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Oncology Institute (NASDAQ: TOI) grows Q1 revenue 41% and boosts 2026 cash outlook

Filing Impact
(High)
Filing Sentiment
(Neutral)
Form Type
8-K

Rhea-AI Filing Summary

The Oncology Institute, Inc. reported strong first-quarter 2026 results with total operating revenue of $147.4 million, a 41% increase from the prior-year quarter, driven by capitated revenue growth and record performance in its pharmacy business.

Net loss narrowed sharply to $2.5 million from $19.6 million, and Adjusted EBITDA improved to negative $2.4 million from negative $5.1 million. Free Cash Flow was negative $2.4 million, better than negative $4.0 million a year earlier. Cash and cash equivalents were $30.3 million as of March 31, 2026.

For full-year 2026, the company reaffirmed guidance for revenue of $630–$650 million, gross profit of $97–$107 million, and Adjusted EBITDA of $0–$9 million, while raising Free Cash Flow guidance to $5–$15 million. It expects about $150 million in capitated revenue in 2026 and Q2 2026 Adjusted EBITDA between negative $1 million and positive $1 million.

Positive

  • Rapid top-line growth and better cash outlook: Q1 2026 operating revenue rose 41% year over year to $147.4 million, net loss narrowed to $2.5 million from $19.6 million, and 2026 Free Cash Flow guidance was raised from $(15)–$5 million to $5–$15 million.

Negative

  • Continuing losses and negative equity: Despite improvement, the company still posted a Q1 2026 net loss of $2.5 million, negative Adjusted EBITDA of $2.4 million, and a stockholders’ deficit of $16.3 million as of March 31, 2026.

Insights

Q1 2026 showed rapid growth, sharply lower losses, and a stronger cash outlook.

The Oncology Institute grew Q1 2026 operating revenue to $147.4M, a 41% increase versus Q1 2025, led by capitated contracts and pharmacy volume. Net loss fell to $2.5M from $19.6M, helped by lower interest expense and favorable derivative fair-value movements.

Operationally, Free Cash Flow improved to negative $2.4M from negative $4.0M, and Adjusted EBITDA improved to negative $2.4M from negative $5.1M. Cash stood at $30.3M, while long-term debt was $78.6M, and stockholders’ equity remained negative at $(16.3)M.

For 2026, management reaffirmed revenue guidance of $630–$650M and Adjusted EBITDA of $0–$9M, while raising Free Cash Flow guidance to $5–$15M and targeting about $150M in capitated revenue. They also expect Q2 2026 Adjusted EBITDA between negative $1M and positive $1M. Actual outcomes will depend on capitated lives, costs, and other factors cited in risk disclosures.

