Starling Oncology, Inc. (STLN) 2025 Q3 法說會逐字稿

Greetings and welcome to the Oncology Institutes third quarter 2025 earnings call. (Operator Instructions)

各位來賓，歡迎參加腫瘤研究所2025年第三季財報電話會議。（操作說明）

As a reminder, this conference is being recorded. It is now my pleasure to introduce Mark Heppelheiser.

再次提醒，本次會議正在錄影。現在我榮幸地向大家介紹馬克·赫佩爾海瑟。

Thank you. You may begin.

謝謝。你可以開始了。

The press release announcing the Oncology Institute's results for the third quarter of 2025 are available at the investors section of the company's website, the oncologyInstitute.com. A replay of this call will also be available at the company's website after the conclusion of this call.

腫瘤研究所2025年第三季業績新聞稿已發佈在公司網站oncologyInstitute.com的投資者關係板塊。本次電話會議結束後，會議錄音也將在公司網站上提供。

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 third quarter of 2025. Management may make forward-looking statements, including guidance and underlying assumptions.

在正式開始之前，我想提醒各位注意公司在 2025 年第三季新聞稿中包含的安全港條款。管理層可能會做出前瞻性聲明，包括指導意見和基本假設。

Forward-looking statements are based on expectations that involve risks and uncertainties that could cause actual results to differ materially. For further discussion of risks related to our business, see our filings with the SEC.

前瞻性陳述是基於預期，但其中存在風險和不確定性，可能導致實際結果與預期有重大差異。有關我們業務相關風險的進一步討論，請參閱我們向美國證券交易委員會提交的文件。

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.

本次電話會議也將討論非GAAP財務指標，例如調整後的EBITDA和自由現金流。這些非GAAP指標與最可比較的GAAP指標的調節表包含在提交給美國證券交易委員會的獲利報告中，該報告可在我們的網站上查閱。

Joining me on the call today are our CEO Daniel Virnich and our CFO Robert Carter. Following our prepared remarks, we'll open the call for your questions. With that, I'll turn the call over to Dan.

今天和我一起參加電話會議的有我們的執行長丹尼爾·維爾尼奇和財務長羅伯特·卡特。在我們發言完畢後，我們將開放提問環節。接下來，我會把電話交給丹。

Thank you, Mark. Good afternoon everyone and thank you for joining our third quarter 2025 earnings call.

謝謝你，馬克。各位下午好，感謝各位參加我們2025年第三季財報電話會議。

During the third quarter, we were able to build on momentum from the first half of this year, delivering strong results across all areas of the business.

第三季度，我們延續了今年上半年的發展勢頭，在業務的各個領域都取得了強勁的業績。

Including proving out MLR performance on our expanding delegated capitation model in Florida in addition to other significant pipeline winds, continuing to set records in our pharmacy business and hitting a big milestone as we achieved adjusted EBITDA profitability for our first month as a public company in September.

其中包括在佛羅裡達州不斷擴大的委託人頭付費模式下驗證 MLR 的性能，以及其他重要的管道進展，繼續在藥房業務中創造記錄，並在 9 月份作為一家上市公司的第一個月實現了調整後的 EBITDA 盈利，這是一個重要的里程碑。

The combination of these factors provides us with the confidence required to increase our outlook for 2025.

這些因素綜合起來，使我們有信心提高對 2025 年的展望。

Our third quarter revenue of $137 million increased 23% compared to a year ago and was driven by 42% growth in our pharmacy business as well as 13% year over year growth in our fee for service business which outperformed expectations.

第三季營收為 1.37 億美元，比去年同期成長 23%，這主要得益於藥局業務成長 42% 以及按服務收費業務年增 13%，均超出預期。

Adjusted EBITDA loss of $3.5 million in Q3 represents a $4.7 million improvement compared to the same quarter last year. We are reinforcing our expectation to achieve profitability in the fourth quarter and become free cash flow positive in 2026.

第三季調整後 EBITDA 虧損 350 萬美元，較去年同期改善 470 萬美元。我們重申，預計第四季將實現盈利，並在 2026 年實現自由現金流為正。

Turning to our operations, during the quarter, we saw material progress on integration of care and MLR performance in the initial 40,000 delegated cappitated lives with our partnership in Florida with Elevan Health.

再來看我們的營運情況，本季度我們在與佛羅裡達州 Elevan Health 的合作中，在最初的 40,000 名委託按人頭付費的患者中，在護理整合和 MLR 績效方面取得了實質性進展。

We are expanding this relationship with elephants in Q4 through additional Medicare Advantage Lives in Central Florida, which more than doubles our relationship with this pair in less than a year as measured by MA Lives under capitation to TOI.

第四季度，我們將透過在佛羅裡達州中部增加 Medicare Advantage Lives 來擴大與大象的關係，這將使我們在不到一年的時間內與這對組合的關係翻一番以上（以按人頭付費的 MA Lives 衡量）。

Other key milestones achieved in Q3 were expansion of our MSO network in Florida to over 200 providers and growing, as well as the official opening of our TOI Florida pharmacy location, which will serve network providers requiring delivery of Part B drugs as well as a fast and convenient option for Part B specialty medications for patients and providers alike.

第三季取得的其他重要里程碑包括：我們在佛羅裡達州的 MSO 網路已擴展到 200 多家供應商，並且還在不斷增長；以及我們位於佛羅裡達州的 TOI 藥房正式開業，該藥房將為需要配送 B 部分藥物的網路供應商提供服務，並為患者和供應商提供快速便捷的 B 部分特殊藥物選擇。

We view the Florida Pharmacy as incremental growth to our core Part B dispensing strategy as well as meaningful to our capitated MLR where we can provide Part B drugs to practices that deliver at our cost.

