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Oncology Institute
(NASDAQ:TOI)
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Rating:56Neutral
Price Target:
$5.50
▲(42.86% Upside)
Action:Reiterated
Date:07/08/26
The score is held back primarily by weak underlying financials (continued losses, cash burn, and negative equity). Offsetting factors include improving forward outlook from the latest earnings call—especially the upgraded positive free cash flow guidance—and supportive technical momentum. Valuation is not a strong support given the company remains unprofitable, while the recent refinancing is a modest positive for near-term financial flexibility.
Positive Factors
Capitation / Value-based Revenue Mix
A meaningful shift toward capitation increases predictable, per-member revenue and aligns incentives to manage total oncology costs. Growing capitated mix reduces pure volume sensitivity, supports steadier margins when utilization is managed, and underpins durable revenue visibility as delegated MA lives expand.
Negative Factors
Negative Stockholders' Equity
Negative equity reflects multi-year accumulated losses that constrain capital flexibility and increase sensitivity to adverse operational shocks. It limits ability to absorb losses, raises refinancing and covenant risk, and can force dilution or asset-backed borrowing under stress, affecting strategic optionality.
Read all positive and negative factors
Positive Factors
Negative Factors
Capitation / Value-based Revenue Mix
A meaningful shift toward capitation increases predictable, per-member revenue and aligns incentives to manage total oncology costs. Growing capitated mix reduces pure volume sensitivity, supports steadier margins when utilization is managed, and underpins durable revenue visibility as delegated MA lives expand.
Read all positive factors
Oncology Institute (TOI) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$588.90M
Dividend YieldN/A
Average Volume (3M)1.89M
Price to Earnings (P/E)―
Beta (1Y)1.65
Revenue Growth35.37%
EPS Growth46.10%
CountryUS
Employees641
SectorHealthcare
Sector Strength45
IndustryMedical - Care Facilities
Share Statistics
EPS (TTM)-0.35
Shares Outstanding99,982,930
10 Day Avg. Volume2,105,444
30 Day Avg. Volume1,887,546
Financial Highlights & Ratios
PEG Ratio0.28
Price to Book (P/B)-209.23
Price to Sales (P/S)6.54
P/FCF Ratio-118.37
Enterprise Value/Market Cap1.02
Enterprise Value/Revenue1.10
Enterprise Value/Gross Profit7.41
Enterprise Value/Ebitda-20.51
Forecast
1Y Price Target
$8.50Price Target Upside120.78% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering4
EPS Forecast (FY)-0.15
Revenue Forecast (FY)$651.94M
Oncology Institute Business Overview & Revenue Model
Company Description
The Oncology Institute (TOI) is a specialized healthcare provider delivering a full range of medical oncology services throughout the United States. Its comprehensive offerings include direct physician care, integrated on-site infusion and medicat...
How the Company Makes Money
TOI generates revenue primarily by providing oncology care services and being reimbursed by third-party payors under a mix of fee-for-service and value-based care arrangements. Under fee-for-service, TOI bills commercial insurers, Medicare, Medica...
Oncology Institute Earnings Call Summary
Earnings Call Date:May 07, 2026
(Q1-2026)
| % Change Since: |
Next Earnings Date:Aug 11, 2026
Earnings Call Sentiment Positive
The call conveyed strong operational and financial momentum: substantial revenue growth (41% YoY), exceptional specialty pharmacy scale, capitation expansion and improved operating leverage drove better adjusted EBITDA and materially upgraded free cash flow guidance. Key operational milestones include Florida market profitability, planned expansion to ~200,000 delegated MA lives, and on-track AI and portal initiatives that are expected to further drive margins and ancillary capture. Headwinds include fee-for-service revenue decline, margin pressure in patient services due to ramping delegated contracts and seasonality in Q1, a reduction in average revenue per pharmacy fill, and refinancing/liquidity considerations. Overall, positive execution and upgraded cash flow outlook outweigh the manageable near-term margin and financing risks.Positive Updates
Strong Top-Line Growth
Total revenue of $147.4 million in Q1 2026, up 41.2% year-over-year, reflecting continued expansion of capitated arrangements and specialty pharmacy volume.
Negative Updates
Fee-for-Service Revenue Decline
Fee-for-service revenue declined ~10% year-over-year to $32.2 million despite higher visit volumes, driven by mix shift from active drug formulary management, conservative reserves against collections, and modest pricing pressure in the IV drug channel.
Read all updates
Q1-2026 Updates
Positive
Negative
Strong Top-Line Growth
Total revenue of $147.4 million in Q1 2026, up 41.2% year-over-year, reflecting continued expansion of capitated arrangements and specialty pharmacy volume.
