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The Oncology Institute Reports Third Quarter 2022 Financial Results and Updates Full Year 2022 Guidance

CERRITOS, Calif., Nov. 09, 2022 (GLOBE NEWSWIRE) -- The Oncology Institute, Inc. (NASDAQ: TOI), one of the largest value-based community oncology groups in the United States, today reported financial results for its third quarter ended September 30, 2022.

Recent Operational Highlights

  • Completed a $110 million strategic investment from Deerfield Management Company, L.P. through secured senior convertible notes on August 9, 2022
  • Increased market count to 14 during the third quarter, including three acquisitions across California, Nevada and Florida and two de novo clinics in California and Texas
  • Ended the third quarter with 100 clinicians, representing 27% growth compared to the third quarter of 2021
  • Received AHRQ (Agency for Healthcare Research and Quality's) certification as an accredited Patient Safety Organization
  • Expanded leadership team with appointments of Philip Reger in newly created Chief Information Officer role and Cristina Green as Vice President of Clinical Research

Third Quarter 2022 Financial Highlights

  • Consolidated revenue of $65 million, an increase of 24.3% from $52 million for the prior year quarter
  • Gross profit of $13 million, an increase of 13.8% compared to the prior year quarter
  • Net loss of $2.7 million compared to net loss of $3.0 million for the prior year quarter
  • Basic and diluted earnings per share of $(0.03) and $(0.17) compared to $(0.05) and $(0.05) for the prior year quarter
  • Adjusted EBITDA of $(7) million compared to $0.1 million for the prior year quarter
  • Cash and cash equivalents of $61 million as of September 30, 2022

Management Commentary

Brad Hively, CEO of TOI, commented, “We delivered another quarter of strong double-digit growth as demand for our services remained robust. We continued our expansion into new markets through a combination of acquisitions and de novo clinics in California, Florida, Texas and Nevada. As our organization expands, we continue to strengthen our leadership team. In the third quarter, we added two seasoned executives overseeing our enterprise-wide technology and data initiatives as well as our clinical research strategy. We are also pleased to have recently completed an important $110 million strategic investment from Deerfield to continue executing our growth strategy. We remain confident in our ability to continue to expand our value-based care model and deliver affordable and high-quality care to more patients in more markets.”

Outlook for Fiscal Year 2022

TOI is updating its full-year 2022 guidance as we have experienced slower than expected revenue growth primarily related to delays in closing acquisitions. We are constantly evaluating opportunities to create efficiencies and reduce costs, while ensuring we maintain the infrastructure needed to continue to provide quality patient care and support our growth. To ensure that our cost structure remains aligned with our revenue growth, we are taking a multi-pronged approach to cost reduction, including a reduction of vendor and contract spend and a difficult, but necessary, workforce reduction. We expect to realize benefits from these efforts beginning in the fourth quarter of 2022.

 Year Ending December 31, 2022
 Updated GuidancePrevious Guidance
(in millions)LowHighLowHigh
Revenue$        245 $        250 $        270 $        310 
Gross Profit$        47 $        50 $        50 $        60 
Adjusted EBITDA(1)$        (28)$        (25)$        (25)$        (20)
Lives under value-based contracts (2) 1.65  1.75  1.75  2 

 


(1)TOI does not reconcile guidance for Adjusted EBITDA, a non-GAAP metric, to net income (loss), the most comparable GAAP measure, and does not provide forward-looking guidance for net income (loss), because of the inherent uncertainty and difficulty around predicting certain items that may impact net income (loss), including stock-based compensation. TOI is not adding back new clinic startup or acquisition cost for this non-GAAP metric. The presentation of this financial information is not intended to be considered in isolation or as a substitute for the financial information prepared and presented in accordance with GAAP. The Company's fiscal 2022 adjusted EBITDA guidance is merely an outlook and is not a guarantee of future performance. Stockholders should not rely or place an undue reliance on such forward-looking statements. See "Forward-Looking Statements" below for additional information.
  