我們認為佛羅裡達藥房是我們核心 B 部分配藥策略的增量增長，並且對我們的按人頭付費的醫療損失率 (MLR) 也意義重大，因為我們可以按成本價向提供服務的診所提供 B 部分藥物。

On a full year basis, the new capitation contracts that we have signed across markets over the course of 2025 will contribute an estimated $19 million of full year revenue, a 29% increase to capitated revenue versus full year 2024.

從全年來看，我們在 2025 年於各市場簽署的新按人頭付費合約預計將帶來 1,900 萬美元的全年收入，比 2024 年全年按人頭付費收入成長 29%。

We expect margins on these contracts to continue to mature to target over the next few quarters as we see these new patients transition their care and pharmacy needs to our in-network providers and as we focus on adherence to our care pathways and increased script attachment.

我們預計，隨著這些新患者將其護理和藥房需求轉移到我們的網路內供應商，以及我們專注於遵守我們的護理路徑和增加處方依從性，這些合約的利潤率將在未來幾個季度繼續成熟並達到目標。

Last quarter, I mentioned that we were launching three AI enablement efforts in the coming months to make meaningful changes in performance and costs, specifically in revenue cycle management, prior authorization services, and our patient call center.

上個季度，我提到我們將在未來幾個月啟動三項人工智慧賦能計劃，以在績效和成本方面做出有意義的改變，尤其是在收入週期管理、事先授權服務和我們的患者呼叫中心方面。

As an example of how this is now benefiting patients and delivering OpEx efficiencies, we expect our offices and authorizations to be fully transitioned to our gente AI model in Q4, which will take submission time from 18 minutes to approximately five seconds and deliver savings per auth of over 80%.

為了說明這項技術如何造福患者並提高營運效率，我們預計我們的辦公室和授權流程將在第四季度全面過渡到我們的 Gente AI 模型，這將使提交時間從 18 分鐘縮短到大約 5 秒，每次授權可節省 80% 以上的成本。

This will expand to other authorization functions in 2026 and our early estimate of savings from authorization efficiencies alone could yield up to $2 million of operating expense efficiencies. This frees up hundreds of hours a week for our staff, which can be directed to patient care and yield a more efficient operating model for our organization.

這項措施將在 2026 年擴展到其他授權功能，我們初步估計，僅授權效率的提高就能節省高達 200 萬美元的營運費用。這樣一來，我們的員工每週就能騰出數百小時的時間，用於病患護理，為我們的組織帶來更有效率的營運模式。

I also want to address an 8k that we filed last week related to a cybersecurity incident at one of our key vendors that we utilize for billing and practice management. Due to the incident, we experienced a period where we were unable to bill for fee for service claims while we transitioned to a new platform.

我還想談談我們上週提交的一份 8-K 表格，該表格與我們用於計費和實踐管理的一家主要供應商發生的網路安全事件有關。由於該事件，在我們過渡到新平台期間，我們經歷了一段無法收取服務費的時期。

Thanks to the quick response of our team, we were able to pivot and manage schedules through our EHR and develop an interim billing process, minimizing the impact on our day to day operations. Importantly, despite this incident, our patient treatment plans remain intact and we have seen no significant disruption to volume.

多虧了我們團隊的快速反應，我們才能迅速調整併透過電子病歷系統管理日程安排，並製定臨時計費流程，從而最大限度地減少對我們日常營運的影響。重要的是，儘管發生了這起事件，我們的患者治療方案仍然保持不變，而且我們沒有看到治療量受到任何重大影響。

From a timing perspective, this event will influence collections in late Q4 and early Q1 as we catch up on submitted claims, but we project ample cash on our balance sheet to manage through this and meet our operating goals for Q4 in 2026.

從時間安排上看，由於我們需要處理已提交的索賠，這一事件將影響 2026 年第四季末和第一季初的收款情況，但我們預計資產負債表上的現金充足，足以應對這種情況，並實現 2026 年第四季的營運目標。

Heading into the last few months of 2025, I'm excited about the momentum we have built over the last year.

進入2025年的最後幾個月，我對過去一年我們的進展感到興奮。

We continue to prove that our model is profitable across markets and have proven our ability to manage full delegation with health plan partners, which opens a massive new TAM of value-based contract growth in upcoming years.

我們不斷證明我們的模式在各個市場都是盈利的，並且已經證明了我們有能力與健康計劃合作夥伴進行完全委託管理，這為未來幾年基於價值的合約成長開闢了巨大的新市場規模。

Now I'll turn the call over to Rob to review the financials. Rob.

現在我將把電話交給羅布，讓他審核財務數據。搶。

Thanks, Dan, and good afternoon everyone. I want to echo Dan's comments on what was another strong quarter for TOI. In the third quarter, we continued to build momentum across our fee for service and capitation businesses, as well as dispensing while moving toward achieving adjusted dividend profitability.

謝謝你，丹，大家下午好。我同意丹對《印度時報》又一個強勁季度的評價。第三季度，我們在按服務收費和按人頭付費業務以及藥品分銷方面繼續保持增長勢頭，同時朝著實現調整後股息盈利的目標邁進。

On the call today, I'll provide an overview of our different value-based care contract methodologies, review our third quarter results, touch on our balance sheet and liquidity, and conclude by reviewing our increased outlook for 2025.

在今天的電話會議上，我將概述我們不同的基於價值的醫療合約方法，回顧我們第三季度的業績，談談我們的資產負債表和流動性，最後回顧我們提高後的 2025 年展望。

Regarding our primary value-based care contracting methods, I want to take a step back to provide an overview of each and describe some of the nuances to give you a better understanding of how they all flow through our P&L.

