Oncology Institute Inc (TOI) 2024 Q4 法說會逐字稿

Good afternoon, and welcome to The Oncology Institute's fourth-quarter and full year 2024 earnings conference call. Today's call is being recorded, and we have allocated one hour for prepared remarks and questions and answers.

下午好，歡迎參加腫瘤研究所 2024 年第四季和全年收益電話會議。今天的電話會議正在錄音，我們預留了一個小時的時間來準備好的發言和問答。

At this time, I'd like to turn the conference over to Mark Hueppelsheuser, General Counselor at TOI. Thank you. You may begin.

現在，我想將會議交給 TOI 總顧問 Mark Hueppelsheuser。謝謝。你可以開始了。

The press release announcing The Oncology Institute's results for the fourth quarter and full year 2024 are available at the Investors 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.

宣布腫瘤研究所 2024 年第四季和全年業績的新聞稿可在公司網站 theoncologyinstitute.com 的投資者部分查閱。本次電話會議結束後，公司網站上也將提供本次電話會議的重播。

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 fourth quarter and full year 2024. 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.

在我們開始之前，我想提醒您注意公司 2024 年第四季和全年新聞稿中包含的安全港語言。管理階層可能會做出前瞻性陳述，包括指導和基本假設。前瞻性陳述是基於涉及風險和不確定性的預期，可能導致實際結果大不相同。

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 is our CEO, Dan Virnich; and our CFO, Rob Carter. Following our prepared remarks, we'll open the call for your questions.

有關我們業務的風險的進一步討論，請參閱我們向美國證券交易委員會提交的文件。本次電話會議也將討論非公認會計準則財務指標，例如調整後的 EBITDA 和自由現金流。這些非 GAAP 指標與最具可比性的 GAAP 指標的對帳包含在提交給美國證券交易委員會 (SEC) 的收益報告中，並可在我們的網站上查閱。今天與我一起參加電話會議的是我們的執行長 Dan Virnich；以及我們的財務長 Rob Carter。在我們準備好發言之後，我們將開始回答您的問題。

With that, I'll turn the call over to Dan.

說完這些，我就把電話轉給丹。

Thank you, Mark. Good afternoon, everyone, and thank you for joining our fourth quarter and full year 2024 call. Today, we will discuss 2024 results, and we'll focus our attention on the positive developments that began in 2024 and have continued through the beginning of this year, all of which give us confidence that we can cross the line to profitability and positive cash flow by the end of 2025. Although our overall financial performance in 2024 did not meet our expectations, I'd like to highlight several notable developments that were key building blocks for 2025 and beyond. First, our revenue increased 21% over the previous year.

謝謝你，馬克。大家下午好，感謝您參加我們的 2024 年第四季和全年電話會議。今天，我們將討論 2024 年的業績，並將重點放在 2024 年開始並持續到今年年初的積極發展，所有這些都讓我們有信心到 2025 年底實現盈利和正現金流。儘管我們 2024 年的整體財務表現未達到預期，但我還是想強調幾項值得注意的發展，這些發展是 2025 年及以後的關鍵基石。首先，我們的收入比上年增長了21%。

Inside of this headline number were several significant factors: our historically highest growth business, value-based patient services is finishing the year on stronger footing, following the launch of six new contracts totaling over 270,000 lives across the third and fourth quarters. We also achieved an important strategic milestone by proving our model outside of California with two new contracts signed in Florida during Q4 totaling over 200,000 lives and over 80,000 additional lives already signed in the first quarter of 2025 through four separate agreements across markets.

這一總體數字中包含著幾個重要因素：我們歷史上增長最快的業務——基於價值的患者服務，在第三季度和第四季度簽訂了六份新合同，總計惠及超過 270,000 人，將以更強勁的基礎結束今年的業務。我們還透過在加州以外地區驗證我們的模式實現了一個重要的戰略里程碑：第四季度在佛羅裡達州簽署了兩份新合同，總計超過 200,000 條生命，並且透過跨市場的四項獨立協議在 2025 年第一季度已經簽署了超過 80,000 條額外生命。

Importantly, one of the 2025 wins includes 42,000 additional lives in Florida in our first fully delegated model with a health plan partner. Pharmacy and medically integrated dispensaries also grew rapidly in 2024 with $48 million for Q4 and $180 million for the full year, representing annualized growth of 73%. While increased revenue is an important part of the story, we are acutely aware that the growth in the top line must lead to profitability and positive cash flow in the near term.

