The Oncology Institute, Inc. (TOI): ANSOFF MATRIX [Dec-2025 Updated]

You're looking at The Oncology Institute, Inc.'s (TOI) playbook for maximizing value-based care, and frankly, the numbers from Q3 2025 show they are hitting key operational targets, like their Pharmacy segment driving $75.9 million in revenue and AI initiatives promising up to $2 million in expense savings. As a seasoned analyst, I see a clear fork in the road here: do you double down on what's working now-like deepening existing Medicare Advantage contracts and pushing for more fee-for-service conversions-or do you take calculated swings into new markets and specialty verticals? The next 18 months will be defined by how effectively TOI executes this four-pronged growth map. Below, we break down the specific actions across Market Penetration, Development, Product Expansion, and even high-risk Diversification that will determine if they transition from strong revenue growth to sustainable profitability.

The Oncology Institute, Inc. (TOI) - Ansoff Matrix: Market Penetration

You're looking at how The Oncology Institute, Inc. (TOI) plans to grow by selling more of its current services into its existing markets. This is about deepening the hold you already have.

First, you're pushing hard on the Pharmacy segment. That segment hit $75.9 million in revenue for the third quarter of 2025. That's a 57.4% year-over-year growth rate for the Pharmacy business in Q3 2025.

Next, you're using technology to drive down costs in the current footprint. The agentic AI model, which started rolling out in September 2025, is expected to deliver up to an estimated $2 million in operating expense savings in 2026 by improving prior authorization submission time by over 80% at pilot sites.

Here's a quick look at the current revenue mix that informs this penetration strategy:

You're working to deepen those existing capitation contracts to capture more of the total cost of care for current Medicare Advantage lives. As of February 26, 2025, the Florida operations alone managed over 50,000 lives under Medicare Advantage agreements. Overall, as of December 31, 2024, The Oncology Institute, Inc. managed a population of approximately 1.9 million patients under value-based agreements across five states. The goal is to capture more of that spend, especially as capitated revenue grew 38.9% year-over-year in Q3 2025.

Converting more traditional fee-for-service patients to the value-based care model in current clinics is a key lever. In 2024, The Oncology Institute, Inc. generated more than 46% of its revenue from patients covered by value-based contracts. This contrasts with the Q3 2025 patient services breakdown where fee-for-service accounted for roughly 66% of revenue, while capitation was 34%. Fee-for-service revenue itself grew 13% year-over-year in Q3 2025.

To expand in-network MSO provider signings in established markets, you're building out infrastructure like the Florida Oncology Network. The launch of that network in Q1 2025 brought in over 42,000 Medicare Advantage lives in the new fully delegated model in Florida alone. Management noted continued organic growth in established markets like Florida and Oregon during Q3 2025.

The near-term actions for market penetration include:

• Drive Pharmacy segment revenue past $75.9 million quarterly run-rate.
• Scale the agentic AI model to realize the estimated $2 million in 2026 operating expense efficiencies.
• Increase the percentage of patient services revenue derived from capitation, which was 34% in Q3 2025.
• Grow the number of lives under existing delegated contracts, building on the 50,000+ Medicare Advantage lives in Florida as of February 2025.
• Expand the network of value-focused providers in Florida and Oregon to capture more of the 81 million lives managed under value-based agreements across five states as of year-end 2024.

Finance: draft the Q4 2025 operating expense forecast incorporating the AI efficiency timeline by Monday.

The Oncology Institute, Inc. (TOI) - Ansoff Matrix: Market Development

You're looking at how The Oncology Institute, Inc. (TOI) plans to expand its footprint using existing service models in new geographic areas. This is Market Development in action, taking what works in one place and applying it elsewhere.

The core of this strategy is replicating the successful value-based care structure already established in key markets. As of the end of 2024, The Oncology Institute, Inc. (TOI) provided care for a population of approximately 1.9 million patients under value-based agreements. The company was already operating across five states as of November 2025.

The plan centers on scaling the capitation model, which guarantees fixed payments per patient, per month. This model has shown strong performance, with the delegated model Medical Loss Ratio (MLR) typically in the mid-seventies.

Here is a snapshot of the recent and targeted growth in capitated lives:

The strategy for Market Development involves several concrete steps for expansion outside the current core footprint:

• - Enter two new US states in 2026, replicating the successful Florida and Nevada capitation model.
• - Target new Medicare Advantage payer contracts to add over 100,000 new capitated lives in new regions.
• - Pursue strategic M&A of smaller, regional oncology groups to gain immediate new market access.
• - Expand the delegated utilization management service model to new payer partners outside current states.
• - Leverage the Nevada Medicaid partnership to enter other state Medicaid markets.

Specific execution points already show momentum. The company expanded its capitation relationship as of July 1 with Silver Summit Health Plan in Nevada to serve all of their Medicaid patients in Clark County. This Nevada Medicaid expansion is part of a trend that added roughly 80,000 Medicaid lives starting July 2025. Also, the delegated capitation partnership with Elevance Health in Florida is planned for expansion into two new counties, which, if finalized, will more than double the number of lives under that current relationship. This Florida expansion is expected to more than double the number of Medicare Advantage lives under capitation in Q4 2025.

For the delegated utilization management service, the MSO network in Florida has grown to over 200 providers. The company is also projecting operational efficiencies from its AI deployment, with early estimates suggesting authorization efficiencies could yield up to $2 million in operating expense savings in 2026. The overall financial outlook for 2025 reflects this growth strategy, with full-year revenue guidance raised to $495-$505 million.