關於我們主要的基於價值的醫療合約方法，我想退一步，概述每一種方法，並描述一些細微差別，以便您更好地了解它們是如何在我們的損益表中體現的。

Let me start with our narrow network competition contracts which represent approximately $50 million of revenue for us this year, where we act as the exclusive oncology provider for a risk bearing organization, typically a risk bearing primary care group or IPA that takes global risk for health plan partners.

首先，我想談談我們今年的窄網絡競爭合同，這些合同為我們帶來了大約 5000 萬美元的收入。在這些合約中，我們作為風險承擔機構（通常是承擔健康計劃合作夥伴全球風險的風險承擔型初級保健集團或 IPA）的獨家腫瘤服務提供者。

This is a product that we have used in California since 2007. In these arrangements, we are required to build clinics to achieve network adequacy.

這是我們自 2007 年以來在加州一直使用的產品。根據這些安排，我們需要建造診所以實現網路充足性。

But due to their exclusivity, we can optimize utilization, experience very low leakage, and drive high Part D script attachments. From a financial standpoint, these narrow network capitation contracts typically produce medical loss ratios in the mid 60%.

但由於其獨特性，我們可以優化利用率，實現極低的洩漏率，並推動高 Part D 腳本附件。從財務角度來看，這些窄網路按人頭付費合約通常會導致醫療損失率達到 60% 左右。

More recently, we've been focused on growing our delegated model first in Florida, although we believe this will eventually become our most prominent model across all markets. In these arrangements, our partner is the Health Plan.

最近，我們一直專注於首先在佛羅裡達州發展我們的委託模式，儘管我們相信這最終將成為我們所有市場中最突出的模式。在這些安排中，我們的合作夥伴是健康計劃。

And we manage the entire oncology benefit from designing the provider network to managing claims and pre-authorizations, allowing real-time views into utilization trends and the ability to include non-employed providers in care.

我們管理整個腫瘤福利，從設計供應商網路到管理索賠和預授權，從而可以即時查看使用趨勢，並能夠將非就業供應商納入護理。

The provider network is a combination of our employed oncologists and clinics and are affiliated with contracted or MSO oncologists and the Health Plan Partners Network.

此醫療服務提供者網絡由我們聘用的腫瘤科醫生和診所組成，並與簽約或MSO腫瘤科醫生以及健康計劃合作夥伴網絡有合作關係。

Leveraging the health plan partners network allows us to more quickly scale and address the TAam in a more capable, effective manner. We can also steer complex patients to our clinics to more closely monitor their treatment.

利用健康計畫合作夥伴網絡，我們可以更快地擴大規模，並以更有能力、更有效的方式解決TAam問題。我們也可以將病情複雜的患者轉診到我們的診所，以便更密切地監測他們的治療情況。

There are also ancillary opportunities to drive revenue and margin through engagement with our MSO partners in our pharmacy business, decentralized clinical trials, and other long-term value creation initiatives.

此外，透過與藥房業務中的 MSO 合作夥伴合作、開展分散式臨床試驗以及其他長期價值創造計劃，還有提升收入和利潤的輔助機會。

Our mature MLR in the delegated model is typically in the mid 80s, although it yields a higher gross profit dollar compared to our legacy network model because we're addressing a larger TA and typically driving savings against higher benchmark utilization.

我們成熟的委託模式下的 MLR 通常在 80 多，儘管與我們傳統的網路模式相比，它產生的毛利更高，因為我們處理的是更大的 TA，並且通常在更高的基準利用率下實現節省。

Our results highlight the strength of our diversified capitation portfolio.

我們的業績凸顯了我們多元化按人頭付費投資組合的優勢。

Turning to financial performance, total revenue for the third quarter was $136.6 million compared to $99.9 million in the prior year period, representing 36.7% year over year growth.

從財務表現來看，第三季總營收為 1.366 億美元，而上年同期為 9,990 萬美元，年增 36.7%。

Patient services revenue, which includes both capitation and fee for service arrangements, totaled $60.2 million, or 44.1% of total revenue and increased 21% year over year.

病患服務收入（包括按人頭付費和按服務收費安排）總計 6,020 萬美元，佔總收入的 44.1%，較去年同期成長 21%。

Within this segment, fee for service contributed roughly 66% of total revenue, and capitation accounted for 34%, reflecting our strong mix of recurring revenue and steady patient volumes.

在這個領域中，按服務收費約佔總收入的 66%，按人頭付費佔 34%，這反映了我們強大的經常性收入和穩定的患者數量組合。

Patient service growth was driven by our capitated revenue, which increased 38.9% year over year. Pharmacy revenue was $75.9 million, representing 55.6% of total revenue, and increased 57.4% year over year, driven by higher prescription volumes and greater pharmacy attachment within our network, which is a key operational focus for us.

病患服務成長主要得益於我們的按人頭付費收入，該收入年增了 38.9%。藥局收入為 7,590 萬美元，佔總收入的 55.6%，年增 57.4%，這主要得益於處方量增加以及我們網絡內藥房的依附性提高，這也是我們營運的重點。

Turning to gross profit, we reported $18.9 million for the quarter compared to $14.4 million in the third quarter of 2024. Gross margin was 13.9% versus 14.4% in the prior period.

再來看毛利，本季毛利為 1,890 萬美元，而 2024 年第三季毛利為 1,440 萬美元。毛利率為 13.9%，而上一時期為 14.4%。

With our fee for service revenue exceeding expectations and following the input from our new Chief Administrative Officer, we've elected out of an abundance of caution to begin reserving for potential future bad debt as fee for service revenue is recognized.

