What factors drove the changes in The Oncology's revenue and profit?

What is The Oncology's gross profit margin?

What does The Oncology do and what are its main business segments?

What is the revenue and EPS growth rate for The Oncology year over year?

What guidance did The Oncology's management provide for the next earnings period?

What is The Oncology's latest dividend and current dividend yield?

What were the key takeaways from The Oncology's earnings call?

Did The Oncology beat or miss consensus estimates last quarter?

- **First Profitable Quarter**: Achieved positive adjusted EBITDA in Q4 2025, marking a milestone for TOI as a public company.
- **Revenue Growth**: Full year 2025 revenue reached $502.7 million (+27.8% YoY), driven by capitated (+17.2%) and pharmacy (+49.6%) segments.
- **Capitated Expansion**: 2026 guidance includes $150 million in capitated revenue, with delegated model in Florida set to more than double.
- **AI Efficiency**: $2 million in SG&A savings expected from AI-driven prior auth, call center, and RCM optimizations.
- **Free Cash Flow**: Anticipated positivity in 2026H2, supported by Q4 2025 operating cash flow of $3.2 million.
- **Market Positioning**: Medicare Advantage rate cycle pressure is a strategic advantage, driving demand for TOI's cost-effective oncology care model.

**【CEO Summary Section】**
- Achieved first positive adjusted EBITDA quarter as a public company in Q4 2025, with full year 2025 revenue surpassing $500 million for the first time.
- Expanded capitated footprint with 9 new contracts in California, Florida, and Nevada, adding 260,000 patient lives under management.
- Part D dispensing platform contributed $270 million in revenue and $50 million in gross profit for the year, with SG&A declining 2% YoY.
- Outsourced clinical trials operations to enhance scalability and focus on high-quality care delivery.
- Balance sheet strengthened with $33.6 million in cash and positive free cash flow in Q4, reducing debt by $24 million.
- Delegated capitation partnership with Elevance in Florida is on track to more than double in 2026, with 70,000 lives under management.
- Hybrid care model combines TOI-affiliated and independent clinics to optimize MLR and access to therapeutics.
- Leadership additions include Jeffrey Jeffrey as Chief Clinical Officer and Kristin England as Chief Administrative Officer, supporting growth strategy.

**【CFO Financial Commentary】**
- Full year 2025 revenue grew 27.8% YoY to $502.7 million, driven by 17.2% growth in capitated revenue and 49.6% growth in pharmacy revenue.
- Q4 2025 gross profit increased 59.5% YoY to $22.7 million, with patient services gross margin improving to 11.9% and pharmacy gross margin to 18.0%.
- 2026 guidance includes revenue of $630-$650 million, capitated revenue of $150 million, and adjusted EBITDA of $0-$9 million.
- Pharmacy revenue growth driven by improved attachment rates and reduced leakage to outside specialty pharmacies.
- SG&A as a percentage of revenue decreased 500 basis points YoY to 19.7%, reflecting operating leverage.
- Free cash flow expected to turn positive by end of 2026, supported by EBITDA growth and working capital optimization.

**【Q&A Key Highlights】**
- Dispensing revenue outperformance in Q4 2025 due to reduced script leakage and capitated contract growth; 2026 pharmacy revenue expected to grow 3-5% from new capitation lives.
- Elevance partnership in Florida to more than double in 2026, with Humana and CarePlus contracts adding 22,000 MA lives in South Florida.
- AI-driven efficiencies in prior auth, call center, and RCM expected to generate $2 million in SG&A savings in 2026.
- Fee-for-service growth constrained by capitated volume cannibalization, but organic growth in mature markets like Florida and Oregon expected to continue.
- SG&A as a percentage of revenue to trend down modestly to ~16% in 2026, reflecting scale benefits.
- Free cash flow positivity anticipated in the second half of 2026, supported by positive Q4 2025 operating cash flow of $3.2 million.
- Medicare Advantage rate cycle pressure on payers is a tailwind for TOI, as risk-bearing medical groups seek cost-effective oncology care solutions.

