The Oncology Institute, Inc. · NASDAQ:TOI
The Oncology Institute — Starling Oncology — Investor Presentation (September 2026)
28 slides from The Oncology Institute's investor presentation, September 2026
Slide 1: Investor Presentation
™ Investor Presentation September 2026 1
Slide 2: Disclaimer: Forward-Looking Statements and Non-GAAP Financial Measures
Disclaimer FORWARD-LOOKING STATEMENTS AND NON-GAAP FINANCIAL MEASURES Some of the information in this presentation is not historical in nature and may constitute forward-looking statements, which are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995.
Slide 3: Investment Highlights
Investment Highlights A leading national oncology-focused VBC Platform 1 Large TAM, with long-term growth driven by secular trends 2 Balanced model with at-risk VBC and FFS ancillary services 3 Multiple levers for growth across a diversified business 4 Proven leadership team with deep industry exper
Slide 4: High-Quality Care Delivery & Benefits Management Platform
High-Quality Care Delivery & Benefits Management Platform Care Delivery Benefits Management Platform Community oncologists Delegated provider network management Nursing & mid-level care Utilization and case management Infusion suites Drug formulary Specialty pharmacy Claims adjudication Radiosurgery
Slide 5: Starling At A Glance
Starling At A Glance SCALE & EXPERIENCE PATIENT REACH FINANCIAL OUTLOOK 19+ Yrs 60+ 2.3M+ 300K+ $650–670M $2–7M In Business Payor Contracts VBC Lives 2025 Encounters FY26 Revenue FY26 Adj. EBITDA REVENUE BY SEGMENT OPERATIONAL FOOTPRINT A GR $660M +25% C $503M $324M $393M 2023 2024 2025 2026E Capita
Slide 6: Recent Announcements
Recent Announcements Refinancing Rebranding Continued Growth Portal Launch Repaid the $86M Relaunched as Starling Signed new delegated Launching Starling Deerfield note through a Oncology and began contracts in Nevada & Oncology Nexus™ to strategic refinancing with trading on Nasdaq under Oregon and
Slide 7: Oncology Care Costs Are Rising Rapidly
Oncology Care Costs Are Rising Rapidly 2.1M+ $246B +8% y/y New U.S. cancer diagnoses in 2026 Total U.S. cancer care cost by 2030E Oncology drug spend growth, 2Q26 (+25% vs. 2016)(1) (+34% vs. 2015)(2) (Top-75, vs. +15% in 1Q26) (3) U.S. Oncology Drug Spending, Annual ($B)(4) $180B '28E) GR ('20– ~12
Slide 8: Fee-for-Service Oncology Misaligns Incentives
Fee-for-Service Oncology Misaligns Incentives U.S. ONCOLOGY SPEND FEE-FOR-SERVICE ONCOLOGY 1 $99B → $180B ~80–85% (2) U.S. oncology drug spending of a typical FFS oncologist’s income comes from the drug spread on buy-and-bill nearly doubles by 2028(1) chemotherapy → Disincentivizes lower-cost, equal
Slide 9: Starling Oncology Solutions and Scale
Starling Oncology Solutions and Scale % OF REVENUE(1) Capitation 16% Fixed per-member-per-month payments from payors to manage a population's oncology care. Fee-for-Service 29% Billing insurance and copay for E&M visits, infusions, drug resale, and radiosurgery services. Specialty Pharmacy Billed to
Slide 10: National Footprint with Significant Upside
National Footprint with Significant Upside Non-CA markets are the growth engine — lives up 272% and revenue up 44% since 2024 Lives by State (Lives in thousands) Revenue by State ($ in millions) CA Non-CA ▲ Non-CA +272% CA Non-CA ▲ +44% White Space Within Existing Markets(1) 2,015 1,880 249 $503 67
Slide 11: Starling's Full-Spectrum Capitated Offering
Starling’s Full-Spectrum Capitated Offering Delegation, Open-Network Narrow Network Capitation Capitation VS. Starling Oncology contracts with providers that are globally Starling Oncology contracts with managed care providers to capitated with a Knox-Keene license to serves as the take full account
Slide 12: Narrow and Delegated Patient Pathways
Narrow and Delegated Patient Pathways Step 1 Step 2 Step 3 Starling Oncology contracts with Payor to Oncology patients seen for capitated STLN captures additional clinical revenue from manage oncology care via: outpatient medical oncology services in services not included in capitation for Starling
Slide 13: Delegated Network Overview
Delegated Network Overview Delegated Contract Ramp Clinics Outside CA: Owned vs. Networked Revenue Gross Margin Owned Networked 222 67 23 24 24 2024 2025 2026 Quarterly Delegated Members 1 2 3 4 5 6 7 8 9 10 11 12 Months ~70K MONTHS 1–4 MONTHS 5–8 MONTHS 9–12 Transition of Care Period VBC Adoption M
Slide 14: Specialty Pharmacy Overview
Specialty Pharmacy Overview Revenue & Gross Margin Multi-Year Growth in Script Volume Scripts per 1K Visits & Clinic Visits $438M 65K 264 198 207 $269M 33K 169 $180M 144 $100M 20K $88M 107 117 115 $46M 8K 11K $29M $31M 51K 51K 50K 53K 57K 53K 56K 58K 2023 2024 2025 2026E 2022 2023 2024 2025 2026E 3Q
