Core Insights - The Oncology Institute (TOI) achieved significant growth in 2025, with revenue surpassing $500 million for the first time, reflecting a year-over-year increase of approximately 28% [3][14] - The company reported its first profitable quarter as a public entity in Q4 2025, with positive adjusted EBITDA, and aims to maintain this momentum into 2026 [4][16] - TOI expanded its capitated care model, adding new contracts and increasing patient lives under management, which is expected to drive further revenue growth [2][5] Financial Performance - Total revenue for 2025 reached $502.7 million, up from $393.4 million in 2024, marking a growth of 27.8% year-over-year [13] - Pharmacy revenue grew significantly by 49.6% year-over-year, totaling $269.2 million, driven by improved prescription attachment rates [14][18] - The company ended Q4 2025 with $33.6 million in cash and positive operating cash flow of $3.2 million, indicating a strengthened balance sheet [21] Operational Developments - TOI initiated 9 new capitated contracts in 2025, adding approximately 260,000 patient lives under management, contributing to the expansion of its integrated care model [2][5] - The company improved operational efficiency, with SG&A expenses declining by 2% year-over-year, reflecting the leverage in its business model [2][20] - A new proprietary network portal is set to launch in Q2 2026, aimed at enhancing provider engagement and improving operational efficiencies [8][9] Strategic Partnerships - TOI's partnership with Elevance in Florida is expected to double in size in 2026, with approximately 70,000 lives currently under capitated arrangements [5][6] - New capitation agreements with Humana and CarePlus were initiated in Q4 2025, adding around 22,000 additional Medicare Advantage lives [6][39] - The company is focused on expanding payer partnerships to enhance its value-based care platform and improve patient access to oncology services [7][11] Future Outlook - For 2026, TOI anticipates revenue in the range of $630 million to $650 million, with a significant portion expected from capitated contracts [21] - The company projects over 80% growth in capitated revenue for the year, supported by its expanding network and operational efficiencies [8][24] - TOI aims to achieve free cash flow positivity by the end of 2026, driven by EBITDA growth and improved working capital dynamics [24][25]

Financial Data and Key Metrics Changes - The Oncology Institute achieved a revenue increase of approximately 28% year-over-year, surpassing $500 million for the first time in its history, with total revenue for Q4 2025 reaching $142 million, a 41.6% year-over-year growth [5][20] - Adjusted EBITDA for Q4 2025 was $147,000, improving from a loss of $7.8 million in Q4 2024, marking the first profitable quarter from an adjusted EBITDA perspective as a public company [4][24] - SG&A expenses decreased by 2% year-over-year, reflecting operational efficiency, with SG&A as a percentage of revenue dropping from 24.8% to 19.7% [7][23] Business Line Data and Key Metrics Changes - The fee-for-service business grew 9% year-over-year from $136.2 million to $148.5 million, while the capitation business grew 17.2% year-over-year from $68.7 million to $80.5 million [17] - Pharmacy revenue grew 49.6% year-over-year from $179.9 million to $269.2 million, driven by improved prescription attachment rates [18] Market Data and Key Metrics Changes - The company expanded its capitated care model, initiating 9 new capitated contracts in California, Florida, and Nevada, adding approximately 260,000 patient lives under management [5][8] - The Florida Oncology Network platform grew to approximately 207 participating providers, supporting a hybrid model of patient care [10] Company Strategy and Development Direction - The Oncology Institute aims to continue scaling its value-based care platform, with a focus on expanding payer partnerships and achieving sustainable profitability [11][13] - The company plans to launch a proprietary network portal in Q2 2026 to enhance provider engagement and improve operational efficiencies [11] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in achieving full-year positive adjusted EBITDA in 2026, driven by strong growth in the delegated capitation model [4][11] - The impact of the Inflation Reduction Act on the company's revenue is expected to be minor, with management indicating multiple strategies to offset any potential negative effects [15][16] Other Important Information - The company reduced debt on its convertible preferred note by $24 million, ending the year with $33.6 million in cash [8] - The leadership team was strengthened with new appointments, enhancing the company's ability to scale and execute its growth strategy [10][12] Q&A Session Summary Question: What drove the higher dispensing revenue in the quarter? - Management attributed the strong performance to operational execution in mitigating prescription leakage and strong patient encounter growth related to capitated contracts [30][31] Question: Will the Elevance contract size double in Florida in 2026? - Yes, that is the goal [32] Question: What is the size of the total addressable market for Elevance or Humana? - There is significant opportunity for growth, with many multiples of current capitated revenue available in Florida [34][35] Question: How are margins looking for capitated revenue? - Performance in terms of volume and medical loss ratio (MLR) is as expected, with no surprises [36] Question: Will SG&A improve in 2026? - Improvements are expected, but not to the same degree as in 2025 due to growth investments [65]