Item 2.02 Results of Operations and Financial Condition Financial
Disclosure of earnings results, typically an earnings press release or preliminary financials.
Item 9.01 Financial Statements and Exhibits Exhibits
Financial statements, pro forma financial information, and exhibit attachments filed with this report.
Q1 2026 operating revenue $147.4M Three months ended March 31, 2026; 41% year-over-year growth
Q1 2026 net loss $2.5M Improved from net loss of $19.6M in Q1 2025
Q1 2026 Adjusted EBITDA -$2.4M Better than -$5.1M Adjusted EBITDA in Q1 2025
Q1 2026 Free Cash Flow -$2.4M Improved from -$4.0M Free Cash Flow in Q1 2025
Cash and cash equivalents $30.3M Balance as of March 31, 2026
Long-term debt $78.6M Net of unamortized issuance costs as of March 31, 2026
2026 revenue guidance $630–$650M Full-year 2026 revenue outlook, unchanged from prior
2026 Free Cash Flow guidance $5–$15M Full-year 2026 range, raised from $(15)–$5M
Adjusted EBITDA financial
"TOI uses Adjusted EBITDA and Free Cash flow, each a non-GAAP metric"
Adjusted EBITDA is a way companies measure how much money they make from their core operations, like running a business, by removing certain costs or income that aren’t part of regular business activities. It helps investors see how well a company is doing without distractions from unusual expenses or gains, making it easier to compare companies or track performance over time.
Free Cash Flow financial
"TOI defines Free Cash Flow as net cash flow provided by (used in) operations plus cash paid for interest, less capital expenditures"
Free cash flow is the amount of money a company has left over after paying all its expenses and investing in its business, like buying equipment or updating facilities. It shows how much cash is available to reward shareholders, pay down debt, or save for future growth. This helps investors understand if a company is financially healthy and able to grow.
capitated revenue financial
"delivering 41% year over year revenue growth, driven in part by strong capitated revenue growth"
Capitated revenue is the fixed amount a healthcare provider or insurer receives for each enrolled patient over a set period, like a monthly subscription fee paid regardless of how much care the patient uses. It matters to investors because it creates predictable cash flow and rewards efficient care, but also transfers financial risk to the provider if patient costs exceed the fixed payments, affecting profitability and future valuation.
value-based contracts financial
"Lives under value-based contracts (millions) | 2.0 | 2.0"
derivative warrant liabilities financial
"Change in fair value of derivative warrant liabilities | (168) | 43"
Derivative warrant liabilities are the obligation a company records for outstanding warrants—contracts that give holders the right to receive cash or shares based on the company’s stock price. They matter to investors because these liabilities signal potential future cash outflows or share dilution that can reduce earnings per share, change available cash, and increase stock volatility; think of them as outstanding IOUs that may force a company to pay money or issue more shares.
conversion option derivative liabilities financial
"Conversion option derivative liabilities | 7,595 | 12,591"
Operating revenue $147.4M +41% YoY
Net loss $2.5M improved from $19.6M prior-year quarter
Adjusted EBITDA -$2.4M improved from -$5.1M prior-year quarter
Free Cash Flow -$2.4M improved from -$4.0M prior-year quarter
Guidance

For 2026, revenue $630–$650M, gross profit $97–$107M, Adjusted EBITDA $0–$9M, Free Cash Flow $5–$15M, and expected capitated revenue of about $150M; Q2 2026 Adjusted EBITDA expected between $(1)M and $1M.

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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

___________________________________

Form 8-K

__________________________________________________________

 

CURRENT REPORT

Pursuant to Section 13 or 15(d)

of the Securities Exchange Act of 1934

 

Date of Report (Date of earliest event reported)  May 7, 2026

___________________________________

 

THE ONCOLOGY INSTITUTE, INC.

(Exact name of registrant as specified in its charter)

___________________________________

 

Delaware   001-39248   84-3562323
(State or other jurisdiction
of incorporation)
  (Commission File Number)   (I.R.S. Employer
Identification No.)

 

18000 Studebaker Road, Suite 800, Cerritos, CA   90703
(Address of principal executive offices)   (Zip Code)

 

Registrant’s telephone number, including area code:  (562) 735-3226

 

 

(Former name or former address, if changed since last report)

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

 

Written communication pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

Pre-commencement communication pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

Pre-commencement communication pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

 

Securities registered pursuant to Section 12(b) of the Act:

 

Title of each class   Trading Symbol(s)   Name of each exchange on which registered
Common stock, par value $0.0001   TOI   The Nasdaq Stock Market LLC
Redeemable warrants, each whole warrant exercisable for one share of Common stock, each at an exercise price of $11.50 per share   TOIIW   The Nasdaq Stock Market LLC

 

 

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (17 CFR §230.405) or Rule 12b-2 of the Securities Exchange Act of 1934 (17 CFR §240.12b-2).

 

Emerging growth company ¨

 

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐.

 
 

 

Item 2.02. Results of Operations and Financial Condition

 

On May 7, 2026, The Oncology Institute, Inc. (the "Company") issued a press release announcing its financial results for the three months ended March 31, 2026 and certain other financial information. A copy of the press release is furnished hereto as Exhibit 99.1, which is incorporated by reference herein.

