The Oncology Institute, Inc.

Second-quarter total revenue was $161.3 million, up from $119.8 million a year ago, or 34.6% growth. Gross profit was $27.2 million versus $17.5 million last year, and gross margin improved to 16.8% from 14.6%, a gain of about 225 basis points. Adjusted EBITDA was $0.2 million, compared with a loss of $4.1 million in Q2 2025, and free cash flow was approximately $12.5 million in the quarter. Specialty Pharmacy revenue was $98.6 million, up 57.6% year over year, while patient services revenue was $58.8 million, up 5.3%. For the full year, management raised guidance to revenue of $650 million to $670 million, gross profit of $105 million to $110 million, adjusted EBITDA of $2 million to positive $7 million, and free cash flow of positive $5 million to positive $15 million. They also said full-year capitation revenue is still expected to be approximately $150 million, and third-quarter adjusted EBITDA is expected to be positive but muted at $500,000 to $1.5 million.

Dan Virnich framed the quarter as proof that the business has reached a new stage, highlighting profitability, operating leverage, and a successful refinancing. He emphasized the strategic rebrand to Starling Oncology as a better fit for a national value-based oncology company and said the new name should better reflect the company’s mission and scale. He was upbeat about contract momentum, the new Starling Nexus provider portal, and the company’s ability to keep growing capitated revenue while investing for 2027.

Rob Carter focused on the balance sheet and the numbers behind the quarter. He said the company repaid the $86 million senior secured convertible note using a $75 million OrbiMed term loan plus about $11 million of cash, without raising equity, and extended maturities from 2027 to 2031. On the income statement, he pointed to 34.6% revenue growth, 16.8% gross margin, SG&A of $29.9 million or 18.6% of revenue, and adjusted EBITDA of $0.2 million. He also noted cash and equivalents of $41.1 million, operating cash flow of $9.7 million for the first half, and year-to-date free cash flow of $9.5 million, up more than $24 million versus the prior-year period.

Analysts focused on the new Nevada and Oregon capitated wins, the expanded California exclusivity, the delayed Florida contract timing, and the high MLR range. Management said the Oregon and Nevada deals together add about 80,000 lives and about $50 million in annualized capitated revenue, while the California exclusivity adds about 230,000 capitated lives and an estimated $6 million in annualized capitation revenue plus Part D upside. They said the Florida contract delay was process-related and pushed 3Q impact into Q4, not a reflection of the contract itself, and that the guided MLR range of 80% to 90% reflects the onboarding of new delegated lives. Management also said the provider portal is soft-launched already, with e-prescribing expected to follow by about a month, and that no Part D lift from the portal is included in guidance.