(2)Represents lives under capitation and gain sharing contracts (in millions).
  

TOI's achievement of the anticipated results is subject to risks and uncertainties, including those disclosed in our filings with the U.S. Securities and Exchange Commission. The outlook does not take into account the impact of any unanticipated developments in the business or changes in the operating environment, nor does it take into account the impact of TOI's acquisitions, dispositions or financings during 2022. TOI's outlook assumes a largely reopened global market, which would be negatively impacted if closures or other restrictive measures persist or are reimplemented.

Third Quarter 2022 Results

Consolidated revenue for Q3 2022 was $65 million, an increase of 24.3% increase compared to Q3 2021, and a 6.7% increase compared to Q2 2022.

Revenue for patient services was $45 million, up 35.4% compared to Q3 2021. Growth in patient services was driven by an increase in capitated contracts entered into during 2022 and in the latter half of 2021 as well as growth in FFS revenue due to practice acquisitions and an overall increase in clinic count. Dispensary revenue growth lagged the growth in patient services revenue largely due to the Medi-Cal Rx transition. Despite the Medi-Cal Rx transition, dispensary revenue increased 5.1% compared to Q3 2021 due to an increase in the number of filled prescriptions as well as an increase in the average revenue per filled prescription. Clinical trials & other revenue increased by 8.7% compared to Q3 2021 due to an increase in miscellaneous contract revenue.

Gross profit in Q3 2022 was $13 million, an increase of 13.8% compared to Q3 2021. The increase was primarily driven by improved cost management of oral and IV drugs and enhanced rebate opportunities. Gross profit is calculated by subtracting direct costs of patient services, dispensary, and clinical trials & other from consolidated revenues.

Selling, general and administrative ("SG&A") expenses in Q3 2022 were $32 million or 49.2% of revenue, compared with $13 million, or 24.4% of revenue, in Q3 2021. During Q3 2022, share-based compensation expense was $7 million and SG&A-related transaction costs was $1 million. The remainder of the increase in SG&A expenses was due to headcount and other costs associated with operating as a public company and to support revenue growth and expansion into new markets.

Net loss for Q3 2022 was $3 million, a decrease of $0.3 million compared to Q3 2021 primarily due to the increase in gross profit and the change in fair value of the warrant, earnout and conversion option derivative liabilities, offset by increased operating expenses. Adjusted EBITDA was $(6.7) million, a decrease of $7 million compared to Q3 2021, primarily as a result of our growth in SG&A.

Year to Date 2022 Results for the Nine Months Ended September 30, 2022

Consolidated revenue for the nine months ended September 30, 2022 was $181 million, an increase of 20.1% compared to the comparable prior year period.

Revenue for patient services was $119 million, an increase of 28.6% compared to the comparable prior year period. Growth in patient services revenue was primarily driven by an increase in capitated contracts entered into during the nine months ended September 30, 2022 and in the latter half of 2021 as well as growth in revenue from fee-for-service contracts due to practice acquisitions and an overall increase in clinic count. Dispensary revenue growth lagged the growth in revenue from patient services largely due to the Medi-Cal Rx transition. Despite the Medi-Cal Rx transition, dispensary revenue increased 8.3% compared to the comparable prior year period due to an increase in the average revenue per filled prescription. Clinical trials & other revenue decreased by 9.5% compared to the comparable prior year period due to a decline in miscellaneous contract revenue.

Gross profit for the nine months ended September 30, 2022 was $36 million, an increase of 12.1% compared to the comparable prior year period. The increase was driven by improved cost management of our oral and IV drugs and enhanced rebate opportunities.

SG&A expenses for the nine months ended September 30, 2022 were $90 million or 49.8% of revenue, compared with $35 million, or 23.3% of revenue, in the comparable prior year period. During 2022, share-based compensation expense was $22 million and SG&A related to transaction costs was $3 million. The remainder of the SG&A growth was due to headcount and other costs associated with operating as a public company and to support revenue growth and expansion into new markets.