Read all positive updates
Company Guidance
Management reaffirmed full‑year 2026 financial guidance of revenue $630–$650 million (including approximately $150 million of capitated revenue), gross profit $97–$107 million, and adjusted EBITDA of $0 to +$9 million, while raising free cash flow to a positive $5–$15 million (up from a prior outlook of −$15M to +$5M); they guided Q2 adjusted EBITDA of −$1M to +$1M, expect to expand delegated Medicare Advantage lives to ~200,000 across 25 counties by July 1 (with ~7 new TOI clinics to open this year), and reiterated $2 million of 2026 operating expense savings from AI initiatives, noting additional upside from pharmacy and portal rollouts not included in the current forecast.Oncology Institute Financial Statement Overview
Summary
Income Statement
32
Negative
Balance Sheet
22
Negative
Cash Flow
24
Negative
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 545.76M | 502.73M | 393.41M | 324.24M | 252.48M | 203.00M |
| Gross Profit | 80.89M | 76.44M | 54.00M | 59.57M | 52.09M | 40.85M |
| EBITDA | -29.23M | -42.52M | -50.88M | -54.28M | -67.60M | -42.04M |
| Net Income | -43.51M | -60.61M | -64.66M | -83.07M | 152.00K | -10.93M |
Balance Sheet | ||||||
| Total Assets | 168.23M | 164.66M | 172.72M | 209.24M | 261.67M | 203.44M |
| Cash, Cash Equivalents and Short-Term Investments | 30.28M | 33.56M | 49.67M | 82.86M | 73.81M | 114.30M |
| Total Debt | 104.86M | 103.69M | 123.15M | 119.67M | 108.18M | 183.00K |
| Total Liabilities | 184.51M | 180.38M | 169.13M | 152.22M | 138.49M | 99.28M |
| Stockholders Equity | -16.29M | -15.72M | 3.59M | 57.02M | 123.17M | 104.16M |
Cash Flow | ||||||
| Free Cash Flow | -25.73M | -27.79M | -30.33M | -40.88M | -67.28M | -35.73M |
| Operating Cash Flow | -21.81M | -24.59M | -26.54M | -36.31M | -61.76M | -32.68M |
| Investing Cash Flow | -3.91M | -3.07M | 46.21M | 62.64M | -131.61M | -12.15M |
| Financing Cash Flow | 16.27M | 11.56M | -3.49M | -6.85M | 92.21M | 154.01M |
Oncology Institute Technical Analysis
Positive
3.85
Price Trends
4.74
Positive
3.91
Positive
3.73
Positive
Market Momentum
0.30
Negative
65.30
Neutral
72.82
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 below the 20-day moving average (MA) of 5.37, below the 50-day MA of 4.74, and above the 200-day MA of 3.73, indicating a bullish trend. The MACD of 0.30 indicates Negative momentum. The RSI at 65.30 is Neutral, neither overbought nor oversold. The STOCH value of 72.82 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 56 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 |
|---|---|---|---|---|---|---|---|
62 Neutral | $876.09M | 1,108.51 | 1.03% | ― | 22.64% | -58.05% | |
59 Neutral | $427.09M | -4.33 | -27.10% | ― | -20.37% | -479.68% | |
58 Neutral | $1.92B | -4.95 | -146.01% | ― | -2.82% | -45.70% | |
56 Neutral | $588.90M | -16.67 | 326.77% | ― | 35.37% | 46.10% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
45 Neutral | $503.07M | -5.34 | 5.89% | ― | -2.87% | ― |
* Healthcare Sector Average
TOI
Oncology Institute
5.89
2.68
83.49%
CYH
Community Health
3.57
-0.14
-3.77%
CCRN
Cross Country Healthcare
13.22
1.14
9.44%
TALK
Talkspace
5.23
2.66
103.50%
AGL
Agilon Health
114.85
58.60
104.18%
Oncology Institute Corporate Events
Business Operations and StrategyPrivate Placements and Financing
Oncology Institute Refinances Debt with New Term Loan
Positive
Jul 7, 2026
On July 1, 2026, The Oncology Institute entered a $75 million term loan agreement with OrbiMed Opportunities, drawing the facility in full and securing it with a first‑priority lien on substantially all assets of the company and certain subs...
Executive/Board ChangesShareholder Meetings
Oncology Institute Shareholders Approve Directors and Annual Say-on-Pay
Positive
Jun 18, 2026
On June 17, 2026, The Oncology Institute held its 2026 annual meeting of stockholders, where holders of approximately 75% of outstanding shares voted on four governance proposals. Stockholders elected eight directors to one-year terms, ratified BD...
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.