The Oncology Institute, Inc.
- Open
- 6.54
- Day high
- 6.57
- Day low
- 6.19
- Prev close
- 6.56
- Volume
- 1.6M
- Mkt cap
- $513M
- P/E (TTM)
- —
- EPS (TTM)
- —
- P/B
- -20.6
- P/S
- 0.9
- Yield
- —
- Per share
- —
- ▲Insiders net buying $54K over the last 3 months (4 open-market buys, 3 sales)
- 🏛Institutions reducing (13F)
The Oncology Institute, Inc. (TOI) is a Healthcare company listed on NASDAQ. The stock is up 77% over the past year. Over the trailing 3 months, insiders filed 4 open-market buys and 3 sales (SEC Form 4).
The Oncology Institute, Inc. (TOI) financials & analyst ratings
Fundamentals (TTM)
Analyst consensus · 3 analysts
Source: exchange market data + company filings. Figures are trailing-twelve-month or as most recently reported. For informational purposes only — not investment advice.
TOI earnings date, history & EPS estimates
| Report date | EPS est | EPS actual | Surprise | Revenue | Rev. surprise |
|---|---|---|---|---|---|
| May 7, 2026 | $-0.07 | $-0.02 | +71.4% | $147M | +3.8% |
| Mar 12, 2026 | $-0.09 | $-0.01 | +91.8% | $142M | +1.6% |
| Nov 13, 2025 | $-0.12 | $-0.14 | -16.7% | $137M | -2.3% |
| Aug 13, 2025 | $-0.14 | $-0.14 | +0.0% | $120M | -2.2% |
| May 14, 2025 | — | $-0.17 | — | $104M | — |
| Mar 24, 2025 | $-0.08 | $-0.14 | -75.0% | $100M | -8.1% |
| Mar 9, 2023 | $-0.18 | $-0.16 | +11.1% | $71M | +10.3% |
| Nov 9, 2022 | $-0.16 | $-0.17 | -6.3% | $65M | -5.8% |
| Mar 10, 2022 | — | $0.26 | — | $52M | — |
| Aug 16, 2021 | — | $0.05 | — | $50M | — |
| May 28, 2021 | — | $-0.02 | — | $49M | — |
| Nov 13, 2020 | — | $-0.02 | — | $47M | — |
TOI insider trading activity (SEC Form 4)
| Date | Insider | Type | Shares | Price |
|---|---|---|---|---|
| Jul 29, 2026 | Kaushal Mohitdirector | Grant | 33,133 | — |
| Jul 29, 2026 | STOLPER MARKdirector | Grant | 31,124 | — |
| Jul 29, 2026 | Pacala Mark Ldirector | Grant | 30,120 | — |
| Jul 29, 2026 | TZOUMAKAS KIMBERLY JOdirector | Grant | 29,116 | — |
| Jul 29, 2026 | Hively Braddirector | Grant | 27,108 | — |
| Jul 29, 2026 | Johnson Karen Mariedirector | Grant | 31,124 | — |
| Jul 29, 2026 | McGeorge Annedirector | Grant | 41,165 | — |
| Jul 22, 2026 | Chernett Jorey10 percent owner | Buy | 18,000 | $5.27 |
| Jul 16, 2026 | Podnos Yaleofficer: Chief Medical Officer | Option | 17,974 | $1.87 |
| Jul 16, 2026 | Podnos Yaleofficer: Chief Medical Officer | Sell | 17,974 | $6.43 |
| Jul 16, 2026 | Podnos Yaleofficer: Chief Medical Officer | Option | 5,478 | $2.00 |
| Jul 16, 2026 | Podnos Yaleofficer: Chief Medical Officer | Sell | 5,478 | $6.35 |
| Jul 13, 2026 | Chernett Jorey10 percent owner | Buy | 15,000 | $5.85 |
| Jul 9, 2026 | STOLPER MARKdirector | Grant | 25,833 | — |
| Jul 9, 2026 | TZOUMAKAS KIMBERLY JOdirector | Grant | 17,185 | — |
Source: TOI SEC Form 4 filings, latest Jul 29, 2026. For informational purposes only — not investment advice.
