The Oncology Institute Reports Fourth Quarter and Full Year 2024 Financial Results and Guidance for 2025
The Oncology Institute (NASDAQ: TOI) reported its Q4 and full-year 2024 financial results. Q4 highlights include consolidated revenue of $100 million, up 16.9% year-over-year, with a net loss of $13.2 million compared to $18.8 million in Q4 2023. The company achieved positive cash flow from operations of $4.2 million in Q4.
Key operational developments include a 12% reduction in SG&A expenses, new drug supplier agreements with improved discounts, and the launch of six new contracts covering over 250,000 lives. Value-based patient services increased by 15% from Q3 2024.
For full-year 2024, TOI reported consolidated revenue of $393 million, a 21.3% increase, though patient services revenue decreased 4% due to a lost contract. The company expects Q1 2025 Adjusted EBITDA of $(5) to $(6) million, citing seasonal factors such as drug price increases and lower encounter volumes.
L'Istituto di Oncologia (NASDAQ: TOI) ha riportato i risultati finanziari del quarto trimestre e dell'intero anno 2024. I punti salienti del quarto trimestre includono ricavi consolidati di 100 milioni di dollari, in aumento del 16,9% rispetto all'anno precedente, con una perdita netta di 13,2 milioni di dollari rispetto ai 18,8 milioni di dollari del quarto trimestre 2023. L'azienda ha registrato un flusso di cassa positivo dalle operazioni di 4,2 milioni di dollari nel quarto trimestre.
Tra i principali sviluppi operativi si segnala una riduzione del 12% delle spese SG&A, nuovi accordi con fornitori di farmaci con sconti migliorati e il lancio di sei nuovi contratti che coprono oltre 250.000 persone. I servizi per i pazienti basati sul valore sono aumentati del 15% rispetto al terzo trimestre 2024.
Per l'intero anno 2024, TOI ha riportato ricavi consolidati di 393 milioni di dollari, con un aumento del 21,3%, sebbene i ricavi dei servizi per i pazienti siano diminuiti del 4% a causa di un contratto perso. L'azienda prevede un EBITDA rettificato per il primo trimestre 2025 di $(5) a $(6) milioni, citando fattori stagionali come l'aumento dei prezzi dei farmaci e volumi di incontri inferiori.
El Instituto de Oncología (NASDAQ: TOI) informó sus resultados financieros del cuarto trimestre y del año completo 2024. Los aspectos destacados del cuarto trimestre incluyen ingresos consolidados de 100 millones de dólares, un aumento del 16,9% interanual, con una pérdida neta de 13,2 millones de dólares en comparación con 18,8 millones de dólares en el cuarto trimestre de 2023. La compañía logró un flujo de caja positivo de operaciones de 4,2 millones de dólares en el cuarto trimestre.
Los principales desarrollos operativos incluyen una reducción del 12% en los gastos SG&A, nuevos acuerdos con proveedores de medicamentos con descuentos mejorados y el lanzamiento de seis nuevos contratos que cubren más de 250,000 vidas. Los servicios para pacientes basados en el valor aumentaron un 15% en comparación con el tercer trimestre de 2024.
Para el año completo 2024, TOI reportó ingresos consolidados de 393 millones de dólares, un aumento del 21,3%, aunque los ingresos por servicios a pacientes disminuyeron un 4% debido a un contrato perdido. La compañía espera un EBITDA ajustado para el primer trimestre de 2025 de $(5) a $(6) millones, citando factores estacionales como el aumento de precios de medicamentos y menores volúmenes de encuentros.
종양학 연구소 (NASDAQ: TOI)는 2024년 4분기 및 연간 재무 결과를 발표했습니다. 4분기 하이라이트에는 1억 달러의 통합 수익이 포함되어 있으며, 이는 전년 대비 16.9% 증가한 수치로, 2023년 4분기 1,880만 달러의 순손실에 비해 1,320만 달러의 순손실을 기록했습니다. 회사는 4분기 운영에서 420만 달러의 긍정적인 현금 흐름을 달성했습니다.
주요 운영 개발 사항으로는 SG&A 비용 12% 감소, 개선된 할인 혜택을 가진 새로운 약품 공급업체 계약 체결, 250,000명 이상의 생명을 포괄하는 6개의 새로운 계약 출시 등이 있습니다. 가치 기반 환자 서비스는 2024년 3분기 대비 15% 증가했습니다.
2024년 전체 연도에 대해 TOI는 3억 9,300만 달러의 통합 수익을 보고했으며, 이는 21.3% 증가한 수치이나 계약 손실로 인해 환자 서비스 수익은 4% 감소했습니다. 회사는 2025년 1분기 조정 EBITDA가 $(5)에서 $(6) 백만 달러가 될 것으로 예상하고 있으며, 이는 약가 인상 및 낮은 만남 수와 같은 계절적 요인을 언급하고 있습니다.