Financial Data and Key Metrics Changes - The Oncology Institute achieved its first profitable quarter as a public company from an adjusted EBITDA perspective in Q4 2025, with a revenue increase of approximately 28% year-over-year, surpassing $500 million for the first time [4][5] - Total revenue for Q4 2025 was $142 million, representing a 41.6% year-over-year growth, driven by patient growth and pharmacy contributions [20] - Adjusted EBITDA was $147,000 in Q4 2025, improving from -$7.8 million in Q4 2024 [24] Business Line Data and Key Metrics Changes - The fee-for-service business grew 9% year-over-year from $136.2 million to $148.5 million, while the capitation business grew 17.2% year-over-year from $68.7 million to $80.5 million [17] - Pharmacy revenue grew 49.6% year-over-year from $179.9 million to $269.2 million, primarily due to improved prescription attachment rates [18] Market Data and Key Metrics Changes - The company expanded its capitated footprint by initiating 9 new capitated contracts during 2025, adding approximately 260,000 patient lives under management [5] - The partnership with Elevance Health in Florida ramped up, with approximately 70,000 lives under capitated arrangements by the end of 2025 [8] Company Strategy and Development Direction - The Oncology Institute aims to continue scaling its value-based care platform and expects over 80% growth in capitated revenue for 2026 [11] - The company plans to launch a proprietary new network portal in Q2 2026 to enhance engagement with providers and improve operational efficiencies [11] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's ability to grow and manage industry-leading medical loss ratio (MLR) performance under its delegated capitation model [13] - The company views the potential lower rate environment for Medicare Advantage as a tailwind, as it allows for proactive engagement with payers seeking to improve care delivery [74] Other Important Information - The company reduced debt on its convertible preferred note by $24 million and ended the year with $33.6 million in cash [8] - The leadership team was strengthened with new appointments, including a Chief Clinical Officer and a Chief Administrative Officer [10] Q&A Session Summary Question: What drove the higher dispensing revenue in Q4? - The strong performance was driven by operational execution in mitigating leakage of prescriptions and strong patient encounter growth related to capitated contract growth [31] Question: Will the Elevance contract double in size in 2026? - Yes, that is the goal [32] Question: What is the size of the total addressable market for Elevance or Humana? - There is significant opportunity for growth, with many multiples of current capitated revenue available in the market [35] Question: Will there be a dip in profit margins due to ramping up capitated contracts? - A slight increase in MLR is expected for delegated contracts, but overall gross margins should not dip [44] Question: Can you provide details on the number of affiliated clinics? - The network has grown to over 200 providers in Florida, bringing the total to close to 300 combined [46] Question: What are the expectations for SG&A in 2026? - Improvements in SG&A as a percentage of revenue are expected, but not to the same degree as in 2025 due to growth investments [65]

