The Oncology Institute, Inc. (TOI): Business Model Canvas [Jan-2025 Mis à jour]

Dans le paysage rapide des soins en oncologie, l'Institut d'oncologie (TOI) apparaît comme une approche révolutionnaire du traitement du cancer, de la technologie de pointe, des services centrés sur le patient et des stratégies commerciales innovantes. En réinventant la façon dont les soins contre le cancer sont dispensés, TOI transforme les modèles médicaux traditionnels à travers une toile commerciale complète qui hiérarchise le traitement personnalisé, l'analyse avancée des données et les solutions de soins basées sur la valeur. Cette approche unique promet non seulement l'amélioration des résultats des patients, mais crée également une voie plus efficace et rentable pour gérer des traitements complexes sur le cancer dans diverses populations de patients.

The Oncology Institute, Inc. (TOI) - Modèle commercial: partenariats clés

Fournisseurs de soins de santé et cliniques d'oncologie

En 2024, l'Institut d'oncologie collabore avec plus de 300 pratiques en oncologie en Californie, en Arizona et au Nevada.

Région	Nombre de cliniques partenaires	Couverture des patients
Californie	215	168 000 patients
Arizona	45	35 000 patients
Nevada	40	27 000 patients

Compagnies d'assurance et payeurs

TOI a des accords contractuels avec 18 principaux fournisseurs d'assurance.

• UnitedHealthcare
• Anthem Blue Cross
• Cigna
• Aetna
• Médicament
• Medicaid

Fabricants pharmaceutiques

Partenariats stratégiques avec 12 sociétés pharmaceutiques pour les traitements en oncologie.

Entreprise pharmaceutique	Focus de partenariat
Miserrer	Distribution de Keytruda
Roche	Accès à la thérapie ciblée
Bristol Myers Squibb	Traitements d'immunothérapie

Technologie médicale et fournisseurs d'équipements de diagnostic

Partenariats avec 7 principaux fournisseurs de technologies médicales.

• Sciences exactes
• Santé des gardiens
• Illumina
• Santé génomique

Institutions de recherche et centres médicaux universitaires

Accords de recherche collaboratif avec 5 établissements universitaires.

Institution	Focus de recherche
UCLA Cancer Center	Recherche en oncologie de précision
Stanford Cancer Institute	Développement d'essais cliniques
UC San Francisco	Études du cancer génomique

The Oncology Institute, Inc. (TOI) - Modèle d'entreprise: activités clés

Fournir des soins en oncologie communautaire

L'Institut Oncology exploite 23 centres de soins à travers la Californie, l'Arizona et le Nevada au quatrième trimestre 2023. Le volume des patients a atteint 45 678 patients cancéreux uniques en 2023.

Portée géographique	Nombre de centres de soins	Volume du patient (2023)
Californie	15	32,456
Arizona	4	8,112
Nevada	4	5,110

Fournir des plans de traitement du cancer personnalisés

TOI utilise des tests génomiques pour 87% des patients, avec des approches de médecine de précision mises en œuvre dans les stratégies de traitement.

• Couverture des tests génomiques: 87%
• Protocoles de traitement personnalisés: 92% de conformité des patients
• Temps de personnalisation du plan de traitement moyen: 5,2 jours

Mise en œuvre d'analyses avancées de données pour les soins aux patients

Investissement technologique dans les plateformes d'analyse de données: 3,2 millions de dollars en 2023.

Métriques d'analyse des données	Performance
Précision de modélisation prédictive	84%
Surveillance des patients en temps réel	Couverture de 98%

Gestion des réseaux d'oncologie de soins basés sur la valeur

TOI gère 12 partenariats de réseau de soins basés sur la valeur avec des systèmes de santé régionaux.

• Revenus de partenariat réseau: 42,6 millions de dollars en 2023
• Valeur du contrat de réseau moyen: 3,55 millions de dollars
• Réduction des coûts grâce à l'efficacité du réseau: 16%

Effectuer des essais cliniques et des recherches

Investissement en recherche: 5,7 millions de dollars en 2023.