由於我們的服務費收入超出預期，並且根據我們新任首席行政官的建議，出於謹慎考慮，我們決定在確認服務費收入時開始提列未來可能出現的壞帳準備。

As a one-time catch up adjustment, we recorded a $1.8 million reserve against fee for service revenue in the third quarter.

作為一次性調整，我們在第三季提列了 180 萬美元的服務費收入準備金。

Normalized for this reserve, gross profit for the quarter would have been $20.7 million with a gross margin of 15.2%. Looking ahead, we do not expect any material impact to be for service revenue recognition on a go-forward basis.

扣除這筆準備金後，該季度的毛利將達到 2,070 萬美元，毛利率為 15.2%。展望未來，我們預期服務收入確認方面不會受到任何重大影響。

Patient services gross profit was $5.6 million, up from $4.6 million a year ago. Representing a 21% year over year increase with a gross margin of 9.3% consistent with the prior year period.

病患服務毛利為 560 萬美元，高於去年同期的 460 萬美元。與去年同期相比成長了 21%，毛利率為 9.3%，與去年同期持平。

With inpatient services, capitation margin declined modestly year over year due to the ramp of new delegated contracts with typical MLRs beginning at low margins. In contrast, fee for service margin improved, driven by higher provider utilization and continued improvement in Part D purchasing as we scale.

由於新的委託合約的增加，住院服務的人均利潤率同比略有下降，而這些合約的典型醫療損失率 (MLR) 起始利潤率較低。相較之下，由於供應商利用率提高以及隨著我們規模擴大，D 部分採購持續改善，服務收費利潤率有所提高。

Pharmacy gross profit totaled $12.8 million compared to $8.1 million in the third quarter of 2024, a 58% year over year increase driven by higher dispensing volumes. The gross margin of 16.9% remained essentially flat compared to the prior year.

藥局毛利總計 1,280 萬美元，而 2024 年第三季為 810 萬美元，年增 58%，主要得益於藥品配發量的增加。毛利率為 16.9%，與上年基本持平。

Turning to SG&A, excluding depreciation and amortization, it was 25.3 million, or 18.5% of revenue. Compared to 26.7% of revenue, a reduction of approximately 820 basis points versus a year ago.

銷售、一般及行政費用（不包括折舊及攤提）為 2,530 萬，佔收入的 18.5%。與去年同期相比，營收佔比為 26.7%，下降了約 820 個基點。

The decrease reflects continued cost discipline, operating leverage inherent in our model, and technology efficiencies realized across our administrative and support functions.

這一下降反映了持續的成本控制、我們模式固有的營運槓桿作用，以及我們在行政和支援職能方面實現的技術效率提升。

Adjusted EBITDA was 3.5 million, improving from 8.2 million in the third quarter of 2024. This is in the range of our prior guidance for Q3, and we remain on track to achieve adjusted EBITDA positivity in the fourth quarter, a key milestone as we exit 2025. As mentioned earlier, we saw our first adjusted EBITDA positive month in September.

調整後 EBITDA 為 350 萬，較 2024 年第三季的 820 萬有所改善。這與我們先前對第三季的預期相符，我們仍有望在第四季度實現調整後 EBITDA 為正，這是我們邁出 2025 年之際的一個重要里程碑。如前所述，我們在9月實現了調整後EBITDA為正值的第一月份。

Turning to the balance sheet and cash flow, we ended the quarter with $27.7 million in cash and cash equivalents and $86 million of convertible debt outstanding, maturing in 2027.

從資產負債表和現金流量來看，本季末我們有 2,770 萬美元的現金及現金等價物，以及 8,600 萬美元的未償可轉換債務，將於 2027 年到期。

Cash flow from operations was $27.8 million, improving 9.5% from prior year, reflecting investments in drug inventory and working capital to support our scaling, dispensing activity.

經營活動產生的現金流為 2,780 萬美元，比上年增長 9.5%，這反映了我們對藥品庫存和營運資金的投資，以支持我們的規模化和分發活動。

I want to remind you that operating cash flow will fluctuate as we scale. And become more active in drug buy-ins with our partners at the end of periods.

我想提醒各位，隨著公司規模的擴大，營運現金流會出現波動。在周期末期，與我們的合作夥伴更積極地進行毒品採購。

During the quarter and immediately subsequent, we efficiently utilize our after-market equity program to generate growth capital consisting of $14.4 million of gross proceeds and $4.1 million of common shares.

在本季及隨後的季度中，我們有效地利用了我們的售後股權計劃，產生了成長資本，其中包括 1,440 萬美元的總收益和 410 萬美元的普通股。

The transaction provided additional operational flexibility and allowed us to participate in end of quarter drug buy-ins which contributed roughly $3 million to incremental profitability year-to-date.

這項交易提供了額外的營運彈性，使我們能夠參與季度末的藥品採購，這為今年迄今的額外獲利貢獻了約 300 萬美元。

Finally, turning to guidance, we are raising our guidance range ranges for the full year 2025 because of the strength of our year-to-date financials and providing our initial outlook for the fourth quarter.

最後，關於業績指引，由於今年迄今的財務狀況強勁，我們提高了 2025 年全年的業績指引範圍，並提供了第四季度的初步展望。

For the full year revenue, we are raising outlook from $460 million to $480 million to a range of $495 million to $505 million. For adjusted EBITDA, we are raising the lower end of our range from our previous guidance of a loss of $17 million to [$8 million] to a range of a loss of $13 million to $11 million.

我們將全年營收預期從 4.6 億美元至 4.8 億美元上調至 4.95 億美元至 5.05 億美元。對於調整後的 EBITDA，我們將先前預期的虧損範圍下限從 1,700 萬美元至 800 萬美元上調至虧損 1,300 萬美元至 1,100 萬美元。

This implies adjusted even of between break even and $2 million for the fourth quarter. We remain focused on executing against our strategic plan and delivering continued progress towards sustained profitability.