See the full TOI insider & 13F page →The Oncology Institute, Inc. company profile
Overview
The Oncology Institute, Inc. (NASDAQ:TOI) is a community-based oncology company founded in 2007 and headquartered in Cerritos, California. The company went public in June 2020 and has grown to become one of the largest value-based oncology providers in the United States. Operating 67 clinic locations across multiple states, TOI specializes in providing comprehensive cancer care services to adult and senior cancer patients through a network of over 100 specialty-trained physicians and healthcare providers.
Business
The Oncology Institute operates in the community oncology sector, which represents an alternative to hospital-based cancer treatment. Community oncology refers to cancer care delivered in outpatient settings closer to patients' homes, rather than in large hospital systems. This model typically offers more personalized care, shorter wait times, and lower costs compared to hospital-based treatment. TOI's core services encompass the full spectrum of cancer care delivery. The company provides physician services through its network of oncologists who diagnose and treat various forms of cancer. Their in-house infusion and dispensary services allow patients to receive chemotherapy and other intravenous treatments directly at TOI facilities, while their pharmacy operations dispense oral cancer medications. The company also offers clinical trial services, giving patients access to experimental treatments and new drug therapies. Additional services include radiation therapy, outpatient stem cell transplants and transfusion programs, and comprehensive patient support services that help navigate the complex healthcare system. The company operates through several revenue-generating segments. The dispensary and pharmacy operations represent the fastest-growing segment, generating approximately $180 million in annual revenue (about 46% of total revenue). The fee-for-service segment provides traditional oncology services and generates roughly $140 million annually (36% of revenue). The capitated contracts segment, where TOI receives fixed payments per patient regardless of services used, accounts for the remaining portion of revenue and covers approximately 1.9 million patient lives across multiple states.
Revenue model
The Oncology Institute operates through three primary revenue models that reflect the evolving healthcare payment landscape. The fee-for-service model represents the traditional healthcare payment system where TOI receives payment for each service rendered, including physician consultations, diagnostic tests, and treatment procedures. This model provides predictable revenue per service but exposes the company to volume fluctuations and reimbursement rate changes from insurance providers. The capitated contract model represents TOI's strategic focus on value-based care, where the company receives fixed monthly payments per patient (typically ranging from $800-1,200 per member per month) regardless of the actual services provided. Under these arrangements, TOI assumes financial risk for the total cost of cancer care, creating incentives to deliver efficient, high-quality treatment while managing costs effectively. This model currently covers approximately 1.9 million lives and provides more predictable revenue streams. The dispensary and pharmacy operations generate revenue through drug sales and dispensing fees. TOI purchases cancer medications at wholesale prices and dispenses them to patients, earning margins on both the drug costs and dispensing services. This segment has shown the strongest growth, with 73% annualized growth rates, as TOI has expanded its pharmacy capabilities and integrated medication management into its care model. Several factors significantly impact TOI's profit margins. Drug pricing dynamics represent the most significant variable, as changes in wholesale acquisition costs, rebate structures, and reimbursement rates directly affect dispensary margins. DIR (Direct and Indirect Remuneration) fees imposed by Medicare Part D plans can retroactively reduce pharmacy revenues, creating margin volatility. Reimbursement rate changes from government programs like Medicare and Medicaid, as well as private insurers, directly impact fee-for-service revenues. Patient mix affects profitability, as different insurance types provide varying reimbursement levels. Operational efficiency in managing clinical staff, facility utilization, and administrative costs determines the company's ability to maintain margins while scaling operations.
