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Oncology Institute, Inc. (TOI)
:TOI
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Oncology Institute
(NASDAQ:TOI)
Select Model
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Rating:47Neutral
Price Target:
$3.00
▼(-7.12% Downside)
The overall stock score is primarily influenced by significant financial challenges, including negative equity and profitability issues. While the earnings call provided positive guidance and strategic advancements, these are overshadowed by the company's financial instability and weak technical indicators.
Positive Factors
Revenue Growth
Strong revenue growth indicates robust demand for TOI's services, enhancing its market position and supporting long-term financial stability.
AI Integration
AI integration is expected to drive operational efficiencies, reducing costs and improving service delivery, which can enhance competitive advantage.
Expansion in Florida
Expansion in Florida strengthens TOI's geographic footprint and patient base, potentially increasing revenue and market influence.
Negative Factors
Financial Instability
Negative equity and high leverage indicate potential solvency issues, posing risks to financial health and limiting growth opportunities.
Profitability Challenges
Ongoing profitability challenges suggest operational inefficiencies, which could hinder long-term financial performance and investor confidence.
Board Resignation
The resignation could lead to strategic uncertainty and potential disruption in governance, affecting long-term strategic execution.
Oncology Institute (TOI) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$371.88M
Dividend YieldN/A
Average Volume (3M)2.69M
Price to Earnings (P/E)―
Beta (1Y)1.48
Revenue Growth21.67%
EPS Growth16.74%
CountryUS
Employees825
SectorHealthcare
Sector Strength45
IndustryMedical - Care Facilities
Share Statistics
EPS (TTM)-0.14
Shares Outstanding98,381,340
10 Day Avg. Volume1,991,990
30 Day Avg. Volume2,685,330
Financial Highlights & Ratios
PEG Ratio0.02
Price to Book (P/B)6.46
Price to Sales (P/S)0.06
P/FCF Ratio-0.76
Enterprise Value/Market Cap1.12
Enterprise Value/Revenue0.90
Enterprise Value/Gross Profit6.09
Enterprise Value/Ebitda-9.29
Forecast
1Y Price Target
$6.67Price Target Upside106.50% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering3
EPS Forecast (FY)-0.57
Revenue Forecast (FY)$500.57M
Oncology Institute Business Overview & Revenue Model
Company DescriptionThe Oncology Institute, Inc., an oncology company, provides medical oncology services in the United States. Its services include physician services, in-house infusion and dispensary, clinical trial services, radiation, outpatient stem cell transplants and transfusions programs, and patient support. The company also offers and manages clinical trial services, such as managing clinical trials, palliative care programs, and stem cell transplants services. It serves adult and senior cancer patients. The company operates 67 clinic locations. The Oncology Institute, Inc. was founded in 2007 and is based in Cerritos, California.
How the Company Makes MoneyThe Oncology Institute generates revenue primarily through patient services, which include consultations, diagnostic testing, and treatment therapies such as chemotherapy and radiation. A significant portion of their income comes from reimbursement agreements with insurance companies, Medicare, and Medicaid, as they provide care to a diverse patient base. Additionally, TOI may earn revenue through partnerships with pharmaceutical companies for clinical trials, where they receive funding for conducting research studies and offering access to new treatment options. The institute's focus on innovation and research also allows it to apply for grants and funding from various health organizations, further contributing to its earnings.
Oncology Institute Earnings Call Summary
Earnings Call Date:Nov 13, 2025
(Q3-2025)
| % Change Since: |
Next Earnings Date:Mar 05, 2026
Earnings Call Sentiment Positive
The call reflects strong financial performance with significant revenue growth, improvements in adjusted EBITDA, and successful expansion efforts, particularly in Florida. However, challenges such as a cybersecurity incident and a one-time reserve impact were noted. The positives, including increased guidance and strategic advancements, substantially outweigh the negatives.Q3-2025 Updates
Positive Updates
Revenue Growth
Third quarter revenue reached $137 million, marking a 23% increase compared to the previous year. The Pharmacy business grew by 42%, and the fee-for-service business saw a 13% year-over-year growth.
Pharmacy Business Success
The Pharmacy segment achieved record performance with revenue increasing by 57.4% year-over-year due to higher prescription volumes and improved pharmacy attachment.
