El Instituto de Oncología, Inc. (TOI): Lienzo del Modelo de Negocio [Actualizado en Ene-2025]

En el panorama en rápida evolución de la atención oncológica, el Instituto de Oncología (TOI) surge como un enfoque revolucionario para el tratamiento del cáncer, combinando tecnología de vanguardia, servicios centrados en el paciente y estrategias comerciales innovadoras. Al reinventar cómo se brinda la atención del cáncer, TOI transforma los modelos médicos tradicionales a través de un lienzo comercial integral que prioriza el tratamiento personalizado, el análisis de datos avanzados y las soluciones de atención basadas en el valor. Este enfoque único no solo promete mejores resultados del paciente, sino que también crea una vía más eficiente y rentable para controlar los tratamientos complejos de cáncer en diversas poblaciones de pacientes.

The Oncology Institute, Inc. (TOI) - Modelo de negocios: asociaciones clave

Proveedores de atención médica y clínicas de oncología

A partir de 2024, el Instituto de Oncología colabora con más de 300 prácticas de oncología en California, Arizona y Nevada.

Región	Número de clínicas asociadas	Cobertura del paciente
California	215	168,000 pacientes
Arizona	45	35,000 pacientes
Nevada	40	27,000 pacientes

Compañías de seguros y pagadores

TOI tiene acuerdos contractuales con 18 principales proveedores de seguros.

• UnitedHealthcare
• Himno cruzado
• Cigna
• Aetna
• Seguro médico del estado
• Seguro de enfermedad

Fabricantes farmacéuticos

Asociaciones estratégicas con 12 compañías farmacéuticas para tratamientos de oncología.

Compañía farmacéutica	Enfoque de asociación
Merck	Distribución de keytruda
Roche	Acceso de terapia dirigida
Bristol Myers Squibb	Tratamientos de inmunoterapia

Proveedores de tecnología médica y equipos de diagnóstico

Asociaciones con 7 principales proveedores de tecnología médica.

• Ciencias exactas
• Salud de Buardant
• Ilumina
• Salud genómica

Instituciones de investigación y centros médicos académicos

Acuerdos de investigación colaborativos con 5 instituciones académicas.

Institución	Enfoque de investigación
Centro de cáncer de UCLA	Investigación de oncología de precisión
Instituto de Cáncer de Stanford	Desarrollo de ensayos clínicos
UC San Francisco	Estudios de cáncer genómico

The Oncology Institute, Inc. (TOI) - Modelo de negocio: actividades clave

Brindar atención oncológica basada en la comunidad

El Instituto de Oncología opera 23 centros de atención en California, Arizona y Nevada a partir del cuarto trimestre de 2023. El volumen del paciente alcanzó 45,678 pacientes con cáncer únicos en 2023.

Alcance geográfico	Número de centros de atención	Volumen del paciente (2023)
California	15	32,456
Arizona	4	8,112
Nevada	4	5,110

Proporcionar planes personalizados de tratamiento del cáncer

TOI utiliza pruebas genómicas para el 87% de los pacientes, con enfoques de medicina de precisión implementados en estrategias de tratamiento.

• Cobertura de prueba genómica: 87%
• Protocolos de tratamiento personalizados: 92% Cumplimiento del paciente
• Tiempo de personalización del plan de tratamiento promedio: 5.2 días

Implementación de análisis de datos avanzados para la atención al paciente

Inversión tecnológica en plataformas de análisis de datos: $ 3.2 millones en 2023.

Métricas de análisis de datos	Actuación
Precisión de modelado predictivo	84%
Monitoreo del paciente en tiempo real	Cobertura del 98%

Gestión de redes de oncología de atención basadas en el valor

TOI maneja 12 asociaciones de red de atención basadas en el valor con sistemas de salud regionales.

• Ingresos de asociación de red: $ 42.6 millones en 2023
• Valor promedio del contrato de red: $ 3.55 millones
• Reducción de costos a través de la eficiencia de la red: 16%

Realización de ensayos clínicos e investigación

Inversión de investigación: $ 5.7 millones en 2023.