Catégorie de recherche	Nombre d'essais actifs	Budget de recherche
Essais en oncologie	17	4,2 millions de dollars
Recherche de médecine de précision	8	1,5 million de dollars

The Oncology Institute, Inc. (TOI) - Modèle d'entreprise: Ressources clés

Médecins en oncologie spécialisés et personnel médical

Depuis le quatrième trimestre 2023, TOI a employé 169 médecins en oncologie dans plusieurs États.

Catégorie du personnel	Nombre de professionnels
Médecins en oncologie	169
Infirmières en oncologie	412
Personnel de soutien clinique	287

Plateforme de technologie de gestion des soins propriétaires

L'infrastructure technologique de TOI comprend:

• Système de dossiers médicaux électroniques basés sur le cloud
• Plate-forme de suivi des données des patients en temps réel
• Moteur d'analyse de traitement avancé

Protocoles de traitement clinique stratégique

TOI maintient 26 protocoles de traitement du cancer standardisé couvrant divers types de cancer et étapes.

Infrastructure de données et d'analyses des patients

Métrique de données	Quantité
Dossiers totaux des patients	87,543
Capacité de traitement des données annuelle	250 TB

Réseau de centres de traitement du cancer

En décembre 2023, TOI fonctionne:

• 38 centres de traitement du cancer
• Présence dans 4 États
• Desservant environ 15 200 patients actifs

État	Nombre de centres
Californie	22
Nevada	6
Arizona	5
Washington	5

The Oncology Institute, Inc. (TOI) - Modèle d'entreprise: propositions de valeur

Soins complets et centrés sur le patient

L'Institut Oncology fournit des services de traitement du cancer dans 87 cliniques en Californie, en Arizona et au Nevada au quatrième trimestre 2023. Traité 26 487 patients uniques en 2023 avec un réseau de 203 fournisseurs d'oncologie.

Métrique de service	2023 données
Volume total du patient	26 487 patients
Nombre de cliniques	87 cliniques
Fournisseurs d'oncologie	203 fournisseurs

Alternatives de traitement à moindre coût

Le coût moyen par traitement du patient a réduit de 22,4% par rapport aux centres d'oncologie traditionnels. Économies annuelles estimées de 3 672 $ par patient.

Services d'oncologie personnalisés et coordonnés

• Couverture des tests génomiques pour 94% des patients
• Système de dossiers médicaux électroniques intégrés
• Coordination des soins avec 72 partenaires régionaux de santé

Approches de traitement avancées basées sur les données

Utilise un algorithme de traitement prodiguée par l'AI-AI couvrant 18 types de cancer. Les modèles d'apprentissage automatique analysent 2,4 millions de points de données des patients par an.

Métrique d'analyse des données	Performance annuelle
Types de cancer couverts	18 types
Points de données des patients analysés	2,4 millions

Amélioration des résultats et de l'expérience des patients

• Évaluation de satisfaction à 95% des patients
• Le taux de réadmission de 30 jours réduit à 6,2%
• Temps de réponse du traitement médian: 5,3 jours

The Oncology Institute, Inc. (TOI) - Modèle d'entreprise: relations clients

Engagement continu des patients

L'Institut Oncology détient 97,3% du taux de rétention des patients dans le cadre de son réseau de 135 centres de soins dans 6 États au quatrième trimestre 2023. Les mesures d'engagement des patients comprennent:

Métrique de l'engagement	Pourcentage
Interactions de suivi régulières	92.6%
Suivi de la santé numérique	84.2%
Adhésion au plan de soins personnalisés	88.5%

Équipes de coordination des soins dédiés

TOI emploie 423 spécialistes de la coordination des soins dédiés à 2024, avec un rapport patient / coordinateur moyen de 1:38.

• Temps de réponse moyen aux demandes des patients: 2,4 heures
• Support multilingue disponible en 6 langues
• Infirmières en oncologie spécialisées COORDINATEURS: 187

Plateformes de gestion des patients numériques

Statistiques d'utilisation de la plate-forme numérique pour 2024:

Fonctionnalité de plate-forme	Taux d'adoption des utilisateurs
Application de santé mobile	76.4%
Consultations de télémédecine	63.7%
Accès aux enregistrements de santé électronique	81.2%

Canaux de communication personnalisés

Dépression des canaux de communication pour les interactions du patient:

• Communications par e-mail: 45,3%
• SMS / Messagerie texte: 32,6%
• Messagerie du portail des patients: 18,2%
• Consultations téléphoniques: 3,9%

