Press Release: The Oncology Institute Reports Fourth Quarter and Full Year 2024 Financial Results and Guidance for 2025

Dow Jones
24 Mar

The Oncology Institute Reports Fourth Quarter and Full Year 2024 Financial Results and Guidance for 2025

CERRITOS, Calif., March 24, 2025 (GLOBE NEWSWIRE) -- The Oncology Institute, Inc. (NASDAQ: TOI) ("TOI" or the "Company"), one of the largest value-based community oncology groups in the United States, today reported financial results for its fourth quarter and year ended December 31, 2024.

Recent Operational Highlights

   -- Cash flow from operations in Q4 2024 was approximately $4.2 million, due 
      to disciplined working capital management that saw improvements across 
      receivables, inventory, and payables. 
 
   -- Selling, general, and administrative expenses decreased 12% in Q4 2024 as 
      compared to the prior year period, as a result of our ongoing efforts to 
      streamline operations, improve efficiency, and optimize our overhead 
      resourcing. 
 
   -- Entered into a new agreement with our primary drug supplier, improving 
      discounts across the board, including volume based discounts, which 
      optimize our cost positioning as we work towards our revenue growth 
      targets. 
 
   -- Launched six new contracts across the third and fourth quarter totaling 
      over 250,000 lives. Value-based patient services increased sequentially 
      by over 15% from Q3 2024, with further revenue upside anticipated as 
      these contracts mature. 
 
   -- Achieved a record quarter of revenue for the pharmaceutical dispensary 
      revenue, which has continued to see increased attachment to clinic visits 
      overall, including from our retail pharmacy in California, which has now 
      lapped a full year of operation after its introduction in the fourth 
      quarter of 2023. The maturation of this pharmacy will lead to a more 
      normalized level of growth in the dispensary business going forward, 
      which we expect to continue to be a key contributor to TOI's future 
      growth. 

Fourth Quarter 2024 Financial Highlights

   -- Consolidated revenue of $100 million, an increase of 16.9% compared to 
      the prior year quarter 
 
   -- Gross profit of $15 million, an increase of 1.8% compared to the prior 
      year quarter 
 
   -- Net loss of $13.2 million compared to net loss of $18.8 million for the 
      prior year quarter 
 
   -- Basic and diluted loss per share of $(0.14) and $(0.14), respectively, 
      compared to $(0.21) and $(0.21) for the prior year quarter 
 
   -- Adjusted EBITDA of $(7.8) million compared to $(6.3) million for the 
      prior year quarter 
 
   -- Cash, cash equivalents, and investments of $50 million as of December 31, 
      2024 

Management Commentary

Daniel Virnich, CEO of TOI, commented, "I am very pleased with our performance in the fourth quarter of 2024. We were able to reduce our cash burn and generate positive cash flow from operations for a second consecutive quarter, driven by disciplined working capital management. Additionally, both dispensary and value-based patient services are gaining widespread adoption in the marketplace, as we build around the chassis of our fee-for-service patient services business. As we enter 2025, we will continue to build on our momentum through strong operational management, increased efficiencies, and strategic market expansion."

Outlook for Fiscal Year 2025

TOI uses Adjusted EBITDA and Free Cash flow, each a non-GAAP metric, as an additional tool to assess its operational and financial performance. See "Financial Information: Non-GAAP Financial Measures" below. In reliance on the unreasonable efforts exception provided under Regulation S-K, TOI is not reasonably able to provide a quantitative reconciliation for forward-looking information of Adjusted EBITDA and Free Cash flow to net (loss) income and net cash provided by operations, respectively, the most directly comparable GAAP financial measures, without unreasonable efforts due to uncertainties regarding taxes, capital expenditures, share-based compensation, goodwill impairment charges, change in fair value of liabilities, unrealized (gains) losses on investments, practice acquisition-related costs, consulting and legal fees, transaction costs and other non-cash items. The variability of these items could have an unpredictable, and potentially significant, impact on TOI's future GAAP financial results.

