Oncology Institute, Inc.

Oncology Institute, Inc. is a U.S.-based community oncology company that operates affiliated and managed outpatient cancer care clinics. Its network provides medical oncology, radiation oncology, infusion services, specialty pharmacy, and clinical trial support across multiple states through a mix of owned, affiliated, and contracted practices.

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— Oncology Institute, Inc.
	%
Patient services	70% Outpatient oncology, hematology, infusion, and radiation care delivered through clinics and provider networks.
Capitation and value-based contracts	15% Population-based arrangements with payors and risk-bearing entities for managing oncology episodes of care.
Specialty pharmacy	10% Dispensing of oral and self-injectable oncology and supportive medications through office and mail order.
Clinical trials and research support	5% Participation in oncology, hematology, and supportive-care clinical research activities.

TOI serves patients undergoing cancer treatment, but its economic customers are mainly payors and managed care...

Payors and managed care organizationsprimary
Contract for capitated, delegated, or shared-risk oncology care to control total episode cost and coordinate treatment.
Medicare and Medicare Advantage patientsprimary
Older oncology patients treated through clinic-based medical and radiation services under government reimbursement.
Commercial insurance patientsprimary
Employer and individual plan members receiving outpatient cancer care and infusion services.
Medicaid / Medi-Cal patientssecondary
State-program patients treated in TOI markets where access and network adequacy matter.
Clinical research participants and sponsorssecondary
Patients and third parties involved in oncology trials and related research activity.

TOI operates across 17 markets in five U.S. states, with clinic and network coverage centered in California, Florida,...

•Operations span 17 markets across five U.S. states
•Core states include California, Florida, Arizona, Oregon, and Nevada
•Clinic network combines owned, affiliated, and contracted sites
•Florida includes a managed provider network under the Florida Oncology Network brand
•Local market density matters for payor contracts and network adequacy

TOI’s strategy centers on expanding clinic capacity and market presence so it can support value-based oncology...

Build and acquire clinics in target marketsshort-term

Clinic density supports payor contracts, patient access, and local market presence.

Expand value-based care relationshipsmedium-term

Capitation and delegated arrangements are central to the company’s differentiated model.

Broaden ancillary oncology servicesmedium-term

Additional services increase patient stickiness and deepen the care platform.

TOI depends on building or acquiring clinics, winning payor contracts, and maintaining a reliable drug supply chain, so...

high

Clinic expansion and acquisition execution risk

The model requires new sites and practice integrations to support contracts and growth.

Scope: New market entry and capacity build-out
Materiality: high

high

Payor contracting and reimbursement pressure

Revenue depends on managed care, capitation, and fee-for-service terms.

Scope: Commercial, Medicare, Medicaid, and risk-bearing contracts
Materiality: high

high

Single-source pharmaceutical supply disruption

A concentrated supplier base can interrupt drug availability and clinic operations.

Scope: Oncology drugs and related distribution
Materiality: high

medium

Information technology and cybersecurity incidents

Clinical operations and billing rely on internal and third-party systems.

Scope: Patient data, scheduling, billing, and inventory systems
Materiality: medium

medium

Goodwill and intangible asset impairment

Acquisitions create balance-sheet assets that must be tested for impairment.

Scope: Acquired practices and reporting units
Materiality: medium

Revenue recognition for capitation and fee-for-service

Can shift quarterly revenue and margins

Variable interest entities

Affects reported revenue, expenses, assets, and liabilities

Deferred tax valuation allowance

Can materially affect tax expense and net assets

Goodwill and intangible impairment testing

Potential non-cash write-downs

Oncology Institute, Inc.

Clinic expansion and acquisition execution risk

Payor contracting and reimbursement pressure

Single-source pharmaceutical supply disruption

Information technology and cybersecurity incidents

Goodwill and intangible asset impairment

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