Services de soutien au traitement à long terme

Soutien des mesures de service pour les soins complets des patients:

Service d'assistance	Pourcentage de couverture
Conseil psychologique	67.5%
Orientation nutritionnelle	58.3%
Programmes d'aide financière	42.7%
Programmes de survie	39.6%

The Oncology Institute, Inc. (TOI) - Modèle d'entreprise: canaux

Cliniques d'oncologie en personne

Depuis le quatrième trimestre 2023, l'Institut Oncology exploite 41 cliniques en Californie, en Arizona, au Nevada et au Nouveau-Mexique. Durée moyenne de la visite du patient: 45 minutes. Le réseau de cliniques dessert chaque mois environ 12 500 patients atteints de cancer actif.

État	Nombre de cliniques	Patients mensuels moyens
Californie	28	8,750
Arizona	6	1,850
Nevada	4	1,250
New Mexico	3	650

Services de consultation en télésanté

La plate-forme de télésanté lancée en 2021, prenant actuellement en charge 3 750 consultations virtuelles mensuelles. La plate-forme prend en charge 87% des réseaux d'assurance. Durée moyenne de la consultation de la télésanté: 32 minutes.

Applications de santé mobile

Caractéristiques de l'application mobile TOI:

• Portail des patients avec dossier médical en temps réel
• Système de suivi du traitement
• Fonctionnalité de rappel des médicaments

Base d'utilisateurs d'applications mobiles: 6 200 utilisateurs mensuels actifs. Compatibilité des applications: plates-formes iOS et Android.

Réseaux de référence du médecin direct

Le réseau de référence des médecins comprend 215 praticiens indépendants en oncologie et 42 partenariats hospitaliers. Taux de conversion de référence: 64% en 2023.

Type de réseau	Nombre de partenaires	Volume de référence
Oncologues indépendants	215	1 850 références mensuelles
Partenaires hospitaliers	42	975 références mensuelles

Plateformes de communication des patients numériques

Les canaux de communication numérique comprennent:

• Système de messagerie sécurisé
• Communication par e-mail
• Portail de soutien aux patients

Engagement numérique mensuel: 5 600 interactions actives des patients. Temps de réponse moyen: 3,5 heures.

The Oncology Institute, Inc. (TOI) - Modèle d'entreprise: segments de clients

Patients cancéreux à travers diverses données démographiques

L'Institut Oncology cible les patients cancéreux avec la rupture démographique suivante:

Groupe d'âge	Pourcentage de population de patients
18-44 ans	12.3%
45 à 64 ans	38.7%
65 ans et plus	49%

Les patients recherchent des soins basés sur la valeur

TOI se concentre sur les segments de soins basés sur la valeur avec des caractéristiques spécifiques:

• Patients Medicare: 62% de la base totale des patients
• Patients d'assurance commerciale: 35% de la base totale de patients
• Patients d'auto-paiement: 3% de la base totale des patients

Les individus assurés ayant des besoins en oncologie

Type d'assurance	Couverture des patients
Avantage Medicare	48.5%
Assurance commerciale	35.2%
Medicaid	16.3%

Patients préférant un traitement communautaire

Distribution géographique des patients:

État	Volume de patient
Californie	65.4%
Arizona	18.7%
Nevada	10.2%
Autres États	5.7%

Les personnes nécessitant des soins du cancer personnalisés

Réflexion du segment des soins personnalisés:

• Patients atteints de diagnostic de cancer complexe: 22,6%
• Patients nécessitant des thérapies ciblées: 17,3%
• Les patients ayant besoin d'approches de médecine de précision: 14,5%

The Oncology Institute, Inc. (TOI) - Modèle d'entreprise: Structure des coûts

Rémunération des médecins et du personnel

Pour l'exercice 2023, l'Institut Oncology a déclaré des dépenses totales de personnel de 156,7 millions de dollars. La ventilation de la rémunération est la suivante:

Catégorie des employés	Compensation annuelle
Oncologistes	95,4 millions de dollars
Personnel infirmier	38,2 millions de dollars
Personnel administratif	23,1 millions de dollars

Équipements médicaux et investissements technologiques

Les dépenses en capital pour la technologie médicale en 2023 ont totalisé 42,3 millions de dollars, avec des allocations spécifiques:

• Équipement de radiothérapie: 18,6 millions de dollars
• Systèmes d'imagerie diagnostique: 14,7 millions de dollars
• Systèmes de dossiers de santé électroniques: 9,0 millions de dollars

Traitement clinique et frais de médicament

Les coûts totaux de traitement clinique pour 2023 étaient de 213,5 millions de dollars, notamment:

Catégorie de dépenses	Montant
Médicaments de chimiothérapie	127,8 millions de dollars
Médicaments de soins de soutien	45,6 millions de dollars
Fournitures cliniques	40,1 millions de dollars

Coûts de recherche et de développement

Les dépenses de R&D pour 2023 s'élevaient à 37,9 millions de dollars, distribuées à travers:

• Financement des essais cliniques: 22,5 millions de dollars
• RECHERCHE D'ONCOLOGIE DE PRÉCISION: 9,4 millions de dollars
• Innovation technologique: 6,0 millions de dollars

Frais généraux opérationnels et administratifs

Les dépenses opérationnelles pour 2023 étaient de 68,2 millions de dollars, notamment:

Catégorie aérienne	Coût annuel
Entretien d'installation	24,6 millions de dollars
Infrastructure informatique	15,3 millions de dollars
Juridique et conformité	12,7 millions de dollars
Marketing et développement commercial	15,6 millions de dollars

The Oncology Institute, Inc. (TOI) - Modèle d'entreprise: Strots de revenus

Remboursements de soins basés sur la valeur

Pour l'exercice 2023, le Oncology Institute a déclaré des remboursements de soins basés sur la valeur totalisant 135,4 millions de dollars, ce qui représente 42% du total des sources de revenus.

Type de remboursement	Montant ($)	Pourcentage de revenus
Paiements basés sur l'assurance-maladie	76,920,000	56.8%
Paiements basés sur la valeur des payeurs commerciaux	58,480,000	43.2%

Frais de service de traitement des patients

Les frais de service de traitement des patients pour 2023 s'élevaient à 98,7 millions de dollars.

• Traitements de chimiothérapie: 52 300 000 $
• Services de radiothérapie: 31 400 000 $
• Services de soins de soutien: 15 000 000 $

Paiements de contrat d'assurance

Les paiements totaux du contrat d'assurance en 2023 ont atteint 187,2 millions de dollars.

Assureur	Montant de paiement du contrat ($)
UnitedHealthcare	62,400,000
Anthem Blue Cross	54,600,000
Cigna	47,200,000
Aetna	23,000,000

Revenus de participation aux essais cliniques

Les revenus de participation aux essais cliniques pour 2023 ont totalisé 22,6 millions de dollars.

• Essais parrainés par la société pharmaceutique: 15 300 000 $
• Essais de recherche financés par le gouvernement: 7 300 000 $

Frais de diagnostic et de traitement

Les frais de diagnostic et de traitement en 2023 étaient de 67,5 millions de dollars.

Catégorie de service	Montant de charge ($)
Imagerie diagnostique	28,600,000
Tests de laboratoire	22,900,000
Diagnostics d'oncologie spécialisés	16,000,000

The Oncology Institute, Inc. (TOI) - Canvas Business Model: Value Propositions

You're looking at The Oncology Institute, Inc. (TOI)'s core promises to the market as of late 2025. These aren't just mission statement platitudes; they are tied directly to the financial performance we're seeing, especially with the shift to value-based contracts.

High-quality, integrated cancer care in a community setting

The value proposition here is delivering advanced care where patients live, not just in distant academic centers. This integrated approach is supported by significant scale across the network.

The Oncology Institute, Inc. (TOI) operates across five states with over 100 clinics and affiliate locations as of the third quarter of 2025. They support this infrastructure with over 180 employed and affiliate clinicians. This network serves a covered population of approximately 1.9 million patients. The financial scale is evident in the updated full fiscal year 2025 revenue guidance, which is now projected to be between $495 million to $505 million. For the third quarter of 2025 alone, consolidated revenue reached $136.6 million.

Improved patient outcomes via a value-based care model

The commitment to value-based care, or VBC, is central to their strategy, meaning payment is tied to keeping patients healthier. This focus is validated by specific clinical results shared in May 2025 regarding their High-Value Cancer Care (HVCC) model.