Categoría de investigación	Número de pruebas activas	Presupuesto de investigación
Pruebas de oncología	17	$ 4.2 millones
Investigación de medicina de precisión	8	$ 1.5 millones

The Oncology Institute, Inc. (TOI) - Modelo de negocios: recursos clave

Médicos de oncología especializada y personal médico

A partir del cuarto trimestre de 2023, TOI empleó 169 médicos de oncología en múltiples estados.

Categoría de personal	Número de profesionales
Médicos de oncología	169
Enfermeras oncológicas	412
Personal de apoyo clínico	287

Plataforma de tecnología de gestión de atención patentada

La infraestructura tecnológica de TOI incluye:

• Sistema de registros médicos electrónicos basado en la nube
• Plataforma de seguimiento de datos de pacientes en tiempo real
• Motor de análisis de tratamiento avanzado

Protocolos estratégicos de tratamiento clínico

TOI mantiene 26 Protocolos estandarizados de tratamiento del cáncer cubriendo varios tipos y etapas de cáncer.

Infraestructura de datos y análisis de pacientes

Métrico de datos	Cantidad
Registros totales de pacientes	87,543
Capacidad de procesamiento de datos anual	250 TB

Red de centros de tratamiento del cáncer

A diciembre de 2023, TOI opera:

• 38 centros de tratamiento del cáncer
• Presencia en 4 estados
• Atender aproximadamente 15,200 pacientes activos

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

The Oncology Institute, Inc. (TOI) - Modelo de negocio: propuestas de valor

Cuidado integral de cáncer centrado en el paciente

El Instituto de Oncología proporciona servicios de tratamiento del cáncer en 87 clínicas en California, Arizona y Nevada a partir del cuarto trimestre de 2023. Trató 26,487 pacientes únicos en 2023 con una red de 203 proveedores de oncología.

Métrico de servicio	2023 datos
Volumen total del paciente	26,487 pacientes
Número de clínicas	87 clínicas
Proveedores de oncología	203 proveedores

Alternativas de tratamiento de menor costo

Costo promedio por paciente El tratamiento reducido en un 22,4% en comparación con los centros de oncología tradicionales. Ahorros anuales estimados de $ 3,672 por paciente.

Servicios de oncología personalizados y coordinados

• Cobertura de prueba genómica para el 94% de los pacientes
• Sistema integrado de registros médicos electrónicos
• Coordinación de la atención con 72 socios de atención médica regional

Enfoques de tratamiento con datos avanzados

Utiliza un algoritmo de tratamiento propietario impulsado por la IA que cubre 18 tipos de cáncer. Los modelos de aprendizaje automático analizan 2,4 millones de puntos de datos del paciente anualmente.

Métrica de análisis de datos	Rendimiento anual
Tipos de cáncer cubiertos	18 tipos
Puntos de datos del paciente analizados	2.4 millones

Mejores resultados y experiencia del paciente

• 95% de calificación de satisfacción del paciente
• La tasa de readmisión de 30 días reducida al 6.2%
• Tiempo de respuesta mediana del tratamiento: 5.3 días

The Oncology Institute, Inc. (TOI) - Modelo de negocios: relaciones con los clientes

Compromiso continuo del paciente

El Instituto de Oncología mantiene el 97.3% de la tasa de retención de los pacientes en su red de 135 centros de atención en 6 estados a partir del cuarto trimestre de 2023. Las métricas de participación del paciente incluyen:

Métrico de compromiso	Porcentaje
Interacciones de seguimiento regulares	92.6%
Seguimiento de salud digital	84.2%
Adherencia al plan de atención personalizada	88.5%

Equipos de coordinación de atención dedicados

TOI emplea 423 especialistas en coordinación de atención dedicada a partir de 2024, con una relación promedio de paciente a coordinador de 1:38.

