The Oncology Institute, Inc.

Ladies and gentlemen, greetings and welcome to the Oncology Institute second quarter 2025 earnings call. At this time, all participants are in the listen-only mode. A brief question and answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star and zero on your telephone keypad. As a reminder, this conference is being recorded. It is now my pleasure to introduce your host, Mark Heppelizer, General Counsel at TOI, please go ahead.

The press release announcing the Oncology Institute's results for the second 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 second 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, see our 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 are 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 second quarter 2025 earnings call. I'm pleased to report another strong quarter of performance for TOI on our path to profitability, driven by the contributions of our over 650 outstanding clinicians and teammates. The strong momentum we saw in the first quarter continued into the second quarter with year-over-year revenue growth of more than 20%. Our second quarter revenue of $120 million was driven by monthly records set in our pharmacy business, as well as 10% year-over-year growth in our fee-for-service business, driven by strong organic growth performance in Florida and Oregon. Our value-based contract pipeline remains equally strong, with contracts effective in Q2 adding over 50,000 capitated lives in Nevada and California. We anticipate new value-based partnerships to continue strong momentum in the second half of the year through several new contracts, which I will provide more detail on shortly. At this point in the year, we remain confident in achieving positive adjusted EBITDA in the fourth quarter. Adjusted EBITDA loss of 4.1 million in Q2 represents a 4.6 million improvement compared to the same quarter last year, reducing the EBITDA loss by more than half. which was primarily the result of organic fee-for-service and pharmacy revenue growth, discipline and clinical payroll and SG&A across higher volumes, as well as improving drug margins across IV and pharmacy, as TOI leverages its increased buying power and distributor relationships. Turning first to our patient service business, we delivered several new capitated contract wins and expansions in the second quarter, and continue to work through a robust pipeline of future opportunities, which will go effective in Q3 and Q4. In addition to the two contracts which went effective in Q2 in Nevada and California, on July 1st, we went effective on an expanded capitation relationship with Silver Summit Health Plan in Nevada to serve all of their Medicaid patients in Clark County, adding an additional 49,000 patient lives to this market. The integration is underway and tracking according to plan. Additionally, in the quarter, we received exclusivity on a capitation contract for another key Optum region in California, which we attribute to our high quality outcomes and ongoing strength of this important partnership. Finally, we have reached a verbal agreement on expansion of our existing fully delegated capitated partnership in Florida with an Elevins health plan into two new counties in Central Florida starting in 4Q of this year, which will add over 40,000 additional Medicare Advantage lives, more than doubling our current relationship with this payer, and bringing our total Medicare Advantage lives under capitation in the Florida market across all payers to over 100,000. This contract expansion will allow us to increase utilization of the existing clinic investments TOI has made in the state without adding significant SG&A and further validates the compelling value proposition of TOI's fully delegated model in Florida, where we are now capable of delivering high-quality, coordinated cancer care across our hybrid employed clinic and MSO model. As a reminder, our fully delegated offering gives TOI control over utilization management, network design, and claims adjudication for the patients that we serve. We believe this will be our primary model of delivering value-based care in markets outside of California, where we will work more directly with health plans and risk arrangements. It increases our ability to not just deliver outstanding quality care and utilization improvement, but also enables access to ancillary services such as pharmacy and clinical trials for our MSO practice partners, which will drive value for them as well as TOI. As we look at the remainder of 2025 and beyond, we see opportunity in nearly every market where we operate to add new cap-titted relationships or expand upon existing partnerships. In regards to our pharmacy business, we experienced impressive growth of over 40% in the quarter versus Q2 of 2024. We are currently forecasting that our pharmacy will grow over 35% for the full year versus prior. The primary drivers of this impressive growth are an increase in patient volumes, leading to additional fill opportunities, as well as a reduction in leakage of prescriptions written by TOI providers to outside pharmacies through operational discipline. We are expecting an additional TOI pharmacy location to open in Florida in the second half of this year, which will help fill both Part B and Part D medications where appropriate to our MSO affiliate practices. This will drive down the unit cost of medications where TOI has risk and offer a convenient alternative for our MSO providers to fill Part D medications where appropriate. Now, I would like to turn to leadership and culture. On our last call, we shared the addition of Dr. Jeff Langsam, our new Chief Clinical Officer, who is focused on leading our efforts around therapeutics, utilization management, and MSO practice engagement. This is the core of our value proposition at TOI and will enable scalability of our delegated model across geographies, as well as unlock tremendous value for TOI and our payer partners. I'm also pleased to announce that Kristen England joined us in July as TOI's new Chief Administrative Officer. Ms. England brings over two decades of leadership experience in healthcare management and operations, most recently serving as a senior executive within McKesson's US Oncology Network. She will be overseeing our enterprise central business operations and technology strategy. Her role will be instrumental in driving our transformation into a technology and AI-enabled care delivery organization. This will not only drive a better patient and physician experience, but further reduce OPEX as a percent of revenue as we grow, driving margin and profitability. We are launching three AI enablement efforts in Q3 to make meaningful changes in performance and cost for revenue cycle management, prior authorization services, and our patient call center. Lastly, our current chairman, Richard Barish, has decided to retire and will be stepping down effective August 12th. Richard has been an incredible mentor for the management team, and we thank him for his steady leadership of our board through our first years as a public company. I'm very pleased to announce that the board has voted unanimously to elect Anne McGeorge as our new chair. Anne has been a TOI board member and chair of our audit committee since we went public in 2021. Anne has a wealth of public and private company experience as both a senior executive and board member. She was the former National Managing Partner of Healthcare for Grant Thornton, and prior to that, a partner at Deloitte. We are thrilled that Anne has been promoted into her new role and look forward to continuing to build on the success of TUI under her mentorship. I'll now turn the call over to our Chief Financial Officer, Rob Carter, to cover the second quarter financials in more detail. Rob?