 

The information contained in Item 2.02 of this Current Report and Exhibit 99.1 is being furnished and shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise subject to the liabilities of such section.

 

Item 9.01. Financial Statements and Exhibits.

(d) Exhibits 

Exhibit
No.
  Description
   
99.1  

Press Release issued by The Oncology Institute, Inc. on May 7, 2026

104   Cover Page Interactive Data File (embedded within the Inline XBRL document).

 

 

 
 

 SIGNATURE

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

Dated: May 7, 2026 THE ONCOLOGY INSTITUTE, INC.
   
  By: /s/ Robert Carter
  Name:  

Robert Carter

  Title:

Chief Financial Officer

 

 

 

Exhibit 99.1

 

 

FOR IMMEDIATE RELEASE

 

The Oncology Institute Reports First Quarter 2026 Financial Results

 

CERRITOS, Calif., May 7, 2026 -- 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 three months ended March 31, 2026.

 

Recent Operational Highlights

 

Specialty Pharmacy had record Part D fills driving Specialty Pharmacy revenue up 78% in the quarter as compared to prior year same quarter, reflecting the volume growth across our membership and continued attachment rate improvements.

Contract expansion bringing our total Medicare Advantage lives to 200,000 across 25 counties in Florida effective July 1, 2026.

Preparing to launch our proprietary provider portal which is designed to strengthen provider engagement and drive continued adherence to our clinical pathways - particularly for our network physicians.

In connection with our clinical model, we saved approximately $2 million in Medicare spending as part of the CMS Enhancing Oncology Model performance program in period 3 - increasing the savings generated from the previous period while maintaining high-quality care.

 

First Quarter 2026 Financial Highlights

 

All comparisons are to the quarter ended March 31, 2025 unless otherwise noted

 

Consolidated revenue of $147.4 million increased 41.2% from $104.4 million

Gross profit of $23.3 million, increased 35.2%

Net loss of $2.5 million compared to net loss of $19.6 million

Basic and diluted (loss) earnings per share of $(0.02) compared to $(0.21)

Adjusted EBITDA of $(2.4) million compared to $(5.1) million

Cash and cash equivalents of $30.3 million as of March 31, 2026

 

Management Commentary

 

Daniel Virnich, CEO of TOI, commented, "The first quarter of 2026 was a strong start to the year for TOI, delivering 41% year over year revenue growth, driven in part by strong capitated revenue growth and a record performance in our pharmacy business. We made meaningful progress on several fronts, including in Florida, where we reached profitability, marking an important milestone that reflects the maturation of our capitated relationships in the state, which is a proof point of our model. Our provider portal, which is designed to underscore our commitment to high quality patient care, strengthen provider engagement, and drive continued adherence to our clinical pathways and quality metrics, is preparing for launch this summer. Looking ahead, we are focused on building on the momentum we have coming out of this quarter, are reaffirming our guidance for 2026 revenue and adjusted EBITDA, and feel confident in our ability to execute sustainable profitability over the long term."

 

 

 
 

Outlook for Fiscal Year 2026

 

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 capitated lives, direct costs, taxes, capital expenditures, share-based compensation, change in fair value of liabilities, unrealized (gains) losses on investments, 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.

 

   2026 Guidance - Previous  2026 Guidance - Updated
Revenue  $630 to $650 million  Unchanged
Gross Profit  $97 to $107 million  Unchanged
Adjusted EBITDA  $0 to $9 million  Unchanged
Free Cash Flow  $(15) to $5 million  $5 to $15 million

 

The Company expects approximately $150 million in capitated revenue in 2026. For the second quarter of 2026, we anticipate Adjusted EBITDA of $(1) million to $1 million, reflecting seasonal improvement as deductibles are satisfied and continued ramp of our Florida delegated lives TOI's achievement of the anticipated results is subject to risks and uncertainties, including those disclosed in its filings with the U.S. Securities and Exchange Commission. The outlook does not take into account the impact of any unanticipated developments in the business or changes in the operating or economic environment, nor does it take into account the impact of TOI's acquisitions, dispositions or financings. TOI's outlook assumes a largely stable global market, which would likely be negatively impacted if recent tariff rate increases and exchange rate changes persist and adversely affect world trade.

