Oncology Institute, Inc. (TOI)
NASDAQ:TOI
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Oncology Institute
(NASDAQ:TOI)
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Rating:54Neutral
Price Target:
$3.00
▼(-22.08% Downside)
Action:ReiteratedDate:03/17/26
The score is held back primarily by weak financial performance (ongoing losses, cash burn, and negative equity). Offsetting that, technicals are constructive with the stock trading above major moving averages, and the latest earnings call/guidance supports improving fundamentals (positive adjusted EBITDA targeted in 2026 and progress toward free-cash-flow breakeven). Valuation remains constrained by the negative P/E and lack of dividend support.
Positive Factors
Sustained Revenue Scale
TOI has materially scaled revenue from ~$188M in 2020 to ~$503M in 2025, demonstrating durable demand for community oncology and infusion services. This scale supports stronger negotiating leverage with payers, better absorption of fixed costs, and a larger platform for cross-selling services over the next 2–6 months.
Negative Factors
Weakened Balance Sheet / Negative Equity
A move to negative equity materially weakens financial flexibility and creditor confidence. Negative shareholders’ equity can constrain access to capital, limit covenant room, and increase refinancing risk if reimbursements or delegated contracts underperform, making the company vulnerable during industry reimbursement shifts or cyclical stress.
Read all positive and negative factors
Positive Factors
Negative Factors
Sustained Revenue Scale
TOI has materially scaled revenue from ~$188M in 2020 to ~$503M in 2025, demonstrating durable demand for community oncology and infusion services. This scale supports stronger negotiating leverage with payers, better absorption of fixed costs, and a larger platform for cross-selling services over the next 2–6 months.
Read all positive factors
Oncology Institute (TOI) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$339.02M
Dividend YieldN/A
Average Volume (3M)2.11M
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)-0.06
Shares Outstanding98,839,140
10 Day Avg. Volume1,219,950
30 Day Avg. Volume2,108,820
Financial Highlights & Ratios
PEG Ratio2.27
Price to Book (P/B)-209.23
Price to Sales (P/S)6.54
P/FCF Ratio-118.37
Enterprise Value/Market Cap0.98
Enterprise Value/Revenue0.66
Enterprise Value/Gross Profit4.77
Enterprise Value/Ebitda-11.38
Forecast
1Y Price Target
$7.00Price Target Upside81.82% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering4
EPS Forecast (FY)-0.3
Revenue Forecast (FY)$647.83M
Oncology Institute Business Overview & Revenue Model
Company Description
The 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 transpl...
How the Company Makes Money
TOI primarily makes money by providing oncology and related clinical services and being reimbursed by commercial insurers, Medicare, and other payers under both traditional and value-based arrangements. A major revenue stream is fee-for-service re...
Oncology Institute Earnings Call Summary
Earnings Call Date:Mar 12, 2026
(Q4-2025)
| % Change Since: |
Next Earnings Date:May 13, 2026
Earnings Call Sentiment Positive
The call highlighted meaningful operational and financial progress—record revenue, large pharmacy growth, expanded capitated relationships, improved margins, first positive adjusted EBITDA quarter, and strengthened balance sheet and leadership. Key near-term headwinds include seasonal Q1 weakness, reliance on pharmacy/dispensing, transitional MLR pressure during delegated ramps, and a free-cash-flow range that allows for interim negative cash flow. Overall, positives (strong top-line growth, margin improvement, profitability milestone, and clear 2026 guidance) significantly outweigh the manageable short-term risks.Positive Updates
Record Revenue and Strong Top-Line Growth
Full year 2025 revenue of $502.7M, up ~27.8% YoY (from $393.4M), surpassing $500M for the first time; Q4 revenue $142.0M, up 41.6% YoY (from $100.3M).
Negative Updates
Near-Term Seasonality and Q1 Loss Expectation
Management expects Q1 to be seasonally weakest due to patient deductible resets and lagged reimbursement; Q1 2026 adjusted EBITDA is anticipated to be a loss of $3M to $1M (and Q1 2025 included a one-time $1.6M benefit).
Read all updates
Q4-2025 Updates
Positive
Negative
Record Revenue and Strong Top-Line Growth
Full year 2025 revenue of $502.7M, up ~27.8% YoY (from $393.4M), surpassing $500M for the first time; Q4 revenue $142.0M, up 41.6% YoY (from $100.3M).