重要的是，2025 年的勝利之一包括在我們與健康計畫合作夥伴首次完全委託的模式下，佛羅裡達州新增 42,000 條生命。2024 年藥局和醫療綜合藥局也快速成長，第四季成長 4,800 萬美元，全年成長 1.8 億美元，年增率為 73%。雖然增加收入是故事的重要組成部分，但我們敏銳地意識到，收入的成長必須在短期內帶來獲利能力和正現金流。

During 2024, we took several steps to accelerate our path to positive cash flow and profitability. On profitability, we saw sequential improvement in adjusted EBITDA in the second half of the year through our acceleration in capitated contract growth and quarterly drug margin improvement. During the fourth quarter, we entered into a new multiyear agreement with our primary drug distributor, which drove substantial margin improvement starting in December, including volume-based discounts which optimized our cost positioning.

2024 年，我們採取了多項措施來加速實現正現金流和獲利。在獲利能力方面，透過加速按人頭計算的合約成長和季度藥品利潤率的提高，我們看到下半年調整後的 EBITDA 連續改善。在第四季度，我們與主要藥品分銷商達成了一項新的多年期協議，從 12 月開始，該協議推動了利潤率的大幅提高，其中包括基於數量的折扣，從而優化了我們的成本定位。

Part of this revised agreement also improves our payment terms and credit parameters, which was a key contributor to the working capital management that supported our positive cash position in Q4. We have more work to do and are continuing to diligently pursue cost optimization opportunities across our supply chain, including the creation of secondary pharmaceutical and medical product suppliers that will allow TOI to continue to grow while benefiting from a cost structure proportionate to our scale.

修訂後的協議的一部分還改善了我們的付款條件和信用參數，這對營運資本管理起到了關鍵作用，支持了我們在第四季度的正現金狀況。我們還有更多工作要做，並將繼續努力尋求整個供應鏈的成本優化機會，包括創建二級藥品和醫療產品供應商，這將使 TOI 能夠繼續成長，同時受益於與我們的規模成比例的成本結構。

Lastly, we maintained tight controls of our internal cost structure, reducing SG&A 12% in Q4 2024 versus Q4 2023. Our ability to grow top line while reducing SG&A expenses is a testament to our focus on operational excellence and strategic execution. This decrease is a direct result of our ongoing efforts to streamline operations, improve efficiency and optimize our overhead resourcing.

最後，我們嚴格控制內部成本結構，2024 年第四季的銷售、一般及行政費用 (SG&A) 與 2023 年第四季相比降低了 12%。我們能夠在降低銷售、一般及行政費用的同時增加營業收入，這證明了我們對卓越營運和策略執行的關注。這一下降是我們持續努力簡化營運、提高效率和優化間接資源的直接結果。

Through selective outsourcing, planned attrition and modest downsizing, we have been able to lower operating costs without compromising the quality of care and service we deliver. Also importantly, we have reduced overall overhead costs while continuing to selectively recruit and promote top talent within our organization.

透過選擇性外包、有計劃的人員減員和適度裁員，我們能夠降低營運成本，同時又不影響我們所提供的護理和服務的品質。同樣重要的是，我們降低了整體管理成本，同時繼續在組織內選擇性地招募和提拔頂尖人才。

By recognizing, retaining and attracting best-in-class performers within the health care ecosystem, we believe that we have been able to continually do more with less through a high-performance culture. We saw a sequential quarterly reduction in cash burn in the second half of the year as a result of our disciplined approach to working capital management. Improvements across receivables, inventory and payables generated over $4 million of cash in the fourth quarter, our second consecutive quarter of positive cash from operations.

透過認可、留住和吸引醫療保健生態系統中表現最優秀的人才，我們相信，透過高績效文化，我們能夠不斷地用更少的資源做更多的事情。由於我們採取了嚴格的營運資本管理方法，因此下半年現金消耗逐季減少。應收帳款、庫存和應付帳款的改善在第四季度產生了超過 400 萬美元的現金，這是我們連續第二季實現營運現金流為正。

We also have taken significant steps to improve our balance sheet, which has led to two notable recent developments in early 2025. In February 2025, we successfully amended and restructured our facility agreement, including a $20 million principal paydown of our outstanding debt. Through this amendment, we removed certain financial covenants, most notably, permanent elimination of the $40 million minimum cash covenant. Strengthening our balance sheet remains a priority as we continue to enhance financial flexibility and position the company for sustainable growth.

