The Oncology Institute Stock Earnings Reports

The Oncology Institute (TOI) reported a strong start to 2026 with first quarter revenue of $147.4M, up 41% year-over-year, driven by robust Specialty Pharmacy growth (revenue up 78% to $87.5M) and expanding capitated arrangements (capitated revenue +54% to $26.9M). Gross profit was $23.3M and adjusted EBITDA was a loss of $2.4M, an improvement versus a $5.1M loss a year ago. Key operational highlights: Florida market reached four-wall profitability and TOI expects to be network-adequate across 25 counties by July 1, bringing delegated Medicare Advantage lives to ~200,000; Specialty Pharmacy delivered record fills and improved gross margin (19.2%); TOI is launching a proprietary provider portal (Q3) to drive pathway adherence, provider engagement and capture more Part D volume; AI initiatives across revenue cycle, prior auth and the call center remain on track to deliver ~$2M of OpEx savings in 2026. Balance sheet and liquidity: cash of $30.3M, $85.9M senior secured convertible note outstanding (matures Aug 9, 2027) and management is in late-stage refinance discussions. Guidance reiterated and improved: full-year 2026 revenue $630M–$650M, gross profit $97M–$107M, adjusted EBITDA $0–$9M, and free cash flow raised to positive $5M–$15M (previously -$15M to +$5M). Key investor takeaways: accelerating shift to value-based revenue mix (capitation now ~45.6% of patient services revenue), meaningful pharmacy-driven margin expansion and cash-flow improvement from supplier negotiations, near-term upside from Florida delegated ramp and potential incremental Part D capture via the provider portal, and further operating leverage expected from AI and scale.