The Oncology Institute, Inc.(TOI)-20260313-2025 Q4 Earnings call transcript

- **Revenue Surge**: Q3 revenue up 23% to $137M, driven by 42% Pharmacy growth and 13% fee-for-service expansion.
- **AI Cost Savings**: Prior auth automation saves $2M annually, freeing 100+ staff hours/week.
- **Profitability Path**: Q4 adjusted EBITDA breakeven, targeting 2026 free cash flow positivity.
- ** Pharmacy Dominance**: Dispensing revenue +57% YoY, Part B pharmacy opening adds incremental growth.
- **Risk Management**: Cybersecurity incident caused billing delay, but minimal patient impact; ample cash to manage Q4 collections.

**【CEO Opening Remarks】**
- **Revenue Growth**: Q3 revenue of $137 million (+23% YoY), driven by 42% Pharmacy growth and 13% fee-for-service expansion.
- **Profitability Milestones**: Adjusted EBITDA loss of $3.5 million (vs. $8.2M prior year), targeting Q4 breakeven and 2026 free cash flow positivity.
- **Florida Expansion**: Added 40k capitated lives with Elevance Health, opening a specialty pharmacy for Part B drugs.
- **AI Efficiency**: Prior auth automation reduces processing time from 18min to 5sec, saving $2M in OpEx annually.
- **Cybersecurity Impact**: Billing delay caused by vendor incident, but minimal patient disruption; expects Q4 collections catch-up.

**【CFO Financial Review】**
- **Top Line**: Total revenue $136.6M (+36.7% YoY), Pharmacy ($75.9M, +57.4%) and Patient Services ($60.2M, +21%) lead growth.
- **Profitability**: Gross profit $18.9M (-$1.8M fee-for-service reserve), adjusted EBITDA loss $3.5M (vs. $8.2M prior year).
- **Balance Sheet**: $27.7M cash, $86M convertible debt; Q3 cash flow negative $27.8M due to drug inventory build.
- **Guidance Update**: Full year revenue raised to $495-505M, EBITDA loss narrowed to -$13M to -$11M.

**【Q&A Highlights】**
- **Reserve Impact**: $1.8M fee-for-service reserve one-time adjustment, no Q4 impact.
- **MLR Performance**: Delegated model MLR mid-80s, stable despite 38% capitated revenue growth.
- **Payer Changes**: IRA-driven drug cost reductions benefit TOI's community-based care model.
- **2026 Outlook**: 20%+ top-line growth, margin expansion, and flat SG&A as % of revenue.
- **Pluvicto Adoption**: Community-based certification achieved, limited but growing use cases.

The Oncology Institute, Inc. (TOI) Q3 2025 Earnings Call Transcript

- **Revenue Surge**: 20% YoY growth to $120M, pharmacy up 41%, fee-for-service +10%.
- **Margin Expansion**: Gross margin 14.6%, SG&A down 12% YoY, EBITDA loss halved.
- **Contract Momentum**: 100,000 Florida Medicare lives added, 50,000 new capitated lives in Q2.
- **AI Transformation**: 3 pilots to reduce OpEx, targeting Q4 EBITDA positivity.
- **Strategic Shift**: Fully delegated model drives network control and MSO scalability.

**【CEO Summary Section】**
- **Revenue Growth**: Q2 2025 revenue of $120 million, up 20% YoY, driven by 41% pharmacy growth and 10% fee-for-service expansion in Florida/Oregon.
- **Contract Wins**: Added 50,000 capitated lives in Nevada/California; Florida expansion to 100,000 Medicare Advantage lives by year-end.
- **EBITDA Improvement**: Adjusted EBITDA loss of $4.1M (vs. $8.7M YoY), 580bps SG&A reduction to 22% of revenue.
- **AI Initiatives**: Launching 3 AI pilots in Q3 for revenue cycle, prior auth, and call center to reduce OpEx.
- **Leadership Changes**: New CCO and CAO hired; Anne McGeorge elected Board Chair.

**【CFO Financial Commentary】**
- **Revenue**: $119.8M (+21.5% YoY), 52% from pharmacy ($62.6M, +41% YoY).
- **Margins**: Gross margin 14.6% (vs. 13.2% YoY), driven by dispensary scale and formulary management.
- **Cost Control**: SG&A $26.9M (-3.5% YoY), 12% decline ex-one-time clinical trials write-off.
- **Guidance**: Full-year revenue $460-480M, targeting high end; Q4 adjusted EBITDA positivity.

