Revenue: As of FY2025, the actual value is USD 502.73 M.

EPS: As of FY2025, the actual value is USD -0.54.

EBIT: As of FY2025, the actual value is USD -24.81 M.

Segment Revenue

• Patient Services Revenue:
  • In 2025, Patient Services Revenue was $228,991 thousand, an 11.8% increase from $204,883 thousand in 2024. This segment constituted 45.6% of total operating revenue in 2025, a decrease from 52.1% in 2024. The growth was primarily driven by a 9.0% increase in Fee-for-Service (FFS) revenue and a 17.2% increase in capitated revenue. Capitated revenue reached $80,481 thousand in 2025, up from $68,686 thousand in 2024, while FFS revenue was $148,510 thousand in 2025, compared to $136,197 thousand in 2024.
• Specialty Pharmacy Revenue:
  • Specialty Pharmacy Revenue increased by 49.6% to $269,176 thousand in 2025 from $179,916 thousand in 2024. This segment’s share of total operating revenue rose to 53.5% in 2025 from 45.7% in 2024, mainly due to a 66.6% increase in the number of fills, partially offset by a 10.2% decrease in average revenue per fill.
• Clinical Trials & Other Revenue:
  • This segment experienced a -47.0% decrease, falling to $4,562 thousand in 2025 from $8,613 thousand in 2024. Its contribution to total operating revenue declined to 0.9% in 2025 from 2.2% in 2024, attributed to a profit-sharing agreement with Helios CR, Inc.
• Total Operating Revenue:
  • Total Operating Revenue for 2025 was $502,729 thousand, marking a 27.8% increase from $393,412 thousand in 2024.

Operational Metrics

• Net Loss:
  • The company reported a Net Loss of - $60,606 thousand in 2025, an improvement from - $64,663 thousand in 2024.
• Loss from Operations:
  • Loss from Operations improved to - $36,083 thousand in 2025 from - $60,118 thousand in 2024. As a percentage of total operating revenue, it was -7.2% in 2025, an improvement from -15.2% in 2024.
• Operating Expenses:
  • Direct Costs – Patient Services: Increased by 10.0% to $205,502 thousand in 2025 from $186,880 thousand in 2024, primarily due to a 13.1% increase in intravenous drug costs, offset by a 4.1% decrease in clinical payroll costs. These costs represented 40.9% of total operating revenue in 2025, down from 47.5% in 2024.
  • Direct Costs – Specialty Pharmacy: Rose by 45.8% to $220,558 thousand in 2025 from $151,231 thousand in 2024, driven by a 66.6% increase in prescriptions filled, partially offset by a 12.5% decrease in average cost per fill. This accounted for 43.9% of total operating revenue in 2025, up from 38.4% in 2024.
  • Direct Costs – Clinical Trials & Other: Decreased significantly by -82.1% to $234 thousand in 2025 from $1,304 thousand in 2024, representing 0% of total operating revenue in 2025.
  • Selling, General and Administrative Expense: Decreased by -2.1% to $105,574 thousand in 2025 from $107,828 thousand in 2024, mainly due to a 59.2% decrease in share-based compensation expense and a 9.4% decrease in non-clinical payroll, partially offset by increases in professional fees and support services. It represented 21.0% of total operating revenue in 2025, down from 27.4% in 2024.
  • Depreciation and Amortization: Increased by 10.5% to $6,944 thousand in 2025 from $6,287 thousand in 2024, representing 1.4% of total operating revenue in 2025, down from 1.6% in 2024.
• Adjusted EBITDA:
  • Adjusted EBITDA was - $12,409 thousand in 2025, a -65.2% change from - $35,688 thousand in 2024.

Cash Flow

• Net Cash Used in Operating Activities:
  • Net cash used in operating activities was - $24,587 thousand in 2025, an improvement from - $26,538 thousand in 2024.
• Net Cash Provided by (Used in) Investing Activities:
  • Net cash used in investing activities was - $3,074 thousand in 2025, compared to $46,211 thousand provided in 2024.
• Net Cash Provided by (Used in) Financing Activities:
  • Net cash provided by financing activities was $11,557 thousand in 2025, contrasting with - $3,492 thousand used in 2024.

Unique Metrics

• Affiliated and Network Clinics:
  • The number of affiliated and network clinics grew to 146 in 2025 from 86 in 2024.
• Markets Served:
  • The company served 17 markets in 2025, up from 16 markets in 2024.
• Lives Under Value-Based Contracts:
  • Lives under value-based contracts increased to 2.0 million in 2025 from 1.9 million in 2024.
• Revenue from Value-Based Contracts:
  • Over 46% of total revenue in 2025 was derived from value-based contracts.
• Largest Customer Concentration:
  • In 2025, the largest customer by revenue represented approximately 14% of patient services revenue.
• Direct Costs from Single Vendor:
  • Vendor A accounted for 98% of direct costs in both 2025 and 2024.

Outlook / Guidance

The Oncology Institute, Inc. (TOI) plans to achieve future growth through acquisitions and de novo clinic builds in new and existing markets, alongside expanding network providers via an asset-lite strategy. The company intends to leverage existing payor relationships to enter new markets and is focusing on highly capital-efficient, scalable market entry strategies. TOI anticipates its operating expenses will increase in absolute dollars in the foreseeable future but decrease as a percentage of revenue over the long term.