The Oncology Institute: A Pioneer in Cost-Effective Cancer Care

The Oncology Institute is a company that aims to reduce costs in oncological treatments and patient management. They bring together cancer care practices across the US, offering patient services, clinical trials, and research. Their goal is to improve cancer care and treatment outcomes while decreasing costs. The company is listed on NASDAQ under the ticker symbol TOI.

The Oncology Institute (TOI), a company dedicated to reducing costs in oncological treatments and patient management, reported its Q2 2025 financial results, highlighting continued growth and strategic shifts in its business model. The company aims to improve cancer care and treatment outcomes while decreasing costs, and its stock is listed on NASDAQ under the ticker symbol TOI.

Key highlights from the earnings call include:

- Revenue Growth: The Oncology Institute reported continued sequential growth in Q3 and Q4 2025, driven by new risk contracts and pharmacy expansion. Total revenue for Q2 2025 was $120 million, up 20% year-over-year.
- Pharmacy Revenue: Pharmacy revenue increased to $62.6 million for Q2 2025, up 41% year-over-year and 27% sequentially. This growth was driven by increases in both capitated and fee-for-service lives.
- Patient Services Revenue: Patient services revenue was $55.9 million for Q2 2025, accounting for 47% of total revenue, up 7% year-over-year.
- Gross Profit: Gross profit was $17.5 million for Q2 2025, increasing 34% year-over-year and 1.5% sequentially. Gross margin was 14.6%, up 140 basis points year-over-year.
- SG&A Expense: SG&A expense was $26.9 million for Q2 2025, a 12% decrease year-over-year after normalizing for a one-time $2.4 million write-off related to outsourced clinical trials.
- Operating Loss: Loss from operations was $11.2 million for Q2 2025.
- Adjusted EBITDA: Adjusted EBITDA loss was $4.1 million for Q2 2025, an improvement from negative $8.7 million in Q2 2024.
- Free Cash Flow: Free cash flow was negative $14.6 million for the first half of 2025.
- Value-Based Contracts: Over 50,000 new capitated lives were added in Nevada and California in Q2 2025, with an additional 49,000 Medicaid patient lives secured in Nevada starting July 1, 2025.
- Florida Capitation Expansion: A verbal agreement was reached to expand an Elevance partnership to cover over 40,000 additional Medicare Advantage lives in two new Florida counties, starting in April.
- Full-Year Guidance: Full-year 2025 revenue (GAAP) is projected at $460 million to $480 million, with adjusted EBITDA loss guidance between $17 million and $8 million for the full year.

The company's strategic focus on risk-based contracting and pharmacy expansion is evident in its Q2 2025 performance. The Oncology Institute's fully delegated model allows it to control utilization management, network design, and claims adjudication for managed populations, cited as the foundation for value-based expansion into new markets. The company anticipates these efforts will continue to gain momentum through the rest of the year, with a likely result near the high end of its full-year revenue guidance.

References:
[1] https://www.fool.com/earnings/call-transcripts/2025/08/13/oncology-institute-toi-earnings-call-transcript/