• Tiempo de respuesta promedio para consultas del paciente: 2.4 horas
• Soporte multilingüe disponible en 6 idiomas
• Coordinadores de enfermería de oncología especializada: 187

Plataformas de gestión de pacientes digitales

Estadísticas de utilización de la plataforma digital para 2024:

Característica de la plataforma	Tasa de adopción de usuarios
Aplicación de salud móvil	76.4%
Consultas de telemedicina	63.7%
Acceso al registro de salud electrónica	81.2%

Canales de comunicación personalizados

Desglose del canal de comunicación para las interacciones del paciente:

• Comunicaciones por correo electrónico: 45.3%
• SMS/Mensajes de texto: 32.6%
• Mensaje del portal del paciente: 18.2%
• Consultas telefónicas: 3.9%

Servicios de soporte de tratamiento a largo plazo

Métricas de servicio de apoyo para la atención integral del paciente:

Servicio de apoyo	Porcentaje de cobertura
Asesoramiento psicológico	67.5%
Guía nutricional	58.3%
Programas de asistencia financiera	42.7%
Programas de supervivencia	39.6%

The Oncology Institute, Inc. (TOI) - Modelo de negocios: canales

Clínicas de oncología en persona

A partir del cuarto trimestre de 2023, el Instituto de Oncología opera 41 clínicas en California, Arizona, Nevada y Nuevo México. Duración promedio de la visita al paciente: 45 minutos. Clinic Network atiende a aproximadamente 12.500 pacientes activos de cáncer mensualmente.

Estado	Número de clínicas	Pacientes mensuales promedio
California	28	8,750
Arizona	6	1,850
Nevada	4	1,250
Nuevo Méjico	3	650

Servicios de consulta de telesalud

TeleHealth Platform se lanzó en 2021, que actualmente admite 3.750 consultas virtuales mensuales. La plataforma admite el 87% de las redes de seguros. Duración promedio de consulta de telesalud: 32 minutos.

Aplicaciones de salud móvil

Características de la aplicación móvil TOI:

• Portal de pacientes con registros médicos en tiempo real
• Sistema de seguimiento de tratamiento
• Funcionalidad de recordatorio de medicamentos

Base de usuarios de la aplicación móvil: 6.200 usuarios mensuales activos. Compatibilidad de la aplicación: plataformas iOS y Android.

Redes directas de referencia médica

La red de referencia médica incluye 215 profesionales de oncología independiente y 42 asociaciones hospitalarias. Tasa de conversión de referencia: 64% a partir de 2023.

Tipo de red	Número de socios	Volumen de referencia
Oncólogos independientes	215	1.850 referencias mensuales
Socios del hospital	42	975 referencias mensuales

Plataformas de comunicación de pacientes digitales

Los canales de comunicación digital incluyen:

• Sistema de mensajería seguro
• Comunicación por correo electrónico
• Portal de apoyo al paciente

Compromiso digital mensual: 5,600 interacciones activas del paciente. Tiempo de respuesta promedio: 3.5 horas.

The Oncology Institute, Inc. (TOI) - Modelo de negocios: segmentos de clientes

Pacientes con cáncer en diversas demografía

El Instituto de Oncología se dirige a pacientes con cáncer con el siguiente desglose demográfico:

Grupo de edad	Porcentaje de población de pacientes
18-44 años	12.3%
45-64 años	38.7%
Más de 65 años	49%

Pacientes que buscan atención basada en el valor

TOI se centra en segmentos de atención basados ​​en el valor con características específicas:

• Pacientes de Medicare: 62% de la base total de pacientes
• Pacientes de seguros comerciales: 35% de la base total de pacientes
• Pacientes de auto pagado: 3% de la base total de pacientes

Individuos asegurados con necesidades oncológicas

Tipo de seguro	Cobertura del paciente
Ventaja de Medicare	48.5%
Seguro comercial	35.2%
Seguro de enfermedad	16.3%

Los pacientes que prefieren el tratamiento basado en la comunidad

Distribución geográfica de pacientes:

Estado	Volumen de paciente
California	65.4%
Arizona	18.7%
Nevada	10.2%
Otros estados	5.7%

