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Oncology Institute, Inc. (TOI)
NASDAQ:TOI
US Market

Oncology Institute (TOI) AI Stock Analysis

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Oncology Institute

(NASDAQ:TOI)

Rating:46Neutral
Price Target:
$2.00
▼(-6.98%Downside)
The Oncology Institute's overall stock score is impacted by its financial struggles, with negative profitability and cash flow metrics. While technical indicators indicate a bearish trend, the earnings call provides some optimism with revenue growth and strategic initiatives for future improvement. The valuation remains unattractive due to the negative P/E ratio and lack of dividends.
Positive Factors
Business Expansion
TOI continues to expand into new markets and increase the number of patients served, driven by macro trends and a differentiated business model.
Cost Efficiency
TOI can help deliver significant cost savings with lower inpatient admissions and healthcare costs, while providing high-quality, well-managed oncology services.
Financial Performance
Margins are expected to improve as TOI signed an improved contract, reduced SG&A costs, and is focusing on driving earnings, aiming for positive EBITDA and FCF.
Negative Factors
Revenue Transition
TOI is working to transition some patients from a fee-for-service model to value-based-care, with ~46% of revenue in 2024 coming from VBC contracts.

Oncology Institute (TOI) vs. SPDR S&P 500 ETF (SPY)

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, Inc. makes money primarily through providing medical services to patients diagnosed with cancer. Its revenue model is based on billing for patient consultations, treatment sessions, and various oncology-related services. Revenue streams include payments from private insurance companies, government healthcare programs like Medicare and Medicaid, and direct payments from patients. TOI may also generate income through partnerships with pharmaceutical companies for clinical trials and research initiatives, although these are typically supplementary to its main revenue from clinical services. Additionally, TOI continuously seeks to expand its clinic network, which could contribute to increased patient volume and, subsequently, higher revenue.

Oncology Institute Earnings Call Summary

Earnings Call Date:May 14, 2025
(Q1-2025)
|
% Change Since: -9.28%|
Next Earnings Date:Aug 12, 2025
Earnings Call Sentiment Positive
The earnings call presented a strong start to 2025 with significant revenue growth and improvements in dispensary segment performance, gross profit, and SG&A reduction. However, challenges remain with adjusted EBITDA loss, net loss, and the revenue impact from outsourcing the clinical trials program. Despite these challenges, the overall trajectory and strategic initiatives indicate a focus on future profitability.
Q1-2025 Updates
Positive Updates
Revenue Growth
Revenue for Q1 2025 increased by 10% versus the prior year period, reaching $104.4 million.
Dispensary Segment Performance
The Dispensary segment grew by 24.2%, contributing $49.3 million in revenue and over $9 million in gross profit in Q1.
Capitated Contract Wins
New capitated contract wins added over 80,000 lives in the first quarter with projected new revenue of approximately $50 million on an annualized basis.
Gross Profit Improvement
Gross profit in Q1 of 2025 was $17.2 million, an increase of 44.1% compared to Q1 of 2024.
SG&A Reduction
SG&A, including depreciation and amortization, was $27.2 million in Q1 of 2025, a 9% decline compared to Q1 of 2024.
Debt Reduction and Capital Raise
Executed a partial paydown of convertible preferred debt of $20 million and a capital raise that added $16 million back to the balance sheet.
Negative Updates
Adjusted EBITDA Loss
Adjusted EBITDA was negative $5.1 million, although this was within the upper end of guidance.
Clinical Trials Revenue Impact
Outsourcing of the clinical trials program to Helios will reduce full year revenue by $5 million due to deconsolidation of clinical research revenue.
Net Loss
Net loss was $19.6 million in Q1 2025, although this was an improvement compared to Q1 of 2024.
Company Guidance
In the first quarter of 2025, The Oncology Institute reported a 10% increase in revenue compared to the same period in the previous year, with total revenue reaching $104.4 million. The company's retail Pharmacy and Dispensary business significantly contributed to this growth, generating $49.3 million in revenue and over $9 million in gross profit, representing a 20% year-over-year increase. The fee-for-service business also saw growth, with a 9% increase quarter-over-quarter and a 2% increase year-over-year. Additionally, the company signed new capitated contracts in Florida, California, and Nevada, adding over 80,000 lives and projecting approximately $50 million in new annualized revenue. The company reported an adjusted EBITDA loss of $5.1 million, aligning with the upper end of their guidance, and achieved a gross profit of $17.2 million, a 44.1% increase from the previous year. The company anticipates continuing this positive trajectory towards profitability and cash flow positivity by the end of 2025, supported by strategic market expansions and operational efficiencies.