**【Q&A Key Highlights】**
- **Dispensing Margins**: 600bps YoY improvement due to scale, rebates, and formulary optimization.
- **Drug Pricing Reform**: Net positive via lower capitated costs and fee-for-service rebates.
- **Patient Service Margin**: New contracts in Florida expected to mature and improve margins Q3-Q4.
- **Florida Expansion**: 100,000 Medicare lives by year-end, 2.5% of total risk portfolio.
- **Fully Delegated Model**: Controls utilization, network, and claims for oncology spend, enabling MSO growth.

The Oncology Institute, Inc. (TOI) Q2 2025 Earnings Call Transcript

- **Revenue Surge**: 10% YoY growth to $104.4 million, fueled by 24% Dispensary segment expansion and 20% Pharmacy growth.
- **Contract Momentum**: 80,000+ new lives secured in Q1, with 100,000+ expected in Q2/Q3, driving $50 million annualized revenue.
- **Profitability Path**: Q4 2025 target for positive EBITDA, with Q2 loss narrowing to $4-5 million.
- **Cost Control**: 9% YoY SG&A decline to $27.2 million, with AI initiatives for future efficiency gains.
- **Tariff Resilience**: Higher drug prices could boost fee-for-service margins, with TOI's reimbursement model mitigating direct impacts.
- **Leadership Expansion**: New Chief Clinical Officer to enhance formulary management and MSO partnerships.


**【CEO Summary Section】**
- **Revenue Growth**: Q1 2025 revenue increased 10% YoY to $104.4 million, driven by a 24% surge in the Dispensary segment and 20% growth in the Pharmacy & Dispensary business.
- **New Contracts**: Secured 80,000+ new lives through 4 capitation contracts in Florida, California, and Nevada, with an additional 100,000 lives expected in Q2/Q3. A fully delegated Florida contract will enhance margin control.
- **Cost Management**: Reduced SG&A expenses by 9% YoY to $27.2 million, with a focus on vendor and labor efficiency. 
- **Clinical Trials Outsourcing**: Partnered with Helios to outsource clinical trials, reducing annual revenue by $5 million but maintaining full-year guidance through Dispensary growth.
- **Tariff Mitigation**: No immediate impact from tariffs; TOI's formulary management and supply chain flexibility protect margins.
- **Leadership Expansion**: Hired Dr. Jeff Langsam as Chief Clinical Officer to strengthen utilization management and MSO engagement.

**【CFO Financial Commentary】**
- **Gross Profit**: $17.2 million (44.1% YoY growth), driven by margin improvements in capitation, fee-for-service, and Dispensary segments.
- **Adjusted EBITDA**: Loss of $5.1 million (narrowed from $10.9 million YoY), with Q4 2025 targeting positive EBITDA.
- **Free Cash Flow**: Negative $3.9 million (improved from $15.4 million YoY), supported by a $16.5 million capital raise.
- **Balance Sheet**: Cash increased to $39.8 million, with debt paydown reducing quarterly interest payments by $1 million.
- **2025 Guidance**: Revenue $460-480 million, adjusted EBITDA loss $8-17 million, free cash flow -$12-21 million.
- **Q2 Outlook**: Adjusted EBITDA loss $4-5 million, driven by Florida contract contributions and Dispensary growth.

**【Q&A Highlights】**
- **Gross Profit Growth**: Driven by a $1.5 million one-time rebate, favorable drug pricing, and volume gains in Dispensary.
- **Fee-for-Service Growth**: 2% YoY expansion, with 30+ new MSO sites in Florida offsetting closures of unprofitable clinics.
- **SG&A Efficiency**: Aiming to keep SG&A flat in 2025, with AI-driven workflow initiatives for long-term savings.
- **Tariff Impact**: Higher drug prices could benefit fee-for-service margins, as TOI's reimbursement spreads are less affected than absolute costs.
- **Contract Stability**: Low historical contract termination rate; 2024's $15 million DIR fee impact fully lapped.
- **Florida Expansion**: Projected capacity fill aligns with forecasts, with upside from pipeline contracts.
- **Seasonality**: Q1 is seasonally the weakest quarter, with progressive improvement expected in Q2+.