我們也採取了重大措施來改善我們的資產負債表，這導致了 2025 年初的兩項顯著進展。2025 年 2 月，我們成功修改並重組了我們的融資協議，包括償還 2,000 萬美元的未償債務本金。透過這項修正案，我們取消了某些財務契約，最顯著的是永久取消了 4,000 萬美元的最低現金契約。隨著我們繼續增強財務靈活性並使公司實現可持續成長，加強資產負債表仍然是我們的首要任務。

Finally, we are happy to announce that following the principal paydown on our facility agreement, we have entered into agreements for a $16.5 million private placement of common equity. In addition, Deerfield converted $4.1 million of its outstanding debt to common equity on the same terms as the cash equity raise. The capital raise included a combination of management, Board members, as well as existing and new outside investors.

最後，我們很高興地宣布，在我們的融資協議的本金償還之後，我們已達成 1,650 萬美元普通股私募協議。此外，迪爾菲爾德還按照與現金股權融資相同的條款，將其 410 萬美元的未償債務轉換為普通股。此次融資的投資者包括管理階層、董事會成員以及現有和新的外部投資者。

This transaction, in addition to our ongoing cash management efforts, strengthens our financial position and provides TOI with greater flexibility to execute on its strategic priorities. In the aggregate, the outstanding principal balance of the debt has been reduced from $110 million at year-end to $86 million. The additional cash reserve will support our rapid organic growth, including implementing technologies that the company believes will drive improved efficiency and margin expansion.

此次交易加上我們正在進行的現金管理工作，增強了我們的財務狀況，並為 TOI 提供了更大的靈活性來執行其策略重點。總體而言，債務未償還本金餘額已從年底的 1.1 億美元減少至 8,600 萬美元。額外的現金儲備將支持我們的快速有機成長，包括實施公司認為將提高效率和擴大利潤率的技術。

Now I'll turn the call over to our CFO, Rob Carter, to provide additional details on our fourth quarter and full year 2024 financial results, along with 2025 guidance and additional operational and strategic updates.

現在，我將把電話轉給我們的財務長 Rob Carter，以提供有關我們 2024 年第四季度和全年財務業績的更多詳細信息，以及 2025 年指引和其他營運和策略更新。

Thanks, Dan, and good afternoon, everyone. Coming off my first quarter as CFO of TOI, I'm more excited than ever to be part of this incredible team and working with all of them as we continue to execute our strategy and drive long-term value.

謝謝，丹，大家下午好。在擔任 TOI 財務長的第一個季度之後，我比以往任何時候都更加高興能夠成為這個不可思議的團隊的一員，並與他們一起繼續執行我們的策略並推動長期價值。

Let's begin by reviewing our financial performance for the fourth quarter and full year 2024. Consolidated revenue for Q4 2024 was $100.3 million, an increase of 17% compared to Q4 2023. The increase is driven primarily by our dispensary revenue due to our California-based pharmacy, which continues to exceed fill expectations.

讓我們先回顧一下 2024 年第四季和全年的財務表現。2024 年第四季綜合營收為 1.003 億美元，較 2023 年第四季成長 17%。這一增長主要得益於我們位於加州的藥房收入，該藥房的銷售額持續超出預期。

As Dan mentioned, we expect to see more normalized levels of growth in the dispensary business going forward now that a full year of operations has lapsed. Gross profit in Q4 2024 was $14.6 million, an increase of 2% compared to Q4 2023. This increase is attributed to the contribution of our dispensary segment.

正如丹所提到的，由於已經運作了一整年，我們預計未來藥局業務的成長水準將更加正常化。2024 年第四季毛利為 1,460 萬美元，較 2023 年第四季成長 2%。這一增長歸功於我們藥房部門的貢獻。

We were able to decrease our SG&A in Q4 2024 by 12% as compared to Q4 2023 despite the strong growth in our top line, which is a testament to our commitment towards driving operational efficiency and our goal towards profitability. As a percentage of revenue, SG&A, including depreciation and amortization, was 26% in the quarter, a decrease of 8% as compared to Q4 2023.

