TOIIW · Starling Oncology, Inc.

The Oncology Institute’s Q1 2026 results reflect strong top-line growth and meaningful bottom-line improvement, anchored by its value-based care model. Revenue surged 41.2% year-over-year to $147.4 million, primarily driven by capitated revenue expansion and a 78% increase in Specialty Pharmacy Part D fills—highlighting both membership growth and improved clinical pathway adherence. Gross profit rose 35.2%, though gross margin compressed slightly (15.8% vs. 16.5% in Q1 2025), suggesting scale benefits partially offset by mix or cost pressures. Net loss narrowed sharply to $2.5 million from $19.6 million, and diluted EPS improved to $(0.02) from $(0.21), aided by lower interest expense ($1.9M vs. $5.6M) and reduced infrastructure costs. Adjusted EBITDA improved to $(2.4) million, supported by operational efficiencies and Florida’s transition to profitability—a key validation of the company’s delegated capitation strategy. Management reaffirmed full-year revenue ($630–$650M) and Adjusted EBITDA ($0–$9M) guidance but upgraded Free Cash Flow guidance to $5–$15 million, citing stronger-than-expected cash conversion and timing of capital expenditures. The $150 million capitated revenue target and upcoming July 1, 2026 expansion to 200,000 Medicare Advantage lives in Florida underscore continued execution on scalable, risk-bearing contracts. While forward-looking metrics remain subject to regulatory, operational, and macroeconomic uncertainties—including CMS model performance variability and tariff-related risks—the quarter marks a material inflection toward sustainable profitability.