Adjusted EBITDA Improvement
The adjusted EBITDA loss for Q3 was $3.5 million, a $4.7 million improvement compared to the same quarter last year. The company achieved its first adjusted EBITDA profitability in September.
Expansion in Florida
Significant progress was made in Florida with Elevance Health, expanding Medicare Advantage lives and opening a new TOI Florida pharmacy location.
AI Enablement Efforts
Introduction of AI in revenue cycle management and patient call centers, reducing submission time from 18 minutes to 5 seconds, expected to save over $2 million in operating expenses.
Increased Guidance for 2025
Full year revenue guidance was raised to $495-505 million, and adjusted EBITDA loss guidance improved to a range of negative $13 million to negative $11 million.
Negative Updates
Cybersecurity Incident
A cybersecurity incident at a key vendor affected the billing and practice management systems, causing a temporary inability to bill for fee-for-service claims.
Adjusted EBITDA Still Negative
Despite improvements, the adjusted EBITDA for Q3 was still negative at $3.5 million.
One-Time Reserve Impact
A $1.8 million reserve against fee-for-service revenue was recorded due to potential future bad debt, impacting the reported adjusted EBITDA.
Company Guidance
In the third quarter of 2025, The Oncology Institute (TOI) demonstrated strong financial performance and operational growth, prompting an increase in its full-year outlook. The company reported a 23% increase in revenue to $137 million, driven by a 42% growth in its Pharmacy business and a 13% increase in its fee-for-service segment. TOI achieved a significant milestone by recording its first month of adjusted EBITDA profitability in September. The adjusted EBITDA loss for Q3 was $3.5 million, a $4.7 million improvement from the previous year. The company is on track to achieve profitability in Q4 and anticipates becoming free cash flow positive by 2026. TOI highlighted progress in its delegated capitation model in Florida, expanding its partnership with Elevance Health, and opening a new pharmacy location. The company anticipates a 29% increase in capitated revenue for the full year compared to 2024, supported by new capitation contracts expected to contribute $19 million in revenue. TOI is also integrating AI into its operations, projecting significant operating expense efficiencies, including estimated savings of up to $2 million from authorization efficiencies.Oncology Institute Financial Statement Overview
Summary
The Oncology Institute faces significant financial challenges. Despite positive revenue growth, profitability and balance sheet metrics indicate operational inefficiencies and financial instability. Negative equity and high leverage pose substantial risks, and cash flow remains a concern despite some growth in free cash flow.Income Statement
The Oncology Institute shows a mixed performance in its income statement. Revenue growth is positive at 8.64% TTM, indicating some expansion. However, profitability metrics are concerning, with negative net profit and EBIT margins, reflecting ongoing operational challenges. The gross profit margin is relatively low at 14.82% TTM, suggesting limited pricing power or high cost of goods sold.45
Neutral
Balance Sheet
The balance sheet reveals significant financial instability. The debt-to-equity ratio is negative due to negative stockholders' equity, indicating potential solvency issues. Return on equity is positive at 21.04% TTM, but this is misleading due to negative equity. The equity ratio is not calculable due to negative equity, highlighting financial distress.30
Negative
Cash Flow
Cash flow analysis shows some improvement in free cash flow growth at 110.56% TTM, but overall cash flow remains negative. The operating cash flow to net income ratio is negative, indicating cash flow challenges. The free cash flow to net income ratio is above 1, suggesting some efficiency in converting earnings to cash, albeit from a negative base.40
Negative
| Breakdown | TTM | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 | Dec 2020 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 461.04M | 393.41M | 324.24M | 252.48M | 203.00M | 187.51M |
| Gross Profit | 68.31M | 54.00M | 59.57M | 52.09M | 40.85M | 36.88M |
