EBITDA Reconciliation Adjusted EBITDA loss improved significantly by over 53% for both the three and six-month periods ending June 30, 2025 Adjusted EBITDA Reconciliation (Three Months Ended June 30): | Metric (in thousands) | 2025 | 2024 | Change ($) | 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] Key Business Metrics Key Business Metrics Summary 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 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 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 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] - 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] Contacts Contacts Information 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] - Investor relations contact: ICR Strategic Communications, investors@icrinc,com[27]