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The Oncology Institute Reports Second Quarter 2025 Financial Results and Reaffirms Full Year 2025 Guidance
Business
Aug 13 2025
17 min read

The Oncology Institute Reports Second Quarter 2025 Financial Results and Reaffirms Full Year 2025 Guidance

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CERRITOS, Calif., Aug. 13, 2025 (GLOBE NEWSWIRE) -- The Oncology Institute, Inc. (NASDAQ: TOI) (“TOI” or the “Company”), one of the largest value-based community oncology groups in the United States, today reported financial results for its three months ended June 30, 2025.

Daniel Virnich, CEO of TOI, commented, "We delivered another strong quarter with over 20% year-over-year revenue growth. This was driven by exceptional performance in our pharmacy business, which grew over 40% year-over-year, as well as the addition of over 50,000 new capitated lives to our value-based business. We are also in the process of expanding our partnership into new geographic regions of Florida with a major health plan which, once finalized, will double the amount of lives we cover for this payor. The momentum we're seeing in new contract signings, combined with continued strength in pharmacy, gives us increasing confidence that we'll achieve revenue at the high end of our guidance range for the year and achieve Adjusted EBITDA positivity as we exit 2025."

Recent Operational Highlights

  • Fee-for-service revenue growth of 10% over Q2 2024, driven by momentum in new markets.

  • Retail Pharmacy and Dispensary set fill records, contributing $62.6 million revenue and over $11 million in gross profit in Q2.

  • Planned expansion of existing fully delegated capitated partnership with Elevance into two new counties in Central Florida, which, if finalized, will more double the number of lives under our current relationship. Expanded capitation relationship as of July 1 with Silver Summit Health Plan in Nevada to serve all of their Medicaid patients in Clark County.

  • Welcomed Dr. Jeff Langsam as our new Chief Clinical Officer, leading our efforts around therapeutics, Utilization Management and MSO practice engagement and Kristin England as our new Chief Administrative Officer overseeing our Enterprise Central Business Operations and Technology Strategy and AI Enablement.

Second Quarter 2025 Financial Highlights

All comparisons are to the quarter ended June 30, 2024 unless otherwise noted

  • Consolidated revenue of $119.8 million increased of 21.5% from $98.6 million

  • Gross profit of $17.5 million, increased 34.4%

  • Net loss of $17.0 million compared to net loss of $15.5 million

  • Basic and diluted (loss) earnings per share of $(0.15) compared to $(0.17)

  • Adjusted EBITDA of $(4.1) million compared to $(8.7) million

  • Cash and cash equivalents of $30.3 million as of June 30, 2025

Outlook for Fiscal Year 2025

TOI uses Adjusted EBITDA and Free Cash flow, each a non-GAAP metric, as an additional tool to assess its operational and financial performance. See "Financial Information: Non-GAAP Financial Measures" below. In reliance on the unreasonable efforts exception provided under Regulation S-K, TOI is not reasonably able to provide a quantitative reconciliation for forward-looking information of Adjusted EBITDA and Free Cash Flow to net (loss) income and net cash provided by operations, respectively, the most directly comparable GAAP financial measures, without unreasonable efforts due to uncertainties regarding taxes, capital expenditures, operating activities, share-based compensation, goodwill impairment charges, change in fair value of liabilities, unrealized (gains) losses on investments, practice acquisition-related costs, consulting and legal fees, transaction costs and other non-cash items. The variability of these items could have an unpredictable, and potentially significant, impact on TOI’s future GAAP financial results. Nevertheless TOI reaffirms its full year 2025 guidance:

2025 Guidance

Revenue

$460 to $480 million

Gross Profit

$73 to $82 million

Adjusted EBITDA

$(8) to $(17) million

Free Cash Flow

$(12) to $(21) million


The Company, given the revenue growth in the first half of the year, currently believes it can reach the higher-end of the revenue guidance range for 2025. Additionally, the Company expects Adjusted EBITDA of approximately $(2.5) to $(3.5) million in the third quarter of 2025. TOI's achievement of the anticipated results is subject to risks and uncertainties, including those disclosed in its filings with the U.S. Securities and Exchange Commission. The outlook does not take into account the impact of any unanticipated developments in the business or changes in the operating environment, nor does it take into account the impact of TOI's acquisitions, dispositions or financings. TOI's outlook assumes a largely open global market, which would likely be negatively impacted if recent tariff rate increases and exchange rate changes persist and adversely affect world trade.