儘管我們的營業收入強勁成長，但我們仍能將 2024 年第四季的銷售、一般及行政費用 (SG&A) 與 2023 年第四季相比降低 12%，證明了我們致力於提高營運效率和實現盈利的目標。以收入百分比計算，包括折舊和攤銷在內的銷售、一般及行政費用 (SG&A) 本季為 26%，與 2023 年第四季相比下降了 8%。

Loss from operations for Q4 2024 was $11.9 million, an improvement of $3.4 million compared to Q4 2023. Net loss for Q4 2024 was $13 million, an improvement of $5.6 million compared to Q4 2023. Adjusted EBITDA for Q4 2024 was negative $7.8 million compared to negative $6.3 million in Q4 of 2023. Contributing to the Q4 loss was a $3 million onetime reduction in fee-for-service revenue unrelated to Q4 dates of service.

2024 年第四季的營業虧損為 1,190 萬美元，與 2023 年第四季相比改善了 340 萬美元。2024 年第四季淨虧損為 1,300 萬美元，與 2023 年第四季相比改善了 560 萬美元。2024 年第四季調整後 EBITDA 為負 780 萬美元，而 2023 年第四季為負 630 萬美元。造成第四季虧損的原因是與第四季服務日期無關的收費服務收入一次性減少了 300 萬美元。

As Dan noted, net cash from operations for Q4 2024 was a positive $4.2 million, and our cash and cash equivalents increased $2.3 million compared to Q3 2024 due to working capital management and noncash expenses in excess of operating losses.

正如丹所指出的，2024 年第四季的淨營運現金為正 420 萬美元，由於營運資本管理和非現金支出超過經營虧損，我們的現金和現金等價物與 2024 年第三季相比增加了 230 萬美元。

Moving to our full year results. Consolidated revenue for 2024 was $393 million, an increase of 21.3% compared to 2023, driven by the contribution of our California-based pharmacy. Gross profit for 2024 was $54 million, a decrease of 9.4% compared to 2023.

轉向我們的全年業績。2024 年綜合收入為 3.93 億美元，較 2023 年增長 21.3%，這得益於我們位於加州的藥房的貢獻。2024 年毛利為 5,400 萬美元，較 2023 年下降 9.4%。

The loss in gross profit is largely attributable to lower infusion drug margin and Part B due to drug price inflation outpacing reimbursement as well as higher clinical payroll as TOI built its care infrastructure around anticipated growth in new contracts that we are now seeing materialize as we exit the year.

毛利的損失主要歸因於輸液藥物利潤率較低以及 B 部分藥物價格上漲超過報銷，以及臨床工資上漲，因為 TOI 圍繞新合約的預期增長建立了其護理基礎設施，我們現在看到這些增長在年底實現。

SG&A, including depreciation and amortization, is $114 million in 2024, a decrease of $5.6 million compared to 2023. As a percentage of revenue, SG&A was 29% in 2024, down 800 basis points from 2023.

2024 年，包括折舊和攤提在內的銷售、一般和行政費用為 1.14 億美元，與 2023 年相比減少 560 萬美元。作為收入的百分比，SG&A 費用在 2024 年為 29%，比 2023 年下降 800 個基點。

Loss from operations for 2024 was $60 million, an improvement of $16.9 million compared to 2023. Net loss for 2024 was $64.6 million, a decrease of $18.4 million compared to 2023. And adjusted EBITDA for 2024 was negative $35.7 million. Further details on how we define non-GAAP financial measures can be found in our Form 10-K and press release.

2024 年營業虧損為 6,000 萬美元，較 2023 年改善 1,690 萬美元。2024 年淨虧損為 6,460 萬美元，較 2023 年減少 1,840 萬美元。2024 年調整後的 EBITDA 為負 3,570 萬美元。有關我們如何定義非公認會計準則財務指標的更多詳細信息，請參閱我們的 10-K 表格和新聞稿。

Moving to the balance sheet. As of the end of Q4 2024, our cash and cash equivalents balance was $49.7 million. This represents an increase of $2.3 million of cash and cash equivalents compared to Q3 2024, which is a result of efforts to maximize efficiencies in working capital, particularly in inventory management.