L'Institut d'Oncologie (NASDAQ: TOI) a annoncé ses résultats financiers pour le quatrième trimestre et l'année complète 2024. Les points forts du quatrième trimestre incluent des revenus consolidés de 100 millions de dollars, en hausse de 16,9 % par rapport à l'année précédente, avec une perte nette de 13,2 millions de dollars comparée à 18,8 millions de dollars au quatrième trimestre 2023. L'entreprise a réalisé un flux de trésorerie positif provenant des opérations de 4,2 millions de dollars au quatrième trimestre.
Les principaux développements opérationnels comprennent une réduction de 12 % des dépenses SG&A, de nouveaux accords avec des fournisseurs de médicaments offrant des remises améliorées, et le lancement de six nouveaux contrats couvrant plus de 250 000 vies. Les services aux patients basés sur la valeur ont augmenté de 15 % par rapport au troisième trimestre 2024.
Pour l'année complète 2024, TOI a déclaré des revenus consolidés de 393 millions de dollars, soit une augmentation de 21,3 %, bien que les revenus des services aux patients aient diminué de 4 % en raison d'un contrat perdu. L'entreprise prévoit un EBITDA ajusté pour le premier trimestre 2025 de $(5) à $(6) millions, citant des facteurs saisonniers tels que l'augmentation des prix des médicaments et des volumes de rencontres plus faibles.
Das Onkologie-Institut (NASDAQ: TOI) hat seine Finanzzahlen für das vierte Quartal und das Gesamtjahr 2024 veröffentlicht. Zu den Highlights des vierten Quartals gehören konsolidierte Einnahmen von 100 Millionen Dollar, was einem Anstieg von 16,9 % im Vergleich zum Vorjahr entspricht, mit einem Nettoverlust von 13,2 Millionen Dollar im Vergleich zu 18,8 Millionen Dollar im vierten Quartal 2023. Das Unternehmen erzielte im vierten Quartal einen positiven Cashflow aus dem operativen Geschäft von 4,2 Millionen Dollar.
Wichtige betriebliche Entwicklungen umfassen eine Reduzierung der SG&A-Ausgaben um 12 %, neue Lieferantenverträge für Medikamente mit verbesserten Rabatten und die Einführung von sechs neuen Verträgen, die über 250.000 Leben abdecken. Die wertorientierten Patientenservices stiegen im Vergleich zum dritten Quartal 2024 um 15 %.
Für das Gesamtjahr 2024 berichtete TOI von konsolidierten Einnahmen von 393 Millionen Dollar, was einem Anstieg von 21,3 % entspricht, obwohl die Einnahmen aus Patientenservices aufgrund eines verlorenen Vertrags um 4 % zurückgingen. Das Unternehmen erwartet für das erste Quartal 2025 ein bereinigtes EBITDA von $(5) bis $(6) Millionen und verweist auf saisonale Faktoren wie Preiserhöhungen bei Medikamenten und geringere Begegnungszahlen.
- Positive cash flow from operations of $4.2 million in Q4 2024
- 12% reduction in SG&A expenses compared to prior year
- Secured new drug supplier agreement with improved discounts
- 72.4% increase in dispensary revenue in Q4 2024
- 15% sequential increase in value-based patient services from Q3 2024
- Net loss of $13.2 million in Q4 2024
- Adjusted EBITDA declined to $(7.8) million from $(6.3) million in Q4 2023
- Patient services revenue decreased 10.6% in Q4 2024 due to lost contract
- Gross profit only increased 1.8% despite 16.9% revenue growth
- Full-year gross profit decreased 9.4% due to margin compression on Part D medications
Insights
TOI's Q4 2024 results show mixed financial performance with notable improvements in several key areas. Revenue reached
Particularly impressive is management's execution on cost discipline, with SG&A expenses decreasing
However, concerning signals include the
For full-year 2024, TOI achieved
The company maintains a reasonable liquidity position with
TOI's strategic shift toward diversified revenue streams is yielding measurable results. Their pharmaceutical dispensary business has become a significant growth driver, posting record quarterly revenue and
The
Supply chain optimization through the new primary drug supplier agreement delivers immediate margin improvement and positions TOI more competitively, particularly important given the documented pressure on Part D medication margins that impacted 2024 results.
However, the loss of a major contract in July 2024 significantly affected patient services revenue, highlighting concentration risk in TOI's business model. The
TOI's positive operational cash flow for two consecutive quarters signals a potential inflection point in financial sustainability. Management's focus on working capital discipline, alongside a
CERRITOS, Calif., March 24, 2025 (GLOBE NEWSWIRE) -- The Oncology Institute, Inc. (NASDAQ: TOI) (“TOI” or the “Company”), one of the largest value-based community oncology groups in the United States, today reported financial results for its fourth quarter and year ended December 31, 2024.
