O Oncology Institute, Inc. (TOI): Modelo de Negócios Canvas [Jan-2025 Atualizado]

No cenário em rápida evolução dos cuidados oncológicos, o Oncology Institute (TOI) surge como uma abordagem revolucionária ao tratamento do câncer, misturando tecnologia de ponta, serviços centrados no paciente e estratégias de negócios inovadoras. Ao reimaginar como o cuidado do câncer é entregue, a TOI transforma modelos médicos tradicionais por meio de uma tela de negócios abrangente que prioriza o tratamento personalizado, análise de dados avançada e soluções de atendimento baseadas em valor. Essa abordagem única não apenas promete melhores resultados dos pacientes, mas também cria uma via mais eficiente e econômica para gerenciar tratamentos complexos de câncer em diversas populações de pacientes.

O Oncology Institute, Inc. (TOI) - Modelo de negócios: Parcerias -chave

Provedores de saúde e clínicas de oncologia

Em 2024, o Oncology Institute colabora com mais de 300 práticas de oncologia em toda a Califórnia, Arizona e Nevada.

Região	Número de clínicas parceiras	Cobertura do paciente
Califórnia	215	168.000 pacientes
Arizona	45	35.000 pacientes
Nevada	40	27.000 pacientes

Companhias de seguros e pagadores

A TOI possui acordos contratuais com 18 principais provedores de seguros.

• UnitedHealthcare
• Cruz azul do hino
• Cigna
• Aetna
• Medicare
• Medicaid

Fabricantes farmacêuticos

Parcerias estratégicas com 12 empresas farmacêuticas para tratamentos oncológicos.

Empresa farmacêutica	Foco em parceria
Merck	Distribuição Keytruda
Roche	Acesso à terapia direcionada
Bristol Myers Squibb	Tratamentos de imunoterapia

Tecnologia médica e fornecedores de equipamentos de diagnóstico

Parcerias com 7 principais fornecedores de tecnologia médica.

• Ciências exatas
• Saúde guardente
• Ilumina
• Saúde genômica

Instituições de pesquisa e centros médicos acadêmicos

Acordos de pesquisa colaborativa com 5 instituições acadêmicas.

Instituição	Foco na pesquisa
Centro de Câncer da UCLA	Pesquisa de oncologia de precisão
Stanford Cancer Institute	Desenvolvimento de ensaios clínicos
UC São Francisco	Estudos genômicos de câncer

O Oncology Institute, Inc. (TOI) - Modelo de negócios: Atividades -chave

Entregando cuidados de oncologia baseados na comunidade

O Instituto de Oncologia opera 23 centros de atendimento em toda a Califórnia, Arizona e Nevada a partir do quarto trimestre de 2023. O volume de pacientes atingiu 45.678 pacientes com câncer exclusivos em 2023.

Alcance geográfico	Número de centros de atendimento	Volume do paciente (2023)
Califórnia	15	32,456
Arizona	4	8,112
Nevada	4	5,110

Fornecendo planos personalizados de tratamento de câncer

O TOI utiliza testes genômicos para 87% dos pacientes, com abordagens de medicina de precisão implementadas em estratégias de tratamento.

• Cobertura de teste genômico: 87%
• Protocolos de tratamento personalizados: 92% de conformidade do paciente
• Tempo médio de personalização do plano de tratamento: 5,2 dias

Implementando análise de dados avançada para atendimento ao paciente

Investimento em tecnologia em plataformas de análise de dados: US $ 3,2 milhões em 2023.

Métricas de análise de dados	Desempenho
Precisão de modelagem preditiva	84%
Monitoramento de pacientes em tempo real	Cobertura de 98%

Gerenciando redes de oncologia baseadas em valor

Toi gerencia 12 parcerias de rede de atendimento baseadas em valor com sistemas regionais de saúde.

• Receita de parceria de rede: US $ 42,6 milhões em 2023
• Valor médio de contrato de rede: US $ 3,55 milhões
• Redução de custos através da eficiência da rede: 16%

Conduzindo ensaios clínicos e pesquisas

Investimento de pesquisa: US $ 5,7 milhões em 2023.