轉到資產負債表。截至 2024 年第四季末，我們的現金和現金等價物餘額為 4,970 萬美元。與 2024 年第三季相比，現金和現金等價物增加了 230 萬美元，這是努力最大限度提高營運資金效率（特別是庫存管理效率）的結果。

Additionally, as mentioned in our last earnings call, we received a cash inflow of $4.1 million as a result of a favorable legal settlement in Q4, which strengthened our balance sheet and added to our liquidity position. Our private placement will further bolster this cash position in this quarter.

此外，正如我們在上次收益電話會議上提到的那樣，由於第四季度達成了有利的法律​​和解，我們獲得了 410 萬美元的現金流入，這增強了我們的資產負債表並增加了我們的流動性狀況。我們的私募將進一步增強本季的現金狀況。

Before I turn the call over to Dan for closing comments, I would like to walk through our 2025 guidance. The cornerstone of our 2025 guidance is the execution of several recent capitation contracts, which are expected to deliver a significant improvement in our profitability in 2025 and beyond.

在我將電話轉給丹進行最後評論之前，我想先介紹一下我們的 2025 年指導。我們 2025 年指引的基石是最近執行的幾份人頭稅合同，預計這些合約將在 2025 年及以後顯著提高我們的盈利能力。

As mentioned, the annualized revenue of the new capitation deals starting between Q3 2024 and the second quarter 2025 is approximately $50 million, with only two-thirds of that to be recognized in 2025 due to staggered start dates of the contracts. We are well positioned to handle substantial growth in the markets we serve without needing to add more providers or increase overhead costs.

如上所述，2024 年第三季至 2025 年第二季期間開始的新人頭稅交易的年化收入約為 5,000 萬美元，由於合約開始日期錯開，其中只有三分之二將在 2025 年實現。我們已做好準備，無需增加更多供應商或增加管理費用，就能應對我們所服務市場的大幅成長。

For the full year 2025, we expect revenue of $460 million to $480 million, representing a 17% to 22% growth over full year 2024. This growth is driven by several factors, including our dispensary business, particularly our pharmacy, as well as the continued expansion of value-based contracts and organic growth, especially in Florida. We expect gross profit in the range of $73 million to $82 million, an increase from $54 million in 2024, representing a 214 to 336 basis point increase in margin over 2024.

我們預計 2025 年全年營收將達到 4.6 億美元至 4.8 億美元，比 2024 年全年成長 17% 至 22%。這一增長受到多種因素的推動，包括我們的藥房業務，特別是我們的藥房，以及基於價值的合約和有機增長的持續擴張，尤其是在佛羅裡達州。我們預計毛利將在 7,300 萬美元至 8,200 萬美元之間，高於 2024 年的 5,400 萬美元，這意味著利潤率將比 2024 年增加 214 至 336 個基點。

We expect adjusted EBITDA in the range of negative $8 million to negative $17 million, of which we expect $5 million to $6 million of the loss to occur in the first quarter, with an expected progression to profitability in the second half of the year. Q1 of 2025 will be our worst quarter due to seasonal factors, such as new year drug price increases and lower encounter volumes.

我們預計調整後的 EBITDA 在負 800 萬美元至負 1700 萬美元之間，其中我們預計第一季的虧損為 500 萬美元至 600 萬美元，預計下半年將實現盈利。由於新年藥品價格上漲和就診量下降等季節性因素，2025 年第一季將是我們表現最差的一個季度。

However, we anticipate a steady improvement in drug margins as reimbursement aligns with price adjustments and as encounter volumes grow organically. A key value-based contract in Florida launched in March with several more contracts set to launch in Q2.

然而，隨著報銷與價格調整一致以及就診量有機增長，我們預計藥品利潤率將穩步提高。佛羅裡達州的一項基於價值的關鍵合約於 3 月啟動，另有幾份合約將於第二季啟動。

The margin contribution from these contracts will increase throughout the year, driven by TOI and our payer partners directing more patients to our provider network, which helps reduce leakage costs, which reduce the capitation payment received by TOI as we are typically responsible for external oncology spend.