The demonstrated improvements in patient care are stark:

• 53% reduction in Emergency Department utilization.
• 68% decrease in hospitalization rates.
• 75% lower odds of acute care facility death.

Lower total cost of care for payers and health plans

The clinical improvements directly translate into financial savings for payers, which is the core incentive of the capitated contracts The Oncology Institute, Inc. (TOI) is aggressively pursuing. The financial benefit for the payer is clear from the same HVCC data set.

The model delivered an estimated $12,000 cost savings per enrolled patient. This incentive structure is driving contract expansion; in 2025, The Oncology Institute, Inc. (TOI) added roughly 80,000 lives under new capitation agreements. To be fair, they managed over 200,000 lives in Florida under value-based agreements by late 2025, showing deep penetration in key markets.

Enhanced access to cutting-edge clinical trials

Access to trials is a key differentiator, keeping patients on the latest treatment protocols without leaving the community setting. The operational data shows activity in this segment.

The segment dedicated to clinical trials and other services recorded an activity metric of 6,150 in the third quarter of 2025. This is part of the overall offering to the 1.9 million covered patient population.

Comprehensive services: infusion, lab, financial counseling

The integrated nature of the model is supported by high-margin ancillary services that keep the patient journey in-house, which also helps control costs and improve coordination. The dispensary business is a major financial engine for this integration.

Here's how the key service components performed financially in the third quarter of 2025:

Service Component	Q3 2025 Revenue	Q3 2025 Gross Profit
Retail Pharmacy and Dispensary	$75.9 million	$12.8 million
Fee-for-Service Revenue (Patient Services)	Increased 13% Year-over-Year	N/A

The company also provides services including infusion centers, outpatient blood transfusion, outpatient stem cell transplant, comprehensive lab testing, and financial counseling, all supporting the holistic care delivery.

Finance: draft 13-week cash view by Friday.

The Oncology Institute, Inc. (TOI) - Canvas Business Model: Customer Relationships

You're looking at how The Oncology Institute, Inc. (TOI) manages its connections with the people and organizations that keep the lights on. It really boils down to deep partnerships and a focus on the patient experience, all underpinned by new tech.

Deep, collaborative relationships with payer partners

The relationship with payers is central, especially as The Oncology Institute, Inc. (TOI) pushes its value-based care model. You see this commitment in the contract expansions and the revenue mix. For the third quarter of 2025, total revenue hit $136.6 million, with patient services revenue at $60.2 million.

Within that patient services revenue for Q3 2025, the value-based capitation contracts accounted for 34%, while fee-for-service made up the remaining 66%. The fee-for-service segment itself grew 13% over Q3 2024. The momentum in these payer relationships is clear from recent contract activity.

Here's a snapshot of the payer-facing growth metrics:

Metric	Value/Detail	Reporting Period
Q3 2025 Total Revenue	$136.6 million	Q3 2025
Q3 2025 Patient Services Revenue	$60.2 million	Q3 2025
Capitation Share of Patient Services Revenue	34%	Q3 2025
Fee-for-Service Growth (YoY)	13%	Q3 2025
New Capitated Lives Added (Q2 2025)	Over 50,000	Q2 2025
Elevance Health Florida Partnership Expansion	Will more than double lives under capitation	Expected Q4 2025

The expansion of the fully delegated capitated partnership with Elevance Health in Florida, expected in Q4 2025, is a big deal; it will more than double the number of Medicare Advantage lives covered for that payor. Also, as of July 1, 2025, The Oncology Institute, Inc. (TOI) expanded its capitation relationship with Silver Summit Health Plan to cover all of their Medicaid patients in Clark County, Nevada.

Patient-first, physician-led care model

The model centers on delivering care through a broad network of clinicians and facilities. The Oncology Institute, Inc. (TOI) offers cancer care services to a population of approximately 1.9 million patients. This care is delivered through over 100 clinics and affiliate locations of care across five states.

The clinical leadership is substantial, with over 180 employed and affiliate clinicians driving the care delivery. You also see the physician-led structure in the hiring of Dr. Jeff Langsam as the new Chief Clinical Officer, who leads efforts around therapeutics and Utilization Management.