 

Webcast and Conference Call

 

TOI will host a conference call on Thursday, May 7, 2026 at 5:30 p.m. (Eastern Time) to discuss first quarter results and management’s outlook for future financial and operational performance.

 

The conference call can be accessed live over the phone by dialing 1-800-225-9448, or for international callers, 1-203-518-9708. 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 11161701. The replay will be available until Thursday, May 21, 2026.

.

About The Oncology Institute, Inc.

 

Founded in 2007, The Oncology Institute, Inc. (NASDAQ: TOI) is 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 2.0 million patients including clinical trials, transfusions, and other care delivery models traditionally associated with the most advanced care delivery organizations. With over 400 employed and network clinicians and over 100 clinics and network locations of care across five states 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 2026 full fiscal year outlook and the Q2 2026 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 a cybersecurity incident affecting a software provider 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, 2025 filed with the SEC on March 12, 2026 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. TOI defines Free Cash Flow as net cash flow provided by (used in) operations plus cash paid for interest, less capital expenditures.

 

TOI believes that the use of Adjusted EBITDA provides an additional tool to assess our operations 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 net cash flow used in operations to Free Cash Flow and net loss to Adjusted EBITDA, the most comparable GAAP metrics, is set forth below:

 

Free Cash Flow Reconciliation
 
   Three Months Ended March 31,   Change 
(dollars in thousands)  2026   2025   $   % 
Net cash and cash equivalents used in operating activities  $(2,215)  $(4,988)  $2,773    55.6%
Cash paid for interest   888    1,290    (402)   31.2%
Purchases of property and equipment   (1,042)   (328)   (714)   (217.7)%
Free Cash Flow  $(2,369)  $(4,026)  $1,657    41.2%

 

 

 

Adjusted EBITDA Reconciliation
 
   Three Months Ended March 31,   Change 
(dollars in thousands)  2026   2025   $   % 
Net loss  $(2,492)  $(19,585)  $17,093    (87.3)%
Depreciation and amortization   1,616    1,784    (168)   (9.4)%
Interest expense, net   1,934    5,570    (3,636)   (65.3)%
Income tax and other taxes   43        43    %
Non-cash addbacks   (248)   (163)   (85)   52.1%
Share-based compensation   1,686    1,458    228    15.6%
Changes in fair value of liabilities   (5,164)   3,352    (8,516)   (254.1)%
Unrealized loss on investments       6    (6)   (100.0)%
Post-combination compensation expense       13    (13)   (100.0)%
Consulting fees   273    332    (59)   (17.8)%
Infrastructure and workforce costs   (86)   2,124    (2,210)   (104.0)%
Adjusted EBITDA  $(2,438)  $(5,109)  $2,671    (52.3)%

 

 

Key Business Metrics
 
   Three Months Ended March 31, 
(dollars in thousands)  2026   2025 
Affiliated and Network Clinics (1)   155    81 
Markets   17    18 
Lives under value-based contracts (millions)   2.0    2.0 
Net loss  $(2,492)  $(19,585)
Adjusted EBITDA (in thousands)  $(2,438)  $(5,109)

 

(1)Clinics operated under the TOI PCs, whereby we receive a percentage of revenue under our management services agreements, or MSAs, and are consolidated. Additionally, includes independent oncology practices to which we provide limited management services and have network provider agreements, but do not bear the operating costs.