The Oncology Institute, Inc. (TOI) - Ansoff Matrix: Product Development

You're looking at how The Oncology Institute, Inc. (TOI) plans to grow by introducing new services or significantly enhancing existing ones. This is the Product Development quadrant of the Ansoff Matrix, and based on their recent performance, the focus is on service line expansion and deepening existing offerings.

Here are the key strategic product development initiatives The Oncology Institute, Inc. is driving:

• - Fully integrate and scale the new specialized mental health care offering via the Protocol Behavioral Health partnership.
• - Formalize and expand palliative care and stem cell transplant services across all existing clinics.
• - Increase Phase 1-4 clinical trial volume by 20% in existing markets to boost the Clinical Trials segment revenue.
• - Offer advanced diagnostic test studies in-house to capture ancillary revenue.
• - Launch a proprietary patient-facing app for 24/7 assistance and care coordination.

To give you a sense of the scale we are working with, The Oncology Institute, Inc. reported consolidated revenue of $136.6 million for the third quarter of 2025, which was a 36.7% increase year-over-year. This growth shows momentum as they push these new product strategies.

The expansion of services like palliative care and stem cell transplant is critical because The Oncology Institute, Inc. already offers these as part of its comprehensive care model across its over 100 clinics and affiliate locations. Formalizing and expanding these services directly supports the value-based care model, which is seeing strong results, like the fee-for-service revenue growing 13% over Q3 2024.

The clinical trials segment is targeted for a volume increase of 20%. While the specific revenue contribution from clinical trials isn't broken out in the latest filings, the overall revenue trajectory suggests this segment is a key lever. For context, the Pharmacy business set fill records, contributing $75.9 million in revenue in Q3 2025 alone, showing the power of new product/service integration.

The AI initiatives are also part of this product enhancement, aiming for operational leverage. Management estimated savings from transitioning authorizations to their agentic AI model could yield up to $2 million in operating expense efficiencies.

Here's a snapshot of The Oncology Institute, Inc.'s Q3 2025 performance metrics to ground these product expansion plans:

The launch of a proprietary patient-facing app for 24/7 assistance is a direct play on improving patient experience and care coordination, which feeds into the performance metrics of the capitated contracts. The company is reinforcing its expectation to achieve profitability in the fourth quarter of 2025, with a full-year 2025 revenue outlook raised to a range of $495 million to $505 million. Defintely, these new product offerings are intended to drive the business toward the targeted Q4 Adjusted EBITDA between $0 to $2 million.

The Oncology Institute, Inc. (TOI) - Ansoff Matrix: Diversification

You're looking at The Oncology Institute, Inc. (TOI) moving beyond its core oncology services, which is a classic Diversification play on the Ansoff Matrix. This means new products in new markets, which inherently carries higher risk, but the current financial momentum suggests a potential runway for such moves.

Consider the current operational scale as the baseline. As of September 30, 2025, The Oncology Institute, Inc. had cash and cash equivalents of $27.7 million. This capital base would need to support the investment required for these new verticals. The company already operates across five states and manages care for approximately 1.9 million patients, with over 100 clinics and affiliate locations.

The existing dispensary business provides a strong, high-margin anchor to test new product lines. In the third quarter of 2025, the Retail Pharmacy and Dispensary segment alone generated $75.9 million in revenue and $12.8 million in gross profit. This segment's performance is a key internal benchmark for any new drug line expansion.

Here is a snapshot of The Oncology Institute, Inc.'s financial standing as of the end of Q3 2025, which informs the risk appetite for diversification:

The proposed diversification strategies represent significant steps into new operational domains:

• - Acquire a primary care or cardiology group in a new state to establish a new specialty care vertical.
• - Develop a proprietary software platform for value-based oncology management and license it to external, non-TOI providers.
• - Establish a joint venture with a radiation oncology provider to offer a fully integrated service line in a new region.
• - Launch a new line of non-oncology specialty drugs through the existing high-growth dispensary infrastructure.
• - Invest in a new, non-oncology-focused ambulatory surgery center (ASC) model; this is defintely a high-risk move.

For the first point, expanding into primary care or cardiology in a new state would leverage the existing value-based contract expertise, similar to how The Oncology Institute, Inc. secured three new capitation agreements in 2025, adding roughly 80,000 lives across California, Nevada, and Florida. The Florida market alone now manages over 200,000 lives under value-based agreements, showing an existing capacity for geographic expansion in value-based models.

Developing and licensing proprietary software is a move into technology services. This would be a product development play leveraging internal expertise, potentially funded by the improved operational leverage that narrowed the full-year 2025 Adjusted EBITDA guidance to a range of $(11) to $(13) million, with an expectation of $0 to $2 million in Q4 2025 Adjusted EBITDA.

A joint venture in radiation oncology would be a vertical integration move in a related specialty, potentially building on the existing network footprint that spans over 100 clinics. This strategy aims to capture more of the total cancer care spend, moving beyond the 13% fee-for-service revenue growth seen in Q3 2025.

Launching non-oncology specialty drugs is a direct extension of the dispensary infrastructure. The dispensary's Q3 2025 revenue of $75.9 million suggests the logistics and compliance framework is robust enough to handle new drug formularies, provided the capital outlay for inventory and new contracts remains manageable relative to the current $27.7 million cash position.

The non-oncology Ambulatory Surgery Center (ASC) model is the most distinct diversification. This requires entirely new operational expertise and capital deployment outside the core competency that generated $18.9 million in gross profit in Q3 2025. Finance: draft 13-week cash view by Friday.