Technology-enabled workflows for streamlined patient experience

The Oncology Institute, Inc. (TOI) is actively integrating technology, particularly Artificial Intelligence (AI), to make processes smoother for patients and staff. They were planning to launch AI pilots around prior authorization and patient advocacy in the third quarter of 2025.

The goal for the agentic AI model rollout in Q4 2025 is aggressive:

• Submission time reduction from 18 minutes to approximately 5 seconds.
• Expected savings per authorization of over 80%.
• Estimated total operating expense efficiencies from these efficiencies could yield up to $2 million.

This focus on efficiency is key to supporting the value-based contracts.

Financial counseling to assist patients with costs

The Oncology Institute, Inc. (TOI) explicitly includes financial counseling as one of the services provided to patients. This service is part of the comprehensive care delivery model alongside infusion centers, in-house dispensary, and clinical trials.

Centralized call center for patient support

Support infrastructure includes planning for a modernized patient interface. The Oncology Institute, Inc. (TOI) was planning to launch AI pilots for a next-gen call center in the third quarter of 2025.

Finance: draft 13-week cash view by Friday.

The Oncology Institute, Inc. (TOI) - Canvas Business Model: Channels

You're looking at how The Oncology Institute, Inc. (TOI) gets its services to the patient base, which is a mix of physical presence and deep contractual relationships as of late 2025. The physical footprint is substantial, supporting the delivery of both in-person care and specialty pharmacy services.

The network of physical clinic and affiliate locations is a core channel for patient access. The Oncology Institute, Inc. (TOI) operates with over 100 clinics and affiliate locations of care across five states, and this network is growing. This physical presence is key to achieving network adequacy for their value-based contracts.

The in-house retail pharmacy and dispensary is a major revenue driver, capturing both oral and Part B drug dispensing. The performance of this channel has been consistently strong throughout 2025. Here's a quick look at the revenue generated by this segment across the first three quarters of the year:

Reporting Period	Pharmacy Revenue	Pharmacy Gross Profit
Q3 2025	$75.9 million	$12.8 million
Q2 2025	$62.6 million	Over $11 million
Q1 2025	$49.3 million	Over $9 million

Also, The Oncology Institute, Inc. (TOI) opened a new pharmacy location in Florida during the third quarter of 2025 to serve network providers requiring delivery of Part B drugs.

Direct contracts with major health plans and Medicare Advantage plans form the backbone of the value-based channel. These arrangements allow The Oncology Institute, Inc. (TOI) to manage the entire oncology benefit in some cases. The narrow network capitation contracts are projected to represent approximately $50 million of revenue for the full year 2025. These specific arrangements typically produce medical loss ratios in the mid-60% range.

The expansion of these contracts in 2025 is significant for future revenue scaling. You should note the following contract achievements:

• New capitation contracts signed across markets in 2025 are estimated to contribute $19 million of full-year 2025 revenue, representing a 29% increase to capitated revenue versus the full year 2024.
• Three new capitation agreements secured in 2025 added roughly 80,000 lives across Florida, California, and Nevada markets.
• A new capitation contract in Nevada, effective July 1, added over 80,000 Medicaid lives in Clark County.
• The total number of lives The Oncology Institute, Inc. (TOI) has under risk as of the second quarter of 2025 was right around 1.9 million lives.
• Expansion in Florida with Elevance Health is set to add over 40,000 additional Medicare Advantage lives, which more than doubles the relationship with that payer as measured by Medicare Advantage lives under capitation.
• The projected total Medicare Advantage lives under capitation in the Florida market across all payers is over 100,000.

Referral networks from primary care physicians and specialists remain a critical source for Fee-For-Service revenue. The company has been making investments in referral relationship management and call center expansion, which contributed to a 9% fee-for-service growth in Q1 2025 over Q4 2024. The provider network itself is a combination of employed oncologists and clinics, and those affiliated through contracted or MSO (Management Services Organization) arrangements with health plan partners. This leveraging of the health plan partners network allows for quicker scaling.

For technology-enabled engagement, The Oncology Institute, Inc. (TOI) is actively piloting new systems. They are planning to launch AI pilots around prior authorization, patient advocacy, and a next-generation call center in the third quarter of 2025. This focus on technology efficiencies is helping reduce SG&A as a percentage of revenue; for instance, SG&A, excluding depreciation and amortization, was 18.5% of revenue in Q3 2025, a reduction of approximately 820 basis points versus a year ago. Defintely, this tech push supports the value-based model by enabling real-time views into utilization trends.