Webcast and Conference Call

TOI will host a conference call on Wednesday, August 13, 2025 at 5:00 p.m. (Eastern Time) to discuss second quarter results and management’s outlook for future financial and operational performance.

The conference call can be accessed live over the phone by dialing 1-877-407-0789, or for international callers, 1-201-689-8562. A replay will be available two hours after the call and can be accessed by dialing 1-844-512-2921, or for international callers, 1-412-317-6671. The passcode for the live call and the replay is 13754165. The replay will be available until Wednesday, August 20, 2025.

Interested investors and other parties may also listen to a simultaneous webcast of the conference call by logging onto the Investor Relations section of TOI's website at https://investors.theoncologyinstitute.com.

About The Oncology Institute, Inc.

Founded in 2007, The Oncology Institute, Inc. (NASDAQ: TOI) is advancing oncology by delivering highly specialized, value-based cancer care in the community setting. TOI offers cutting-edge, evidence-based cancer care to a population of approximately 1.9 million patients including clinical trials, transfusions, and other care delivery models traditionally associated with the most advanced care delivery organizations. With over 180 employed and affiliate clinicians and over 100 clinics and affiliate locations of care across five states and growing, TOI is changing oncology for the better. For more information visit www.theoncologyinstitute.com.

Forward-Looking Statements

This press release includes certain statements that are not historical facts but are forward-looking statements for purposes of the safe harbor provisions under the United States Private Securities Litigation Reform Act of 1995. Forward-looking statements generally are accompanied by words such as “preliminary,” “believe,” “may,” “will,” “estimate,” “continue,” “anticipate,” “intend,” “expect,” “should,” “would,” “plan,” “project,” “predict,” “potential,” “guidance,” “approximately,” “seem,” “seek,” “future,” “outlook,” and similar expressions that predict or indicate future events or trends or that are not statements of historical matters. These forward-looking statements include, but are not limited to, statements regarding projections, anticipated financial results, estimates and forecasts of revenue and other financial and performance metrics and projections of market opportunity and expectations. These statements are based on various assumptions and on the current expectations of TOI and are not predictions of actual performance. These forward-looking statements are provided for illustrative purposes only and are not intended to serve as, and must not be relied on by anyone as, a guarantee, an assurance, a prediction or a definitive statement of fact or probability. Actual events and circumstances are difficult or impossible to predict and will differ from assumptions. Many actual events and circumstances are beyond the control of TOI. These forward-looking statements are subject to a number of risks and uncertainties, including the accuracy of the assumptions underlying the 2025 full fiscal year outlook and the Q3 2025 outlook with respect to Adjusted EBITDA discussed herein, the outcome of judicial and administrative proceedings to which TOI may become a party or investigations to which TOI may become or is subject that could interrupt or limit TOI’s operations, result in adverse judgments, settlements or fines and create negative publicity; changes in TOI’s patient or payors' preferences, prospects and the competitive conditions prevailing in the healthcare sector; failure to continue to meet stock exchange listing standards; the impact of COVID-19 on TOI’s business; those factors discussed in the documents of TOI filed, or to be filed, with the SEC, including the Item 1A. "Risk Factors" section of TOI's Annual Report on Form 10-K for the year ended December 31, 2024 filed with the SEC on March 26, 2025 and any subsequent Quarterly Reports on Form 10-Q or Current Reports on Form 8-K. If the risks materialize or assumptions prove incorrect, actual results could differ materially from the results implied by these forward-looking statements. There may be additional risks that TOI currently is evaluating or does not presently know or that TOI currently believes are immaterial that could also cause actual results to differ from those contained in the forward-looking statements. In addition, forward-looking statements reflect TOI’s plans or forecasts of future events and views as of the date of this press release. TOI anticipates that subsequent events and developments will cause TOI’s assessments to change. TOI does not undertake any obligation to update any of these forward-looking statements. These forward-looking statements should not be relied upon as representing TOI’s assessments as of any date subsequent to the date of this press release. Accordingly, undue reliance should not be placed upon the forward-looking statements.