Net income for the nine months ended September 30, 2022 was $11 million, an increase of $12 million compared to the comparable prior year period, primarily due to the increase in gross profit and the change in the fair value of the warrant, earnout and conversion option derivative liabilities, offset by increased operating expenses. Adjusted EBITDA was $(19) million, a decrease of $19 million compared to the comparable prior year period, primarily as a result of our growth in SG&A.

Webcast and Conference Call

TOI will host a conference call on Wednesday, November 9, 2022 at 5:00 p.m. (Eastern Time) to discuss third quarter results and management’s outlook for future financial and operational performance.

The conference call can be accessed live over the phone by dialing 1-877-407-0789, or for international callers, 1-201-689-8562. A replay will be available two hours after the call and can be accessed by dialing 1-844-512-2921, or for international callers, 1-412-317-6671. The passcode for the live call and the replay is 13732555. The replay will be available until November 16, 2022.

Interested investors and other parties may also listen to a simultaneous webcast of the conference call by logging onto the Investor Relations section of TOI's website at https://investors.theoncologyinstitute.com.

About The Oncology Institute, Inc.

Founded in 2007, TOI is advancing oncology by delivering highly specialized, value-based cancer care in the community setting. TOI offers cutting-edge, evidence-based cancer care to a population of approximately 1.7 million patients including clinical trials, transfusions, and other care delivery models traditionally associated with the most advanced care delivery organizations. With 100+ employed clinicians and more than 700 teammates in over 60 clinic locations and growing, TOI is changing oncology for the better. For more information visit www.theoncologyinstitute.com.

Forward-Looking Statements

This press release includes certain statements that are not historical facts but are forward-looking statements for purposes of the safe harbor provisions under the United States Private Securities Litigation Reform Act of 1995. Forward-looking statements generally are accompanied by words such as “preliminary,” “believe,” “may,” “will,” “estimate,” “continue,” “anticipate,” “intend,” “expect,” “should,” “would,” “plan,” “project,” “predict,” “potential,” “guidance,” “approximately,” “seem,” “seek,” “future,” “outlook,” and similar expressions that predict or indicate future events or trends or that are not statements of historical matters. These forward-looking statements include, but are not limited to, statements regarding projections, anticipated financial results, estimates and forecasts of revenue and other financial and performance metrics and projections of market opportunity and expectations. These statements are based on various assumptions and on the current expectations of TOI and are not predictions of actual performance. These forward-looking statements are provided for illustrative purposes only and are not intended to serve as, and must not be relied on by anyone as, a guarantee, an assurance, a prediction or a definitive statement of fact or probability. Actual events and circumstances are difficult or impossible to predict and will differ from assumptions. Many actual events and circumstances are beyond the control of TOI. These forward-looking statements are subject to a number of risks and uncertainties, including the accuracy of the assumptions underlying the 2022 outlook discuss herein, the outcome of judicial and administrative proceedings to which TOI may become a party or governmental investigations to which TOI may become subject that could interrupt or limit TOI’s operations, result in adverse judgments, settlements or fines and create negative publicity; changes in TOI’s clients’ preferences, prospects and the competitive conditions prevailing in the healthcare sector; failure to continue to meet stock exchange listing standards; the impact of COVID-19 on TOI’s business; those factors discussed in the documents of TOI filed, or to be filed, with the SEC, including the Item 1A. "Risk Factors" section of TOI's Annual Report on Form 10-K for the year ended December 31, 2021. If the risks materialize or assumptions prove incorrect, actual results could differ materially from the results implied by these forward-looking statements. There may be additional risks that TOI does not presently know or that TOI currently believes are immaterial that could also cause actual results to differ from those contained in the forward-looking statements. In addition, forward-looking statements reflect TOI’s plans or forecasts of future events and views as of the date of this press release. TOI anticipates that subsequent events and developments will cause TOI’s assessments to change. TOI does not undertake any obligation to update any of these forward-looking statements. These forward-looking statements should not be relied upon as representing TOI’s assessments as of any date subsequent to the date of this press release. Accordingly, undue reliance should not be placed upon the forward-looking statements.