| EBITDA | -44.80M | -53.83M | -54.28M | -67.60M | -42.04M | -11.29M |
| Net Income | -66.28M | -64.66M | -83.07M | 152.00K | -10.93M | -14.32M |
Balance Sheet | ||||||
| Total Assets | 163.62M | 172.72M | 209.24M | 261.67M | 203.44M | 65.69M |
| Cash, Cash Equivalents and Short-Term Investments | 27.66M | 49.67M | 82.86M | 73.81M | 114.30M | 6.00M |
| Total Debt | 27.36M | 123.15M | 119.67M | 108.18M | 183.00K | 11.93M |
| Total Liabilities | 175.89M | 169.13M | 152.22M | 138.49M | 99.28M | 37.59M |
| Stockholders Equity | -12.27M | 3.59M | 57.02M | 123.17M | 104.16M | 28.10M |
Cash Flow | ||||||
| Free Cash Flow | -27.53M | -30.33M | -40.88M | -67.28M | -35.73M | -686.00K |
| Operating Cash Flow | -23.63M | -26.54M | -36.31M | -61.76M | -32.68M | 508.00K |
| Investing Cash Flow | -3.77M | 46.21M | 62.64M | -131.61M | -12.15M | -8.84M |
| Financing Cash Flow | 7.66M | -3.49M | -6.85M | 92.21M | 154.01M | 11.89M |
Oncology Institute Technical Analysis
Positive
3.23
Price Trends
3.75
Positive
3.66
Positive
2.95
Positive
Market Momentum
-0.02
Negative
57.94
Neutral
86.01
Negative
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For TOI, the sentiment is Positive. The current price of 3.23 is below the 20-day moving average (MA) of 3.31, below the 50-day MA of 3.75, and above the 200-day MA of 2.95, indicating a bullish trend. The MACD of -0.02 indicates Negative momentum. The RSI at 57.94 is Neutral, neither overbought nor oversold. The STOCH value of 86.01 is Negative, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for TOI.
Oncology Institute Risk Analysis
Oncology Institute disclosed 58 risk factors in its most recent earnings report. Oncology Institute reported the most risks in the "Finance & Corporate" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Oncology Institute Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
61 Neutral | $581.45M | 143.85 | 3.74% | ― | 18.37% | ― | |
61 Neutral | $489.88M | -39.14 | -2.10% | ― | 1.02% | 89.58% | |
61 Neutral | $448.80M | 1.33 | ― | ― | 0.74% | ― | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
47 Neutral | $371.88M | ― | -3407.86% | ― | 21.67% | 16.74% | |
46 Neutral | $278.13M | -17.08 | -3.76% | ― | -22.14% | -787.87% | |
42 Neutral | $298.08M | -0.85 | -73.31% | ― | 5.21% | 5.21% |
* Healthcare Sector Average
TOI
Oncology Institute
3.77
3.58
1884.21%
CYH
Community Health
3.22
0.01
0.31%
CCRN
Cross Country Healthcare
8.25
-9.65
-53.91%
TALK
Talkspace
3.51
0.25
7.67%
AGL
Agilon Health
0.66
-1.34
-67.00%
EHAB
Enhabit, Inc
9.69
1.40
16.89%
Oncology Institute Corporate Events
Executive/Board Changes
Oncology Institute Announces Board Member Resignation
Neutral
Dec 1, 2025
On December 1, 2025, The Oncology Institute announced the resignation of Gabe Ling from its Board of Directors, effective the same day. The resignation is not due to any disagreements with the company. A search for new independent directors with expertise in healthcare and value-based care has been initiated to enhance the board’s capabilities and support the company’s mission and growth goals.
M&A TransactionsBusiness Operations and StrategyFinancial Disclosures
Oncology Institute Projects Strong 2025 Revenue Growth
Positive
Nov 14, 2025
The Oncology Institute has released an investor presentation highlighting its strategic plans and financial outlook. The company anticipates over 20% revenue growth in 2025 and aims to achieve EBITDA positive by the fourth quarter of 2025. The presentation outlines multiple growth channels, including strategic M&A, expanding contracts, and increasing specialty pharmacy services, which are expected to enhance the company’s market positioning and operational efficiency.
Business Operations and Strategy
Oncology Institute Reports Cybersecurity Incident Impact
Neutral
Nov 6, 2025
On November 3, 2025, The Oncology Institute, Inc. announced a cybersecurity incident involving an IT software provider that could delay fee-for-service collections. The delay is expected to be brief and immaterial, with no evidence of compromised patient information. The company is working with the provider to mitigate the impact and restore normal billing operations.
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.