Oncology Institute, Inc. (TOIIW) Stock Analysis
Oncology Institute, Inc.
▾ What's in the 54/100 risk score? (higher = riskier)
Contributions (weight × component score) sum to the total. This near-term score now includes fundamental health (leverage, FCF trend). See the Financial Health section for the full balance-sheet read.
How to read TOIIW (speculative micro-cap)
No model can pin a precise fair value on a company this small — but that does not mean there is nothing to learn. The useful questions are what the price is betting on, and whether the company can survive long enough to deliver it.
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1
Reverse-DCF — what growth the price assumes ↓
The single most useful number here: it backs out the growth the market is paying for. If that figure is "historically unprecedented," the price is running on hype, not fundamentals.
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2
Cash runway ↓
A pre-profit micro-cap lives or dies on whether it can fund itself to profitability before running out of money and diluting you.
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3
The raw financial statements + the 10-K ↓
At this scale, the actual numbers, insider ownership, and share-count trend tell you more than any ratio.
Standard DCF doesn't fit TOIIW well — but that's expected for this kind of business. The Rule of 40 (Pre-Profit Growth) Lens below uses the metrics actually used by analysts who value physician offices. Reverse DCF + Football Field also work as cross-checks.
How to read a company this small
TOIIW is too small and/or too volatile for the valuation lenses we use on larger, more stable companies. The numbers shown below should be taken as rough orientation only.
- Market cap $4.5M — nano-cap territory (below $50M)
Growth percentages on tiny revenue bases (1000% going from $200K to $2M is not predictive). P/E and ROE swing wildly with small earnings changes. Peer comparisons fail because there often aren't comparable companies at this scale.
Start with the Reverse-DCF above — it backs out the growth the price is betting on; if that figure is "historically unprecedented," the price is running on hype, not fundamentals. Then the cash runway (can it fund itself to profitability before diluting you?). Then the raw Financials table and the 10-K on SEC EDGAR — at this scale, insider ownership and the share-count trend often matter more than any ratio.
Classified as Speculative Nano / Micro-cap (confidence 80%). Disagree? An admin can override via the post edit screen.
⚠ Genuine comparables are scarce at this size, so peer multiples are unreliable here. Treat as rough context only — see 📍 What to focus on above.
How does TOIIW stack up against its closest peers?
Ideally we compare TOIIW only to same-industry peers, but too few exist in our universe right now, so the basket below mixes in broader-sector names. Treat the multiples as rough context, not a valuation. For a leveraged business, EV/EBIT and FCF yield (both in the table) are usually more reliable than EV/Sales, because revenue multiples ignore differences in margins and debt.
▾ What's "EV / Sales" in plain English?
EV (Enterprise Value) = market cap + total debt − cash. It's "what you'd pay to buy the entire company outright" — you pay the market cap to shareholders and take over their debt, but you keep their cash. EV is fairer than market cap alone because it includes the debt the new owner inherits.
EV / Sales = EV ÷ annual revenue. So "2.5×" means investors pay $2.50 of enterprise value per $1 of yearly sales. Higher = market is paying more per dollar of sales (usually because they expect future growth or fat margins).
p25 / median / p75 are the 25th, 50th (middle), and 75th percentile of the peers' multiples. Half the peers fall between p25 and p75. The median (p50) is the typical peer — that's the benchmark we compare to.
| EV / SalesEV / Sales — For every $1 of yearly revenue, this is how many dollars investors pay to own the whole business (including debt). Why it matters: Works for pre-profit growth companies where P/E and FCF don't apply. The most apples-to-apples cross-company multiple because it ignores accounting choices. Reference: 1–3x for mature companies · 4–10x for software/SaaS · 10–20x for hypergrowth · >20x is rare and demanding Full explanation → |
0.6x / 1.9x / 6.7x |
| EV / Gross ProfitEV / Gross Profit — Enterprise value divided by gross profit — the multiple paid for what each dollar of sales contributes after direct costs. Why it matters: More refined than EV/Sales for high-margin businesses (software, marketplaces) where gross margin is the real economic engine. Reference: 8–15x for SaaS · 15–25x for hypergrowth software · >30x demanding Full explanation → |
0.1x / 1.0x / 7.2x |
Bold middle number = median peer. Half the peers trade above it, half below. Computed over 8 peers (broad — see caveat); implausible multiples excluded.