Financial Information; Non-GAAP Financial Measures

Some of the financial information and data contained in this press release, such as Adjusted EBITDA, have not been prepared in accordance with United States generally accepted accounting principles (“GAAP”). TOI believes that the use of Adjusted EBITDA provides an additional tool to assess operational performance and trends in, and in comparing our financial measures with, other similar companies, many of which present similar non-GAAP financial measures to investors. TOI’s non-GAAP financial measures may be different from non-GAAP financial measures used by other companies. The presentation of non-GAAP financial measures is not intended to be considered in isolation or as a substitute for, or superior to, financial measures determined in accordance with GAAP. The principal limitation of Adjusted EBITDA is that it excludes significant expenses and income that are required by GAAP to be recorded in TOI's financial statements. Because of the limitations of non-GAAP financial measures, you should consider the non-GAAP financial measures presented in this press release in conjunction with TOI’s financial statements and the related notes thereto.

TOI defines Adjusted EBITDA as net (loss) income plus depreciation, amortization, interest, taxes, non-cash items, share-based comp and other adjustments to add-back the following: board fees, consulting and legal fees related to acquisitions, one-time consulting and legal fees related to certain advisory projects, software implementations and debt or equity financings, severance expense and temp labor and recruiting charges to build out our corporate infrastructure. A reconciliation of Adjusted EBITDA to net loss, the most comparable GAAP metric, is set forth below.

Adjusted EBITDA Reconciliation
 Three Months Ended September 30, Change
(dollars in thousands) 2022   2021  $ %
Net income (loss)$        (2,674) $        (2,980) $        306          (10.3)%
Depreciation and amortization         1,134           850           284          33.4 %
Interest expense         1,497           78           1,419          1,819.2 %
Income tax expense         (24)          799           (823)         (103.0)%
Board and management fees         64           106           (42)         (39.6)%
Non-cash addbacks(1)         299           99           200          202.0 %
Share-based compensation         6,546           59           6,487          10,994.9 %
Change in fair value of liabilities         (18,932)          —           (18,932) N/A  
Unrealized gains (losses) on investments         33           —           33  N/A  
Practice acquisition-related costs(2)         166           71           95          133.8 %
Practice acquisition deferred purchase price(3)         2,088           —           2,088  N/A  
Consulting and legal fees(4)         883           221           662          299.5 %
Other, net(5)         1,239           807           432          53.5 %
Transaction costs(6)         1,001           —           1,001  N/A  
Adjusted EBITDA$        (6,680) $        110  $        (6,790)         (6,172.7)%

 


(1)During the three months ended September 30, 2022, non-cash addbacks were primarily comprised of net bad debt write-offs of $143 and non-cash rent of $148. During the three months ended September 30, 2021, non-cash addbacks were primarily comprised of net bad debt write-offs of $54 and non-cash rent of $45.
  
(2)Practice acquisition-related costs were comprised of consulting and legal fees incurred to perform due diligence, execute, and integrate acquisitions of various oncology practices.
  
(3)Deferred consideration payments for practice acquisitions that are contingent upon the seller’s future employment at the Company.
  
(4)Consulting and legal fees were comprised of a subset of the Company’s total consulting and legal fees during the three months ended September 30, 2022 and 2021, and related to certain advisory projects, software implementations, and legal fees for debt financing and predecessor litigation matters.
  
(5)Other, net is comprised of severance expenses resulting from cost rationalization programs of $117 and $124, as well as temporary labor of $291 and $331, recruiting expenses to build out corporate infrastructure of $798 and $352 and other miscellaneous charges of $33 and $0 during the three months ended September 30, 2022 and 2021, respectively.
  