Recent Operational Highlights
- Cash flow from operations in Q4 2024 was approximately
$4.2 million , due to disciplined working capital management that saw improvements across receivables, inventory, and payables. - Selling, general, and administrative expenses decreased
12% in Q4 2024 as compared to the prior year period, as a result of our ongoing efforts to streamline operations, improve efficiency, and optimize our overhead resourcing. - Entered into a new agreement with our primary drug supplier, improving discounts across the board, including volume based discounts, which optimize our cost positioning as we work towards our revenue growth targets.
- Launched six new contracts across the third and fourth quarter totaling over 250,000 lives. Value-based patient services increased sequentially by over
15% from Q3 2024, with further revenue upside anticipated as these contracts mature. - Achieved a record quarter of revenue for the pharmaceutical dispensary revenue, which has continued to see increased attachment to clinic visits overall, including from our retail pharmacy in California, which has now lapped a full year of operation after its introduction in the fourth quarter of 2023. The maturation of this pharmacy will lead to a more normalized level of growth in the dispensary business going forward, which we expect to continue to be a key contributor to TOI's future growth.
Fourth Quarter 2024 Financial Highlights
- Consolidated revenue of
$100 million , an increase of16.9% compared to the prior year quarter - Gross profit of
$15 million , an increase of1.8% compared to the prior year quarter - Net loss of
$13.2 million compared to net loss of$18.8 million for the prior year quarter - Basic and diluted loss per share of
$(0.14) and$(0.14) , respectively, compared to$(0.21) and$(0.21) for the prior year quarter - Adjusted EBITDA of
$(7.8) million compared to$(6.3) million for the prior year quarter - Cash, cash equivalents, and investments of
$50 million as of December 31, 2024
Management Commentary
Daniel Virnich, CEO of TOI, commented, "I am very pleased with our performance in the fourth quarter of 2024. We were able to reduce our cash burn and generate positive cash flow from operations for a second consecutive quarter, driven by disciplined working capital management. Additionally, both dispensary and value-based patient services are gaining widespread adoption in the marketplace, as we build around the chassis of our fee-for-service patient services business. As we enter 2025, we will continue to build on our momentum through strong operational management, increased efficiencies, and strategic market expansion."
Outlook for Fiscal Year 2025
TOI uses Adjusted EBITDA and Free Cash flow, each a non-GAAP metric, as an additional tool to assess its operational and financial performance. See "Financial Information: Non-GAAP Financial Measures" below. In reliance on the unreasonable efforts exception provided under Regulation S-K, TOI is not reasonably able to provide a quantitative reconciliation for forward-looking information of Adjusted EBITDA and Free Cash flow to net (loss) income and net cash provided by operations, respectively, the most directly comparable GAAP financial measures, without unreasonable efforts due to uncertainties regarding taxes, capital expenditures, share-based compensation, goodwill impairment charges, change in fair value of liabilities, unrealized (gains) losses on investments, practice acquisition-related costs, consulting and legal fees, transaction costs and other non-cash items. The variability of these items could have an unpredictable, and potentially significant, impact on TOI’s future GAAP financial results.
| 2025 Guidance | |
| Revenue | |
| Gross Profit | |
| Adjusted EBITDA | |
| Free Cash Flow | |
The Company expects Adjusted EBITDA of approximately
Fourth Quarter 2024 Results
Consolidated revenue for Q4 2024 was
Revenue for patient services was
Gross profit in Q4 2024 was
Selling, general and administrative ("SG&A") expenses in Q4 2024 were
Net loss for Q4 2024 was
Adjusted EBITDA was
Results for the Year Ended December 31, 2024
Consolidated revenue for the year ended December 31, 2024 was
Revenue for patient services was
Gross profit for the year ended December 31, 2024 was
SG&A expenses, excluding depreciation and amortization, for year ended December 31, 2024 were
Net loss for the year ended December 31, 2024 was
Adjusted EBITDA was
Webcast and Conference Call
TOI will host a conference call on Tuesday, March 25, 2025 at 5:00 p.m. (Eastern Time) to discuss fourth quarter and full year results and management’s outlook for future financial and operational performance.
The conference call can be accessed live over the phone by dialing 1-877-407-0789, or for international callers, 1-201-689-8562. A replay will be available two hours after the call and can be accessed by dialing 1-844-512-2921, or for international callers, 1-412-317-6671. The passcode for the live call and the replay is 13750791. The replay will be available until April 1, 2025.