 

 
 

Consolidated Balance Sheets (Unaudited)

(in thousands except share data)

 

   March 31, 2026   December 31, 2025 
Assets          
Current assets:          
Cash and cash equivalents  $30,280   $33,565 
Accounts receivable, net   58,134    58,998 
Other receivables   1,316    322 
Inventories   24,290    16,875 
Prepaid expenses and other current assets   2,843    2,987 
Total current assets   116,863    112,747 
Property and equipment, net   10,697    10,684 
Operating right of use assets   22,520    22,374 
Intangible assets, net   10,300    11,015 
Goodwill   7,230    7,230 
Other assets   620    606 
Total assets  $168,230   $164,656 
Liabilities and stockholders’ equity (deficit)          
Current liabilities:          
Accounts payable  $47,650   $43,167 
Current portion of operating lease liabilities   7,404    7,156 
Accrued expenses and other current liabilities   24,297    20,639 
Total current liabilities   79,351    70,962 
Operating lease liabilities   18,843    19,131 
Derivative warrant liabilities   96    264 
Conversion option derivative liabilities   7,595    12,591 
Long-term debt, net of unamortized debt issuance costs   78,611    77,400 
Other non-current liabilities   19    28 
Total liabilities   184,515    180,376 
Stockholders’ deficit:          
Common Stock, 0.0001 par value, authorized 500,000,000 shares; 101,707,558 and 99,973,784 shares issued and outstanding at March 31, 2026 and 100,596,918 shares issued and 98,863,144 shares outstanding at December 31, 2025   10    10 
Series A Convertible Preferred Stock, 0.0001 par value, authorized 10,000,000 shares; 193,507 shares issued and outstanding at March 31, 2026 and 193,507 shares issued and outstanding at December 31, 2025        
Additional paid-in capital   258,635    256,708 
Treasury Stock at cost, 1,733,774 shares at March 31, 2026 and December 31, 2025   (1,019)   (1,019)
Accumulated deficit   (273,911)   (271,419)
Total stockholders’ equity (deficit)   (16,285)   (15,720)
Total liabilities and stockholders’ equity (deficit)  $168,230   $164,656 

 

 

 
 

Consolidated Statements of Operations (Unaudited)

(in thousands except share data)

 

   Three Months Ended March 31, 
   2026   2025 
Revenue        
Patient services  $59,087   $53,068 
Specialty Pharmacy   87,541    49,293 
Clinical trials & other   813    2,045 
Total operating revenue   147,441    104,406 
Operating expenses          
Direct costs – patient services   53,383    47,080 
Direct costs – specialty pharmacy   70,743    39,863 
Direct costs – clinical trials & other       214 
Selling, general and administrative expense   28,212    25,376 
Depreciation and amortization   1,616    1,784 
Total operating expenses   153,954    114,317 
Loss from operations   (6,513)   (9,911)
Other non-operating expense (income)          
Interest expense, net   1,934    5,570 
Change in fair value of derivative warrant liabilities   (168)   43 
Change in fair value of conversion option derivative liabilities   (4,996)   3,309 
Other, net   (791)   752 
Total other non-operating expense (income)   (4,021)   9,674 
Loss before provision for income taxes   (2,492)   (19,585)
Income taxes        
Net loss  $(2,492)  $(19,585)
Net loss attributable to common stockholders, basic and diluted  $(2,094)  $(16,075)
Net loss per share attributable to common stockholders:          
Basic  $(0.02)  $(0.21)
Diluted  $(0.02)  $(0.21)
Weighted-average number of shares outstanding:          
Basic   101,801,609    77,098,825 
Diluted   101,801,609    77,098,825 

 

 

 
 

Consolidated Statements of Cash Flows (Unaudited)

(in thousands)