Competitive moat
The Oncology Institute's competitive moat is moderate and primarily built around specialized expertise and operational scale in community oncology. The company has developed significant expertise in managing value-based oncology contracts, which requires sophisticated capabilities in risk assessment, care coordination, and cost management that many competitors lack. This expertise creates barriers for new entrants and provides advantages when competing for capitated contracts with health plans. TOI's geographic density and network effects provide some defensive characteristics. With 67 clinics across multiple states and relationships with nearly 2 million covered lives, the company has achieved meaningful scale that enables better negotiating power with drug suppliers, payers, and potential partners. The integrated model combining physician services, infusion centers, and pharmacy operations creates operational efficiencies and patient convenience that standalone providers cannot easily replicate. However, the company's moat faces significant challenges. Large hospital systems with substantial financial resources continue to acquire community oncology practices, potentially limiting TOI's growth opportunities and creating competitive pressure. Regulatory changes in drug pricing, reimbursement structures, and healthcare policy could disrupt the company's business model. The capital-intensive nature of oncology practice acquisition and clinic expansion creates ongoing funding requirements that may limit the company's ability to compete with better-capitalized rivals. The competitive landscape includes both large integrated health systems that can cross-subsidize oncology services and other community oncology consolidators pursuing similar strategies. TOI's differentiation lies primarily in its focus on value-based care contracts, but this advantage may erode as competitors develop similar capabilities. The company's long-term success depends on executing its profitability plan and maintaining its position as payers increasingly adopt value-based payment models.
Risks & safety
The Oncology Institute presents significant financial risks with limited margin of safety for investors. • Cash burn and solvency concerns: The company generated negative $30.3 million in free cash flow for 2024, with $39.7 million in cash and short-term investments as of Q1 2025. At current burn rates, the company has approximately 12-15 months of liquidity remaining. • High debt burden: Total debt of approximately $86 million with a debt-to-equity ratio of 5.6x creates significant financial leverage. The company has been paying down debt but remains highly leveraged. • Profitability challenges: The company has posted consistent losses with negative $64.7 million net income in 2024. Management projects reaching profitability in Q4 2025, but execution risk remains high. • Valuation metrics: Trading at negative EV/EBITDA multiples due to losses, with price-to-book ratio of 6.5x indicating the stock trades at a significant premium to tangible book value. • Working capital position: Current ratio of 1.79x provides some near-term liquidity cushion, but the company's cash conversion cycle and accounts receivable management remain critical for maintaining operations. • Market risks: The stock has experienced significant volatility, trading below $3 per share with NASDAQ compliance concerns requiring potential reverse stock splits.
Recent development
Over the past two years, The Oncology Institute has undergone a strategic transformation focused on achieving profitability and expanding its value-based care footprint. The company has significantly expanded its capitated contract portfolio, signing 13 new contracts in 2024 alone and adding over 270,000 covered lives. This expansion included the company's first foray outside California with major contracts in Florida covering over 200,000 lives, including a fully delegated risk model with 42,000 lives. The company has made substantial investments in its pharmacy and dispensary operations, which have become the fastest-growing revenue segment with 73% annualized growth. TOI acquired and integrated a California pharmacy, expanded its oral drug dispensing capabilities, and developed sophisticated drug procurement and inventory management systems. The company also launched radiopharmaceutical therapy services in California, targeting $1 million in incremental EBITDA contribution for 2025. Operational efficiency initiatives have been a major focus, with management implementing comprehensive cost reduction programs that reduced SG&A expenses by 12% in Q4 2024. The company outsourced its clinical trials program to Helios to reduce overhead costs while maintaining service capabilities. TOI also hired Dr. Jeff Langsam as Chief Clinical Officer to strengthen its clinical leadership and care quality initiatives. The company underwent a strategic alternatives review with Leerink Partners in 2024, ultimately deciding to focus on internal operational improvements rather than pursuing a sale or merger. Management has established clear targets for achieving positive adjusted EBITDA by Q4 2025 and has been actively managing working capital and debt levels to improve financial stability.
TOI company profile · for informational purposes only — not investment advice.
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