Interested investors and other parties may also listen to a simultaneous webcast of the conference call by logging onto the Investor Relations section of TOI's website at https://investors.theoncologyinstitute.com.
About The Oncology Institute, Inc.
Founded in 2007, TOI and its affiliates are advancing oncology by delivering highly specialized, value-based cancer care in the community setting. TOI offers cutting-edge, evidence-based cancer care to a population of approximately 1.9 million patients including clinical trials, transfusions, and other services traditionally associated with the most advanced care delivery organizations. With approximately 120+ employed clinicians and more than 700 teammates at approximately 70 clinic locations and growing, TOI is changing oncology for the better. For more information visit www.theoncologyinstitute.com.
Forward-Looking Statements
This press release includes certain statements that are not historical facts but are forward-looking statements for purposes of the safe harbor provisions under the United States Private Securities Litigation Reform Act of 1995. Forward-looking statements generally are accompanied by words such as “preliminary,” “believe,” “may,” “will,” “estimate,” “continue,” “anticipate,” “intend,” “expect,” “should,” “would,” “plan,” “project,” “predict,” “potential,” “guidance,” “approximately,” “seem,” “seek,” “future,” “outlook,” and similar expressions that predict or indicate future events or trends or that are not statements of historical matters. These forward-looking statements include, but are not limited to, statements regarding projections, anticipated financial results, estimates and forecasts of revenue and other financial and performance metrics and projections of market opportunity and expectations. These statements are based on various assumptions and on the current expectations of TOI and are not predictions of actual performance. These forward-looking statements are provided for illustrative purposes only and are not intended to serve as, and must not be relied on by anyone as, a guarantee, an assurance, a prediction or a definitive statement of fact or probability. Actual events and circumstances are difficult or impossible to predict and will differ from assumptions. Many actual events and circumstances are beyond the control of TOI. These forward-looking statements are subject to a number of risks and uncertainties, including the accuracy of the assumptions underlying the 2025 full fiscal year outlook and the Q1 2025 outlook with respect to Adjusted EBITDA discussed herein, the outcome of judicial and administrative proceedings to which TOI may become a party or investigations to which TOI may become or is subject that could interrupt or limit TOI’s operations, result in adverse judgments, settlements or fines and create negative publicity; changes in TOI’s patient or payors' preferences, prospects and the competitive conditions prevailing in the healthcare sector; failure to continue to meet stock exchange listing standards; the impact of COVID-19 on TOI’s business; those factors discussed in the documents of TOI filed, or to be filed, with the SEC, including the Item 1A. "Risk Factors" section of TOI's Annual Report on Form 10-K for the year ended December 31, 2023 filed with the SEC on March 28, 2024 and any subsequent Quarterly Reports on Form 10-Q or Current Reports on Form 8-K. If the risks materialize or assumptions prove incorrect, actual results could differ materially from the results implied by these forward-looking statements. There may be additional risks that TOI currently is evaluating or does not presently know or that TOI currently believes are immaterial that could also cause actual results to differ from those contained in the forward-looking statements. In addition, forward-looking statements reflect TOI’s plans or forecasts of future events and views as of the date of this press release. TOI anticipates that subsequent events and developments will cause TOI’s assessments to change. TOI does not undertake any obligation to update any of these forward-looking statements. These forward-looking statements should not be relied upon as representing TOI’s assessments as of any date subsequent to the date of this press release. Accordingly, undue reliance should not be placed upon the forward-looking statements.
Financial Information; Non-GAAP Financial Measures
Some of the financial information and data contained in this press release, such as Adjusted EBITDA and Free Cash Flow, have not been prepared in accordance with United States generally accepted accounting principles (“GAAP”). TOI’s non-GAAP financial measures may be different from non-GAAP financial measures used by other companies. The presentation of non-GAAP financial measures is not intended to be considered in isolation or as a substitute for, or superior to, financial measures determined in accordance with GAAP. Because of the limitations of non-GAAP financial measures, you should consider the non-GAAP financial measures presented in this press release in conjunction with TOI’s financial statements and the related notes thereto.
TOI believes that the use of Free Cash Flow provides an additional tool to assess the Company's financial performance, evaluate its ability to generate cash from operations, and plan for future investments and obligations. Free Cash Flow is useful in understanding the cash available for strategic initiatives. It also helps in comparing TOI's financial performance with other similar companies, many of which use similar non-GAAP financial measures to provide insights into their cash generation capabilities. However, the principal limitation of Free Cash Flow is that it does not account for certain cash outflows or inflows that are required by GAAP to be recorded in TOI's financial statements, such as mandatory interest payments or certain capital expenditures, which may impact the overall financial health of the Company. TOI defines Free Cash Flow as net cash flow provided by (used in) operations plus cash interest, less capital expenditures.