Financial Information; Non-GAAP Financial Measures

Some of the financial information and data contained in this press release, such as Adjusted EBITDA and Free Cash Flow, have not been prepared in accordance with United States generally accepted accounting principles (“GAAP”). TOI’s non-GAAP financial measures may be different from non-GAAP financial measures used by other companies. The presentation of non-GAAP financial measures is not intended to be considered in isolation or as a substitute for, or superior to, financial measures determined in accordance with GAAP. Because of the limitations of non-GAAP financial measures, you should consider the non-GAAP financial measures presented in this press release in conjunction with TOI’s financial statements and the related notes thereto.

TOI believes that the use of Free Cash Flow provides an additional tool to assess the Company's financial performance, evaluate its ability to generate cash from operations, and plan for future investments and obligations. Free Cash Flow is useful in understanding the cash available for strategic initiatives. It also helps in comparing TOI's financial performance with other similar companies, many of which use similar non-GAAP financial measures to provide insights into their cash generation capabilities. However, the principal limitation of Free Cash Flow is that it does not account for certain cash outflows or inflows that are required by GAAP to be recorded in TOI's financial statements. TOI defines Free Cash Flow as net cash flow provided by (used in) operations plus cash paid for interest, less capital expenditures.

TOI believes that the use of Adjusted EBITDA provides an additional tool to assess our operations and results of our performance, to plan and forecast future periods, and factors and trends in, and in comparing our financial measures with, other similar companies, many of which present similar non-GAAP financial measures to investors. The principal limitation of Adjusted EBITDA is that it excludes significant expenses and income that are required by GAAP to be recorded in TOI's financial statements.

TOI defines Adjusted EBITDA as net (loss) income plus depreciation, amortization, interest, taxes, non-cash items, share-based compensation, goodwill impairment charges, change in fair value of liabilities, unrealized gains or losses on investments and other adjustments to add-back the following: consulting and legal fees related to acquisitions, one-time consulting and legal fees related to certain advisory projects, software implementations and debt or equity financings, severance expense and temporary labor and recruiting charges to build out our corporate infrastructure.

A reconciliation of Adjusted EBITDA to net loss and Free Cash Flow to net cash flow used in operations, the most comparable GAAP metrics, is set forth below:

Free Cash Flow Reconciliation

 

 

Six Months Ended June 30,

 

Change

 

(dollars in thousands)

 

2025

 

 

 

2024

 

 

$

 

%

 

Net cash and cash equivalents used in operating activities

$

(15,190

)

 

$

(31,543

)

 

$

16,353

 

 

51.8

%

 

Cash paid for interest

 

2,158

 

 

 

2,224

 

 

 

(66

)

 

3.0

%

 

Purchases of property and equipment

 

(1,536

)

 

 

(2,436

)

 

 

900

 

 

36.9

%

 

Free Cash Flow

$

(14,568

)

 

$

(31,755

)

 

$

17,187

 

 

54.1

%

 

 


Adjusted EBITDA Reconciliation

 

Three Months Ended June 30,

 

Change

 

Six Months Ended June 30,

 

Change

(dollars in thousands)

 

2025

 

 

 

2024

 

 

$

 

%

 

 

2025

 

 

 

2024

 

 

$

 

%

Net loss

$

(17,009

)

 

$

(15,479

)

 

$

(1,530

)

 

9.9

%

 

$

(36,594

)

 

$

(35,368

)

 

$

(1,226

)

 

3.5

%

Depreciation and amortization

 

1,805

 

 

 

1,518

 

 

 

287

 

 

18.9

%

 

 

3,589

 

 

 

3,007

 

 

 

582

 

 

19.4

%

Interest expense, net

 

1,870

 

 

 

2,119

 

 

 

(249

)

 

(11.8

)%

 

 

7,440

 

 

 

4,103

 

 

 

3,337

 

 

81.3

%

Income tax and other taxes

 

(61

)

 

 

 

 

 

(61

)

 

%

 

 

(61

)

 

 

 

 

 

(61

)

 

%

Non-cash addbacks(1)

 

2,222

 

 

 

(69

)

 

 

2,291

 

 

(3,320.3

)%

 

 

2,059

 

 

 

(108

)

 

 

2,167

 

 

(2,006.5

)%

Share-based compensation

 

752

 

 

 

3,387

 

 

 

(2,635

)

 

(77.8

)%

 

 