(6)Transaction costs incurred related to the issuance of the Senior Secured Convertible Note such as legal, audit, administrative, and registration fees.
  


Adjusted EBITDA Reconciliation
 Nine Months Ended September 30, Change
(dollars in thousands) 2022   2021  $ %
Net income (loss)$        11,159  $        (771) $        11,930          (1,547.3)%
Depreciation and amortization         3,219           2,421           798          33.0 %
Interest expense         1,632           260           1,372          527.7 %
Income tax expense         124           1,797           (1,673)         (93.1)%
Board and management fees         171           314           (143)         (45.5)%
Non-cash addbacks(1)         604           (5,642)          6,246          (110.7)%
Share-based compensation         21,613           152           21,461          14,119.1 %
Change in fair value of liabilities         (69,776)          —           (69,776) N/A  
Unrealized gains (losses) on investments         33           —           33  N/A  
Practice acquisition-related costs(2)         699           268           431          160.8 %
Practice acquisition deferred purchase price(3)         2,088           —           2,088  N/A  
Consulting and legal fees(4)         2,682           1,151           1,531          133.0 %
Other, net(5)         3,826           572           3,254          568.9 %
Transaction costs(6)         3,195           —           3,195  N/A  
Adjusted EBITDA$        (18,731) $        522  $        (19,253)         (3,688.3)%


(1)During the nine months ended September 30, 2022, non-cash addbacks were primarily comprised of net bad debt write-offs of $402, non-cash rent of $180 and other miscellaneous charges of $22. During the nine months ended September 30, 2021, non-cash addbacks were primarily comprised of gain on debt extinguishment of $5,186 and net bad debt recoveries of $667.
  
(2)Practice acquisition-related costs were comprised of consulting and legal fees incurred to perform due diligence, execute, and integrate acquisitions of various oncology practices.
  
(3)Deferred consideration payments for practice acquisitions that are contingent upon the seller’s future employment at the Company.
  
(4)Consulting and legal fees were comprised of a subset of the Company’s total consulting and legal fees during the nine months ended September 30, 2022 and 2021, and related to certain advisory projects, software implementations, and legal fees for debt financing and predecessor litigation matters.
  
(5)Other, net is comprised of severance expenses resulting from cost rationalization programs of $203 and $124, as well as temporary labor of $1,105 and $847, recruiting expenses to build out corporate infrastructure of $2,429 and $624, and other miscellaneous expense of $89 and $0 during the nine months ended September 30, 2022 and 2021, respectively. During the nine months ended September 30, 2022 and 2021 such expenses were partially offset by $0 and $1,023, respectively, of stimulus funds received under the CARES Act.
  
(6)Transaction costs incurred related to the Business Combination and the issuance of the Senior Secured Convertible Note such as legal, audit, administrative, and registration fees.
  


Key Business Metrics
 Three Months Ended September 30, Nine Months Ended September 30,
  2022   2021   2022   2021 
Clinics (1)         74           62           74           62 
Markets         14           10           14           10 
Lives under value-based contracts (millions)         1.7           1.6           1.7           1.6 
Adjusted EBITDA (in thousands)$        (6,680) $        110  $        (18,731) $        522 


(1)Includes independent oncology practices to which we provide limited management services, but do not bear the operating costs.
  

Condensed Consolidated Balance Sheets
(in thousands except share data)