TOI believes that the use of Adjusted EBITDA provides an additional tool to assess operational and results of our performance, to plan and forecast future periods, and factors and trends in, and in comparing our financial measures with, other similar companies, many of which present similar non-GAAP financial measures to investors. The principal limitation of Adjusted EBITDA is that it excludes significant expenses and income that are required by GAAP to be recorded in TOI's financial statements.
TOI defines Adjusted EBITDA as net (loss) income plus depreciation, amortization, interest, taxes, non-cash items, share-based compensation, goodwill impairment charges, change in fair value of liabilities, unrealized gains or losses on investments and other adjustments to add-back the following: consulting and legal fees related to acquisitions, one-time consulting and legal fees related to certain advisory projects, software implementations and debt or equity financings, severance expense and temporary labor and recruiting charges to build out our corporate infrastructure. A reconciliation of Adjusted EBITDA to net loss, the most comparable GAAP metric, is set forth below.
| Adjusted EBITDA Reconciliation | ||||||||||||||
| Three Months Ended December 31, | Change | |||||||||||||
| (dollars in thousands) | 2024 | 2023 | $ | % | ||||||||||
| Net loss | $ | (13,182 | ) | $ | (18,754 | ) | $ | 5,572 | (29.7 | )% | ||||
| Depreciation and amortization | 1,707 | 1,577 | 130 | 8.2 | % | |||||||||
| Interest expense, net | 1,168 | 1,941 | (773 | ) | (39.8 | )% | ||||||||
| Tax payments and penalties | — | (86 | ) | 86 | (100.0 | )% | ||||||||
| Non-cash addbacks(1) | 71 | 1,876 | (1,805 | ) | (96.2 | )% | ||||||||
| Share-based compensation | 1,289 | 3,817 | (2,528 | ) | (66.2 | )% | ||||||||
| Change in fair value of liabilities | (176 | ) | 1,488 | (1,664 | ) | (111.8 | )% | |||||||
| Unrealized (gains) losses on investments | (4 | ) | (206 | ) | 202 | N/A | ||||||||
| Practice acquisition-related costs(2) | — | 1 | (1 | ) | (100.0 | )% | ||||||||
| Post-combination compensation expense(3) | 13 | 487 | (474 | ) | N/A | |||||||||
| Consulting and legal fees(4) | 69 | 55 | 14 | 25.5 | % | |||||||||
| Infrastructure and workforce costs(5) | 1,217 | 1,551 | (334 | ) | (21.5 | )% | ||||||||
| Transaction costs(6) | — | 1 | (1 | ) | (100.0 | )% | ||||||||
| Adjusted EBITDA | $ | (7,828 | ) | $ | (6,252 | ) | $ | (1,576 | ) | 25.2 | % | |||
(1) During the three months ended December 31, 2024, non-cash addbacks were primarily comprised of non-cash rent of
(2) Practice acquisition-related costs were comprised of consulting and legal fees incurred to perform due diligence, execute, and integrate acquisitions of various oncology practices.
(3) Deferred consideration payments for practice acquisitions that are contingent upon the seller’s future employment at the Company.
(4) Consulting and legal fees were comprised of a subset of the Company’s total consulting and legal fees, and related to certain non-recurring advisory projects including software implementations during the three months ended December 31, 2024 and 2023.
(5) Infrastructure and workforce costs were comprised primarily of temporary labor of
(6) Transaction costs were comprised of legal and escrow fees associated with one practice acquisition for the three months ended December 31, 2023.
| Adjusted EBITDA Reconciliation | ||||||||||||||
| Year Ended December 31, | Change | |||||||||||||
| (dollars in thousands) | 2024 | 2023 | $ | % | ||||||||||
| Net loss | $ | (64,663 | ) | $ | (83,068 | ) | $ | 18,405 | (22.2 | )% | ||||
| Depreciation and amortization | 6,287 | 5,873 | 414 | 7.0 | % | |||||||||
| Interest expense, net | 7,496 | 6,777 | 719 | 10.6 | % | |||||||||
| Tax payments and penalties | (32 | ) | (36 | ) | 4 | (11.1 | )% | |||||||
| Non-cash addbacks(1) | (139 | ) | 2,029 | (2,168 | ) | (106.9 | )% | |||||||
| Share-based compensation | 11,152 | 17,548 | (6,396 | ) | (36.4 | )% | ||||||||
| Goodwill impairment charges | — | 16,867 | (16,867 | ) | N/A | |||||||||
| Change in fair value of liabilities | (3,316 | ) | (1,395 | ) | (1,921 | ) | 137.7 | % | ||||||
| Unrealized (gains) losses on investments | (133 | ) | (237 | ) | 104 | N/A | ||||||||
| Practice acquisition-related costs(2) | — | 113 | (113 | ) | (100.0 | )% | ||||||||
| Post-combination compensation expense(3) | 374 | 2,048 | (1,674 | ) | N/A | |||||||||
| Consulting and legal fees(4) | 841 | 1,570 | (729 | ) | (46.4 | )% | ||||||||
| Infrastructure and workforce costs(5) | 6,427 | 5,965 | 462 | 7.7 | % | |||||||||
| Transaction costs(6) | 18 | 141 | (123 | ) | (87.2 | )% | ||||||||
| Adjusted EBITDA | $ | (35,688 | ) | $ | (25,805 | ) | $ | (9,883 | ) | 38.3 | % | |||
(1) During the year ended December 31, 2024, non-cash addbacks were primarily comprised of non-cash rent of
(2) Practice acquisition-related costs were comprised of consulting and legal fees incurred to perform due diligence, execute, and integrate acquisitions of various oncology practices.