⚠️ Important caveat: peer multiples only work if the peers are genuinely comparable. Always check the peer list below — if the auto-picker grabbed micro-caps or unrelated businesses, the comparison is noise. A medical-device giant priced against tiny biotech startups won't produce a useful signal.
▾ View peer list (8)
| Ticker | Company | Industry | Mcap | EV/Sales | EV/GP | EV/EBIT | FCF Yield |
|---|---|---|---|---|---|---|---|
| BMGL | Basel Medical Group Ltd | Physician Offices | $11M | — | — | — | — |
| SBCWW | SBC Medical Group Holdings Inc | Physician Offices | $15M | 0.1x | 0.1x | 0.2x | 139.0% |
| XAIR | Beyond Air, Inc. | Medical Devices ·fallback | $5M | 1.3x | — | — | 16.1% |
| VIVS | VivoSim Labs, INC. | Biotechnology ·fallback | $3M | 23.7x | — | — | 2.4% |
| XBIO | Xenetic Biosciences, Inc. | Pharmaceuticals ·fallback | $7M | 2.4x | — | — | 8.6% |
| VBIO | Valion Bio, Inc. | Medical Devices ·fallback | $2M | — | — | — | — |
| VTAK | Catheter Precision, Inc. | Medical Devices ·fallback | $2M | 6.7x | 7.2x | — | 66.6% |
| VVOS | Vivos Therapeutics, Inc. | Medical Devices ·fallback | $10M | 0.6x | 1.0x | — | 20.4% |
Bankruptcy + quality screens
Cheap stocks can be cheap for a reason. These screens warn when a low valuation comes paired with structural fragility.
Why it matters: Cheap-looking stocks (low P/E or P/B) often have low Z-scores because the market knows the company is dying. Z-score warns you before you fall into a value trap.
Reference: > 3.0 = safe zone · 1.81–3.0 = grey zone · < 1.81 = distress zone
Full explanation →
Grey zone — a mixed, inconclusive band under the classic thresholds. A warning to verify the recent trend, not a probability of failure.
The classic Z-score was calibrated on manufacturers. It is less reliable for asset-light or non-manufacturing businesses (broadcasters, media, software, services) and not applicable to banks, REITs, or insurers — for those the coefficients and the asset-turnover term distort the result. Read it as one screening input, not a verdict.
▾ The checks — what passed, what didn't (and what we couldn't measure)
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✗ Positive net incomeNet income -$60.6M in the latest year.Why this matters: Does the company actually earn a profit? Sustained losses eventually force it to raise money — diluting you — or take on debt.
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✗ Positive operating cash flowOperating cash flow -$24.6M (was -$26.5M the prior year).Why this matters: Profit can be an accounting figure; cash from running the business is harder to fake. Negative operating cash flow means the core business consumes cash and must be funded externally.
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✓ Cash flow backs up reported profitOperating cash flow -$24.6M vs net income -$60.6M.
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✓ Return on assets improvingReturn on assets -36.8% vs -37.4% a year ago.
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✓ Debt load (vs assets)Long-term debt is 47.0% of assets vs 53.9% a year ago ($77.4M now).
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✗ Short-term liquidity (current ratio)Current ratio 1.59x vs 2.15x a year ago.Why this matters: The current ratio compares assets it can turn to cash within a year against bills due within a year. Below 1.0 means it may struggle to cover near-term obligations.
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✗ Share count (dilution)Share count rose 23.1% (75.0M → 92.4M year-over-year).Why this matters: Issuing lots of new shares splits the pie into more pieces, shrinking your slice. Stable or falling share count protects existing owners.
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· Pricing power (gross margin) (n/a — data not reported; not scored)
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✓ Sales per asset (asset turnover)Asset turnover 3.05x vs 2.28x a year ago.
Missing data is never counted as a pass or a fail — it's shown as n/a and excluded from the denominator. Each check compares the company against its own prior year.
Plain English: the company holds about $34M in cash and is burning roughly $25M/year in operations. At that pace, the cash lasts 16 mo before it must raise capital (diluting shareholders), take on debt, or cut spending.
Assumes constant burn and ignores financing/asset sales. For pre-profit biotech and growth companies, this matters more than a DCF — a great drug pipeline is worthless if they run out of money before approval.
What if you assume different inputs?
Here's where we land — and what happens if you change the assumptions. Drag the sliders to set your own Discount RateDiscount Rate — The annual return you demand for taking single-stock risk instead of buying a safe Treasury or index fund.