 September 30, 2022 December 31, 2021
 (Unaudited)  
Assets   
Current assets:   
Cash (includes restricted cash of $0 and $875 as of September 30, 2022 and December 31, 2021)$        61,425  $        115,174 
Marketable securities         29,154           — 
Accounts receivable         34,820           20,007 
Other receivables         559           1,237 
Inventories, net         10,018           6,438 
Prepaid expenses         7,655           11,200 
Total current assets         143,631           154,056 
Non-current investments         58,215           — 
Property and equipment, net         7,006           4,192 
Operating right of use assets         24,808           — 
Intangible assets, net         18,665           18,245 
Goodwill         31,016           26,626 
Other assets         461           320 
Total assets$        283,802  $        203,439 
Liabilities and stockholders’ equity   
Current liabilities:   
Current portion of operating lease liabilities$        5,163  $        — 
Current portion of long-term debt         —           183 
Accounts payable         11,155           15,559 
Income taxes payable         387           132 
Accrued expenses and other current liabilities         16,147           13,924 
Total current liabilities         32,852           29,798 
Operating lease liabilities         21,828           — 
Derivative warrant liabilities         1,748           2,193 
Derivative earnout liabilities         6,197           60,018 
Conversion option derivative liabilities         12,650           — 
Long-term debt         79,069           — 
Other non-current liabilities         970           6,900 
Deferred income taxes liability         554           371 
Total liabilities         155,868           99,280 
Commitments and contingencies (Note 15)         —           — 
Stockholders’ equity:   
TOI Common shares, $0.0001 par value, authorized 500,000,000 shares; 72,341,687 and 73,249,042 shares issued and outstanding at September 30, 2022 and December 31, 2021         7           7 
TOI Convertible Series A Common Equivalent Preferred Shares, $0.0001 par value, authorized 10,000,000 shares; 165,045 shares and 163,510 issued and outstanding at September 30, 2022 and December 31, 2021         —           — 
Additional paid-in capital         180,002           167,386 
Accumulated deficit         (52,075)          (63,234)
Total stockholders’ equity         127,934           104,159 
Total liabilities, cumulative preferred shares and stockholders’ equity$        283,802  $        203,439 


Condensed Consolidated Statements of Income (Operations) (Unaudited)
(in thousands except share data)

 Three Months Ended September 30,
 Nine Months Ended September 30,
  2022   2021   2022   2021 
Revenue       
Patient services$        44,627  $        32,967  $        118,793  $        92,375 
Dispensary         18,839           17,918           57,736           53,318 
Clinical trials & other         1,511           1,390           4,530           5,006 
Total operating revenue         64,977           52,275           181,059           150,699 
Operating expenses       
Direct costs – patient services         36,126           25,391           96,379           72,051 
Direct costs – dispensary         15,738           15,279           47,816           45,639 
Direct costs – clinical trials & other         113           182           400           494 
Selling, general and administrative expense         31,963           12,730           90,117           35,120 
Depreciation and amortization         1,134           850           3,219           2,421 
Total operating expenses         85,074           54,432           237,931           155,725 
Loss from operations         (20,097)          (2,157)          (56,872)          (5,026)
Other non-operating expense (income)       
Interest expense, net         1,497           78           1,632           260 
Change in fair value of derivative warrant liabilities         159           —           (445)          — 
Change in fair value of earnout liabilities         (3,581)          —           (53,821)          — 
Change in fair value of conversion option derivative liabilities         (15,510)          —           (15,510)          — 
Gain on debt extinguishment         —           —           (183)          (5,186)
Other, net         36           (54)          172           (1,126)
Total other non-operating (income) loss         (17,399)          24           (68,155)          (6,052)
Income (loss) before provision for income (loss) taxes         (2,698)          (2,181)          11,283           1,026 
Income tax benefit (expense)         24           (799)          (124)          (1,797)
Net income (loss)$        (2,674) $        (2,980) $        11,159  $        (771)
Net income (loss) per share attributable to common stockholders:    
Basic$        (0.03) $        (0.05) $        0.12  $        (0.01)
Diluted$        (0.17) $        (0.05) $        (0.03) $        (0.01)
Weighted-average number of shares outstanding:       
Basic 72,184,366   66,021,828   72,807,277   64,977,298 
Diluted 79,581,304   66,021,828   75,300,018   64,977,298 


Condensed Consolidated Statements of Cash Flows (Unaudited)

(in thousands)