這些合約的利潤貢獻將在全年增加，這是由於 TOI 和我們的付款人合作夥伴將更多患者引導至我們的提供者網絡，這有助於降低洩漏成本，從而減少 TOI 收到的人頭費，因為我們通常負責外部腫瘤學支出。

As a result, we expect a gradual reduction in losses over the course of the year, ultimately achieving positive EBITDA in Q4. In an effort to provide more clarity on cash use and runway, we are providing free cash flow guidance for 2025. In the first half of the year, we expect cash burn from operating losses with progressive improvement as the year progresses.

因此，我們預計今年的虧損將逐步減少，最終在第四季實現正的 EBITDA。為了更清楚地了解現金使用情況和跑道，我們提供了 2025 年的免費現金流指導。我們預計，今年上半年經營虧損帶來的現金消耗將隨著時間的推移逐步改善。

Working capital is expected to generate cash through reductions in fee-for-service DSOs and improved inventory management. In addition to the burn associated with operating losses, we expect modest capital expenditures of $2 million and onetime expenses and add-backs of $5 million. As such, we are guiding to free cash flow in the range of negative $12 million to negative $21 million for full year 2025, with anticipated cash flow breakeven in the fourth quarter of 2025.

預計營運資金將透過減少按服務收費的 DSO 和改善庫存管理來產生現金。除了與營運損失相關的燒錢之外，我們預計資本支出將達到 200 萬美元，一次性支出和附加支出將達到 500 萬美元。因此，我們預計 2025 年全年自由現金流將在負 1,200 萬美元至負 2,100 萬美元之間，預計 2025 年第四季現金流將達到收支平衡。

With that, I'll turn it back to Dan for closing comments.

好了，現在我將把話題交還給丹，請他發表最後的評論。

Thanks, Rob. As mentioned earlier, subsequent to year-end 2024, we strengthened our balance sheet through two key initiatives, a debt paydown and a successful capital raise. We remain committed to reducing leverage and improving our financial flexibility. This new capital strengthens our balance sheet and positions us to execute on our strategic priorities. We are pleased with the strong interest from investors and broad support from the Board, which reflects confidence in our business model and long-term growth prospects.

謝謝，羅布。如前所述，在 2024 年底之後，我們透過兩項關鍵措施（償還債務和成功籌集資金）加強了資產負債表。我們仍然致力於降低槓桿率並提高財務靈活性。這筆新資本增強了我們的資產負債表，使我們能夠執行策略重點。我們很高興看到投資者的濃厚興趣和董事會的廣泛支持，這反映了他們對我們的商業模式和長期成長前景的信心。

As we enter 2025, we will continue to build on our momentum through strong operational management, increased efficiencies and strategic market expansion and expect a near-term path with the same cash flow positivity and profitability in the second half of 2025. With that, we're now ready to take your questions. Operator?

進入 2025 年，我們將透過強大的營運管理、提高效率和策略市場擴張繼續保持發展勢頭，並預計在 2025 年下半年實現同樣的現金流量正成長和獲利能力。現在，我們就可以回答您的問題了。操作員？

(Operator Instructions) Yuan Zhi, B. Riley.

（操作員指示）袁志，B. Riley。

I have a couple of them, if I may. Rob, for 2025 guidance, what are the significant moving factors there? Do you need to sign new contracts to get the revenue and the gross profit go there?

如果可以的話，我有幾個。羅布，對於 2025 年的指導，有哪些重大的變動因素？您是否需要簽署新合約才能獲得收入和毛利？

Thanks for the question. Yes, several things contributing to the growth on 2025 guidance, among them, as you mentioned, growth in cap contracts, yes, is integral to us hitting our targets. We also have organic growth planned for both fee-for-service and dispensary. We'll need to hit on all of those in order to hit that target. But the combination of those are how we're viewing growth in 2025.

謝謝你的提問。是的，有幾個因素促成了 2025 年指引的成長，其中，正如您所提到的，上限合約的成長對於我們實現目標至關重要。我們還計劃實現按服務收費和藥房的有機增長。為了達到這個目標，我們需要全力以赴。但這些因素的結合正是我們對 2025 年成長的看法。

Beyond that, as mentioned a little bit in the section that I just went through, is a reduction in our clinical payroll as a percentage of revenue. As mentioned, we incurred expenses in 2024 in terms of putting in clinics and doctors in our growth markets, particularly in Florida. And we're now in a position where these incremental lives from these value-based contracts will fill the clinics, thus reducing the overall cost of clinical payroll as a percentage of revenue and then the cost per visit.