 
 2025 Guidance 
----------------------------------------- 
 Revenue             $460 to $480 million 
                   ---------------------- 
 Gross Profit          $73 to $82 million 
-----------------  ---------------------- 
 Adjusted EBITDA   $(8) to $(17) million 
-----------------  ---------------------- 
 Free Cash Flow    $(12) to $(21) million 
-----------------  ---------------------- 
 
 

The Company expects Adjusted EBITDA of approximately $(5) to $(6) million in the first quarter of 2025 primarily due to seasonal factors such as new year drug price increases and lower encounter volumes. TOI's achievement of the anticipated results is subject to risks and uncertainties, including those disclosed in its filings with the U.S. Securities and Exchange Commission. The outlook does not take into account the impact of any unanticipated developments in the business or changes in the operating environment, nor does it take into account the impact of TOI's acquisitions, dispositions or financings. TOI's outlook assumes a largely reopened global market, which would be negatively impacted if closures or other restrictive measures persist or are reimplemented.

Fourth Quarter 2024 Results

Consolidated revenue for Q4 2024 was $100 million, an increase of 16.9% compared to Q4 2023, and a 0.4% increase compared to Q3 2024. The increase is driven primarily by our dispensary revenue due to our California based pharmacy, which continues to exceed fill expectations.

Revenue for patient services was $50 million, down 10.6% compared to Q4 2023. The decrease in patient services was due to the loss of a large contract in July 2024. Dispensary revenue increased 72.4% compared to Q4 2023 due to an increase in the number of filled prescriptions and an increase in the average revenue per filled prescription. Clinical trials & other revenue increased by 22.5% compared to Q4 2023 primarily due to an increase in Proposition 56 revenue and TOI Clinical Research revenue.

Gross profit in Q4 2024 was $15 million, an increase of 1.8% compared to Q4 2023. Gross profit is calculated by subtracting direct costs of patient services, dispensary, and clinical trials and other from consolidated revenues.

Selling, general and administrative ("SG&A") expenses in Q4 2024 were $25 million or 24.8% of revenue, compared with $28 million, or 32.7% of revenue, in Q4 2023. The decrease in SG&A is a direct result of our ongoing efforts to streamline operations, improve efficiency, and optimize our overhead resourcing. Through selective outsourcing, planned attrition, and modest downsizing, we have been able to lower operating costs without compromising the quality of care or service we deliver.

Net loss for Q4 2024 was $13.2 million, a decrease of $5.6 million compared to Q4 2023 primarily due to an increase in operating revenue and decrease in SG&A expenses, offset by a decreased change in fair value of derivative liabilities.

Adjusted EBITDA was $(7.8) million, a decrease of $1.6 million compared to Q4 2023, primarily as a result of a decrease in share-based compensation and the change in fair value of derivative liabilities.

Results for the Year Ended December 31, 2024

Consolidated revenue for the year ended December 31, 2024 was $393 million, an increase of 21.3% compared to the prior year, driven by the contribution of our CA based pharmacy.

Revenue for patient services was $205 million, a decrease of 4.0% year-over-year, due to the loss of a contract earlier in 2024, offset by new contracts in the latter half of 2024. Dispensary revenue increased 73.3% compared to the comparable prior year period due to an increase in the average revenue per filled prescription. Clinical trials & other revenue increased by 24.8% compared to the prior year period due to an increase in miscellaneous contract revenue.

Gross profit for the year ended December 31, 2024 was $54 million, a decrease of 9.4% year-over-year. The loss in gross profit is largely attributed to the impacts of industry wide compression of margins on Part D medications, related to changes in DIR fee assessment.

SG&A expenses, excluding depreciation and amortization, for year ended December 31, 2024 were $108 million or 27.4% of revenue, compared with $114 million, or 35.1% of revenue, in the prior year. The decrease was primarily due to cost-management efforts to streamline operations and improve efficiency.