Financial Data and Key Metrics Changes - The Oncology Institute achieved approximately 28% year-over-year revenue growth, surpassing $500 million for the first time in its history, with total revenue reaching $502.7 million in 2025 compared to $393.4 million in 2024 [5][17] - The company reported its first profitable quarter as a public company from an adjusted EBITDA perspective in Q4 2025, with adjusted EBITDA of $147,000, improving from a loss of $7.8 million in Q4 2024 [4][23] - SG&A expenses decreased by 2% year-over-year, reflecting operational efficiency, with total SG&A at $28 million or 19.7% of revenue in Q4 2025, down from 24.8% in the prior year [6][22] Business Line Data and Key Metrics Changes - The fee-for-service business grew 9% year-over-year from $136.2 million to $148.5 million, while the capitation business grew 17.2% from $68.7 million to $80.5 million, driven by the new delegation model in Florida [17] - Pharmacy revenue increased by 49.6% year-over-year from $179.9 million to $269.2 million, primarily due to improved prescription attachment rates [18] - Patient services revenue, including capitation and fee-for-service, totaled $59.8 million in Q4 2025, representing 42.2% of total revenue and a 19.2% increase year-over-year [20] Market Data and Key Metrics Changes - The company expanded its capitated footprint by initiating 9 new capitated contracts in California, Florida, and Nevada, adding approximately 260,000 patient lives under management [5] - The partnership with Elevance Health in Florida is expected to double in size in 2026, with approximately 70,000 lives currently under capitated arrangements [8][32] - The Florida Oncology Network platform grew to approximately 207 participating providers, supporting a hybrid model of patient care [10] Company Strategy and Development Direction - The Oncology Institute aims to continue scaling its value-based care platform to serve more patients and payers while improving access to therapeutics and reducing financial burdens [11] - The company plans to launch a proprietary new network portal in Q2 2026 to enhance engagement with providers and improve utilization management [11] - The leadership team was strengthened with new appointments, including a Chief Clinical Officer and a Chief Administrative Officer, to support growth strategy execution [10] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in achieving full-year positive adjusted EBITDA in 2026, driven by strong growth in the delegated capitation model [4][11] - The impact of the Inflation Reduction Act on the company's revenue is expected to be minor, with multiple levers available to offset any unfavorable effects [14][15] - The company believes it is well-positioned to expand payer partnerships and deliver sustainable profitability over the long term [13] Other Important Information - The company ended 2025 with $33.6 million in cash and positive free cash flow in Q4, providing flexibility for growth [7][23] - The company expects revenue in the range of $630 million to $650 million for 2026, with approximately $150 million from capitated revenue [24] Q&A Session Summary Question: What drove the higher dispensing revenue in the quarter? - The strong performance was driven by operational execution in mitigating leakage of scripts and strong patient encounter growth related to capitated contract growth [29][30] Question: Will the Elevance contract size double in Florida in 2026? - Yes, that is the goal [32] Question: Is the Humana contract new or an expansion? - The Humana contract went effective in Q4 2025 and is a new partnership [33] Question: What is the total addressable market for Elevance or Humana? - There is significant opportunity for growth in Florida, with many multiples of current capitated revenue available [34][35] Question: How are margins looking for capitated revenue? - Performance in terms of volume and MLR is as expected, with no surprises [36] Question: Will there be a dip in profit margins due to ramping up capitated contracts? - A slightly higher MLR is expected for delegated contracts, but no dip at the aggregate level [44] Question: Can you provide details on the number of affiliated clinics? - The network is larger than previously reported, with over 200 providers in Florida, totaling close to 300 combined [46] Question: Will CAR T therapies be added to treatment offerings? - Currently, the company does not take risk on CAR T therapies due to low incidence and limited availability [47] Question: What are the expectations for SG&A in 2026? - Improvements in SG&A are expected, but not to the same degree as in 2025, as investments for growth will continue [65]