(3) Deferred consideration payments for practice acquisitions that are contingent upon the seller’s future employment at the Company.
(4) Consulting and legal fees were comprised of a subset of the Company’s total consulting and legal fees during the years ended December 31, 2024 and 2023, and related to certain advisory projects, software implementations, and legal fees for debt financing and predecessor litigation matters.
(5) Infrastructure and workforce costs were primarily comprised of recruiting expenses to build out corporate infrastructure of
(6) Transaction costs were comprised of consulting and legal fees associated with non-recurring due diligence projects during the year ended December 31, 2024, and related to consulting, legal, administrative and regulatory fees associated with share repurchases and practice acquisitions during the year ended December 31, 2023.
| Key Business Metrics | |||||||||||||||
| Three Months Ended | Year Ended | ||||||||||||||
| December 31, | December 31, | ||||||||||||||
| 2024 | 2023 | 2024 | 2023 | ||||||||||||
| Clinics (1) | 86 | 83 | 86 | 83 | |||||||||||
| Markets | 16 | 15 | 16 | 15 | |||||||||||
| Lives under value-based contracts (millions) | 1.9 | 1.8 | 1.9 | 1.8 | |||||||||||
| Net income (loss) | $ | (13,182 | ) | $ | (18,754 | ) | $ | (64,663 | ) | $ | (83,068 | ) | |||
| Adjusted EBITDA (in thousands) | $ | (7,828 | ) | $ | (6,252 | ) | $ | (35,688 | ) | $ | (25,805 | ) | |||
(1) Includes independent oncology practices to which we provide limited management services, but do not bear the operating costs.
| Consolidated Balance Sheets (Unaudited) | |||||||
| (in thousands except share data) | |||||||
| December 31, 2024 | December 31, 2023 | ||||||
| Assets | |||||||
| Current assets: | |||||||
| Cash and cash equivalents | $ | 49,669 | $ | 33,488 | |||
| Marketable securities | — | 49,367 | |||||
| Accounts receivable, net | 48,335 | 42,360 | |||||
| Other receivables | 346 | 551 | |||||
| Inventories | 10,039 | 13,678 | |||||
| Prepaid expenses and other current assets | 4,029 | 4,049 | |||||
| Total current assets | 112,418 | 143,493 | |||||
| Property and equipment, net | 11,888 | 10,883 | |||||
| Operating right of use assets | 25,782 | 29,169 | |||||
| Intangible assets, net | 14,810 | 17,904 | |||||
| Goodwill | 7,230 | 7,230 | |||||
| Other assets | 589 | 561 | |||||
| Total assets | $ | 172,717 | $ | 209,240 | |||
| Liabilities and stockholders’ equity | |||||||
| Current liabilities: | |||||||
| Accounts payable | $ | 24,324 | $ | 14,429 | |||
| Current portion of operating lease liabilities | 6,798 | 6,363 | |||||
| Accrued expenses and other current liabilities | 21,093 | 13,996 | |||||
| Total current liabilities | 52,215 | 34,788 | |||||
| Operating lease liabilities | 23,223 | 26,486 | |||||
| Derivative warrant liabilities | 17 | 636 | |||||
| Conversion option derivative liabilities | 385 | 3,082 | |||||
| Long-term debt, net of unamortized debt issuance costs | 93,131 | 86,826 | |||||
| Other non-current liabilities | 125 | 365 | |||||
| Deferred income taxes liability | 32 | 32 | |||||
| Total liabilities | 169,128 | 152,215 | |||||
| Stockholders’ equity: | |||||||
| Common Stock, 0.0001 par value, authorized 500,000,000 shares; 77,470,886 shares issued and 75,737,112 shares outstanding at December 31, 2024 and 75,879,025 shares issued and outstanding at December 31, 2023 | 8 | 8 | |||||
| Series A Convertible Preferred Stock, 0.0001 par value, authorized 10,000,000 shares; 165,045 shares issued and outstanding at December 31, 2024 and 2023 | — | — | |||||
| Treasury Stock at cost, 1,733,774 shares at December 31, 2024 and 2023 | (1,019 | ) | (1,019 | ) | |||