Individuos que requieren atención personalizada del cáncer

Desglose del segmento de atención personalizada:

• Pacientes con diagnósticos de cáncer complejos: 22.6%
• Pacientes que requieren terapias dirigidas: 17.3%
• Los pacientes que necesitan enfoques de medicina de precisión: 14.5%

The Oncology Institute, Inc. (TOI) - Modelo de negocio: Estructura de costos

Compensación médica y del personal

Para el año fiscal 2023, el Instituto de Oncología reportó gastos totales de personal de $ 156.7 millones. El desglose de la compensación es el siguiente:

Categoría de empleado	Compensación anual
Oncólogos	$ 95.4 millones
Personal de enfermería	$ 38.2 millones
Personal administrativo	$ 23.1 millones

Equipos médicos e inversiones en tecnología

Los gastos de capital para la tecnología médica en 2023 totalizaron $ 42.3 millones, con asignaciones específicas:

• Equipo de radioterapia: $ 18.6 millones
• Sistemas de diagnóstico de imágenes: $ 14.7 millones
• Sistemas de registros de salud electrónicos: $ 9.0 millones

Tratamiento clínico y gastos de medicamentos

Los costos totales de tratamiento clínico para 2023 fueron de $ 213.5 millones, que incluyen:

Categoría de gastos	Cantidad
Medicamentos de quimioterapia	$ 127.8 millones
Medicamentos de atención de apoyo	$ 45.6 millones
Suministros clínicos	$ 40.1 millones

Costos de investigación y desarrollo

Los gastos de I + D para 2023 ascendieron a $ 37.9 millones, distribuidos en todo:

• Financiación del ensayo clínico: $ 22.5 millones
• Investigación de oncología de precisión: $ 9.4 millones
• Innovación tecnológica: $ 6.0 millones

Gastos generales operativos y administrativos

Los gastos operativos para 2023 fueron de $ 68.2 millones, que incluyen:

Categoría de gastos generales	Costo anual
Mantenimiento de la instalación	$ 24.6 millones
Infraestructura	$ 15.3 millones
Legal y cumplimiento	$ 12.7 millones
Marketing y desarrollo de negocios	$ 15.6 millones

The Oncology Institute, Inc. (TOI) - Modelo de negocios: flujos de ingresos

Reembolsos de atención basados ​​en el valor

Para el año fiscal 2023, el Instituto de Oncología informó reembolsos de atención basados ​​en el valor por un total de $ 135.4 millones, lo que representa el 42% de las fuentes de ingresos totales.

Tipo de reembolso	Monto ($)	Porcentaje de ingresos
Pagos basados ​​en el valor de Medicare	76,920,000	56.8%
Pagos basados ​​en el valor del pagador comercial	58,480,000	43.2%

Tarifas de servicio de tratamiento del paciente

Las tarifas de servicio de tratamiento del paciente para 2023 ascendieron a $ 98.7 millones.

• Tratamientos de quimioterapia: $ 52,300,000
• Servicios de radioterapia: $ 31,400,000
• Servicios de atención de apoyo: $ 15,000,000

Pagos de contrato de seguro

Los pagos totales del contrato de seguro en 2023 alcanzaron $ 187.2 millones.

Proveedor de seguros	Monto de pago del contrato ($)
UnitedHealthcare	62,400,000
Himno cruzado	54,600,000
Cigna	47,200,000
Aetna	23,000,000

Ingresos de participación en el ensayo clínico

Los ingresos por participación de ensayos clínicos para 2023 totalizaron $ 22.6 millones.

• Pruebas patrocinadas por la compañía farmacéutica: $ 15,300,000
• Ensayos de investigación financiados por el gobierno: $ 7,300,000

Cargos de servicio de diagnóstico y tratamiento

Los cargos de diagnóstico y servicio de tratamiento en 2023 fueron de $ 67.5 millones.

Categoría de servicio	Monto de carga ($)
Imágenes de diagnóstico	28,600,000
Prueba de laboratorio	22,900,000
Diagnóstico de oncología especializada	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.