Net loss for the year ended December 31, 2024 was $64.7 million, a decrease of $18.4 million compared to the prior year, primarily due to the increase in gross profit and the change in the fair value of the warrant, earnout and conversion option derivative liabilities, offset by the goodwill impairment charge and increased operating expenses.

Adjusted EBITDA was $(35.7) million, a decrease of $9.9 million compared to the prior year, primarily as a result of the change in fair value of the warrant, earnout and conversion option derivative liabilities.

Webcast and Conference Call

TOI will host a conference call on Tuesday, March 25, 2025 at 5:00 p.m. (Eastern Time) to discuss fourth quarter and full year results and management's outlook for future financial and operational performance.

The conference call can be accessed live over the phone by dialing 1-877-407-0789, or for international callers, 1-201-689-8562. A replay will be available two hours after the call and can be accessed by dialing 1-844-512-2921, or for international callers, 1-412-317-6671. The passcode for the live call and the replay is 13750791. The replay will be available until April 1, 2025.

Interested investors and other parties may also listen to a simultaneous webcast of the conference call by logging onto the Investor Relations section of TOI's website at https://investors.theoncologyinstitute.com.

About The Oncology Institute, Inc.

Founded in 2007, TOI and its affiliates are advancing oncology by delivering highly specialized, value-based cancer care in the community setting. TOI offers cutting-edge, evidence-based cancer care to a population of approximately 1.9 million patients including clinical trials, transfusions, and other services traditionally associated with the most advanced care delivery organizations. With approximately 120+ employed clinicians and more than 700 teammates at approximately 70 clinic locations and growing, TOI is changing oncology for the better. For more information visit www.theoncologyinstitute.com.

Forward-Looking Statements

This press release includes certain statements that are not historical facts but are forward-looking statements for purposes of the safe harbor provisions under the United States Private Securities Litigation Reform Act of 1995. Forward-looking statements generally are accompanied by words such as "preliminary," "believe," "may," "will," "estimate," "continue," "anticipate," "intend," "expect," "should," "would," "plan," "project," "predict," "potential," "guidance," "approximately," "seem," "seek," "future," "outlook," and similar expressions that predict or indicate future events or trends or that are not statements of historical matters. These forward-looking statements include, but are not limited to, statements regarding projections, anticipated financial results, estimates and forecasts of revenue and other financial and performance metrics and projections of market opportunity and expectations. These statements are based on various assumptions and on the current expectations of TOI and are not predictions of actual performance. These forward-looking statements are provided for illustrative purposes only and are not intended to serve as, and must not be relied on by anyone as, a guarantee, an assurance, a prediction or a definitive statement of fact or probability. Actual events and circumstances are difficult or impossible to predict and will differ from assumptions. Many actual events and circumstances are beyond the control of TOI. These forward-looking statements are subject to a number of risks and uncertainties, including the accuracy of the assumptions underlying the 2025 full fiscal year outlook and the Q1 2025 outlook with respect to Adjusted EBITDA discussed herein, the outcome of judicial and administrative proceedings to which TOI may become a party or investigations to which TOI may become or is subject that could interrupt or limit TOI's operations, result in adverse judgments, settlements or fines and create negative publicity; changes in TOI's patient or payors' preferences, prospects and the competitive conditions prevailing in the healthcare sector; failure to continue to meet stock exchange listing standards; the impact of COVID-19 on TOI's business; those factors discussed in the documents of TOI filed, or to be filed, with the SEC, including the Item 1A. "Risk Factors" section of TOI's Annual Report on Form 10-K for the year ended December 31, 2023 filed with the SEC on March 28, 2024 and any subsequent Quarterly Reports on Form 10-Q or Current Reports on Form 8-K. If the risks materialize or assumptions prove incorrect, actual results could differ materially from the results implied by these forward-looking statements. There may be additional risks that TOI currently is evaluating or does not presently know or that TOI currently believes are immaterial that could also cause actual results to differ from those contained in the forward-looking statements. In addition, forward-looking statements reflect TOI's plans or forecasts of future events and views as of the date of this press release. TOI anticipates that subsequent events and developments will cause TOI's assessments to change. TOI does not undertake any obligation to update any of these forward-looking statements. These forward-looking statements should not be relied upon as representing TOI's assessments as of any date subsequent to the date of this press release. Accordingly, undue reliance should not be placed upon the forward-looking statements.