2,210

 

 

 

7,474

 

 

 

(5,264

)

 

(70.4

)%

Changes in fair value of liabilities

 

4,040

 

 

 

(3,120

)

 

 

7,160

 

 

(229.5

)%

 

 

7,392

 

 

 

(3,120

)

 

 

10,512

 

 

(336.9

)%

Unrealized (gains) losses on investments

 

 

 

 

(34

)

 

 

34

 

 

(100.0

)%

 

 

6

 

 

 

(116

)

 

 

122

 

 

(105.2

)%

Post-combination compensation expense(2)

 

13

 

 

 

186

 

 

 

(173

)

 

(93.0

)%

 

 

26

 

 

 

316

 

 

 

(290

)

 

(91.8

)%

Consulting and legal fees(3)

 

507

 

 

 

244

 

 

 

263

 

 

107.8

%

 

 

839

 

 

 

420

 

 

 

419

 

 

99.8

%

Infrastructure and workforce costs(4)

 

1,771

 

 

 

2,539

 

 

 

(768

)

 

(30.2

)%

 

 

3,895

 

 

 

3,724

 

 

 

171

 

 

4.6

%

Transaction costs

 

1

 

 

 

 

 

 

1

 

 

%

 

 

1

 

 

 

18

 

 

 

(17

)

 

(94.4

)%

Adjusted EBITDA

$

(4,089

)

 

$

(8,710

)

 

$

4,621

 

 

(53.1

)%

 

$

(9,198

)

 

$

(19,651

)

 

$

10,453

 

 

(53.2

)%


(1

)

During the three and six months ended June 30, 2025, non-cash addbacks was primarily comprised of the write-off of the net assets of the Clinical Trials segment of $2,398.

 

 

(2

)

Deferred consideration payments for practice acquisitions that are contingent upon the seller’s future employment at the Company.

 

 

(3

)

Consulting and legal fees were comprised of a subset of the Company’s total consulting and legal fees, and related to certain advisory projects during the three and six months ended June 30, 2025 and 2024.

 

 

(4

)

Infrastructure and workforce costs were primarily comprised of non-recurring legal fees related to infrastructure build out of $1,269 and $2,359, recruiting expenses to build out corporate infrastructure of $427 and $712, severance expenses resulting from cost rationalization programs of $189 and $151, stop-loss contract timing of approximately $1,099 and $0, and temporary labor of $215 and $326 during the six months ended June 30, 2025 and 2024, respectively.


Key Business Metrics

 

Three Months Ended June 30,

 

Six Months Ended June 30,

(dollars in thousands)

 

2025

 

 

 

2024

 

 

 

2025

 

 

 

2024

 

Clinics (1)

 

80

 

 

 

87

 

 

 

80

 

 

 

87

 

Markets

 

20

 

 

 

14

 

 

 

20

 

 

 

14

 

Lives under value-based contracts (millions)

 

1.9

 

 

 

2.0

 

 

 

1.9

 

 

 

2.0

 

Net loss

$

(17,009

)

 

$

(15,479

)

 

$

(36,594

)

 

$

(35,368

)

Adjusted EBITDA (in thousands)

$

(4,089

)

 

$

(8,709

)

 

$

(9,198

)

 

$

(19,650

)

(1)  Includes independent oncology practices to which we provide limited management services, but do not bear the operating costs.

Consolidated Balance Sheets (Unaudited)
(in thousands except share data)

 

June 30, 2025

 

December 31, 2024

Assets

 

 

 

Current assets:

 

 

 

Cash and cash equivalents

$

30,292

 

 

$

49,669

 

Accounts receivable, net

 

55,659

 

 

 

48,335

 

Other receivables

 

276

 

 

 

346

 

Inventories

 

15,786

 

 

 

10,039

 

Prepaid expenses and other current assets

 

2,779

 

 

 

4,029

 

Total current assets

 

104,792

 

 

 

112,418

 

Property and equipment, net

 

10,854

 

 

 

11,888

 

Operating right of use assets

 

23,887

 

 

 

25,782

 

Intangible assets, net

 

12,449

 

 

 

14,810

 

Goodwill

 

7,230

 

 

 

7,230

 

Other assets

 

586

 

 

 

589

 

Total assets

$

159,798

 

 

$

172,717

 