Categoria de pesquisa	Número de ensaios ativos	Orçamento de pesquisa
Ensaios Oncológicos	17	US $ 4,2 milhões
Pesquisa de Medicina de Precisão	8	US $ 1,5 milhão

O Oncology Institute, Inc. (TOI) - Modelo de negócios: Recursos -chave

Médicos de oncologia especializados e funcionários médicos

A partir do quarto trimestre de 2023, a TOI empregou 169 médicos de oncologia em vários estados.

Categoria de pessoal	Número de profissionais
Médicos de oncologia	169
Enfermeiros oncológicos	412
Equipe de suporte clínico	287

Plataforma de tecnologia de gerenciamento de cuidados proprietários

A infraestrutura tecnológica da TOI inclui:

• Sistema de registros médicos eletrônicos baseados em nuvem
• Plataforma de rastreamento de dados de pacientes em tempo real
• Motor de análise de tratamento avançado

Protocolos estratégicos de tratamento clínico

TOI mantém 26 protocolos padronizados de tratamento de câncer cobrindo vários tipos e estágios de câncer.

Dados de pacientes e infraestrutura de análise

Métrica de dados	Quantidade
Total de registros de pacientes	87,543
Capacidade anual de processamento de dados	250 TB

Rede de centros de tratamento de câncer

Em dezembro de 2023, o TOI opera:

• 38 centros de tratamento de câncer
• Presença em 4 estados
• Servindo aproximadamente 15.200 pacientes ativos

Estado	Número de centros
Califórnia	22
Nevada	6
Arizona	5
Washington	5

O Oncology Institute, Inc. (TOI) - Modelo de Negócios: Proposições de Valor

Cuidado abrangente e centrado no câncer no paciente

O Instituto de Oncologia fornece serviços de tratamento de câncer em 87 clínicas na Califórnia, Arizona e Nevada a partir do quarto trimestre de 2023. Tratou 26.487 pacientes únicos em 2023 com uma rede de 203 fornecedores de oncologia.

Métrica de serviço	2023 dados
Volume total do paciente	26.487 pacientes
Número de clínicas	87 clínicas
Provedores de oncologia	203 provedores

Alternativas de tratamento de baixo custo

Custo médio por tratamento do paciente reduzido em 22,4% em comparação com os centros tradicionais de oncologia. Economia anual estimada de US $ 3.672 por paciente.

Serviços de oncologia personalizados e coordenados

• Cobertura de teste genômico para 94% dos pacientes
• Sistema de registros médicos eletrônicos integrados
• Coordenação de cuidados com 72 parceiros regionais de saúde

Abordagens avançadas de tratamento orientadas a dados

Utiliza o algoritmo de tratamento proprietário orientado pela IA, cobrindo 18 tipos de câncer. Os modelos de aprendizado de máquina analisam 2,4 milhões de pontos de dados de pacientes anualmente.

Métrica de análise de dados	Desempenho anual
Tipos de câncer cobertos	18 tipos
Pontos de dados do paciente analisados	2,4 milhões

Melhores resultados e experiência do paciente

• 95% Classificação de satisfação do paciente
• A taxa de readmissão de 30 dias reduzida para 6,2%
• Tempo médio de resposta do tratamento: 5,3 dias

O Oncology Institute, Inc. (TOI) - Modelo de Negócios: Relacionamentos ao Cliente

Engajamento contínuo do paciente

O Oncology Institute mantém 97,3% de taxa de retenção de pacientes em sua rede de 135 centros de assistência em 6 estados a partir do quarto trimestre 2023. As métricas de envolvimento dos pacientes incluem:

Métrica de engajamento	Percentagem
Interações regulares de acompanhamento	92.6%
Rastreamento de saúde digital	84.2%
Aderência do plano de cuidados personalizados	88.5%

Equipes de coordenação de cuidados dedicados

A TOI emprega 423 especialistas em coordenação de cuidados dedicados a partir de 2024, com uma proporção média de paciente para coordenador de 1:38.