Financial Information; Non-GAAP Financial Measures

Some of the financial information and data contained in this press release, such as Adjusted EBITDA and Free Cash Flow, have not been prepared in accordance with United States generally accepted accounting principles ("GAAP"). TOI's non-GAAP financial measures may be different from non-GAAP financial measures used by other companies. The presentation of non-GAAP financial measures is not intended to be considered in isolation or as a substitute for, or superior to, financial measures determined in accordance with GAAP. Because of the limitations of non-GAAP financial measures, you should consider the non-GAAP financial measures presented in this press release in conjunction with TOI's financial statements and the related notes thereto.

TOI believes that the use of Free Cash Flow provides an additional tool to assess the Company's financial performance, evaluate its ability to generate cash from operations, and plan for future investments and obligations. Free Cash Flow is useful in understanding the cash available for strategic initiatives. It also helps in comparing TOI's financial performance with other similar companies, many of which use similar non-GAAP financial measures to provide insights into their cash generation capabilities. However, the principal limitation of Free Cash Flow is that it does not account for certain cash outflows or inflows that are required by GAAP to be recorded in TOI's financial statements, such as mandatory interest payments or certain capital expenditures, which may impact the overall financial health of the Company. TOI defines Free Cash Flow as net cash flow provided by (used in) operations plus cash interest, less capital expenditures.

TOI believes that the use of Adjusted EBITDA provides an additional tool to assess operational and results of our performance, to plan and forecast future periods, and factors and trends in, and in comparing our financial measures with, other similar companies, many of which present similar non-GAAP financial measures to investors. The principal limitation of Adjusted EBITDA is that it excludes significant expenses and income that are required by GAAP to be recorded in TOI's financial statements.

TOI defines Adjusted EBITDA as net (loss) income plus depreciation, amortization, interest, taxes, non-cash items, share-based compensation, goodwill impairment charges, change in fair value of liabilities, unrealized gains or losses on investments and other adjustments to add-back the following: consulting and legal fees related to acquisitions, one-time consulting and legal fees related to certain advisory projects, software implementations and debt or equity financings, severance expense and temporary labor and recruiting charges to build out our corporate infrastructure. A reconciliation of Adjusted EBITDA to net loss, the most comparable GAAP metric, is set forth below.

 
                     Adjusted EBITDA Reconciliation 
 
                             Three Months Ended 
                                December 31,               Change 
                                                    -------------------- 
  (dollars in thousands)       2024         2023       $          % 
-------------------------  ------------  ---------  --------  ---------- 
  Net loss                 $(13,182)     $(18,754)  $ 5,572    (29.7)% 
  Depreciation and 
   amortization               1,707         1,577       130      8.2% 
  Interest expense, net       1,168         1,941      (773)   (39.8)% 
  Tax payments and 
   penalties                     --           (86)       86   (100.0)% 
  Non-cash addbacks(1)           71         1,876    (1,805)   (96.2)% 
  Share-based 
   compensation               1,289         3,817    (2,528)   (66.2)% 
  Change in fair value of 
   liabilities                 (176)        1,488    (1,664)  (111.8)% 
  Unrealized (gains) 
   losses on investments         (4)         (206)      202          N/A 
  Practice 
   acquisition-related 
   costs(2)                      --             1        (1)  (100.0)% 
  Post-combination 
   compensation 
   expense(3)                    13           487      (474)         N/A 
  Consulting and legal 
   fees(4)                       69            55        14     25.5% 
  Infrastructure and 
   workforce costs(5)         1,217         1,551      (334)   (21.5)% 
  Transaction costs(6)           --             1        (1)  (100.0)% 
                            -------       -------    ------   ------ 
  Adjusted EBITDA          $ (7,828)     $ (6,252)  $(1,576)    25.2% 
                            =======       =======    ======   ====== 
 