Slide 15: The Starling Care Model
The Starling Care Model Care Navigation PROVEN IMPACT Program with Proven Outcomes IHI Patient Safety Accessible Community- ~85% 29% Organization Overall MLR Lower Inpatient Admissions based locations Comprehensive ~23% 33% Behavioral Health Typical Payor Savings in Year 1 of STLN Fewer ER Visits Am
Slide 16: Powered by Starling Oncology Nexus
Powered by Starling Oncology Nexus™ KEY PLATFORM CAPABILITIES The Command Center Automated pathway compliance checking for Value-Based Care against continuously updated evidence- based guidelines. Real-time drug waste identification with Starling's proprietary actionable recommendations. platform se
Slide 17: Strong NCCN Adherence Through Starling Oncology Nexus
Strong NCCN Adherence Through Starling Oncology Nexus™ 300+ >98% >95% Network providers on Nexus and Adherence to Starling value-based Orders receiving same-day decision Growing formulary >27% >41% Reduction in Cost per Cancer Episode Reduction in Cost per IV Visit Post- Post-delegation delegation D
Slide 18: What Sets Starling Apart in a Competitive Landscape
What Sets Starling Apart in a Competitive Landscape Incentivized to Keep Purchasing Drugs at Care Delivery Model Provide Clinical Care Utilization Management Drug Costs Low Scale Care Navigation Model Utilization Management Only Subsidiary of a Distributor Independent Provider Starling Oncology | In
Slide 19: Growth Strategy
Growth Strategy ™ Strategic M&A Add Ancillary Services Enter New Markets Add New Customers and Deepen Relationships with Existing Customers New Lives Drives Growth Starling Oncology | Investor Presentation 19
Slide 20: Strong Leadership with Deep Industry Experience
Strong Leadership with Deep Industry Experience Jordan McInerney Jeffrey Langsam, DO Chief Development Officer Chief Clinical Officer Prior Experience Prior Experience Daniel Virnich, MD Rob Carter Anne McGeorge = = Chief Executive Officer Chief Financial Officer Chairperson of the Board • Joined ST
Slide 21: Financial Overview
Financial Overview Starling Oncology | Investor Presentation 21
Slide 22: Financial Highlights
Financial Highlights 1 2 3 Diversified Revenue Base Recurring, Visible Revenue Direct Cost Control Revenue spans capitation, fee-for- Multi-year capitation contracts and Full control over oncology drug service, specialty pharmacy, and clinical recurring treatment cycles create purchasing, formulary
Slide 23: Consistent Revenue Growth
Consistent Revenue Growth Revenue ($M) Patient Lives (000s) Adjusted EBITDA ($M) $660M $4.5 G R CA v. Re $503M 2,014 % + 27 1,800 1,880 $393M $324M ($12.4) ($25.8) ($35.7) 2023 2024 2025 2026E 2023 2024 2025 2023 2024 2025 2026E Capitated Revenue FFS Revenue Specialty Pharmacy Clinical Trials & Othe
Slide 24: 2Q26 Quarterly Results
2Q26 Quarterly Results 2Q26 Operational Revenue Patient Lives Adjusted EBITDA(1) Highlights ($ in millions) (000’s) ($ in millions) Adjusted EBITDA turned 2Q25 2Q26 +13.7% 2Q25 2Q26 positive at $0.2M, a $4.3M improvement Y/Y 2,128 35% YoY $161.3 $3.8 Achieved California exclusivity $0.2 1,872 with a
Slide 25: Proven Ability to Maintain Stable MLR at Scale
Proven Ability to Maintain Stable MLR at Scale Consistent MLR Performance Despite Elevated Industry Utilization MLR Levers Cap Revenue ($M) (1) MLR (1)(2) Industry-Leading Utilization Management Launched Delegated contract and began on-boarding those patients Proprietary platform manages cost of 85%
Slide 26: Path to Breakeven and Future Profitability Levers
Path to Breakeven and Future Profitability Levers SG&A Declining as a Percentage of Adj EBITDA Margin Levers Revenue, Gross Margins Trending Higher ($ in millions) Gross Margin 30% • Leverage existing 28% clinical labor 27% 25% • Drive Specialty 24% Pharmacy, Clinical 22% Research, and $0.1 $0.2 20%
Slide 27: Longer Term Guidance
Longer Term Guidance FY2025 FY2026 2028 TARGETS REVENUE REVENUE REVENUE GROWTH $502.7M $650–$670M +31% mid. (Raised from $630–$650)1 ~20% REVENUE CAGR THROUGH 2028 GROSS PROFIT GROSS PROFIT $76.4M $105–$110M +41% mid. BUSINESS MIX (Raised from $97–$107)1 Capitation ~30% / ADJUSTED EBITDA ADJUSTED EB
Slide 28: Investment Highlights
Investment Highlights A leading national oncology-focused VBC Platform 1 Large TAM, with long-term growth driven by secular trends 2 Balanced model with at-risk VBC and FFS ancillary services 3 Multiple levers for growth across a diversified business 4 Proven leadership team with deep industry exper
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