Liabilities and stockholders’ equity

 

 

 

Current liabilities:

 

 

 

Accounts payable

$

34,933

 

 

$

24,324

 

Current portion of operating lease liabilities

 

6,953

 

 

 

6,798

 

Accrued expenses and other current liabilities

 

22,892

 

 

 

21,093

 

Total current liabilities

 

64,778

 

 

 

52,215

 

Operating lease liabilities

 

21,179

 

 

 

23,223

 

Derivative warrant liabilities

 

112

 

 

 

17

 

Conversion option derivative liabilities

 

7,681

 

 

 

385

 

Long-term debt, net of unamortized debt issuance costs

 

75,023

 

 

 

93,131

 

Other non-current liabilities

 

10

 

 

 

125

 

Deferred income taxes liability

 

 

 

 

32

 

Total liabilities

 

168,783

 

 

 

169,128

 

Stockholders’ equity (deficit):

 

 

 

Common Stock, 0.0001 par value, authorized 500,000,000 shares; 95,013,596 and 93,279,822 shares issued and outstanding at June 30, 2025 and 77,470,886 shares issued and 75,737,112 shares outstanding at December 31, 2024

 

9

 

 

 

8

 

Series A Convertible Preferred Stock, 0.0001 par value, authorized 10,000,000 shares; 193,706 shares issued and outstanding at June 30, 2025 and 165,045 shares issued and outstanding at December 31, 2024

 

 

 

 

 

Additional paid-in capital

 

239,432

 

 

 

215,413

 

Treasury Stock at cost, 1,733,774 shares at June 30, 2025 and December 31, 2024

 

(1,019

)

 

 

(1,019

)

Accumulated deficit

 

(247,407

)

 

 

(210,813

)

Total stockholders’ equity (deficit)

 

(8,985

)

 

 

3,589

 

Total liabilities and stockholders’ equity (deficit)

$

159,798

 

 

$

172,717

 

 


Consolidated Statements of Operations (Unaudited)
(in thousands except share data)

 

Three Months Ended June 30,

 

Six Months Ended June 30,

 

 

2025

 

 

 

2024

 

 

 

2025

 

 

 

2024

 

Revenue

 

 

 

 

 

 

 

Patient services

$

55,891

 

 

$

52,461

 

 

$

108,959

 

 

$

104,914

 

Dispensary

 

62,573

 

 

 

44,440

 

 

 

111,866

 

 

 

84,119

 

Clinical trials & other

 

1,338

 

 

 

1,677

 

 

 

3,383

 

 

 

4,211

 

Total operating revenue

 

119,802

 

 

 

98,578

 

 

 

224,208

 

 

 

193,244

 

Operating expenses

 

 

 

 

 

 

 

Direct costs – patient services

 

51,150

 

 

 

46,522

 

 

 

98,230

 

 

 

96,019

 

Direct costs – dispensary

 

51,086

 

 

 

38,801

 

 

 

90,949

 

 

 

71,610

 

Direct costs – clinical trials & other

 

65

 

 

 

229

 

 

 

279

 

 

 

620

 

Selling, general and administrative expense

 

26,907

 

 

 

27,872

 

 

 

52,283

 

 

 

56,324

 

Depreciation and amortization

 

1,805

 

 

 

1,518

 

 

 

3,589

 

 

 

3,007

 

Total operating expenses

 

131,013

 

 

 

114,942

 

 

 

245,330

 

 

 

227,580

 

Loss from operations

 

(11,211

)

 

 

(16,364

)

 

 

(21,122

)

 

 

(34,336

)

Other non-operating expense (income)

 

 

 

 

 

 

 

Interest expense, net

 

1,870

 

 

 

2,118

 

 

 

7,440

 

 

 

4,103

 

Change in fair value of derivative warrant liabilities

 

53

 

 

 

(552

)

 

 

96

 

 

 

(552

)

Change in fair value of conversion option derivative liabilities

 

3,987

 

 

 

(2,568

)

 

 

7,296

 

 

 

(2,568

)

Other, net

 

19

 

 

 

117

 

 

 

771

 

 

 

49

 

Total other non-operating loss (income)

 

5,929

 

 

 

(885

)

 

 

15,603

 

 

 

1,032

 

Loss before provision for income taxes

 

(17,140

)

 

 

(15,479

)

