The Oncology Institute (TOI) 25th Annual Needham Virtual Healthcare Conference summary

Business overview and market positioning

• Operates as a value-based oncology provider in five states with over 130 providers and a growing ancillary network.

• Manages risk on Part B drugs and is at risk for over two million patients, with a public track record and $500 million revenue in 2025.

• Utilizes both California's delegated primary care model and a delegated model in Florida, allowing direct partnerships with health plans and full network control.

• Employed physician model and strict utilization management protocols enable strong cost control and stable medical loss ratios.

• Expansion is driven by payer demand, focusing on markets with clear needs and underwriting for growth opportunities.

Growth strategy and contract pipeline

• Recent wins include new value-based contracts with Humana and CarePlus, and expansion with Elevance, especially in Florida.

• Florida pipeline is robust due to high Medicare Advantage spend and strong reputation, with significant word-of-mouth impact.

• Delegated model contracts are larger in deal size but have lower gross margin percentages, offset by significant gross profit tailwinds.

• Capitated revenue is projected to grow from $80 million in 2025 to $150 million in 2026, with contracts maturing to full profitability in about nine months.

• 20% growth target through 2028 can be achieved within current geographies, with additional expansion considered opportunistically.

Segment performance and operational highlights

• Dispensary segment (Part D oral oncolytics) became the largest revenue segment in 2025 after nearly 50% growth.

• Acquisition of a pharmacy in 2023 enabled script fulfillment for Medi-Cal patients, adding $70 million incremental revenue in 2024.

• Dispensary operates at 18% margin, provides a natural hedge to capitated business, and benefits from low DSOs and high script attachment rates.

• Growth in the dispensary segment is expected as more patients and contracts are added, with the market shifting toward oral medications.