除此之外，正如我剛剛提到的那樣，我們的臨床工資佔收入的百分比有所減少。如上所述，我們在 2024 年在成長市場（尤其是佛羅裡達州）設立診所和醫生方面產生了成本。現在我們處於這樣的情況：這些基於價值的合約所帶來的增量生命將填滿診所，從而降低臨床工資佔收入的總體成本，進而降低每次就診的成本。

Yes, got it. Yes, we will get into that in a moment. So maybe a quick follow-up there. How do we think about the contribution from the patient service segment and/or dispensary? Will patient service be a meaningful growth driver there in 2025?

是的，明白了。是的，我們馬上就會討論這個問題。因此也許可以快速跟進。我們如何看待病患服務部門和/或藥局的貢獻？到 2025 年，病患服務是否會成為重要的成長動力？

Yes. The cap segment being a part of patient services will be the primary and most significant driver of our improvement of overall profitability. We expect organic growth in fee-for-service to continue at the sort of market rates and levels, but the main contribution from the patient services segment will be within cap.

是的。作為病患服務的一部分，資本部分將成為我們提高整體獲利能力的主要和最重要的驅動力。我們預計按服務收費的有機成長將繼續保持市場利率和水平，但患者服務部門的主要貢獻將在上限範圍內。

Yes, got it. And either Rob or Daniel, can you provide more operating or operational metrics comparing the new territories such as Florida versus established market in California? And what's the goal there in 2025?

是的，明白了。無論是 Rob 還是 Daniel，您能否提供更多營運或營運指標，比較佛羅裡達等新地區與加州的成熟市場？2025 年的目標是什麼？

Yes, absolutely. I'm happy to take that one. We continue to grow in California, which is our oldest market. However, there are several things about Florida and other new expansion markets which are very attractive to TOI and makes our value proposition even stronger with payer partners and patients. One, we see benchmark oncology utilization much higher than California and new markets, so the opportunity to provide value against that much higher benchmark is significant.

是的，絕對是。我很高興接受這個。我們在加州繼續發展，它是我們最古老的市場。然而，佛羅裡達州和其他新擴張市場的幾個方面對 TOI 非常有吸引力，並使我們的價值主張對付款方合作夥伴和患者更加強大。首先，我們看到腫瘤學的基準利用率遠高於加州和新市場，因此，根據更高的基準提供價值的機會是巨大的。

The other key difference is that almost all markets outside of California are pure Medicare Advantage risk markets, which creates a much higher opportunity, given the higher prevalence rate and spend associated with the senior population versus commercial and managed Medicaid, which predominates, in addition to Medicare Advantage, in California.

另一個主要區別是，加州以外的幾乎所有市場都是純粹的醫療保險優勢風險市場，這創造了更高的機會，因為與商業和管理的醫療補助相比，老年人口的患病率更高，支出也更高，除了醫療保險優勢之外，加州還占主導地位。

Got it. Just maybe some specifics there. Where are we in terms of the capacity of the new clinic in Florida versus, let's say, in California, you are already in 90% or 100% capacity?

知道了。也許只是一些細節。就佛羅裡達州新診所的容量而言，我們處於什麼位置？而加州的容量已經達到 90% 或 100% 了？

Yes. So our California clinics are below 90%. They're about 75%, so there's opportunity for additional capacity in California. In Florida, we've got much greater capacity. We're currently operating about 40%, depending on the clinic across our clinics in 5 counties in that market.

是的。因此，我們加州診所的接受率低於 90%。大約佔 75%，因此加州還有機會增加產能。在佛羅裡達州，我們的容量要大得多。我們目前的營運率約為 40%，具體取決於該市場 5 個縣的診所。

So we've got the opportunity just in those 5 counties to add significant contribution to our P&L. There's also other high-priority markets in Florida that we don't currently have clinics or we've got near-term expansion opportunities through capitation.