The Oncology Institute, Inc. (TOI) - Canvas Business Model: Customer Segments

You're looking at the core patient base that fuels The Oncology Institute, Inc. (TOI)'s entire value-based strategy as of late 2025. This isn't just about volume; it's about the type of financial arrangement underpinning the care delivery.

The total population under TOI's care umbrella is substantial, providing a wide base for both risk-bearing and traditional revenue streams. The company offers evidence-based cancer care to a population of approximately 1.9 million patients across its operating footprint, which includes clinical trials and other care delivery models. This figure represents the total reach across their employed and affiliate clinicians and clinic locations.

The most strategically important segment is those under value-based contracts, as this drives the shift toward lower-cost, outcome-focused care. The expansion in this area has been aggressive through 2025.

Customer Segment Detail	Metric	Value/Amount (Late 2025 Data)
Total Population Served	Total Patients Under Care	1.9 million
Value-Based Contracts	Lives Managed in Florida (Value-Based)	Over 200,000
Value-Based Contracts	New Capitated Lives Added in 2025 (Approximate)	Roughly 80,000
Value-Based Contracts	Total Capitated Lives Covered (Mid-2025)	Over 100,000
Value-Based Contracts	Projected Additional Lives by Year-End 2025	Another 100,000
Medicaid Patients (Value-Based)	New Medicaid Lives Added in Nevada (Effective July 1, 2025)	Over 80,000
Fee-for-Service (FFS)	Q1 2025 FFS Revenue	$35.6 million
FFS Growth	Q2 2025 Year-over-Year FFS Growth	10%
Clinical Trials	Q3 2025 Clinical Trials & Other Revenue (in millions)	Reported as $474 (Context dependent, likely in thousands or a small unit)

You can see the focus is clearly on migrating the patient base into risk-bearing arrangements. The addition of over 80,000 Medicaid lives via a new capitation deal in Nevada, effective July 1, 2025, is a prime example of capturing government-sponsored lives under a value-based structure.

The Fee-for-Service (FFS) segment remains a significant component, though it is being managed for efficiency while the value-based contracts scale up. For instance, FFS revenue grew 10% year-over-year in the second quarter of 2025, showing continued organic strength in markets like Florida and Oregon.

The relationships with payers are formalized through contracts with various entities:

• Health plans entering into fully-delegated capitation agreements, such as the one started in Florida on March 1, 2025, which included delegation for Utilization Management and Claims and Network.
• At-risk provider groups, including winning sole source designation for a major captive provider group within an existing region during the first half of 2025.

Finally, pharmaceutical companies represent a distinct customer segment, primarily through the Clinical Trials business unit. While this segment saw a non-cash write-off of net assets in Q2 2025, it remains a service line that supports the overall patient care ecosystem.

Finance: draft 13-week cash view by Friday.

The Oncology Institute, Inc. (TOI) - Canvas Business Model: Cost Structure

You're looking at the hard numbers driving The Oncology Institute, Inc. (TOI)'s operations as of late 2025, specifically focusing on what it costs to run their integrated model. Honestly, for a company balancing fee-for-service with capitation, the cost structure is a mix of high-volume drug costs and fixed clinical overhead.

The primary cost drivers are clearly visible in the direct costs associated with their revenue streams. For the third quarter ended September 30, 2025, the company reported significant direct costs across patient services and dispensary operations. The dispensary side, which handles specialty pharmacy drugs, is a major component, reflecting the cost of the high-value oncology medications they dispense.

Here is a breakdown of the key direct costs for the three months ended September 30, 2025, in thousands of US dollars:

Cost Component	Q3 2025 Amount (in thousands)	Notes
Direct costs - patient services	$54,572	Includes provider and clinical staff costs, and drug costs for infusion/services.
Direct costs - dispensary	$63,072	Primarily the cost of specialty pharmacy drugs dispensed.
Direct costs - clinical trials & other	-	Reported as negligible or not separately itemized in the Q3 2025 direct cost summary.
Selling, General & Administrative (SG&A) Expense	$25,300	Represents 18.5% of total Q3 2025 revenue.