| Additional paid-in capital | 215,413 | 204,186 | |||||
| Accumulated deficit | (210,813 | ) | (146,150 | ) | |||
| Total stockholders’ equity | 3,589 | 57,025 | |||||
| Total liabilities and stockholders’ equity | $ | 172,717 | $ | 209,240 | |||
| Consolidated Statements of Operations (Unaudited) | |||||||||||||||
| (in thousands except share data) | |||||||||||||||
| Three Months Ended | Year Ended | ||||||||||||||
| December 31, | December 31, | ||||||||||||||
| 2024 | 2023 | 2024 | 2023 | ||||||||||||
| Revenue | |||||||||||||||
| Patient services | $ | 50,217 | $ | 56,171 | $ | 204,883 | $ | 213,504 | |||||||
| Dispensary | 47,587 | 27,607 | 179,916 | 103,835 | |||||||||||
| Clinical trials & other | 2,463 | 2,010 | 8,613 | 6,900 | |||||||||||
| Total operating revenue | 100,267 | 85,788 | 393,412 | 324,239 | |||||||||||
| Operating expenses | |||||||||||||||
| Direct costs – patient services | 45,743 | 48,364 | 186,880 | 181,017 | |||||||||||
| Direct costs – dispensary | 39,530 | 22,743 | 151,231 | 83,071 | |||||||||||
| Direct costs – clinical trials & other | 358 | 302 | 1,304 | 578 | |||||||||||
| Goodwill impairment charges | — | — | — | 16,867 | |||||||||||
| Selling, general and administrative expense | 24,858 | 28,090 | 107,828 | 113,851 | |||||||||||
| Depreciation and amortization | 1,707 | 1,577 | 6,287 | 5,873 | |||||||||||
| Total operating expenses | 112,196 | 101,076 | 453,530 | 401,257 | |||||||||||
| Loss from operations | (11,929 | ) | (15,288 | ) | (60,118 | ) | (77,018 | ) | |||||||
| Other non-operating expense (income) | |||||||||||||||
| Interest expense, net | 1,168 | 1,941 | 7,496 | 6,777 | |||||||||||
| Change in fair value of derivative warrant liabilities | (47 | ) | 344 | (619 | ) | 286 | |||||||||
| Change in fair value of earnout liabilities | — | (11 | ) | — | (803 | ) | |||||||||
| Change in fair value of conversion option derivative liabilities | (129 | ) | 1,156 | (2,697 | ) | (878 | ) | ||||||||
| Other, net | 261 | 123 | 365 | 704 | |||||||||||
| Total other non-operating loss expense | 1,253 | 3,553 | 4,545 | 6,086 | |||||||||||
| Loss before provision for income taxes | (13,182 | ) | (18,841 | ) | (64,663 | ) | (83,104 | ) | |||||||
| Income tax benefit | — | 87 | — | 36 | |||||||||||
| Net loss | $ | (13,182 | ) | $ | (18,754 | ) | $ | (64,663 | ) | $ | (83,068 | ) | |||
| Net income (loss) per share attributable to common stockholders: | |||||||||||||||
| Net income (loss) attributable to common stockholders, basic and diluted | (10,821 | ) | (15,314 | ) | (53,005 | ) | (67,877 | ) | |||||||
| Weighted-average number of shares outstanding, basic and diluted | 75,655,231 | 73,469,101 | 75,043,678 | 73,748,660 | |||||||||||
| Net income (loss) per share attributable to common stockholders, basic and diluted | $ | (0.14 | ) | $ | (0.21 | ) | $ | (0.71 | ) | $ | (0.92 | ) | |||
| Consolidated Statements of Cash Flows (Unaudited) | |||||||||||||||
| (in thousands) | |||||||||||||||
| Three Months Ended | Year Ended | ||||||||||||||
| December 31, | December 31, | ||||||||||||||
| 2024 | 2023 | 2024 | 2023 | ||||||||||||
| Cash flows from operating activities: | |||||||||||||||
| Net loss | $ | (13,182 | ) | $ | (18,754 | ) | $ | (64,663 | ) | $ | (83,068 | ) | |||
| Adjustments to reconcile net income (loss) to cash and cash equivalents used in operating activities: | |||||||||||||||
| Depreciation and amortization | 1,707 | 1,577 | 6,287 | 5,873 | |||||||||||
| Amortization of debt issuance costs and debt discount | 1,594 | 1,572 | 6,305 | 6,205 | |||||||||||
| Goodwill impairment charges | — | — | — | 16,867 | |||||||||||
| Share-based compensation | 1,289 | 4,079 | 11,152 | 17,810 | |||||||||||