   Three Months Ended March 31, 
   2026   2025 
Cash flows from operating activities:          
Net loss  $(2,492)  $(19,585)
Adjustments to reconcile net loss to cash and cash equivalents used in operating activities:          
Depreciation and amortization   1,616    1,784 
Amortization of debt issuance costs and debt discount   1,211    4,874 
Share-based compensation   1,686    1,458 
Change in fair value of liability classified warrants   (168)   43 
Change in fair value of liability classified conversion option derivatives   (4,996)   3,309 
Changes in operating assets and liabilities:          
Accounts receivable   864    (985)
Other receivables   (994)    
Inventories   (7,415)   (2,269)
Prepaid expenses   144    (1,078)
Other assets   (14)   (2)
Accounts payable   4,611    5,057 
Change in operating leases   (186)   (162)
Accrued expenses and other current liabilities   3,918    2,567 
Other non-current liabilities       1 
Net cash and cash equivalents used in operating activities   (2,215)   (4,988)
Cash flows from investing activities:          
Purchases of property and equipment   (1,042)   (328)
Proceeds from asset disposition       126 
Net cash and cash equivalents used in investing activities   (1,042)   (202)
Cash flows from financing activities:          
Proceeds from private placement, net of offering costs       15,359 
Proceeds from employee stock purchase plan   220     
Payments made for financing of insurance payments   (260)   (226)
Principal payments on long-term debt       (20,000)
Principal payments on financing leases   (9)   (10)
Common stock issued for options exercised   21    137 
Net cash and cash equivalents provided by (used in) financing activities   (28)   (4,740)
Net decrease in cash and cash equivalents   (3,285)   (9,930)
Cash and cash equivalents at beginning of period   33,565    49,669 
Cash and cash equivalents at end of period  $30,280   $39,739 
Contacts

 

Media

 

The Oncology Institute, Inc.

Daniel Virnich, MD

danielvirnich@theoncologyinstitute.com

(562) 735-3226 x 81125

 

Investors

 

ICR Strategic Communications

investors@icrinc.com

FAQ

How did The Oncology Institute (TOI) perform financially in Q1 2026?

The Oncology Institute delivered strong growth in Q1 2026, with total operating revenue of $147.4 million, up 41% from Q1 2025. Net loss improved significantly to $2.5 million from $19.6 million, and Adjusted EBITDA improved to negative $2.4 million from negative $5.1 million.

What guidance did The Oncology Institute (TOI) give for full-year 2026?

For 2026, The Oncology Institute reaffirmed revenue guidance of $630–$650 million, gross profit of $97–$107 million, and Adjusted EBITDA of $0–$9 million. It raised Free Cash Flow guidance to $5–$15 million and expects approximately $150 million in capitated revenue during the year.

What is The Oncology Institute’s outlook for Q2 2026 Adjusted EBITDA?

The Oncology Institute expects Q2 2026 Adjusted EBITDA between $(1) million and $1 million. Management links this to seasonal improvement as patient deductibles are satisfied and continued ramp of delegated lives in Florida, while cautioning that results remain subject to various business and market risks.

How did The Oncology Institute’s Free Cash Flow trend in Q1 2026?

Free Cash Flow in Q1 2026 was negative $2.4 million, an improvement from negative $4.0 million in Q1 2025. The change reflected better operating cash usage and interest costs, and the company now targets positive full-year 2026 Free Cash Flow of $5–$15 million.

What were The Oncology Institute’s key balance sheet figures as of March 31, 2026?

As of March 31, 2026, The Oncology Institute reported cash and cash equivalents of $30.3 million, long-term debt of $78.6 million, and total assets of $168.2 million. Total liabilities were $184.5 million, resulting in a stockholders’ deficit of $16.3 million on its balance sheet.

How many clinics and value-based lives does The Oncology Institute (TOI) serve?

In its key business metrics, The Oncology Institute reported 155 affiliated and network clinics for Q1 2026, up from 81 a year earlier. Lives under value-based contracts remained at approximately 2.0 million for both Q1 2026 and Q1 2025, showing stable contracted population coverage.

Filing Exhibits & Attachments

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