 

(1) During the three months ended December 31, 2024, non-cash addbacks were primarily comprised of non-cash rent of $149 and the loss on disposal of fixed assets. During the three months ended December 31, 2023, non-cash addbacks were primarily comprised of net bad debt write-offs of $1,989 and non-cash rent of $83.

(2) Practice acquisition-related costs were comprised of consulting and legal fees incurred to perform due diligence, execute, and integrate acquisitions of various oncology practices.

(3) Deferred consideration payments for practice acquisitions that are contingent upon the seller's future employment at the Company.

(4) Consulting and legal fees were comprised of a subset of the Company's total consulting and legal fees, and related to certain non-recurring advisory projects including software implementations during the three months ended December 31, 2024 and 2023.

(5) Infrastructure and workforce costs were comprised primarily of temporary labor of $280 and $148, recruiting expenses to build out corporate infrastructure of $364 and $633, as well as severance expenses resulting from cost rationalization programs of $125 and $81, and lease terminations, settlements, and penalty addbacks of $380 and $672 during the three months ended December 31, 2024 and 2023, respectively.

(6) Transaction costs were comprised of legal and escrow fees associated with one practice acquisition for the three months ended December 31, 2023.

 
                     Adjusted EBITDA Reconciliation 
 
                           Year Ended December 31,         Change 
                           -----------------------  --------------------- 
  (dollars in thousands)       2024         2023        $          % 
-------------------------  ------------  ---------  ---------  ---------- 
  Net loss                 $(64,663)     $(83,068)  $ 18,405    (22.2)% 
  Depreciation and 
   amortization               6,287         5,873        414      7.0% 
  Interest expense, net       7,496         6,777        719     10.6% 
  Tax payments and 
   penalties                    (32)          (36)         4    (11.1)% 
  Non-cash addbacks(1)         (139)        2,029     (2,168)  (106.9)% 
  Share-based 
   compensation              11,152        17,548     (6,396)   (36.4)% 
  Goodwill impairment 
   charges                       --        16,867    (16,867)         N/A 
  Change in fair value of 
   liabilities               (3,316)       (1,395)    (1,921)   137.7% 
  Unrealized (gains) 
   losses on investments       (133)         (237)       104          N/A 
  Practice 
   acquisition-related 
   costs(2)                      --           113       (113)  (100.0)% 
  Post-combination 
   compensation 
   expense(3)                   374         2,048     (1,674)         N/A 
  Consulting and legal 
   fees(4)                      841         1,570       (729)   (46.4)% 
  Infrastructure and 
   workforce costs(5)         6,427         5,965        462      7.7% 
  Transaction costs(6)           18           141       (123)   (87.2)% 
                            -------       -------    -------   ------ 
  Adjusted EBITDA          $(35,688)     $(25,805)  $ (9,883)    38.3% 
                            =======       =======    =======   ====== 
 
 

(1) During the year ended December 31, 2024, non-cash addbacks were primarily comprised of non-cash rent of $411 and $259 loss on disposal of fixed assets. During the year ended December 31, 2023, non-cash addbacks were primarily comprised of a $2,020 of net bad debt write-off.

(2) Practice acquisition-related costs were comprised of consulting and legal fees incurred to perform due diligence, execute, and integrate acquisitions of various oncology practices.

(3) Deferred consideration payments for practice acquisitions that are contingent upon the seller's future employment at the Company.

(4) Consulting and legal fees were comprised of a subset of the Company's total consulting and legal fees during the years ended December 31, 2024 and 2023, and related to certain advisory projects, software implementations, and legal fees for debt financing and predecessor litigation matters.