Why it matters: Higher discount rate = stricter valuation (a stock has to produce more cash to be worth holding). Lower = more generous.
Reference: 8–12% is standard · 9–10% matches S&P 500 historical return · Below 7% is illogical for single-stock risk
Full explanation → (the annual return you demand for single-stock risk) and terminal growth; the value updates live so you can see whether the stock looks cheaper or richer. The discount rate starts at 10.0%, the figure our model used for TOIIW. Open Advanced to also change beta, growth and the rate path.
Note: no headline intrinsic value is published for this stock (the valuation is held for a data-quality reason — see the notes above). The calculator below is a what-if tool: the values it produces are your assumptions played out, not our estimate.
A full intrinsic value isn't shown for TOIIW because the valuation is currently held for a data-quality reason (see the guardrail notes above). The reverse-DCF reading still works — it needs only the price and cash flow — but we won't publish a forward value until the underlying data passes our checks.
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⚙ Advanced — tinker with every input (beta, growth, rate path, margin → full intrinsic value)
A standard discounted cash flowDCF — Discounted Cash Flow — sums up all future cash a business will produce, adjusted for the fact that future dollars are worth less than dollars today.
Why it matters: It is the most fundamentally honest valuation method when applicable — but only works for companies with predictable, positive cash flow.
Reference: Best for: mature, profitable businesses. Fails for: pre-profit growth, banks, REITs.
Full explanation → (DCF) valuation is not meaningful for The Oncology Institute, Inc. due to its consistently negative operating cash flow and net income, indicating a cash-burning growth stage. Investors are likely betting on the company's ability to achieve profitability and positive cash flow from its revenue growth. The primary quantifiable risk is the rising long-term debt, which increased from $0M to $77M.
As of 2 months ago
Anatomy of a share
What you're buying per share. Bars are at the same scale so you can see the relative size of revenue, costs, cash flow, and debt — not just read them in a table.
What's free cash flow / what do these mean?
Revenue per share — how much the business earns from customers, divided by the number of shares outstanding. Top of the income statement.
Earnings per share — profit left after operating costs, interest, and taxes, per share. Two versions appear on this page and are not interchangeable: GAAP diluted EPS uses the company's weighted-average diluted share count during the reporting period (this is the "earnings" in "price-to-earnings"); net income per current share divides annual net income by today's share count. They differ whenever the share count has changed.
Owner-earnings free cash flow per share — the cash the business produces for shareholders. Savng's owner-earnings FCF subtracts capital expenditures and stock-based compensation from operating cash flow (SBC is a real dilution cost even though it's non-cash). This is deliberately more conservative than "standard" FCF, which subtracts only capital expenditures — so our figure is lower than the headline FCF you'll see elsewhere. FCF funds dividends, buybacks, debt repayment, and acquisitions; a company can report positive earnings yet negative FCF.
Debt per share — total interest-bearing borrowings divided by shares. High debt-per-share next to thin FCF-per-share is a fragility signal.
What you actually need to decide
Every stock price is a disagreement. Here's the single thing that must go right for the bulls, the single thing that breaks the thesis, and the concrete signposts to watch so you can update your view as real results arrive.
- Quarterly operating cash flow turning positive
- Reduction in the rate of long-term debt accumulation
- Improvement in net income towards profitability
The trend, in plain numbers (2024 → 2025)
Straight from the financial statements — no model, no opinion. For a small or unprofitable company, the direction of these numbers usually tells you more than any single valuation.
- Revenue grew +28% to $502.7M.
- Free cash flow is negative at -$32.3M — the cash burn narrowed vs last year.
- Still unprofitable at -$60.6M — loss narrowing.
Nothing clearly worsening year-over-year.
Management & Leadership
Dr. David Currow serves as the Chief Executive Officer of The Oncology Institute, Inc. The company focuses on providing comprehensive cancer care services. Further executive details are not readily available in public data.
What They Make
The Oncology Institute, Inc. provides comprehensive cancer care services, including medical oncology, hematology, and other related support services, to patients across various communities.
End Markets
Revenue Drivers
Why Is It Priced Like This?
Why Customers Pay
What we use instead: earnings (P/E, EV/EBIT), book value (P/B) — computed from the figures this company does report, shown in the sections below. Those numbers are unaffected by the missing cash-flow data.