這意味著第四季調整後的損益平衡點在損益兩平點至 200 萬美元之間。我們將繼續專注於執行戰略計劃，並不斷取得進展，實現可持續盈利。

The third quarter reflected clear momentum in the business, notably, September marked the first month of profitability in our business and demonstrated the inherent leverage in our model. With that, I'll turn the call over to Dan for closing remarks.

第三季業務發展動能明顯，尤其值得一提的是，9 月是我們業務首次獲利，也證明了我們模式中固有的槓桿效應。接下來，我會把電話交給丹，請他作總結發言。

Thanks Rob. In closing, in the 3rd quarter, we saw very strong top-line growth in all lines of our business and have now shown 2 full quarters of strong MLR performance on our delegated model which we believe will give confidence to investors in our ability to manage risk and lead the world in oncology value based care.

謝謝羅伯。最後，在第三季度，我們所有業務線的營收都實現了非常強勁的成長，我們已經連續兩個季度在委託模式下實現了強勁的醫療損失率 (MLR) 表現，我們相信這將增強投資者對我們管理風險和引領全球腫瘤價值醫療的能力的信心。

We also continue to set records in our pharmacy business and look forward to the next leg of growth as we expand our use cases over our rapidly growing network of non-employed providers.

我們在藥房業務方面也持續創下紀錄，並期待隨著我們在快速成長的非就業提供者網路中擴展應用案例，迎來下一階段的成長。

Finally, we saw some amazing results from integration of Bygente AI into our central business office functions and are in a position to fully scale these efforts through the course of 2026 as we grow.

最後，我們看到了將 Bygente AI 整合到我們中央業務辦公室功能中取得的一些驚人成果，隨著我們的發展，我們有能力在 2026 年全面擴大這些努力的規模。

I am excited that we can increase our guidance on 2025 full year revenue and reaffirm Q4 adjusted EBITDA positivity. We look forward to continuing to update you in future earnings calls.

我很高興我們能夠提高對 2025 年全年營收的預期，並重申第四季度調整後 EBITDA 為正。我們期待在未來的財報電話會議上繼續向您通報最新情況。

Operator, at this point, let's open the call to questions.

操作員，現在我們開始接受提問。

(Operator Instructions)

（操作說明）

First question comes from David Larson with BTIG. Please go ahead.

第一個問題來自 BTIG 的 David Larson。請繼續。

Hi, congratulations on the very good quarter.

您好，恭喜您本季業績非常出色。

Rob, you mentioned, a, an impact to the cost of goods, I think, for a reserve. Can you just, describe what that was again, please? What was the amount and was that unfavorable impact included in your reported adjusted EBITDA for the quarter?

羅布，你提到了儲備金對商品成本的影響，我認為是這樣。請您再描述一下那是什麼？具體金額是多少？該不利影響是否已計入您當季報告的調整後 EBITDA 中？

Hi Dave. Yes, so it was a $1.8 million dollar reserve to fee for service revenue, right? So that flows directly to adjusted EBITDA and was included in the adjusted EBITDA figures that we gave.

嗨，戴夫。是的，所以這是一筆 180 萬美元的儲備金，用於支付服務收入，對嗎？因此，這直接影響到調整後的 EBITDA，並已包含在我們給出的調整後 EBITDA 資料中。

And so we normalized for that, in the script, to show what sort of the normalized performance was, which was obviously significantly better than what we reported.

因此，我們在腳本中對此進行了標準化處理，以顯示標準化後的效能如何，顯然比我們報告的效能好得多。

So it would've been, obviously, not a $3.5 million dollar loss, it would've been. 17 okay great and then and I think you said that you had your first month of profitability, in September, I guess how sustainable do you think that is? Was there anything unusual in September?

所以，顯然不會虧損350萬美元，而是虧損1700萬美元。好的，很好。然後，我想你說過你們在9月份實現了第一個盈利月，我想問的是，你認為這種盈利模式的可持續性如何？九月有什麼異常狀況嗎？

And it sounds like you're on track for at least break even even in the fourth quarter.

聽起來你們第四季至少能達到收支平衡。

Yeah, no, that's exactly right, so we're fully expecting break even for the quarter, obviously we haven't put out a full year guidance for next year yet, but, as we've talked about before, are expecting full year positive adjusted EBITDA in 2026.

是的，沒錯，所以我們完全預期本季度能夠實現盈虧平衡，顯然我們還沒有發布明年的全年業績指引，但是，正如我們之前討論過的，我們預計 2026 年全年調整後 EBITDA 將為正。

And then will you have a positive free cash flow in 4Q FY '25 as well?

那麼，你們在2025財年第四季也能實現正的自由現金流嗎？

In 14, we will, yes. Yes, in terms of free cash flow, it will be positive in in Q4, not from a, run rate basis. We expect free cash flow positivity, mid 2026.

14年，我們會的。是的，就自由現金流而言，第四季將為正，但不是以年率計算。我們預計2026年中期自由現金流轉正。

Okay, great, and then, can you talk a little bit about the delegated contract, and I think you mentioned, like a very good MLR actually just just any more color there what was that MLR? I think I heard mid 60% is that correct? . Just any any more thoughts there would be very helpful.

好的，太好了。那麼，您能稍微談談委託合約嗎？我想您有提到過，就像一個非常好的MLR，實際上，還有什麼細節可以補充嗎？那個MLR是什麼？我好像聽到的是60%左右，是這樣嗎？。如果還有其他想法，那就太好了。

Yeah, so, thank, thanks, Dave, so, we will be filing an updated investor deck, at after hours today which will kind of go into great detail on the MLRs between different contract types, but, yeah, the rough way to think about it is kind of an overall MLR for TOI across all markets and contract types in the high 60s.