 Three Months Ended September 30, Nine Months Ended September 30,
  2022   2021   2022   2021 
Cash flows from operating activities:       
Net income (loss)$        (2,674) $        (2,980) $        11,159  $        (771)
Adjustments to reconcile net income (loss) to cash and restricted cash used in operating activities:
Depreciation and amortization         1,134           850           3,219           2,421 
Amortization of debt issuance costs         892           18           892           53 
Share-based compensation         6,546           59           21,613           152 
Decrease in fair value of liability classified warrants         159           —           (445)          — 
Decrease in fair value of liability classified earnouts         (3,581)          —           (53,821)          — 
Decrease in fair value of liability classified conversion option derivatives         (15,510)          —           (15,510)          — 
Unrealized (gain) loss on investments         62           —           62           — 
Accretion of discount on investment securities         (29)          —           (29)          — 
Deferred taxes         52           (3,759)          183           (3,538)
Gain on debt extinguishment         —           —           (183)          (5,186)
Bad debt expense         143           55           402           (667)
Loss on disposal of property and equipment         8           —           22           — 
Changes in operating assets and liabilities, net of business combinations:
Accounts receivable         (6,015)          (2,401)          (15,215)          (4,195)
Inventories         (851)          (1,068)          (2,584)          (1,340)
Other receivables         (137)          71           678           (319)
Prepaid expenses         2,393           (217)          3,545           32 
Other current assets         —           (3,009)          —           (9,094)
Operating lease right-of-use assets         1,529           —           3,720           — 
Other assets         (55)          (68)          (141)          (128)
Accrued expenses and other current liabilities         332           (55)          2,894           1,432 
Income taxes payable         255           4,381           255           5,015 
Accounts payable         (2,746)          5,299           (4,404)          6,250 
Current and long-term operating lease liabilities         (1,231)          —           (2,998)          — 
Other non-current liabilities         (1,075)          145           (1,073)          538 
Net cash, cash equivalents, and restricted cash used in operating activities         (20,399)          (2,679)          (47,759)          (9,345)
Cash flows from investing activities:       
Purchases of property and equipment         (1,190)          (950)          (3,534)          (1,976)
Purchases of intangible asset in practice acquisitions         —           —           —           (200)
Cash paid for practice acquisitions, net         813           —           (8,107)          (827)
Purchases of marketable securities/investments         (87,402)          —           (87,402)          — 
Net cash, cash equivalents, and restricted cash used in investing activities         (87,779)          (950)          (99,043)          (3,003)
Cash flows from financing activities:       
Proceeds from issuance of long-term debt         110,000           —           110,000           — 
Transactions costs related to issuance of long-term debt         (3,663)          —           (3,663)          — 
Payments made for financing of insurance payments         (1,258)          —           (3,739)          — 
Payment of deferred consideration liability for acquisition         250           —           (509)          — 
Principal payments on long-term debt         —           —           —           (2,094)
Principal payments on financing leases         (13)          (8)          (39)          (24)
Common stock repurchase         —           —           (9,000)          — 
Common stock issuance         79           —           416           — 
Taxes for common shares net settled         —           —           (413)          — 
Issuance of Legacy TOI preferred stock         —           —           —           20,000 
Net cash, cash equivalents, and restricted cash provided by financing activities         105,395           (8)          93,053           17,882 
Net (decrease) increase in cash, cash equivalents, and restricted cash         (2,783)          (3,637)          (53,749)          5,534 
Cash, cash equivalents, and restricted cash at beginning of period         64,208           15,169           115,174           5,998 
Cash, cash equivalents, and restricted cash at end of period$        61,425  $        11,532  $        61,425  $        11,532 


Contacts

Media

The Oncology Institute, Inc.
Julie Korinke
juliekorinke@theoncologyinstitute.com
(562) 735-3226 x 88806

Revive

Michael Petrone
mpetrone@reviveagency.com
(615) 760-4542

Investors

Solebury Strategic Communications
investors@theoncologyinstitute.com


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