Core Insights - The Oncology Institute, Inc. (TOI) reported significant financial growth in Q4 2025, with consolidated revenue increasing by 41.6% to $142.0 million compared to Q4 2024, and gross profit rising by 55.2% to $22.7 million [5][31] - The company achieved a net loss of $7.5 million in Q4 2025, an improvement from a net loss of $13.2 million in the same quarter of the previous year [5][31] - For the full year 2025, TOI's consolidated revenue reached $502.7 million, a 27.8% increase from 2024, while the net loss narrowed to $60.6 million from $64.7 million [5][31] Financial Highlights - Cash flow from operations in Q4 2025 was approximately $3.2 million, attributed to disciplined working capital management and an increase in gross profit margin [5] - Adjusted EBITDA for Q4 2025 was $147 thousand, a significant recovery from a loss of $7.8 million in Q4 2024 [5][31] - As of December 31, 2025, TOI had cash and cash equivalents of $33.6 million [5][31] Operational Developments - TOI expanded its capitated footprint by initiating 9 new capitated contracts in California, Florida, and Nevada, adding approximately 260,000 lives under management [5] - The company ramped up its capitation partnership with Elevance in Florida and initiated agreements with Humana and CarePlus, further expanding its payor partnerships [5] - The company operates 146 affiliated and network clinics across 17 markets, managing approximately 2.0 million lives under value-based contracts [27] Outlook for 2026 - TOI projects revenue between $630 million and $650 million for fiscal year 2026, with expected gross profit ranging from $97 million to $107 million [4][6] - The company anticipates Adjusted EBITDA to be between $(1) million and $(3) million in Q1 2026 due to seasonal factors and drug pricing increases [6] - TOI expects approximately $150 million in capitated revenue in 2026 and aims to achieve full-year positive Adjusted EBITDA [6][9]

Core Viewpoint - Oncology Consultants has joined the American Oncology Network (AON), enhancing its ability to provide patient-focused cancer care and access to advanced therapies while maintaining its commitment to high-quality, compassionate care since its establishment in 1982 [1][2][3]. Company Overview - Oncology Consultants is the largest independent community oncology practice in Houston, offering a comprehensive range of services including infusion therapy, radiotherapy, diagnostic imaging, pharmacy services, clinical trials, and genetic testing [9]. - The practice operates 18 locations across South Texas and is staffed by 16 Board-certified medical oncologists, 3 Board-certified radiation oncologists, and 23 advanced practitioners [3][9]. Partnership Benefits - The partnership with AON allows Oncology Consultants to expand its patient services, enhance access to clinical trials, and pursue new growth opportunities while preserving its independence and culture [2][8]. - This collaboration provides the necessary scale, infrastructure, and clinical resources to support innovation in cancer care, while allowing physicians to focus on delivering personalized care [8][10]. AON Overview - American Oncology Network is an alliance of over 350 providers across 21 states, founded in 2018, aimed at ensuring the long-term success of community oncology through innovative healthcare solutions and a physician-led model [10]. - AON is committed to promoting health equity and addressing disparities in cancer care, ensuring all patients have access to necessary care for optimal health outcomes [10].

Core Viewpoint - The Oncology Institute, Inc. (TOI) reaffirms its 2025 guidance and provides a preliminary outlook for 2026, expecting significant revenue growth and the potential for Adjusted EBITDA profitability for the first time as a public company [1][2][3]. 2026 Outlook - TOI anticipates total revenue for 2026 to be between $630 million and $650 million, indicating a 28% growth from the midpoint of 2025 guidance [2]. - Approximately $150 million of the expected revenue will come from Capitation revenue, driven by the expansion of delegated contracts in Florida and strong performance in the Dispensary segment [2]. - Profitability from newly onboarded delegated contracts is expected to build progressively throughout 2026, with more substantial economic benefits anticipated in 2027 [2]. Adjusted EBITDA Expectations - Adjusted EBITDA for 2026 is projected to be in the range of $0 million to $9 million, marking TOI's first full year of Adjusted EBITDA profitability as a public entity at the midpoint of this range [3]. Longer-Term Outlook - The company aims for total revenue growth at an annual rate of approximately 20% through 2028, with Capitation and Dispensary revenue expected to rise to about 30% and 50% of total revenue, respectively [5]. - As TOI scales, margins are projected to expand to the mid-single-digit range as a percentage of revenue by 2028, supported by the asset-light delegated capitated model and continued SG&A leverage [6]. Company Overview - Founded in 2007, TOI is a leading provider of value-based oncology care in the United States, serving approximately 1.9 million patients through over 100 clinics and affiliate locations across five states [7].

