The Oncology Institute, Inc. (TOI) Stock Analysis

The Oncology Institute manages approximately 2.0 million patients under value-based agreements as of December 31, 2025, generating more than 46% of that year's revenue from value-based and capitated contracts rather than traditional fee-for-service billing. The company operates through 65 affiliated clinics (the TOI PCs), 81 independently owned clinics contracted with its managed services organization, and a network of 198 independent providers spanning 17 markets across California, Arizona, Nevada, Florida, and Oregon.

TOI earns revenue across four lines: fee-for-service medical oncology and infusion billed on a CPT-code and cost-plus drug basis; value-based and capitated contracts that pay a fixed per-member-per-month amount and let TOI keep the difference if care costs less, including a full delegation model where TOI also performs utilization management and claims adjudication; specialty pharmacy filling oral, IV, and injectable medications reimbursed by pharmacy benefit managers on a WAC-minus basis; and clinical trial services billed to pharmaceutical companies and contract research organizations. The company's payor relationships span Medicare Advantage, Medicaid, and commercial plans, with named counterparties including Anthem, CareMore Health, Heritage Provider Network, and Optum Care. A significant portion of Patient Services revenue depends on a limited number of health insurance, IPA, and medical group payors, while prescription drug sales rely on a number of contracted pharmacy benefit management companies.