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- **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

Sales and Services Revenue

Financing Services Revenue

Other Revenue

Cost of Revenue

Cost of Goods and Services

Cost of Financing Services

Other Cost

Gross Profit

Other Operating Income

Operating Expenses

Selling, General and Administrative Expenses

Selling and Marketing Expenses

General and Administrative Expenses

Research and Development Expenses

Loss on Bad Debts

Loss on Impairment of Other Assets

Loss on Disposal of Assets

Other Operating Expenses

Operating Income

Non-Operating Income (Loss)

Income (Loss) from Affiliates

Income (Loss) from Associates

Income (Loss) from Joint ventures

Gain (Loss) on Other Investment

Gain (Loss) on Change in Fair Value

Gain (Loss) on Foreign Currency Exchange

Other Non-Operating Income (Loss)

Net Interest Expense

Interest Expense

Interest Income

Pretax Income From Continuing Operations

Income Tax Expense

Current Income Tax

Deferred Income Tax

Income Tax Adjustments

Net Income from Continuing Operations

Income from Discontinued Operations

Other Items Before Net Income

Net Income

Net Income Attributable to Minority Interests

Net Income Attributable to Owners of the Company

Preferred Stock Dividends

Other Adjustments

Net Income Attributable to Common Stockholders

Other Comprehensive Income

Total Comprehensive Income

Total Comprehensive Income Attributable to Minority Interests

Total Comprehensive Income Attributable to Owners of the Company

Basic EPS

Basic EPS from Continuing Operations

Basic EPS from Discontinued Operations

Diluted EPS

Diluted EPS from Continuing Operations

Diluted EPS from Discontinued Operations

TOI

TOI fundamentals

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