The Oncology Institute, Inc. Q4 FY2025 earnings call

• CEO Dan Vernick thanked physicians, clinicians, and employees. Fourth quarter was first profitable quarter as public company from adjusted EBITDA perspective. Reaffirmed expectation to achieve full-year positive adjusted EBITDA in 2026. • Big driver of progress is expansion of capitated care model, especially delegated arrangements. • 2025 was productive year: revenue up ~28% to over $500 million, initiated nine new capitated contracts in 2025 in California, Florida, Nevada (~260,000 additional patient lives). Pharmacy segment reached almost $270M in total revenue. • Operationally: SG&A declined 2% y/y. Outsourced clinical trials operations. Reduced debt on convertible preferred note by $24 million, ended year with $33.6 million in cash after positive free cash flow in Q4. • In Florida: Delegated capitation partnership with Elements continued to ramp, on track to expand more in 2026. Initiated capitation agreements with Humana and Care Plus in fourth quarter. Florida Oncology Network platform grew with ~207 participating providers. • Strengthened leadership team in 2025 with additions of Chief Clinical Officer and Chief Administrative Officer. • In 2026: Focus on scaling and driving profitability in value-based care platform. Expect continued strong growth in delegated capitation model (guided to over 80% growth in capitated revenue). Prepare to launch proprietary new network portal in Q2. Strengthened board of directors in Q1 with additions of Mark Stolper and Kim Zumakis

Patient services revenue: In fourth quarter, patient services revenue (including capitation and fee-for-service) totaled $59.8 million, 42.2% of total revenue, up 19.2% y/y. Fee-for-service contributed ~25.6% of total revenue, capitation 16.6%. Pharmacy revenue: $81.4 million in fourth quarter, 57.4% of total revenue, up 71.1% y/y. Full year 2025: Revenue grew ~27.8% to $502.7 million. Fee-for-service grew 9% to $148.5 million. Capitation grew 17.2% to $80.5 million. Pharmacy revenue grew 49.6% to $269.2 million. Pharmacy segment reached almost $270 million in total revenue and contributed close to $50 million in gross profit for full year. Gross profit in fourth quarter: $22.7 million, up from $14.6 million in prior year. Patient services gross profit $7.1 million, up from $4.5 million y/y. Pharmacy gross profit $14.9 million, up from $8.1 million y/y. Adjusted EBITDA in fourth quarter: $147,000, improving from negative $7.8 million in prior year's fourth quarter

• Full year 2026 guidance: Revenue $630 million to $650 million. Approximately $150 million of capitated revenue. Gross profit $97 million to $107 million. Adjusted EBITDA $0 to $9 million. Free cash flow negative $15 million to $5 million. • First quarter 2026 anticipated to have adjusted EBITDA loss between $3 million and $1 million due to seasonality (patients' deductible resets and lagged pharmaceutical reimbursement adjustments). • Pharmacy performance assumed to be in line with second half 2025 revenue run rate of ~$27 million per month plus 3% to 5% incremental growth from attachment to new capitation lives. • Gross profit expected to grow slightly ahead of revenue, gross margins improving by 100 to 200 basis points. SG&A expected to trend down to ~16% of revenue. Expect to achieve free cash flow positivity by end of 2026

Q: Congratulations on the good quarter and year. For dispensing revenue in the quarter, driver and expectation for 2026?

A: Fourth quarter dispensing revenue strong due to mitigating script leakage and strong patient encounter growth related to capitated contract growth.

Q: Did I hear you say you're going to double the size of your Elevance contract in Florida in 2026?

A: Yes, that's the goal.

Q: Is the Humana contract a new contract signed in fourth quarter or first quarter?

A: Effective in fourth quarter, for Medicare Advantage Lives in South Florida on behalf of risk-bearing medical groups.

Q: Could you give a sense for TAM of Elevance or Humana?

A: Publicly available data on MA penetration in Florida by payer shows many multiples of current capitated revenue, tremendous opportunity.

Q: For capitated revenue, how are margins, volumes, cost trends?

A: Performance in terms of volume and MLR is good, coming in as expected.

Q: With guidance, ramp up of capitated contracts in delegated networks, anticipate dip in profit margins in mid-2026?

A: Specific to delegated contracts, may see slightly higher MLR, but not a dip at aggregate level.

Q: On press release, details of affiliated and network clinics?

A: 80 employed sites of care across five states, network over 200 by headcount in Florida now, totals close to 300 combined.

Q: On CAR T, do you anticipate adding to treatment offerings?

A: Across the board, do not take risk on CAR T currently, but may consider adding if utilization and indications grow.

Q: Wins in quarter with Humana and Care+, commentary on deals?

A: Both net new payer partner ads in South Florida, won due to reputation for access and high-quality care, coordinating with referring primary care physicians.

Q: AI related efficiencies in 2026 guide?

A: Expect $2 million in SG&A savings from AI-related efficiencies across prior authorization, call center, and RCM, with savings expanding over time.

Q: Thoughts on SG&A in 2026?

A: Will see improvements, not to the degree of 2025, with some investment for growth but discipline maintained.

Q: Expect free cash flow positive in 2026?

A: Exiting and second half of the year, yes.

Q: Underlying assumptions for $160 million revenue guidance with CapitaJ contract?

A: Have ~$50 million of run rate revenue from Florida-based delegated contracts, healthy pipeline within existing markets, opportunistic about expansion if right opportunity comes.

Q: Positioning in lower rate environment?

A: MA rate cycle is a tailwind for TOI, top line Medicare Advantage reimbursement not impacted by risk adjustment, pressure on payers drives them to seek opportunities, our care model with combination of employed and network providers helps protect contract terms