 

 

(36,725

)

 

 

(35,368

)

Income tax expense

 

131

 

 

 

 

 

 

131

 

 

 

 

Net loss

$

(17,009

)

 

$

(15,479

)

 

$

(36,594

)

 

$

(35,368

)

Net loss attributable to common stockholders, basic and diluted

$

(13,991

)

 

$

(12,679

)

 

$

(30,072

)

 

$

(28,953

)

Net loss per share attributable to common stockholders:

 

 

 

 

 

 

 

Basic

$

(0.15

)

 

$

(0.17

)

 

$

(0.35

)

 

$

(0.39

)

Diluted

$

(0.15

)

 

$

(0.17

)

 

$

(0.35

)

 

$

(0.39

)

Weighted-average number of shares outstanding:

 

 

 

 

 

 

 

Basic

 

93,203,665

 

 

 

74,748,365

 

 

 

85,195,734

 

 

 

74,491,326

 

Diluted

 

93,203,665

 

 

 

74,748,365

 

 

 

85,195,734

 

 

 

74,491,326

 

 


Consolidated Statements of Cash Flows (Unaudited)
(in thousands)

 

Six Months Ended June 30,

 

 

2025

 

 

 

2024

 

Cash flows from operating activities:

 

 

 

Net loss

$

(36,594

)

 

$

(35,368

)

Adjustments to reconcile net loss to cash and cash equivalents used in operating activities:

Depreciation and amortization

 

3,589

 

 

 

3,007

 

Amortization of debt issuance costs and debt discount

 

6,003

 

 

 

3,124

 

Write-off of assets from clinical trials segment

 

2,398

 

 

 

 

Share-based compensation

 

2,210

 

 

 

7,474

 

Change in fair value of liability classified warrants

 

96

 

 

 

(552

)

Change in fair value of liability classified conversion option derivatives

 

7,296

 

 

 

(2,568

)

Unrealized (gain) loss on investments

 

 

 

 

(121

)

Accretion of discount on investment securities

 

 

 

 

(451

)

Deferred taxes

 

(32

)

 

 

 

Loss on disposal of property and equipment

 

 

 

 

50

 

Changes in operating assets and liabilities:

Accounts receivable

 

(8,969

)

 

 

(11,657

)

Other receivables

 

(228

)

 

 

201

 

Inventories

 

(5,747

)

 

 

2,356

 

Prepaid expenses

 

1,250

 

 

 

(108

)

Other assets

 

3

 

 

 

(21

)

Accounts payable

 

11,490

 

 

 

898

 

Change in operating leases

 

(120

)

 

 

384

 

Accrued expenses and other current liabilities

 

2,262

 

 

 

1,976

 

Other non-current liabilities

 

(97

)

 

 

(167

)

Net cash and cash equivalents used in operating activities

 

(15,190

)

 

 

(31,543

)

Cash flows from investing activities:

 

 

 

Purchases of property and equipment

 

(1,536

)

 

 

(2,436

)

Proceeds from asset disposition

 

126

 

 

 

 

Sales of marketable securities/investments

 

 

 

 

40,000

 

Net cash and cash equivalents (used in) provided by investing activities

 

(1,410

)

 

 

37,564

 

Cash flows from financing activities:

 

 

 

Proceeds from private placement, net of offering costs

 

15,359

 

 

 

 

Payments made for financing of insurance payments

 

(456

)

 

 

(1,002

)

Payment of deferred consideration liability for acquisition

 

 

 

 

(2,140

)

Principal payments on long-term debt

 

(20,000

)

 

 

 

Principal payments on financing leases

 

(20

)

 

 

(18

)

Common stock issued for options exercised

 

2,340

 

 

 

75

 

Net cash and cash equivalents used in financing activities

 

(2,777

)

 

 

(3,085

)

Net (decrease) increase in cash and cash equivalents

 

(19,377

)

 

 

2,936

 

Cash and cash equivalents at beginning of period

 

49,669

 

 

 

33,488

 

Cash and cash equivalents at end of period

$

30,292

 

 

$

36,424

 

 


Contacts

Media

The Oncology Institute, Inc.
Daniel Virnich, MD
danielvirnich@theoncologyinstitute.com
(562) 735-3226 x 81125

Investors

ICR Strategic Communications
investors@icrinc.com