(5) Infrastructure and workforce costs were primarily comprised of recruiting expenses to build out corporate infrastructure of $1,294 and $2,227, software implementation fees of $120 and $105, severance expenses resulting from cost rationalization programs of $343 and $979, temporary labor of $748 and $1,365, and lease terminations, settlements, and penalty addbacks of $3,921 and $1,289 during the years ended December 31, 2024 and 2023, respectively.

(6) Transaction costs were comprised of consulting and legal fees associated with non-recurring due diligence projects during the year ended December 31, 2024, and related to consulting, legal, administrative and regulatory fees associated with share repurchases and practice acquisitions during the year ended December 31, 2023.

 
 
                     Key Business Metrics 
 
                  Three Months Ended         Year Ended 
                     December 31,           December 31, 
                 --------------------  ---------------------- 
                   2024       2023       2024        2023 
                 ---------  ---------  ---------  ----------- 
Clinics (1)            86         83         86         83 
Markets                16         15         16         15 
Lives under 
 value-based 
 contracts 
 (millions)           1.9        1.8        1.9        1.8 
Net income 
 (loss)          $(13,182)  $(18,754)  $(64,663)  $(83,068) 
Adjusted EBITDA 
 (in 
 thousands)      $ (7,828)  $ (6,252)  $(35,688)  $(25,805) 
 
 

(1) Includes independent oncology practices to which we provide limited management services, but do not bear the operating costs.

 
Consolidated Balance Sheets (Unaudited) 
(in thousands except share data) 
 
                                 December 31, 2024     December 31, 2023 
Assets 
  Current assets: 
     Cash and cash equivalents   $          49,669    $          33,488 
     Marketable securities                      --               49,367 
     Accounts receivable, net               48,335               42,360 
     Other receivables                         346                  551 
     Inventories                            10,039               13,678 
     Prepaid expenses and 
      other current assets                   4,029                4,049 
                                    --------------       -------------- 
  Total current assets                     112,418              143,493 
  Property and equipment, net               11,888               10,883 
  Operating right of use 
   assets                                   25,782               29,169 
  Intangible assets, net                    14,810               17,904 
  Goodwill                                   7,230                7,230 
  Other assets                                 589                  561 
                                    --------------       -------------- 
Total assets                     $         172,717    $         209,240 
                                    ==============       ============== 
Liabilities and stockholders' 
equity 
  Current liabilities: 
     Accounts payable            $          24,324    $          14,429 
     Current portion of 
      operating lease 
      liabilities                            6,798                6,363 
     Accrued expenses and 
      other current 
      liabilities                           21,093               13,996 
                                    --------------       -------------- 
  Total current liabilities                 52,215               34,788 
  Operating lease liabilities               23,223               26,486 
  Derivative warrant 
   liabilities                                  17                  636 
  Conversion option derivative 
   liabilities                                 385                3,082 
  Long-term debt, net of 
   unamortized debt issuance 
   costs                                    93,131               86,826 
  Other non-current 
   liabilities                                 125                  365 
  Deferred income taxes 
   liability                                    32                   32 
                                    --------------       -------------- 
Total liabilities                          169,128              152,215 
Stockholders' equity: 
   Common Stock, 0.0001 par 
    value, authorized 
    500,000,000 shares; 
    77,470,886 shares issued 
    and 75,737,112 shares 
    outstanding at December 
    31, 2024 and 75,879,025 
    shares issued and 
    outstanding at December 
    31, 2023                                     8                    8 
   Series A Convertible 
   Preferred Stock, 0.0001 par 
   value, authorized 
   10,000,000 shares; 165,045 
   shares issued and 
   outstanding at December 31, 
   2024 and 2023                                --                   -- 
   Treasury Stock at cost, 
    1,733,774 shares at 
    December 31, 2024 and 
    2023                                    (1,019)              (1,019) 
  Additional paid-in capital               215,413              204,186 
  Accumulated deficit                     (210,813)            (146,150) 
                                    --------------       -------------- 
Total stockholders' equity                   3,589               57,025 
                                    --------------       -------------- 
Total liabilities and 
 stockholders' equity            $         172,717    $         209,240 
                                    ==============       ============== 
 