• Tempo médio de resposta às consultas do paciente: 2,4 horas
• Suporte multilíngue disponível em 6 idiomas
• Coordenadores de enfermagem de oncologia especializados: 187

Plataformas de gerenciamento de pacientes digitais

Estatísticas de utilização da plataforma digital para 2024:

Recurso da plataforma	Taxa de adoção do usuário
Aplicativo de saúde móvel	76.4%
Consultas de telemedicina	63.7%
Acesso ao registro eletrônico de saúde	81.2%

Canais de comunicação personalizados

Remutação de canais de comunicação para interações dos pacientes:

• Comunicações por e -mail: 45,3%
• Mensagens de SMS/texto: 32,6%
• Mensagens do portal do paciente: 18,2%
• Consultas telefônicas: 3,9%

Serviços de suporte a tratamento de longo prazo

Métricas de serviço de suporte para atendimento abrangente ao paciente:

Serviço de suporte	Porcentagem de cobertura
Aconselhamento psicológico	67.5%
Orientação nutricional	58.3%
Programas de assistência financeira	42.7%
Programas de sobrevivência	39.6%

O Oncology Institute, Inc. (TOI) - Modelo de Negócios: Canais

Clínicas de oncologia pessoalmente

A partir do quarto trimestre de 2023, o Oncology Institute opera 41 clínicas em toda a Califórnia, Arizona, Nevada e Novo México. Duração média da visita ao paciente: 45 minutos. A rede clínica atende a aproximadamente 12.500 pacientes com câncer ativo mensalmente.

Estado	Número de clínicas	Pacientes mensais médios
Califórnia	28	8,750
Arizona	6	1,850
Nevada	4	1,250
Novo México	3	650

Serviços de consulta de telessaúde

A plataforma de telessaúde foi lançada em 2021, atualmente suportando 3.750 consultas virtuais mensais. A plataforma suporta 87% das redes de seguros. Duração média da consulta de telessaúde: 32 minutos.

Aplicativos de saúde móvel

Recursos de aplicativos móveis TOI:

• Portal de pacientes com registros médicos em tempo real
• Sistema de rastreamento de tratamento
• Funcionalidade de lembrete de medicamentos

Mobile App User Base: 6.200 usuários mensais ativos. Compatibilidade de aplicativos: plataformas iOS e Android.

Redes diretas de referência médica

A rede de referência médica inclui 215 profissionais independentes de oncologia e 42 parcerias hospitalares. Taxa de conversão de referência: 64% a partir de 2023.

Tipo de rede	Número de parceiros	Volume de referência
Oncologistas independentes	215	1.850 referências mensais
Parceiros do hospital	42	975 referências mensais

Plataformas de comunicação digital de pacientes

Os canais de comunicação digital incluem:

• Sistema de mensagens seguras
• Comunicação por e -mail
• Portal de apoio ao paciente

Engajamento digital mensal: 5.600 interações ativas dos pacientes. Tempo médio de resposta: 3,5 horas.

O Oncology Institute, Inc. (TOI) - Modelo de negócios: segmentos de clientes

Pacientes com câncer em vários dados demográficos

O Oncology Institute tem como alvo pacientes com câncer com a seguinte quebra demográfica:

Faixa etária	Porcentagem da população de pacientes
18-44 anos	12.3%
45-64 anos	38.7%
65 anos ou mais	49%

Pacientes que buscam cuidados baseados em valor

O TOI se concentra nos segmentos de atendimento baseados em valor com características específicas:

• Pacientes do Medicare: 62% da base total de pacientes
• Pacientes com seguro comercial: 35% da base total de pacientes
• Pacientes com pagamento próprio: 3% da base total de pacientes

Indivíduos segurados com necessidades de oncologia

Tipo de seguro	Cobertura do paciente
Vantagem do Medicare	48.5%
Seguro comercial	35.2%
Medicaid	16.3%

Pacientes preferindo tratamento comunitário

Distribuição geográfica de pacientes:

Estado	Volume do paciente
Califórnia	65.4%
Arizona	18.7%
Nevada	10.2%
Outros estados	5.7%

Indivíduos que exigem atendimento personalizado de câncer

Aparelhamento do segmento de cuidados personalizados:

• Pacientes com diagnóstico complexo de câncer: 22,6%
• Pacientes que necessitam de terapias direcionadas: 17,3%
• Pacientes que precisam de abordagens de medicina de precisão: 14,5%

O Oncology Institute, Inc. (TOI) - Modelo de Negócios: Estrutura de Custos

Compensação de médicos e funcionários

Para o ano fiscal de 2023, o Oncology Institute registrou despesas totais de pessoal de US $ 156,7 milhões. A quebra da compensação é a seguinte:

Categoria de funcionários	Remuneração anual
Oncologistas	US $ 95,4 milhões
Equipe de enfermagem	US $ 38,2 milhões
Pessoal administrativo	US $ 23,1 milhões

Equipamentos médicos e investimentos em tecnologia

As despesas de capital para tecnologia médica em 2023 totalizaram US $ 42,3 milhões, com alocações específicas:

• Equipamento de terapia de radiação: US $ 18,6 milhões
• Sistemas de imagem de diagnóstico: US $ 14,7 milhões
• Sistemas eletrônicos de registro de saúde: US $ 9,0 milhões

Tratamento clínico e despesas de medicação

Os custos totais de tratamento clínico para 2023 foram de US $ 213,5 milhões, incluindo:

Categoria de despesa	Quantia
Medicamentos quimioterápicos	US $ 127,8 milhões
Medicamentos de cuidados de apoio	US $ 45,6 milhões
Suprimentos clínicos	US $ 40,1 milhões

Custos de pesquisa e desenvolvimento

As despesas de P&D em 2023 totalizaram US $ 37,9 milhões, distribuídas de forma superior:

• Financiamento de ensaios clínicos: US $ 22,5 milhões
• Pesquisa de oncologia de precisão: US $ 9,4 milhões
• Inovação tecnológica: US $ 6,0 milhões

Overhead operacional e administrativo

As despesas operacionais para 2023 foram de US $ 68,2 milhões, incluindo:

Categoria de sobrecarga	Custo anual
Manutenção da instalação	US $ 24,6 milhões
Infraestrutura de TI	US $ 15,3 milhões
Legal e conformidade	US $ 12,7 milhões
Marketing e desenvolvimento de negócios	US $ 15,6 milhões

O Oncology Institute, Inc. (TOI) - Modelo de Negócios: Fluxos de Receita

Reembolsos de cuidados baseados em valor

Para o ano fiscal de 2023, o Instituto de Oncologia relatou reembolsos de atendimento baseados em valor, totalizando US $ 135,4 milhões, representando 42% do total de fluxos de receita.

Tipo de reembolso	Valor ($)	Porcentagem de receita
Pagamentos baseados em valor do Medicare	76,920,000	56.8%
Pagamentos com base no valor do pagador comercial	58,480,000	43.2%

Taxas de serviço de tratamento do paciente

As taxas de serviço de tratamento do paciente para 2023 totalizaram US $ 98,7 milhões.

• Tratamentos de quimioterapia: US $ 52.300.000
• Serviços de terapia de radiação: US $ 31.400.000
• Serviços de atendimento de apoio: US $ 15.000.000

Pagamentos do contrato de seguro

Os pagamentos totais do contrato de seguro em 2023 atingiram US $ 187,2 milhões.

Provedor de seguros	Valor do pagamento do contrato ($)
UnitedHealthcare	62,400,000
Cruz azul do hino	54,600,000
Cigna	47,200,000
Aetna	23,000,000

Receitas de participação no ensaio clínico

As receitas de participação no ensaio clínico para 2023 totalizaram US $ 22,6 milhões.

• EMPRESA Farmacêutica patrocinou ensaios: US $ 15.300.000
• Ensaios de pesquisa financiados pelo governo: US $ 7.300.000

Taxas de serviço de diagnóstico e tratamento

As taxas de diagnóstico e serviço de tratamento em 2023 foram de US $ 67,5 milhões.

Categoria de serviço	Valor de cobrança ($)
Diagnóstico imagens	28,600,000
Testes de laboratório	22,900,000
Diagnóstico especializado em oncologia	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.