是的，謝謝，Dave，我們將在今天盤後提交一份更新的投資者演示文稿，其中將詳細介紹不同合約類型之間的MLR，但是，是的，粗略的理解方式是，TOI在所有市場和合約類型中的總體MLR在60%以上。

With the delegated model being slightly higher so typically we would be kind of mid 70s and then the narrow network model being slightly better and again that's due to the differences in engaging with non-employed providers in the delegated model but a much greater TAM in that model so we expect long-term both the growth rate and total gross profit contribution of that model to be much greater.

委託模式的成長率略高，通常約為 70% 左右；窄網路模式的成長率略高，這是因為委託模式與非就業服務提供者的合作方式不同，但該模式的潛在市場規模更大，因此我們預計從長遠來看，該模式的成長率和總毛利貢獻都將更大。

Okay, and then there's a lot of, we'll call them generalist health care investors, watching the managed care plans just come under enormous pressure because of pressure on their MLRs.

好的，還有很多，我們稱他們為綜合醫療保健投資者，他們眼睜睜地看著管理式醫療計劃因為醫療損失率 (MLR) 的壓力而面臨巨大的壓力。

Can you maybe just remind us why you're able to manage trends so much better than, some of these other like MA plans and and the value that you bring to them?

您能否提醒我們一下，為什麼您在趨勢管理方面比其他一些管理顧問公司做得更好，以及您為它們帶來了哪些價值？

Yeah, absolutely. I think really the core of our value proposition is the fact that we have a very unique care delivery model because we've got a backbone of employee clinics and providers with a wrap network of non-employed providers in select markets where we work with health plans.

是的，絕對的。我認為我們價值主張的核心在於我們擁有非常獨特的醫療服務模式，因為我們以員工診所和醫療服務提供者為骨幹，並在我們與健康計劃合作的特定市場中擁有非員工醫療服務提供者組成的補充網絡。

Which just gives us a much greater degree of control over consistency of care and NCC and guideline adherence and prescribing patterns across all encounter types, so that gives us a differential ability to drive better value for patients and pairs.

這使我們能夠更好地控制所有就診類型的護理一致性、NCC 和指南遵守情況以及處方模式，從而使我們能夠為患者和醫患關係創造更大的價值。

Okay, and then just one more and I'll hop in the in the queue. The dispensing revenue was, fantastic, up almost 60% year over year. Was there anything unusual driving that?

好的，那就再來一個，然後我就去排隊。藥品銷售收入非常可觀，較去年同期成長近 60%。開車時有什麼異常狀況嗎？

Not unusual, as we've talked about before, we've done quite a bit of work around minimize minimizing leakage, in our strip attachment and so I think that we've gotten that to a level, that quite frankly we weren't expecting to get to.

正如我們之前討論過的，我們做了很多工作來盡量減少洩漏，尤其是在我們的貼片連接方面，所以我認為我們已經達到了一個坦率地說我們沒想到的水平。

So it's been fantastic to see. I think there's a little bit of juice to be squeezed from here, but I wouldn't expect that level of growth, at least sequentially, in Q4.

所以，看到這一切真是太棒了。我認為這裡還有一些成長空間可以挖掘，但我預計第四季不會出現這種程度的成長，至少不會比去年同期成長。

Okay, I'll hop back in the queue. Congrats on a great quarter.

好的，我重新排隊。恭喜你本季表現出色。

Thank you. Thanks, Dave.

謝謝。謝謝你，戴夫。

Next question. UN Z to see Riley Securities. Please go ahead.

下一個問題。UN Z 將會見 Riley Securities。請繼續。

Congratulations on a strong helpline and thank you for taking our questions. Maybe just a follow-up there on the reserve for the receivables. What was the past performance of that res reserve or receivables? Why suddenly we need to change the reserve for this, in revenue part or receivable part?

恭喜你們的專線服務非常出色，感謝你們解答我們的問題。或許應該就應收帳款準備金問題做個後續說明。該儲備金或應收帳款過去的表現如何？為什麼突然需要更改這筆款項的準備金，是在收入部分還是應收帳款部分？

Hey thanks for the question. So this is fairly standard, across provider practices. We're at a point now with future service revenue being as substantial as it is, that we thought it prudent, and so we don't think of this as something that's sort of out of the ordinary.

謝謝你的提問。所以這在各醫療機構都相當普遍。鑑於未來服務收入目前已相當可觀，我們認為這樣做是審慎的，因此我們並不認為這是不尋常的事。

We think of this as something that we should be doing proactively, and we're in a position to do so and so we made that choice to take that reserve in Q3.

我們認為這是我們應該積極主動做的事情，而且我們有能力這樣做，所以我們決定在第三季提列這筆儲備金。

Got it. And then what will be the impact for 4Q? And what if we can recover most of the receivables from this reserve?

知道了。那麼，第四季會受到什麼影響呢？如果我們能從這筆儲備金中收回大部分應收帳款呢？

Yeah, no impact to Q4 specifically. We want to keep it on the books, obviously out of conservatism, so no impact forecasted at this point.

是的，對第四季沒有具體影響。出於保守考慮，我們希望保留這項條款，因此目前預計不會產生任何影響。

Got it. .

知道了。。

So, the other question I have is on the payer part. So, payers are changing their behavior. Cigna is eliminating drug drug rebates, and then CMs in the process of removing many or most prior prior authorizations.