Read all positive updates
Company Guidance
The company reiterated its January 2026 guidance: revenue $630–650M (vs $502.7M in 2025) with roughly $150M of capitated revenue and an expectation of >80% capitated revenue growth, gross profit $97–107M (gross margins improving ~100–200 bps), adjusted EBITDA $0–9M (reaffirming full‑year positive adjusted EBITDA in 2026) with Q1 adjusted EBITDA expected to be a loss of $3M–$1M due to seasonality, free cash flow of -$15M to $5M (with FCF positivity expected by year‑end), SG&A trending to ~16% of revenue, pharmacy assumed at a ~$27M/month run rate with 3–5% incremental growth from attachment to new capitated lives, and delegated contract MLRs targeted around ~85%.Oncology Institute Financial Statement Overview
Summary
Income Statement
28
Negative
Balance Sheet
22
Negative
Cash Flow
25
Negative
| Breakdown | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|
Income Statement | |||||
| Total Revenue | 502.73M | 393.41M | 324.24M | 252.48M | 203.00M |
| Gross Profit | 69.49M | 54.00M | 59.57M | 52.09M | 40.85M |
| EBITDA | -29.14M | -53.83M | -54.28M | -67.60M | -42.04M |
| Net Income | -60.61M | -64.66M | -83.07M | 152.00K | -10.93M |
Balance Sheet | |||||
| Total Assets | 164.66M | 172.72M | 209.24M | 261.67M | 203.44M |
| Cash, Cash Equivalents and Short-Term Investments | 33.56M | 49.67M | 82.86M | 73.81M | 114.30M |
| Total Debt | 103.69M | 123.15M | 119.67M | 108.18M | 183.00K |
| Total Liabilities | 180.38M | 169.13M | 152.22M | 138.49M | 99.28M |
| Stockholders Equity | -15.72M | 3.59M | 57.02M | 123.17M | 104.16M |
Cash Flow | |||||
| Free Cash Flow | -27.79M | -30.33M | -40.88M | -67.28M | -35.73M |
| Operating Cash Flow | -24.59M | -26.54M | -36.31M | -61.76M | -32.68M |
| Investing Cash Flow | -3.07M | 46.21M | 62.64M | -131.61M | -12.15M |
| Financing Cash Flow | 11.56M | -3.49M | -6.85M | 92.21M | 154.01M |
Oncology Institute Technical Analysis
Positive
3.85
Price Trends
2.92
Positive
3.17
Positive
3.39
Positive
Market Momentum
0.08
Negative
61.49
Neutral
76.38
Neutral
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 3.85 is above the 20-day moving average (MA) of 3.20, above the 50-day MA of 2.92, and above the 200-day MA of 3.39, indicating a bullish trend. The MACD of 0.08 indicates Negative momentum. The RSI at 61.49 is Neutral, neither overbought nor oversold. The STOCH value of 76.38 is Neutral, 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 |
|---|---|---|---|---|---|---|---|
70 Outperform | $863.78M | 78.45 | 6.89% | ― | 18.37% | ― | |
61 Neutral | $695.42M | -101.82 | -0.84% | ― | 1.02% | 89.58% | |
56 Neutral | $436.67M | 0.82 | -31.57% | ― | 0.74% | ― | |
54 Neutral | $339.02M | -54.27 | 759.71% | ― | 21.67% | 16.74% | |
54 Neutral | $324.48M | -2.77 | -24.30% | ― | -22.14% | -787.87% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
50 Neutral | $446.37M | -0.70 | -116.65% | ― | 5.21% | 5.21% |
* Healthcare Sector Average
TOI
Oncology Institute
3.43
1.27
58.80%
CYH
Community Health
3.15
0.74
30.71%
CCRN
Cross Country Healthcare
10.04
-4.22
-29.59%
TALK
Talkspace
5.17
2.50
93.63%
AGL
Agilon Health
26.88
-73.12
-73.12%
EHAB
Enhabit, Inc
13.71
6.03
78.52%
Oncology Institute Corporate Events
Business Operations and StrategyRegulatory Filings and Compliance
Oncology Institute Updates Investors With New Presentation
Neutral
Mar 13, 2026
The Oncology Institute, Inc. has prepared a new investor presentation for use in meetings with current and prospective investors, signaling an effort to update the market on its business and financial outlook. The materials were furnished in conne...
Business Operations and StrategyExecutive/Board Changes
Oncology Institute Adds Independent Director to Board
Positive
Feb 23, 2026
The Oncology Institute, Inc., a leading U.S. value-based oncology group with over 100 clinics and affiliate locations across five states, delivers specialized, evidence-based cancer care and clinical trials to about 1.9 million patients. Operating...
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.