The market is pricing TOIIW based on expectations of future growth and the potential for its business model to achieve profitability, despite current negative net income and operating cash flow. The market may be assigning value to the expansion of its clinic network and the potential for improved economies of scale in cancer care delivery, which is not in the model. The company's revenue is growing at 25.4% per year, suggesting investors are focused on this top-line expansion rather than current cash generation.
Business Model & Valuation
How They Make Money
The company primarily funds itself through equity raises and has seen long-term debt rising from $0M to $77M, indicating reliance on external financing given its negative operating cash flow.
Growth / Revenue DCF
Negative free cash flow: revenue/margin growth model used - standard FCF DCF is unreliable for companies still scaling.
Show advanced inputs
| RevenueGrowth | 25.5% |
What this model does NOT do: this is a consolidated owner-earnings FCF model. Standalone segment assumptions: none. It does not project its revenue segments independently; their combined effect is embedded in the historical revenue and cash-flow trend the model extrapolates. The calculator above can only approximate a segment's impact through the single consolidated growth rate — it cannot model any one line separately. For a true segment-level view, build a separate model from the company's segment disclosures.
Maturity & Competitive Position
Moat Signals
Revenue is growing at 25.4% per year over four years, from $203M to $503M, though net income and operating cash flow are negative.
Geography & Markets
The Oncology Institute, Inc. primarily operates within the United States, focusing on establishing clinics in various communities. Specific geographic revenue splits are not available from current data sources.
Geographic Risks
Market Signals
These are timing signals, not value signals — they describe the stock's recent price behavior, not what the business is worth. Use them for the "the thesis looks good, but is now the moment?" question. Each tile below explains what it's saying.
Why it matters: Short-term contrarian indicator. Extreme readings often precede mean reversion, though not always.
Reference: 30–70 normal · >70 overbought · <30 oversold
Full explanation → (14)50.9NeutralMomentum is balanced — neither overbought nor oversold.
Why it matters: When the fast line crosses above the slow line, short-term momentum is turning up; below, turning down. A timing cue, not a value signal.
Reference: Line above signal = bullish momentum · below = bearish
Full explanation →BullishLine above signalThe fast trend is above the slow trend — short-term momentum is currently upward.
Technicals describe price, not the business. A great company can have a "bearish" tape (a buying chance) and a weak one a "bullish" tape (a trap). Pair these with the valuation and health sections above.
QUALITY
Data Quality & Risk Flags (4 notes — click to expand/collapse)
Guardrail Notes (4)
- FCF negative: revenue/margin growth model projects future cash flows from revenue trajectory.
- Illiquidity discount 25% applied (small/micro-cap — harder to exit, demand a margin).
- Extreme valuation (P/IV 0.0044x, IV $11.27 vs price $0.05); output dominated by data/units issue (often a multi-class share-count mismatch). Suppressed.
- DATA UNAVAILABLE: per-share values suppressed due to missing/unreliable shares data.
FINANCIALS
Financial Statements (5-year tables — click to expand)
From Oncology Institute, Inc.'s SEC filings (EDGAR).
Income (5yr)
| Year | Revenue | Net Income | EPS |
|---|---|---|---|
| 2025 | 502.7M | -60.6M | $-0.54 |
| 2024 | 393.4M | -64.7M | $-0.71 |
| 2023 | 324.2M | -83.1M | $-0.92 |
| 2022 | 252.5M | 152,000 | $-0.21 |
| 2021 | 203.0M | -10.9M | $-0.16 |
Cash Flow (5yr)
| Year | Operating CF | CapEx | − SBC & adj. | Free Cash Flow |
|---|---|---|---|---|
| 2025 | -24.6M | 3.2M | 4.6M | -32.3M |
| 2024 | -26.5M | 3.8M | 11.2M | -41.5M |
| 2023 | -36.3M | 4.6M | 17.8M | -58.7M |
| 2022 | -61.8M | 5.5M | 27.7M | -95.0M |
| 2021 | -32.7M | 2.8M | 24.5M | -60.1M |
How we define FCF: operating cash flow − capital expenditure − stock-based compensation (owner-earnings basis — SBC is a real cost to shareholders even though it's non-cash). Latest year: -24.6M − 3.2M − 4.6M (SBC & adj.) = -32.3M. This is the same owner-earnings FCF definition the valuation model uses, though the DCF's starting value is a projected from revenue × terminal margin, not this single year.
Balance Sheet
| Total Assets | 164.7M |
| Total Liabilities | 180.4M |
| Equity | -15.7M |
| Total Debt | 77.4M |