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The Oncology Institute (TOI) Stock Fundamentals, Analysis & Risk Signals

Health score, price, valuation, risk signals, and key metrics at a glance.

The Oncology Institute
NasdaqCM•Healthcare•Medical Care Facilities
$5.13+5.13(0.00%)Market closed
Market Cap
$528.55M
P/S
0.9x

The Oncology Institute, Inc., an oncology company, provides various oncology services in the United States. It operates through three segments: Specialty pharmacy, Patient Services, and Clinical Trials & Other. The company offers physician services, in-house infusion, in-house specialty pharmacy, clinical trials, radiation therapy, and outpatient blood product transfusion services, as well as educational seminars, support groups, counseling services, and 24/7 patient assistance and support services. It also manages clinical trials and palliative care programs; operates combined community clinics and infusion suites; and operates a specialty pharmacy that includes both in-office and mail-order dispensing for complementary oral and self-injectable medications taken by patients concurrent with their in-office cancer therapies. It serves adult and senior cancer patients. The Oncology Institute, Inc. was founded in 2007 and is headquartered in Cerritos, California.

D

How this company scores

WeakMetricSide Score: 50/100

Grade capped at D — Negative equity — the balance sheet is insolvent. Strongest: Growth (20/25); weakest: Balance Sheet & Red Flags (5/25).

Profitability17/25
Growth20/25
Balance Sheet & Red Flags5/25
Cash & Earnings Quality8/25
Strengths
Growing revenueLong cash runwayProfit converts from growthConsistent growth
Grade capped at D
  • Negative equity — the balance sheet is insolvent.
  • Interest coverage below 1× (-3.5x) — earnings cannot cover interest.

Valuation vs. 5-year range

Today's multiple positioned against its own trailing range — a visual premium/discount check.

P/E · 2455.0x5y range 112.1x – 2455.0x
P/E 2455.0x · above its 4-quarter median

Currently above its 4-quarter median.

P/S · 0.9x5y range 0.9x – 1.7x
P/S 0.9x · near its 19-quarter median

Currently near its 19-quarter median.

P/B · 78.0x5y range 2.8x – 108.2x

Watch items

Data-driven signals worth keeping an eye on across the last 8 quarters

High Risk

Margin Pressure

Red Flag

The company posted negative operating margins in recent quarters — core operations are unprofitable.

Earnings Quality

Red Flag

Free cash flow has been negative in 4 of the last 8 quarters — earnings are not translating to cash.

Price & Volume
Market Cap $528.55M

Metrics at a Glance

as of June 2026

Revenue & Profit

Revenue, EBITDA, operating income, net income, EPS, and shares

TTM Revenue
$587.24M
7Q
Q. Revenue
$161.28M
7Q
TTM EBITDA
$-19.28M
7Q
TTM Op. Income
$-26.09M
7Q
Q. Op. Income
$-4.62M
4Q
TTM Net Income
$-36.29M
3Q
Q. Net Income
$-9.79M
42%
EPS
$-0.08
47%
Shares Out.
$103.03M
2Q
$587.24M in TTM revenue grew 38.4% YoY, reaching $161.28M last quarter. TTM EBITDA of $-19.28M and TTM operating income of $-26.09M show growth is flowing through to the bottom line. However, net income is negative at $36.29M — growth is not yet reaching the bottom line. Across the last 8 quarters, TTM revenue has risen for 7 consecutive quarters — an improving trend.

Margins

Gross, EBITDA, operating, and net margin trends

EBITDA Margin
-1.7%
4Q
Op. Margin
-2.9%
7Q
Net Margin
-6.1%
57%
Op. margin of -2.9% is up 6.5% YoY — cost efficiency is improving. Net margin at -6.1% Across the last 8 quarters, operating margin has risen for 7 consecutive quarters — an improving trend.

Price Ratios

P/E, P/S, P/B, EV/EBITDA, FCF yield, and earnings yield

P/E Ratio
N/A
P/S Ratio
0.9x
20%
P/B Ratio
N/A
P/S of 0.9x and P/B of 0.0x. P/S is low relative to typical market levels.

Assets & Liabilities

Total assets, cash, debt, book value, and leverage

Total Assets
$178.23M
4Q
Cash
$41.09M
36%
Long-Term Debt
$79.87M
5Q
Book Value
$-24.91M
5Q
D/E Ratio
N/A
Debt/EBITDA
N/A

Cash Flow

Operating cash flow, free cash flow, FCF margin, and earnings quality

Op. Cash Flow
$11.94M
217%
TTM Free Cash Flow
$-3.29M
2Q
FCF Margin
-0.6%
3Q
FCF / Net Income
0.1
54%
TTM FCF of $-3.29M on $11.94M in operating cash flow. The FCF / Net Income ratio of 0.1x means cash covers only part of net income — earnings quality needs attention. Across the last 8 quarters, free cash flow has risen for 2 consecutive quarters — an improving trend.

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· above its 14-quarter median

Currently above its 14-quarter median.

Leverage Risk

Red Flag

D/E ratio is 14.6 — heavily leveraged and vulnerable to rising rates or cash flow dips.

Cash Burn

Watch

4 of the last 8 quarters had negative FCF — inconsistent cash generation raises sustainability concerns.

Share Dilution

Red Flag

Shares outstanding increased 36.4% — significant dilution, likely from stock compensation or capital raises.