所以，我的另一個問題是關於付款方的。所以，支付方正在改變他們的行為。Cigna 正在取消藥品回扣，然後 CM 也在取消許多或大多數先前的預先授權的過程中。

How will that impact your business? Great to see your AI initiative already in the prior authorization. I know this is a big question, so perhaps you can break it down into smaller pieces.

這將對您的業務產生什麼影響？很高興看到貴公司的人工智慧專案已經進入了事先審批階段。我知道這是一個很大的問題，所以或許你可以把它分解成幾個小部分。

Yeah, I would say that at the highest level, I mean, the overall, sort of macro landscape, when it comes to drugs, which we're obviously firmly believers in is to lower the cost of drugs for patients and to simplify the drug reimbursement process,

是的，我認為從最高層面來看，我的意思是，從宏觀角度來看，就藥品而言，我們顯然堅信要降低患者的藥品成本並簡化藥品報銷流程。

As it relates to specific changes that we see coming through, the IRA and some of the other, policies that are being enacted, those as we talked about on prior earnings calls we believe are still net positive for the oncology Institute, because they're.

至於我們看到的即將發生的具體變化，例如 IRA 和其他一些正在實施的政策，正如我們在之前的財報電話會議上討論的那樣，我們認為這些政策對腫瘤研究所來說仍然是淨利好的，因為它們是。

Again, overall lowering the unit cost of drugs for the most part, and, enhancing accessibility, so, the health plan specific changes like the Cigna prior auth change again that wouldn't really impact us that much directly if anything we think it would help accelerate kind of the care delivery process.

再次強調，整體而言，降低藥品單位成本並提高藥品可近性至關重要。因此，像 Cigna 的事先授權變更這樣的健康計劃具體變更，實際上不會對我們產生太大的直接影響，如果有什麼影響的話，我們認為它將有助於加快醫療服務流程。

But sort of at a very high level we think that the general trend towards lower cost, drugs and then also kind of easing the kind of reimbursement model, is not favorable for TI.

但從整體來看，我們認為降低藥品成本以及放寬報銷模式的整體趨勢對TI不利。

Got it. And now we have a very high, medical utilization across the board in the industry, especially in oncology. Can you please comment on the current PMM trend you are, on your new contract,

知道了。現在，整個產業的醫療利用率都非常高，尤其是在腫瘤領域。請問您能否就您目前所處的PMM（產品行銷管理）趨勢以及您的新合約發表一下看法？

And how does that compare to versus, let's say, one year ago, and then for your existing contract, are you able to get the same level of upward adjustment based on this current utilization trend?

那麼，與一年前相比，情況如何？對於您現有的合同，您能否根據當前的利用率趨勢獲得相同程度的上調？

Yeah, so as we've talked about before, PMPM is dependent on where the population is located and ultimately the benchmark spend of that market. And so, we're doing deals in markets like Florida, that the MAP and PM there is going to be significantly higher than it is in California.

是的，正如我們之前討論過的，PMPM 取決於人口所在地區以及最終該市場的基準支出。因此，我們在佛羅裡達等市場進行交易，那裡的MAP和PM將比加州高得多。

The majority of our contracts at this point have PMPM escalators in them and so it's contractual. We'll take an increase every year going forward contract by contract.

目前我們的合約大多包含按人均月供遞增條款，所以這是合約規定的。我們將逐年增加合約金額。

And I would just also add to that, as we called out in our earnings call, we've had, phenomenal success growing our capitated business. We expect that growth rate to continue, if not accelerate as you go forward.

我還要補充一點，正如我們在財報電話會議上提到的，我們的按人頭付費業務取得了巨大的成功。我們預計這種成長速度將會持續，甚至隨著時間的推移而加快。

So the key question on many investors' minds is, as you're growing so quickly, how's the MLR trending, and again we've got a pretty crisp update in our new investor deck, but it's been basically, stable, despite the rapid growth, which is what we want to see.

因此，許多投資者最關心的問題是，隨著公司快速成長，MLR（多邊貸款比率）的趨勢如何？我們在新的投資者簡報中對此進行了非常清晰的更新，儘管成長迅速，但MLR基本上保持穩定，這正是我們所希望看到的。

Yeah, got it. Maybe my last question, Novata reported a strong adoption of Provital in their community setting. I'm curious about your observation so far in California clinics and any plans for you to offer that in your Florida clinics.

好的，明白了。也許我的最後一個問題是，Novata 報告稱，Provital 在其社區環境中得到了廣泛應用。我很想知道您目前在加州診所的觀察結果，以及您是否計劃在佛羅裡達州的診所提供類似的服務。

Yeah, absolutely. We achieved certification on Pluto, a little bit after this time last year. We have seen, increased requests from patients for the therapy and, in general, generally I would say, strong adoption from a par and risk bearing medical group perspective, given the fact that we can do it in the community as opposed to an acute care setting.

是的，絕對的。去年這個時候之後不久，我們就獲得了冥王星的認證。我們看到，患者對這種療法的需求不斷增加，而且總的來說，我認為，考慮到我們可以在社區而不是在急診環境中進行治療，從承擔風險的醫療集團的角度來看，這種療法得到了強有力的採納。

At this point that the use cases are still fairly limited, so we're, it's not massive numbers when you look at our overall encounters versus the number of patients that enrolled in Picto, but we expect as the use cases expand over time, kind of the community-based, ability to provide radio pharmaceuticals will be a distinct advantage for us.

目前，這些應用案例仍然相當有限，所以，從我們整體的接觸次數與參與 Picto 的患者人數相比，數量並不龐大，但我們預計，隨著應用案例的不斷擴展，這種基於社區的、提供放射性藥物的能力將成為我們的明顯優勢。

Got it. I will hop back on with you. Thank you.

知道了。我會盡快和你連線。謝謝。

Thanks John.

