The Oncology Institute, Inc.

2025 earnings conference call. Today's call is being recorded, and we have allocated one hour for prepared remarks and Q&A. At this time, I'd like to turn the conference over to Mark Heppelheiser, General Counsel at TOI.

Thank you. You may begin. The press release announcing the Oncology Institute's results for the first quarter of 2025 are available at the investor section of the company's website, theoncologyinstitute.com. A replay of this call will also be available at the company's website after the conclusion of this call. Before we get started, I would like to remind you of the company's safe harbor language included within the company's press release for the first quarter of 2025. Management may make forward-looking statements, including guidance and underlying assumptions. Forward-looking statements are based on expectations that involve risks and uncertainties that could cause actual results to differ materially. For a further discussion of risks related to our business Seer Filings with the SEC. This call will also discuss non-GAAP financial measures, such as adjusted EBITDA and free cash flow. Reconciliation of these non-GAAP measures to the most comparable GAAP measures are included in the earnings release furnished to the SEC and available on our website. Joining me on the call today is our CEO, Dan Vernick, and our CFO, Rob Carter. Following our prepared remarks, we'll open the call for your questions. With that, I'll turn the call over to Dan.

Thank you, Mark. Good afternoon, everyone, and thank you for joining our first quarter 2025 earnings call. Today, we will discuss first quarter 2025 results with a focus on our strong start to the year and momentum on our path to profitability and positive cash flow by the end of 2025. I'd like to start with some key updates on Q1 performance. I'm happy to report that revenue for Q1 increased by 10% versus the prior year period. This was driven by a few important factors. Our retail pharmacy and dispensary business continues to grow rapidly and set fill records, contributing 49.3 million in revenue and over 9 million in gross profit in Q1 alone. This business segment grew over 20% in the first quarter of 2025 versus prior year. As noted on our year-end call in March, we had a very strong start to the year with new capitated contract wins, adding over 80,000 lives in the first quarter on four agreements across the Florida, California, and Nevada markets. Anticipated new capitation contracts in the first half of 2025 are projected to add approximately $50 million in new revenue on an annualized basis. We started our first fully delegated capitation agreement with a major health plan in Florida on March 1st. where we are delegated for utilization management claims and network. This is going to be our preferred model for health plan relationships going forward, as it gives us differential ability to manage therapeutics with our MSO practice partners, as well as engage with them on future high value opportunities for TOI through our retail pharmacy and clinical trials program. We also signed a new capitation contract in Nevada during the first quarter, which adds over 80,000 Medicaid lives to Clark County with an effective date of July 1. Our fee-for-service business also returned to growth in the quarter, growing 9% quarter-over-quarter and 2% year-over-year, highlighting the impact of our investments in referral relationship management and call center expansion. Achieving profitability and our near-term path to positive free cash flow generation in Q4 remain the management team's North Star. Some highlights from Q1 related to this effort include adjusted EBITDA loss of $5.1 million, which is on the upper end of our guidance for the quarter, gross profit of $17.2 million, which represents growth of 44.1% year-over-year, continued acceleration of near-term capitation opportunities in the pipelines, with line of sight to an additional 100,000 lives with anticipated effective dates in Q2 and Q3. Focus on growing our radiation oncology and radiopharmaceutical segments, which will be accretive to fee-for-service margins. Successful outsourcing of our clinical trials for REM to Helios Clinical Trials. Helios will operate as a site management organization, and we believe their expertise will dramatically accelerate trials growth in existing and new markets in the second half of the year. However, the structure of the transaction will involve deconsolidating clinical research revenue from QI's income statement, which will modestly impact our full-year revenue, which Rob will discuss in more detail shortly. As it stands today, we are not currently projecting a negative impact to drug costs in 2025 related to recently announced tariffs, although we are carefully assessing country of origin for all therapeutics in our portfolio, ensuring we have optionality for all of these classes to protect our margins. Finally, we successfully executed a partial pay down of our convertible preferred debt of $20 million in Q1 with permanent elimination of our minimum cash covenant, followed by a capital raise that added $16 million back to our balance sheet. Combined, these transactions strengthen TOI's financial position and provide us with greater flexibility to execute on our strategic priorities. Finally, this afternoon, we announced that Dr. Jeff Langsam is joining the TOI team as Chief Clinical Officer. Jeff joins us from Cigna, where he led national efforts in oncology and specialty pharmacy, lending to his role at TOI, where he will lead our efforts around therapeutics, utilization management, and MSO practice engagement. The Chief Clinical Officer role was conceived as part of TOI's evolution. In light of the increasingly complex drug and delegation landscape, in which TOI operates, allowing us to further distance our capabilities and delivered value. To this end, Dr. Langsam's role is designed as a net addition to TOI's central clinical infrastructure and is expected to remain collaborative, but ultimately distinct from that of TOI's chief medical officer, Dr. Yale Podmes, who will continue to serve as the chief clinician overseeing our provider staff. Last week, we also announced that TOI will be presenting clinical trial data at the American Society of Clinical Oncology annual meeting later this month, which demonstrates the value and effectiveness of TOI's clinical model at reducing cost of care while driving improvements in Part A utilization for the patients that we serve. With that, I will turn the call over to Rob to provide additional details on our Q1 performance and 2025 outlook.