Company Overview - Lone Star Oncology is a community-based medical oncology and hematology practice that provides treatment for patients diagnosed with various types of cancer and blood disorders [8] - The practice opened in June 2023 and is part of the American Oncology Network (AON) [3] New Appointment - Dr. Derrick Nguyen, a Board-certified medical oncologist with over 15 years of experience, has joined Lone Star Oncology and is accepting new patients [2][3] - Dr. Nguyen completed his medical education and training at the University of Texas Health Science Center and the University of New Mexico Health Sciences Center [2] Commitment to Care - Dr. Nguyen expressed his honor in joining Lone Star Oncology, highlighting the practice's strong reputation for compassionate, patient-centered care [3] - Brian J. Shimkus, MD, emphasized that Dr. Nguyen's clinical expertise will enhance the quality of oncology services provided to Central Texas patients [3] Partnership with AON - Through its partnership with AON, Lone Star Oncology has expanded access to various services, including infusion therapy, centralized laboratory and pathology services, and financial counseling [4] - AON aims to ensure the long-term success of community oncology practices by providing support and resources to its network of over 300 providers across 20 states [7] Mission and Values - AON is dedicated to delivering exceptional, patient-centered cancer care and promoting health equity by addressing disparities in cancer care [7] - The organization focuses on innovative healthcare solutions and value-based care to improve patient outcomes while reducing costs [7]

Core Insights - American Oncology Network (AON) has appointed Dr. Robert J. McDonald as Radiology Medical Director to enhance its radiotheranostic services and cancer care delivery [1][6][10] Group 1: Appointment and Role - Dr. McDonald will serve as the primary reading radiologist for AON partner practices in Naples, Fort Myers, and Macon, providing expert interpretations for PET and CT imaging [3] - He will oversee radiology services and perform advanced radiotheranostic therapies at the Naples and Fort Myers locations [3][4] Group 2: Strategic Expansion - AON aims to expand its radiotheranostic footprint, with Dr. McDonald playing a key role in developing physicians and supporting program growth [4][5] - His responsibilities include conducting clinical preceptorships for new Authorized Users of radioligand therapies, ensuring safe and timely expansion of expertise across the network [4] Group 3: Innovation and Leadership - Dr. McDonald will lead the clinical refinement of AON's radioligand therapy protocols and assist in the rollout of newly FDA-approved therapies [5][6] - His extensive experience in diagnostic imaging and radioligand therapies, including previous leadership roles, positions AON at the forefront of innovation in community oncology [7][8] Group 4: Company Overview - AON is an alliance of over 300 providers across 20 states, focusing on innovative healthcare solutions and value-based care to improve patient outcomes [10] - The organization is committed to promoting health equity and addressing disparities in cancer care, ensuring access to quality care for all patients [10]

Core Points - Gabe Ling has resigned from the Board of Directors of The Oncology Institute, effective December 1, 2025, and a search for new independent directors with relevant expertise has begun [1] - The Chairman of the Board, Anne McGeorge, expressed gratitude for Gabe Ling's contributions during a significant period for the company and emphasized the focus on enhancing the Board's capabilities for long-term growth [2] - The Oncology Institute, founded in 2007, provides specialized, value-based cancer care to approximately 1.9 million patients through over 100 clinics and affiliate locations across five states [3]