The Strategic Synergy of OneOncology and United Urology Group: A Transformative Play in Value-Based Urologic and Oncologic Care

The U.S. healthcare landscape is undergoing a seismic shift as the industry pivots from fee-for-service models to value-based care. At the forefront of this transformation is OneOncology, a physician-led platform that has redefined the oncology care ecosystem through strategic partnerships and operational innovation. The recent $2.1 billion acquisition of United Urology Group (UUG) in October 2024 has not only expanded OneOncology's footprint but also created a unique synergy between urology and oncology care, positioning it as a transformative force in the sector. For investors, this merger represents a compelling case study in how physician-led platforms can capitalize on industry tailwinds while delivering measurable clinical and financial outcomes.

Strategic Synergy: Bridging Urology and Oncology

The acquisition of UUG—a leader in urology management services—has expanded OneOncology's capabilities to address the growing convergence of urology and oncology care. Urologists are increasingly serving as "quarterbacks" for complex genitourinary cancers, such as prostate and bladder cancer, which require multidisciplinary coordination. By integrating UUG's expertise in advanced radiation therapy, interventional radiology, and ambulatory surgery centers (ASCs) into its existing oncology platform, OneOncology has created a seamless care model that reduces costs and improves patient outcomes.

This synergy is not just operational but also financial. UUG's proven ability to enhance practice profitability through integrated services—such as ASCs and group purchasing—aligns with OneOncology's mission to empower independent providers in a value-based care environment. The combined entity now supports over 1,600 providers across 525+ sites, serving 915,000 patients annually. For example, the opening of a new urologic oncology clinic by Mary Bird Perkins Cancer Center in 2025 and the addition of six urologists to Astera Cancer Care underscore the platform's ability to scale efficiently.

Financial Resilience and Growth Trajectory

OneOncology's financial performance post-acquisition reflects its strategic acumen. With an estimated EBITDA of $110 million in 2024, the company is on track to achieve a 19x EBITDA multiple by 2026, driven by its put/call structure with TPG and Cencora. The partnership with UUG has unlocked economies of scale, particularly in drug procurement and ancillary services, which are critical for managing the rising costs of oncology care. U.S. oncology drug spending is projected to reach $180 billion by 2028, and OneOncology's integrated platform is uniquely positioned to capture this growth.

The acquisition also accelerates service line expansion. UUG's operational infrastructure in radiation oncology, pathology, and care management complements OneOncology's existing capabilities, enabling the delivery of comprehensive, cost-effective care. For instance, the integration of UUG's ASCs into OneOncology's network has reduced the need for hospital-based procedures, improving margins for providers and outcomes for patients.

Broader Industry Trends: Vertical Integration and Value-Based Care

The merger aligns with a broader industry trend of vertical integration, where drug distributors and healthcare services companies are consolidating the oncology value chain. McKesson, Cencora, and Cardinal Health—three of the largest drug wholesalers—have invested heavily in physician-led platforms to secure downstream demand for their products. Cencora's $2.1 billion acquisition of OneOncology in 2023 and its subsequent partnership with UUG exemplify this strategy. By controlling both the supply and delivery of care, these platforms can optimize pricing, reduce waste, and improve patient adherence to treatment protocols.

Value-based care is another critical tailwind. Medicare's Oncology Care Model (OCM) and the upcoming Oncology Care First model are reshaping reimbursement structures, rewarding providers who demonstrate quality and cost efficiency. OneOncology's partner practices, such as Tennessee Oncology, have already achieved measurable savings under OCM, saving Medicare $5 million in a single performance period. These successes highlight the platform's ability to thrive in risk-based contracts—a key differentiator in a competitive market.

Investment Potential: A Physician-Led Platform for the Future

For investors, the long-term appeal of physician-led platforms lies in their scalability, adaptability, and alignment with policy trends. OneOncology's model—rooted in clinical expertise and operational innovation—offers a blueprint for sustainable growth. The company's ability to attract capital from TPG and Cencora, while retaining physician governance, ensures that it remains agile in a rapidly evolving sector.

The oncology and urology markets are also poised for significant expansion. Prostate cancer therapeutics, for instance, are projected to grow from $14 billion in 2023 to $26 billion by 2030, driven by advancements in precision medicine and radiopharmaceuticals. OneOncology's focus on integrating these therapies into its care model positions it to capture this growth. Additionally, the company's partnerships with New York Oncology and Hematology (NYOH) and Beacon Clinic in 2025 signal its intent to expand into new geographies and service lines.

Conclusion: A Compelling Long-Term Bet

The merger of OneOncology and United Urology Group is more than a transaction—it's a strategic alignment of complementary strengths that accelerates the shift toward value-based care. By combining UUG's operational excellence with OneOncology's clinical innovation, the platform is well-positioned to capitalize on the $180 billion oncology market and the broader trend of vertical integration. For investors seeking exposure to the future of healthcare, this is a compelling long-term opportunity. The key risks—such as regulatory changes or reimbursement model adjustments—are mitigated by the platform's agility and strong financial foundation.

In an industry where the ability to deliver high-quality care at lower costs is paramount, OneOncology's physician-led model offers a clear path to sustained value creation. As the U.S. healthcare system continues its transformation, platforms that prioritize both clinical outcomes and financial sustainability will emerge as winners. OneOncology, with its strategic synergy and robust growth trajectory, is a prime example—and a must-watch for forward-thinking investors.