因此，我們有機會在這 5 個縣為我們的損益做出重大貢獻。佛羅裡達州還有其他一些高優先市場，我們目前在這些市場沒有診所，或者我們透過人頭稅獲得了短期擴張機會。

Yes, got it. Especially on that, on the 40% right now, is there a goal to achieve in 2025? Are we targeting similarly to California at 75% or slightly lower but the gap there in 2026?

是的，明白了。特別是現在的40%，2025年有沒有一個目標要達成？我們的目標是否與加州類似，即 75% 或略低，但到 2026 年差距仍然存在？

Yes, our goal is to grow, I mean, as fast and efficiently as we can. We definitely have the clinical capacity to achieve California productivity in 2025. There are substantial contracts in the pipeline in Florida and new markets that could bring us to those levels, depending on the speed of execution beyond those which have already signed.

是的，我們的目標是盡可能快速、有效率地發展。我們絕對有臨床能力在 2025 年達到加州的生產力。佛羅裡達州和新市場正在醞釀大量合同，這些合約可以使我們達到這些水平，這取決於已簽署合約的執行速度。

Yes, got it. Maybe one last question from me. Any thoughts on the recent reimbursement landscape? Anything you are watching for with this new administration, including new CMS administrators in the office now?

是的，明白了。我還有最後一個問題。對最近的報銷情況有什麼看法？您對新政府有什麼關注，包括現在辦公室裡的新 CMS 管理員嗎？

Yes, absolutely. I think all of the general macro trends that we see in the oncology industry are favorable for The Oncology Institute. So the big changes which have been discussed, although it's debatable as to how fast it would take place would be changes related to IRA. Any reduction in more expensive oncology drugs will definitely benefit The Oncology Institute since we're capable of managing in a value-based construct, and we've been doing that for 18 years. That would be harder obviously on a pure fee-for-service oncology business, but that would be favorable for us.

是的，絕對是。我認為我們在腫瘤學行業看到的所有總體宏觀趨勢都對腫瘤學研究所有利。因此，儘管對於發生的速度有爭議，但已經討論過的重大變化是與 IRA 相關的變化。任何昂貴的腫瘤藥物的減少肯定會使腫瘤研究所受益，因為我們有能力以基於價值的結構進行管理，而且我們已經這樣做了 18 年。對於純粹的按服務收費的腫瘤學業務來說，這顯然會更加困難，但對我們來說卻是有利的。

And then if anything ever happens to 340B pricing, which The Oncology Institute does not benefit from, that would push volume from hospital-based infusion centers and oncology out into the community, again, which we believe would ultimately benefit us in terms of the growth -- organic growth in our clinic as well as increased opportunity, again, working with payers.

然後，如果 340B 定價發生任何事情，而腫瘤研究所不會從中受益，那麼這將把醫院輸液中心和腫瘤科的數量推向社區，同樣，我們相信這最終將使我們在增長方面受益 - 我們診所的有機增長以及增加的機會，再次與付款人合作。

(Operator Instructions) Robert LeBoyer, NOBLE Capital Markets.

（操作員指示）NOBLE Capital Markets 的 Robert LeBoyer。

Congratulations on the quarter. I was looking at the revenue guidance and wondering if you could give any of the individual line items, the patient services, dispensary, and clinical trial breakout as to what the revenue expectations and growth for each of those areas is.

恭喜本季。我正在查看收入指南，想知道您是否可以提供任何單獨的項目、患者服務、藥房和臨床試驗的細分，以及每個領域的收入預期和增長。

Yes, at this point, we're not guiding to specific segments. The thought here though is, as I mentioned before, that in terms of overall contribution to profitability, cap is going to be the greatest contributor, followed by dispensary and then fee-for-service. We expect organic growth from both dispensary and fee-for-service with this robust pipeline that we have driving the cap.

是的，目前我們還沒有針對特定細分市場進行指導。不過，正如我之前提到的，這裡的想法是，就盈利能力的整體貢獻而言，上限將是最大的貢獻者，其次是藥房，然後是按服務收費。我們預計，憑藉我們強大的管道推動上限，藥房和按服務收費都將實現有機增長。

(Operator Instructions)

（操作員指示）

There's no further questions. This concludes the question-and-answer session. This also concludes today's teleconference. You may disconnect your lines at this time. Thank you again for your participation.

沒有其他問題了。問答環節到此結束。今天的電話會議到此結束。現在您可以斷開線路。再次感謝您的參與。