| Change in fair value of liability classified warrants | (47 | ) | 344 | (619 | ) | 286 | |||||||||
| Change in fair value of liability classified earnouts | — | (11 | ) | — | (803 | ) | |||||||||
| Change in fair value of liability classified conversion option derivatives | (129 | ) | 1,156 | (2,697 | ) | (878 | ) | ||||||||
| Unrealized (gain) loss on investments | 1 | (194 | ) | (133 | ) | (249 | ) | ||||||||
| Accretion of discount on investment securities | (1 | ) | (1,919 | ) | (500 | ) | (2,631 | ) | |||||||
| Deferred taxes | — | (137 | ) | — | (76 | ) | |||||||||
| Bad debt expense | — | 1,989 | — | 2,020 | |||||||||||
| (Gain) loss on disposal of property and equipment | 220 | (30 | ) | 271 | (30 | ) | |||||||||
| Changes in operating assets and liabilities, net of business combinations: | |||||||||||||||
| Accounts receivable | 6,167 | 4,093 | (5,975 | ) | (4,564 | ) | |||||||||
| Inventories | 67 | (1,472 | ) | 3,639 | (4,385 | ) | |||||||||
| Other receivables | 12 | (87 | ) | 205 | 66 | ||||||||||
| Prepaid expenses | 1,184 | 400 | 1,176 | 3,128 | |||||||||||
| Operating lease right-of-use assets | 1,301 | 1,358 | 3,387 | 5,806 | |||||||||||
| Other assets | (1 | ) | (1 | ) | (28 | ) | (84 | ) | |||||||
| Accrued expenses and other current liabilities | 4,656 | 2,778 | 9,471 | 3,357 | |||||||||||
| Income taxes payable | — | (255 | ) | — | (255 | ) | |||||||||
| Accounts payable | 739 | 1,096 | 9,215 | 5,057 | |||||||||||
| Current and long-term operating lease liabilities | (1,392 | ) | (1,415 | ) | (2,828 | ) | (5,324 | ) | |||||||
| Other non-current liabilities | 1 | (49 | ) | (203 | ) | (443 | ) | ||||||||
| Net cash and cash equivalents provided by (used in) operating activities | 4,186 | (3,882 | ) | (26,538 | ) | (36,315 | ) | ||||||||
| Cash flows from investing activities: | |||||||||||||||
| Purchases of property and equipment | (1,755 | ) | (861 | ) | (3,789 | ) | (4,567 | ) | |||||||
| Cash paid for practice acquisitions, net | — | (156 | ) | — | (4,456 | ) | |||||||||
| Purchases of marketable securities/investments | — | 88 | — | (9,595 | ) | ||||||||||
| Sales of marketable securities/Investments | — | 12,556 | 50,000 | 81,258 | |||||||||||
| Net cash and cash equivalents provided by (used in) investing activities | (1,755 | ) | 11,627 | 46,211 | 62,640 | ||||||||||
| Cash flows from financing activities: | |||||||||||||||
| Payments made for financing of insurance payments | (154 | ) | (259 | ) | (1,156 | ) | (3,269 | ) | |||||||
| Payment of deferred consideration liability for acquisition | — | (1,625 | ) | (2,372 | ) | (2,584 | ) | ||||||||
| Principal payments on financing leases | (10 | ) | (10 | ) | (39 | ) | (101 | ) | |||||||
| Common stock repurchase from related party | — | — | — | (1,019 | ) | ||||||||||
| Common stock issued for options exercised | — | 113 | 75 | 126 | |||||||||||
| Net cash and cash equivalents used in financing activities | (164 | ) | (1,781 | ) | (3,492 | ) | (6,847 | ) | |||||||
| Net increase in cash and cash equivalents | 2,267 | 5,964 | 16,181 | 19,478 | |||||||||||
| Cash and cash equivalents at beginning of period | 47,402 | 27,524 | 33,488 | 14,010 | |||||||||||
| Cash and cash equivalents at end of period | $ | 49,669 | $ | 33,488 | $ | 49,669 | $ | 33,488 | |||||||
Contacts
Media
The Oncology Institute, Inc.
Jaime Valles
marketing@theoncologyinstitute.com
Investors
Solebury Strategic Communications
investors@theoncologyinstitute.com
FAQ
What was TOI's revenue growth in Q4 2024 compared to Q4 2023?
How much did TOI's dispensary revenue increase in Q4 2024?
What is TOI's financial outlook for Q1 2025?
How many new contracts did TOI secure in late 2024?