 
 
Consolidated Statements of Operations (Unaudited) 
(in thousands except share data) 
 
                         Three Months Ended               Year Ended 
                            December 31,                 December 31, 
                     --------------------------  ---------------------------- 
                         2024          2023          2024           2023 
                     ------------  ------------  ------------  -------------- 
Revenue 
  Patient services   $    50,217   $    56,171   $   204,883   $   213,504 
  Dispensary              47,587        27,607       179,916       103,835 
  Clinical trials & 
   other                   2,463         2,010         8,613         6,900 
                      ----------    ----------    ----------    ---------- 
Total operating 
 revenue                 100,267        85,788       393,412       324,239 
Operating expenses 
  Direct costs -- 
   patient 
   services               45,743        48,364       186,880       181,017 
  Direct costs -- 
   dispensary             39,530        22,743       151,231        83,071 
  Direct costs -- 
   clinical trials 
   & other                   358           302         1,304           578 
  Goodwill 
   impairment 
   charges                    --            --            --        16,867 
  Selling, general 
   and 
   administrative 
   expense                24,858        28,090       107,828       113,851 
  Depreciation and 
   amortization            1,707         1,577         6,287         5,873 
                      ----------    ----------    ----------    ---------- 
Total operating 
 expenses                112,196       101,076       453,530       401,257 
                      ----------    ----------    ----------    ---------- 
Loss from 
 operations              (11,929)      (15,288)      (60,118)      (77,018) 
Other non-operating 
expense (income) 
  Interest expense, 
   net                     1,168         1,941         7,496         6,777 
  Change in fair 
   value of 
   derivative 
   warrant 
   liabilities               (47)          344          (619)          286 
  Change in fair 
   value of earnout 
   liabilities                --           (11)           --          (803) 
  Change in fair 
   value of 
   conversion 
   option 
   derivative 
   liabilities              (129)        1,156        (2,697)         (878) 
  Other, net                 261           123           365           704 
                      ----------    ----------    ----------    ---------- 
Total other 
 non-operating loss 
 expense                   1,253         3,553         4,545         6,086 
                      ----------    ----------    ----------    ---------- 
Loss before 
 provision for 
 income taxes            (13,182)      (18,841)      (64,663)      (83,104) 
  Income tax 
   benefit                    --            87            --            36 
                      ----------    ----------    ----------    ---------- 
Net loss             $   (13,182)  $   (18,754)  $   (64,663)  $   (83,068) 
                      ==========    ==========    ==========    ========== 
Net income (loss) 
per share 
attributable to 
common 
stockholders: 
  Net income (loss) 
   attributable to 
   common 
   stockholders, 
   basic and 
   diluted               (10,821)      (15,314)      (53,005)      (67,877) 
  Weighted-average 
   number of shares 
   outstanding, 
   basic and 
   diluted            75,655,231    73,469,101    75,043,678    73,748,660 
  Net income (loss) 
   per share 
   attributable to 
   common 
   stockholders, 
   basic and 
   diluted           $     (0.14)  $     (0.21)  $     (0.71)  $     (0.92) 
 
 
 
Consolidated Statements of Cash Flows (Unaudited) 
(in thousands) 
 