Oncology Institute Financial Statement Overview

Summary
The Oncology Institute faces significant financial challenges. Despite slight revenue growth, the company struggles with profitability, with negative EBIT and net profit margin. Its high debt-to-equity ratio and negative cash flow are concerning, indicating financial instability and a need for improved cost management.
Income Statement
35
Negative
The Oncology Institute demonstrates a consistent increase in revenue over recent years, but it is struggling with profitability. The TTM data shows a slight revenue growth of 2.48% compared to the previous year, but the company reports a negative EBIT and net profit margin. This indicates an ongoing challenge in managing operational costs and achieving profitability.
Balance Sheet
40
Negative
The company's financial stability is challenged by a high debt-to-equity ratio due to its significant debt levels, which poses a risk in terms of leverage. The equity ratio has declined over time, reflecting decreased stockholders' equity and increased liabilities. Return on equity is negative, signaling inefficiencies in generating returns for shareholders.
Cash Flow
30
Negative
The Oncology Institute's cash flow situation is concerning, with negative free cash flow and operating cash flow in the TTM. While there was a significant improvement in free cash flow growth from the previous year, the negative operating cash flow to net income ratio highlights the company's struggle to generate cash from operations.
BreakdownTTMDec 2024Dec 2023Dec 2022Dec 2021Dec 2020
Income Statement
Total Revenue403.15M393.41M324.24M252.48M203.00M187.51M
Gross Profit59.28M54.00M59.57M52.09M40.85M36.88M
EBITDA-46.70M-50.88M-70.45M8.40M-7.94M-11.29M
Net Income-64.36M-64.66M-83.07M152.00K-10.93M-14.32M
Balance Sheet
Total Assets164.00M172.72M209.24M263.75M203.44M65.69M
Cash, Cash Equivalents and Short-Term Investments39.74M49.67M82.86M73.81M114.30M6.00M
Total Debt102.31M123.15M119.67M108.18M183.00K11.93M
Total Liabilities158.93M169.13M152.22M139.07M99.28M37.59M
Stockholders Equity5.07M3.59M57.02M124.68M104.16M28.10M
Cash Flow
Free Cash Flow-19.15M-30.33M-40.88M-67.28M-35.73M-685.88K
Operating Cash Flow-15.64M-26.54M-36.31M-61.76M-32.68M508.24K
Investing Cash Flow26.62M46.21M62.64M-131.61M-12.15M-8.84M
Financing Cash Flow-7.29M-3.49M-6.85M92.21M154.01M11.89M

Oncology Institute Technical Analysis

Technical Analysis Sentiment
Neutral
Last Price2.15
Price Trends
50DMA
2.71
Negative
100DMA
1.86
Positive
200DMA
1.09
Positive
Market Momentum
MACD
-0.14
Positive
RSI
39.46
Neutral
STOCH
21.25
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For TOI, the sentiment is Neutral. The current price of 2.15 is below the 20-day moving average (MA) of 2.67, below the 50-day MA of 2.71, and above the 200-day MA of 1.09, indicating a neutral trend. The MACD of -0.14 indicates Positive momentum. The RSI at 39.46 is Neutral, neither overbought nor oversold. The STOCH value of 21.25 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Neutral 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

Overall Rating
UnderperformOutperform
Sector (51)
Financial Indicators
Name
Overall Rating
Market Cap
P/E Ratio
ROE
Dividend Yield
Revenue Growth
EPS Growth
NHNHC
78
Outperform
$1.67B15.5911.19%2.27%19.16%31.92%
EHEHC
75
Outperform
$12.16B24.9625.33%0.56%11.21%30.38%
SESEM
64
Neutral
$1.92B11.2310.38%1.66%-8.86%-36.22%
60
Neutral
$1.93B10.286.35%5.48%
51
Neutral
$7.39B0.31-61.07%2.34%17.46%1.71%
CYCYH
51
Neutral
$472.83M39.18%1.05%-288.07%
TOTOI
46
Neutral
$197.61M-227.77%17.64%13.86%
* Healthcare Sector Average
Performance Comparison
Ticker
Company Name
Price
Change
% Change
TOI
Oncology Institute
2.24
1.79
397.78%
ACHC
Acadia Healthcare
22.06
-45.98
-67.58%
CYH
Community Health
3.48
0.28
8.75%
EHC
Encompass Health
121.54
36.28
42.55%
NHC
National Healthcare
109.05
4.00
3.81%
SEM
Select Medical
15.01
-3.61
-19.39%

Oncology Institute Corporate Events

Private Placements and FinancingBusiness Operations and Strategy
Oncology Institute Explores PIPE Financing Opportunity
Neutral
May 19, 2025

The Oncology Institute, Inc. has prepared an investor presentation to explore a potential private placement of securities, known as PIPE Financing. The presentation highlights the company’s unique approach in the oncology market, emphasizing its capability to manage population-level care contracts and its focus on reducing patient healthcare costs. The company’s strategy positions it to capitalize on the growing oncology market, driven by factors such as reimbursement misalignment and high-cost drugs.

The most recent analyst rating on (TOI) stock is a Buy with a $7.00 price target. To see the full list of analyst forecasts on Oncology Institute stock, see the TOI Stock Forecast page.

Executive/Board ChangesShareholder MeetingsStock Split
Oncology Institute Holds Annual Stockholders Meeting
Neutral
May 8, 2025

On May 7, 2025, The Oncology Institute held its Annual Meeting of Stockholders where three proposals were considered. The stockholders elected eight directors, ratified the appointment of BDO USA, LLP as the independent registered public accounting firm, and approved a proposal to amend the company’s certificate of incorporation to potentially effect a reverse stock split.

Executive/Board Changes
Oncology Institute COO Jeremy Castle Resigns
Neutral
May 7, 2025

On May 2, 2025, Jeremy Castle announced his resignation as Chief Operating Officer of The Oncology Institute, Inc., effective May 30, 2025. His departure was not due to any disagreements with the company regarding its operations, policies, or practices.

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.Date of analysis: Jun 26, 2025