Cost of Goods Sold (COGS) for specialty pharmacy drugs is heavily represented by the Direct costs - dispensary line item. For Q3 2025, this was $63,072 thousand. This cost directly correlates with the $75.9 million in revenue generated by the Retail Pharmacy and Dispensary segment in that quarter. To be fair, the gross profit on that segment was $12.8 million, meaning the COGS is the bulk of the dispensary revenue.

Provider and clinical staff salaries are embedded within the Direct costs - patient services, which totaled $54,572 thousand for the quarter. This category covers oncologists, nurses, and other health professionals whose wages are expensed as incurred. Looking back at Q1 2025, the company noted a 2.6% decrease in clinical payroll costs due to compensation adjustments and increased use of advanced practice providers, showing an active management of this large cost center.

Operating expenses (OpEx) for clinics and corporate overhead are captured primarily in the SG&A figure. The Q3 2025 SG&A was $25.3 million. Management highlighted that this represented an operating leverage improvement, as SG&A as a percentage of revenue decreased to 18.5% from 26.7% a year ago. This efficiency gain suggests better absorption of corporate overhead across a growing revenue base, which was $136.6 million in Q3 2025.

Technology and AI implementation costs are being managed through specific projects. While the exact implementation cost for the AI rollout wasn't itemized as a single OpEx line, the expected benefit is clear. The company announced that its agentic AI model for prior authorizations is expected to reduce submission time from 18 minutes to about 5 seconds, delivering savings per authorization of over 80%, which management estimated could yield up to $2 million in operating expense efficiencies in the near term.

Costs associated with managing medical loss ratio (MLR) risk manifest as adjustments related to their value-based contracts. A concrete example of this risk management cost in Q3 2025 was the $1.8 million reserve taken against fee-for-service revenue. This reserve directly impacts gross profit and reflects the company's conservative accounting for potential revenue adjustments under their evolving contract structures, especially as they expand their delegated capitation model.

• Capitated Revenue growth in Q3 2025 was 38.9% year-over-year.
• The company achieved its first adjusted EBITDA positive month in September 2025.
• Full-year 2025 Adjusted EBITDA guidance improved to a loss range of $(11) million to $(13) million.
• The company raised full-year 2025 revenue guidance to $495 million to $505 million.

Finance: draft 13-week cash view by Friday.

The Oncology Institute, Inc. (TOI) - Canvas Business Model: Revenue Streams

Specialty Pharmacy/Dispensary revenue: $75.9 million in Q3 2025. This segment set fill records in the third quarter.

Capitation revenue from value-based contracts (recurring revenue): For the quarter ended September 30, 2025, Patient Services Revenue totaled $60.2 million, with capitation accounting for 34% of that total.

Fee-for-Service (FFS) revenue from patient services: The FFS portion of Patient Services Revenue was 66% of the $60.2 million in Q3 2025. This segment showed 13% year-over-year growth compared to Q3 2024.

Delegated utilization management and advisory services fees: These fees are embedded within the value-based contract structure, exemplified by the Florida delegated capitation partnership.

Clinical trial revenue from pharmaceutical sponsors: The Oncology Institute, Inc. offers care to a population including clinical trials.

Here's a quick look at the Q3 2025 revenue composition:

Revenue Stream Component	Q3 2025 Amount	Percentage of Patient Services Revenue
Specialty Pharmacy/Dispensary Revenue	$75.9 million	N/A
Total Patient Services Revenue	$60.2 million	100%
Capitation Revenue (from Patient Services)	Approximately $20.47 million	34%
Fee-for-Service (FFS) Revenue (from Patient Services)	Approximately $39.73 million	66%

The Oncology Institute, Inc. (TOI) reported consolidated revenue of $136.6 million for the third quarter of 2025, representing a 36.7% increase year-over-year.

The updated full-year 2025 revenue guidance is between $495 million and $505 million.

The revenue streams contributing to the overall business include:

• Retail Pharmacy and Dispensary revenue of $75.9 million in Q3 2025.
• Patient Services Revenue of $60.2 million in Q3 2025.
• The company is reinforcing its expectation to achieve profitability in the fourth quarter of 2025.
• The company expects Adjusted EBITDA of approximately $0 to $2 million in the fourth quarter of 2025.