                            Three Months Ended         Year Ended 
                               December 31,           December 31, 
                                                 ---------------------- 
                             2024       2023       2024        2023 
                           ---------  ---------  ---------  ----------- 
Cash flows from operating 
activities: 
  Net loss                 $(13,182)  $(18,754)  $(64,663)  $(83,068) 
  Adjustments to reconcile net income (loss) to cash 
   and cash equivalents used in operating activities: 
    Depreciation and 
     amortization             1,707      1,577      6,287      5,873 
    Amortization of debt 
     issuance costs and 
     debt discount            1,594      1,572      6,305      6,205 
    Goodwill impairment 
     charges                     --         --         --     16,867 
    Share-based 
     compensation             1,289      4,079     11,152     17,810 
    Change in fair value 
     of liability 
     classified warrants        (47)       344       (619)       286 
    Change in fair value 
     of liability 
     classified earnouts         --        (11)        --       (803) 
    Change in fair value 
     of liability 
     classified 
     conversion option 
     derivatives               (129)     1,156     (2,697)      (878) 
    Unrealized (gain) 
     loss on investments          1       (194)      (133)      (249) 
    Accretion of discount 
     on investment 
     securities                  (1)    (1,919)      $(500.SI)$    (2,631) 
    Deferred taxes               --       (137)        --        (76) 
    Bad debt expense             --      1,989         --      2,020 
    (Gain) loss on 
     disposal of property 
     and equipment              220        (30)       271        (30) 
    Changes in operating assets and liabilities, net of 
     business combinations: 
      Accounts receivable     6,167      4,093     (5,975)    (4,564) 
      Inventories                67     (1,472)     3,639     (4,385) 
      Other receivables          12        (87)       205         66 
      Prepaid expenses        1,184        400      1,176      3,128 
      Operating lease 
       right-of-use 
       assets                 1,301      1,358      3,387      5,806 
      Other assets               (1)        (1)       (28)       (84) 
      Accrued expenses 
       and other current 
       liabilities            4,656      2,778      9,471      3,357 
      Income taxes 
       payable                   --       (255)        --       (255) 
      Accounts payable          739      1,096      9,215      5,057 
      Current and 
       long-term 
       operating lease 
       liabilities           (1,392)    (1,415)    (2,828)    (5,324) 
      Other non-current 
       liabilities                1        (49)      (203)      (443) 
                            -------    -------    -------    ------- 
Net cash and cash 
 equivalents provided by 
 (used in) operating 
 activities                   4,186     (3,882)   (26,538)   (36,315) 
Cash flows from investing 
activities: 
  Purchases of property 
   and equipment             (1,755)      (861)    (3,789)    (4,567) 
  Cash paid for practice 
   acquisitions, net             --       (156)        --     (4,456) 
  Purchases of marketable 
   securities/investments        --         88         --     (9,595) 
  Sales of marketable 
   securities/Investments        --     12,556     50,000     81,258 
                            -------    -------    -------    ------- 
Net cash and cash 
 equivalents provided by 
 (used in) investing 
 activities                  (1,755)    11,627     46,211     62,640 
Cash flows from financing 
activities: 
  Payments made for 
   financing of insurance 
   payments                    (154)      (259)    (1,156)    (3,269) 
  Payment of deferred 
   consideration 
   liability for 
   acquisition                   --     (1,625)    (2,372)    (2,584) 
  Principal payments on 
   financing leases             (10)       (10)       (39)      (101) 
  Common stock repurchase 
   from related party            --         --         --     (1,019) 
  Common stock issued for 
   options exercised             --        113         75        126 
Net cash and cash 
 equivalents used in 
 financing activities          (164)    (1,781)    (3,492)    (6,847) 
                            -------    -------    -------    ------- 
Net increase in cash and 
 cash equivalents             2,267      5,964     16,181     19,478 
Cash and cash equivalents 
 at beginning of period      47,402     27,524     33,488     14,010 
                            -------    -------    -------    ------- 
Cash and cash equivalents 
 at end of period          $ 49,669   $ 33,488   $ 49,669   $ 33,488 
                            =======    =======    =======    ======= 
 
 

Contacts

Media

The Oncology Institute, Inc.

Jaime Valles

marketing@theoncologyinstitute.com

Investors

Solebury Strategic Communications

investors@theoncologyinstitute.com

(END) Dow Jones Newswires

March 24, 2025 06:01 ET (10:01 GMT)

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