The Oncology Institute, Inc. (TOI) Q1 2025 Earnings Call Transcript

- **Revenue Surge**: 21% YoY growth ($393M in 2024), driven by 73% pharmacy/dispensary expansion and 270,000+ new capitated lives. 
- **Profitability Path**: Sequential EBITDA improvement, 12% SG&A reduction, and Q4 positive cash flow ($4.2M). Target Q4 2025 EBITDA breakeven. 
- **2025 Growth Engine**: $50M annualized capitation contracts (2/3 in 2025) and Florida expansion (40% clinic utilization). 
- **Financial Strength**: Debt reduced to $86M, $16.5M equity raise, and $4.1M debt conversion. 
- **Key Risk**: Q1 2025 seasonal drug price hikes, offset by Q4 margin recovery.

**【CEO Summary Section】**
- **Revenue Growth**: 21% year-over-year in 2024, driven by 73% growth in pharmacy and dispensaries ($180M full-year). Key milestones include 270,000+ new lives in California and 200,000+ in Florida (first fully delegated model). 
- **Profitability Progress**: Sequential improvement in adjusted EBITDA (Q4: -$7.8M vs. Q3: -$10.2M). 12% reduction in SG&A to 26% of revenue, achieved through operational efficiency and cost optimization. 
- **Cash Flow Management**: Positive cash from operations ($4.2M Q4) and reduced debt ($86M post-restructuring vs. $110M). $16.5M private placement and $4.1M debt conversion strengthen liquidity. 
- **2025 Outlook**: Target $460-480M revenue (+17-22%), with capitation contracts contributing $50M annualized. Expect EBITDA breakeven in Q4 2025. 

**【CFO Financial Commentary】**
- **Q4 2024 Results**: $100.3M revenue (+17% YoY), $14.6M gross profit, -$13M net loss (vs. -$18.6M YoY). Adjusted EBITDA improved to -$7.8M (vs. -$6.3M YoY). 
- **2025 Guidance**: 
  - Revenue: $460-480M (17-22% growth). 
  - Gross Profit: $73-82M (137-152% of 2024). 
  - EBITDA: -$8M to -$17M (Q4 breakeven). 
  - Free Cash Flow: -$12M to -$21M (Q4 breakeven). 
- **Key Drivers**: Capitation contracts (2/3 of $50M in 2025), dispensary growth, and clinical payroll efficiency (reduction as new contracts fill clinics). 

**【Q&A Highlights】**
- **Florida Expansion**: Clinics operating at 40% capacity vs. 75% in California. Target 2025: Scale Florida to match California productivity with pipeline contracts. 
- **Reimbursement Trends**: Favorable for value-based care (e.g., IRA drug cost reductions). CMS policy changes (e.g., 340B pricing) could shift volume to community oncology. 
- **2025 Risks**: Q1 seasonal drug price increases and lower encounter volumes. Improving margins as contracts ramp and reimbursement aligns with costs.

Actual	-0.15	-0.09	-0.17	-0.16	-0.33	-0.19	-0.19	-0.21	-0.22	-0.17	-0.18	-0.14	-0.21	-0.15	-0.14	-0.06
Forecast			-0.18	-0.2	-0.17	-0.17	-0.13	-0.11	-0.12	-0.09	-0.07	-0.08		-0.12	-0.1133	-0.09
Surprise	0.00%	0.00%	+5.56%	+20.00%	-94.12%	-11.76%	-46.15%	-90.91%	-83.33%	-88.89%	-157.14%	-75.00%	0.00%	-25.00%	-23.57%	+33.33%

TOI

TOI fundamentals

TOI Q4 2025 Earnings

Earnings Call

You can ask Aime

TOI

TOI fundamentals

TOI Q4 2025 Earnings

Earnings Call

TOI Earnings Call Summary for Q4/20255:00 PM on Mar 12, 2026

TOI Earnings Call Summary for Q3/20255:00 PM on Nov 13, 2025

TOI Earnings Call Summary for Q2/20255:00 PM on Aug 13, 2025

TOI Earnings Call Summary for Q1/20255:00 PM on May 14, 2025

TOI Earnings Call Summary for Q4/20245:00 PM on Mar 25, 2025

You can ask Aime