謝謝你，約翰。

Next question. Robert LaBoyer with Noble Capital Markets. Please go ahead.

下一個問題。Robert LaBoyer，來自 Noble Capital Markets。請繼續。

Good afternoon and congratulations on a great quarter. You had mentioned that it's probably too early to give guidance for 2026. There were some things that you mentioned in terms of free cash flow, but in terms of.

下午好，恭喜你們本季業績優異。您曾提到現在給出 2026 年的指導意見可能還為時過早。您提到了一些關於自由現金流的問題，但是就…而言。

What's in the pipeline for new contracts, new covered lives, margin goals, or ballpark figures for revenue or anything else? Is there anything that you can tell us along those lines in addition to what's been mentioned already?

未來有哪些新合約、新承保人次、利潤目標、收入預估或其他方面的計畫？除了前面提到的內容之外，您還能告訴我們一些其他資訊嗎？

Yeah, hey Robert, yeah, we're looking at, top-line growth, that mirrors what we've seen in the last couple of years, so 20% plus, subtle improvement to gross margin, and a SG&A percent of revenue that stays relatively flat.

是的，嘿，羅伯特，是的，我們看到營收成長與過去幾年的情況類似，成長超過 20%，毛利率略有改善，銷售、一般及行政費用佔收入的百分比保持相對穩定。

Okay, great. And anything in terms of pipeline prospects or additions to covered lives or territories?

好的，太好了。管道建​​設前景如何？或是新增承保範圍或覆蓋區域方面有進展嗎？

Yeah, hey, Robert, I would say at a very high level, again, we continue to see rampant interest in our model. I think, we're working with obviously very high-quality pairs like Elephants.

是的，嘿，羅伯特，我想再次強調，從宏觀層面來看，我們繼續看到人們對我們的模式表現出濃厚的興趣。我認為，我們顯然是在與像 Elephants 這樣非常高品質的組合合作。

And we think that, our relationships are going to continue to grow, with plans across markets as we kind of prove our ability to provide great care, and high-quality care in the community, so, no slowdown at this point in terms of what we're seeing, in terms of opportunities to value-based contracting across markets.

我們認為，隨著我們不斷證明自己有能力在社區提供優質的護理和高品質的護理，我們的關係將會繼續發展，並制定跨市場的計劃。因此，就我們目前所看到的，以及在跨市場開展基於價值的合約的機會而言，目前沒有任何放緩的跡象。

Okay, great.

好的，太好了。

Thank you very much. That's helpful.

非常感謝。那很有幫助。

Next question, David Larson with BTIG. Please go ahead.

下一個問題，來自 BTIG 的 David Larson。請繼續。

Just a quick follow-up in terms of like the the new contracts that you won, that are being deployed in 2025. Just just any thoughts on on how much of that has been recognized.

我只是想快速跟進一下，關於你們贏得的新合同，這些合同將於 2025 年部署。大家覺得這些成就有多少被認可了？

I think the annualized value was like $50 million bucks and of that like how much has has been deployed and just any thoughts on what we could expect for 26.

我認為年化價值大約是 5000 萬美元，其中有多少已經部署，以及我們對 26 年可以期待什麼，大家有什麼想法嗎？

Yeah, so Dan mentioned this in the script, so deals that have launched this year have generated about $19 million in revenue, that's got a good 10 to 15 left in it.

是的，丹在劇本裡提到過，今年推出的交易已經產生了約 1,900 萬美元的收入，還有 1,000 萬到 1,500 萬美元的收入空間。

So that's again deals signed within the year, not contemplating, deals that are in the pipeline that are going to be launching, over the course of the next three months and into 2026.

所以，這裡指的是今年已經簽署的交易，而不是正在考慮中的交易，這些交易將在未來三個月內以及到 2026 年陸續推出。

Okay, great, thanks very much, congrats on a good quarter.

好的，太好了，非常感謝，恭喜你們本季業績出色。

Thanks so much.

非常感謝。

Next question. UNZ to see Riley Securities. Please go ahead.

下一個問題。UNZ 將與 Riley Securities 會面。請繼續。

Maybe a quick follow-up here. So, now we have this ACA debate or the ACA exchange debate. We're not sure whether we will get, credit for that. How will that impact your patient population or, the broad business?

這裡或許需要快速跟進。所以，現在我們有了關於《平價醫療法案》（ACA）或《平價醫療法案》交易所的爭論。我們不確定能否因此獲得學分。這將對您的患者群體或整個業務產生什麼影響？

So, are you on, can you clarify a bit more like what aspects of the ACA specifically?

所以，您現在方便嗎？能否再詳細解釋一下，例如具體是《平價醫療法案》（ACA）的哪些面向？

So, for the ACA if the patients cannot get their credit or cannot pay the insurance themselves, how will that impact your patient population?

那麼，對於《平價醫療法案》(ACA) 而言，如果病患無法獲得信貸或無法自行支付保險費用，這將對您的病患群體產生怎樣的影響？

Yeah, I don't think there'd be much impact in our model broadly speaking. I think most of the patients that would qualify under that new rule are already in cap arrangements to us, so they would have access regardless. I don't really foresee it as a major shift in volume or sort of patient mix for for TOI at this point.

是的，我認為總體而言，這對我們的模型不會有太大影響。我認為大多數符合新規條件的患者已經和我們簽訂了配額協議，所以無論如何他們都能獲得醫療服務。目前來看，我並不認為TOI的銷售量或患者組成會發生重大變化。

Got it.

知道了。

Thank you. This does conclude today's teleconference. You may disconnect your life at this time and thank you for your participation.

謝謝。今天的電話會議到此結束。您可以暫時放下生活中的其他事情，感謝您的參與。