Oncology Institute Inc (TOI) 2025 Q1 法說會逐字稿

Good afternoon, and welcome to The Oncology Institute's first-quarter 2025 earnings conference call. Today's call is being recorded, and we have allocated one hour for prepared remarks and Q&A. At this time, I'd like to turn the conference over to Mark Hueppelsheuser, General Counsel at TOI. Thank you. You may begin.

下午好，歡迎參加腫瘤研究所 2025 年第一季財報電話會議。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。現在，我想將會議交給 TOI 總法律顧問 Mark Hueppelsheuser。謝謝。你可以開始了。

The press release announcing The Oncology Institute's results for the first quarter of 2025 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. 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 first quarter 2025. 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.

腫瘤研究所2025年第一季業績新聞稿可於公司網站theoncologyinstitute.com的「投資者」板塊查閱。本次電話會議結束後，公司網站也將提供本次電話會議的重播。在我們開始之前，我想提醒您注意公司 2025 年第一季新聞稿中包含的公司安全港語言。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還有我們的執行長 Dan Virnich 和財務長 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 first-quarter '25 earnings call. Today, we will discuss first-quarter 2025 results with a focus on our strong start to the year and momentum on our path to profitability and positive cash flow by the end of 2025. I'd like to start with some key updates on Q1 performance. I'm happy to report that revenues for Q1 increased by 10% versus the prior year period.

謝謝你，馬克。大家下午好，感謝大家參加我們的 2025 年第一季財報電話會議。今天，我們將討論 2025 年第一季的業績，重點是我們今年的強勁開局以及到 2025 年底實現盈利和正現金流的勢頭。我想先介紹第一季業績的一些重要更新。我很高興地報告，第一季的營收比去年同期成長了 10%。

This was driven by a few important factors. Our retail pharmacy and Dispensary business continues to grow rapidly and set fill records, contributing $49.3 million in revenue and over $9 million in gross profit in Q1 alone. This business segment grew over 20% in the first quarter of 2025 versus prior year. As noted on our year-end call in March, we had a very strong start to the year with new capitated contract wins, adding over 80,000 lives in the first quarter on four agreements across the Florida, California, and Nevada markets. Anticipated new capitation contracts in the first half of 2025 are projected to add approximately $50 million in new revenue on an annualized basis.

這是由幾個重要因素造成的。我們的零售藥局和藥局業務持續快速成長並創下紀錄，光是第一季就貢獻了 4,930 萬美元的收入和超過 900 萬美元的毛利。2025 年第一季度，該業務部門較上年同期成長了 20% 以上。正如我們在 3 月的年終電話會議上所指出的那樣，我們今年開局非常強勁，贏得了新的按人頭計費的合同，第一季度我們在佛羅裡達州、加利福尼亞州和內華達州市場簽訂了四份協議，為超過 80,000 人帶來了生命。預計 2025 年上半年的新人頭稅合約將增加約 5,000 萬美元的新收入。

We started our first fully delegated capitation agreement with a major health plan in Florida on March 1 where we are delegated for utilization management, claims and network. This is going to be our preferred model for health plan relationships going forward as it gives us differential ability to manage therapeutics with our MSO practice partners as well as engage with them on future high-value opportunities for TOI through our retail pharmacy and clinical trials program. We also signed a new capitation contract in Nevada during the first quarter, which adds over 80,000 Medicaid lives to Clark County with an effective date of July 1.

我們於 3 月 1 日與佛羅裡達州一家大型健康計畫簽署了第一份完全委託人頭稅協議，該計畫委託我們負責利用管理、索賠和網路。這將是我們未來健康計畫關係的首選模式，因為它使我們能夠與 MSO 實踐合作夥伴一起管理治療，並透過我們的零售藥局和臨床試驗計畫與他們合作，為 TOI 提供未來的高價值機會。我們還在第一季與內華達州簽署了新的人頭稅合同，該合約將於 7 月 1 日生效，為克拉克縣增加 80,000 多名醫療補助受益人。

Our fee-for-service business also returned to growth in the quarter, growing 9% quarter-over-quarter and 2% year-over-year, highlighting the impact of our investments in referral relationship management and call center expansion. Achieving profitability and our near-term path to positive free cash flow generation in Q4 remain the management team's North Star.

我們的收費服務業務在本季度也恢復了成長，環比成長 9%，年成長 2%，突顯了我們在推薦關係管理和呼叫中心擴展方面的投資的影響。實現盈利以及在第四季度產生正自由現金流的近期路徑仍然是管理團隊的北極星。

Some highlights from Q1 related to this effort include: adjusted EBITDA loss of $5.1 million, which is on the upper end of our guidance for the quarter; gross profit of $17.2 million, which represents growth of 44.1% year-over-year; continued acceleration of near-term capitation opportunities in the pipeline, with line of sight to an additional 100,000 lives with anticipated effective dates in Q2 and Q3; focus on growing our radiation oncology and radiopharmaceutical segments, which will be accretive to fee-for-service margins; successful outsourcing of our clinical trials for Helios clinical trials.

與此工作相關的第一季度的一些亮點包括：調整後的 EBITDA 虧損為 510 萬美元，處於本季度預期的上限；毛利潤為 1,720 萬美元，同比增長 44.1%；近期人頭稅機會的持續加速，預計將在第二季度和第三季度為另外 10萬人帶來益處；專注於擴大我們的放射腫瘤學和放射性藥物部門，這將有助於增加按服務收費的利潤率；成功將我們的臨床試驗外包給 Helios 臨床試驗。

Helios will operate as the site management organization, and we believe their expertise will dramatically accelerate trials growth in existing and new markets in the second half of the year. However, the structure of the transaction will involve deconsolidating clinical research revenue from TOI's income statement, which will modestly impact our full year revenue, which Rob will discuss in more detail shortly. As it stands today, we are not currently projecting a negative impact to drug costs in 2025 related to recently announced tariffs, although we are carefully assessing country of origin for all therapeutics in our portfolio, ensuring we have optionality for all disease classes to protect our margins.

Helios 將作為現場管理組織運營，我們相信他們的專業知識將大大加速今年下半年現有和新市場的試驗成長。然而，交易結構將涉及將臨床研究收入從 TOI 的損益表中分離出來，這將對我們的全年收入產生輕微影響，Rob 將很快對此進行更詳細的討論。就目前情況而言，我們目前預計最近宣布的關稅不會對 2025 年的藥品成本產生負面影響，儘管我們正在仔細評估我們產品組合中所有治療藥物的原產國，確保我們對所有疾病類別都有可選性，以保護我們的利潤率。

Finally, we successfully executed a partial paydown of our convertible preferred debt of $20 million in Q1 with permanent elimination of our minimum cash covenant, followed by a capital raise that added $16 million back to our balance sheet. Combined, these transactions strengthen TOI's financial position and provide us with greater flexibility to execute on our strategic priorities.

最後，我們在第一季成功償還了 2000 萬美元的可轉換優先債的部分款項，並永久取消了最低現金契約，隨後又進行了資本籌集，為我們的資產負債表增加了 1600 萬美元。這些交易結合起來增強了 TOI 的財務狀況，並為我們執行策略重點提供了更大的靈活性。

Finally, this afternoon, we announced that Dr. Jeff Langsam is joining the TOI team as Chief Clinical Officer. Jeff joined us from Cigna, where he led national efforts in oncology and specialty pharmacy, lending to his role at TOI, where he will lead our efforts around therapeutics, utilization management and MSO practice engagement. The Chief Clinical Officer role was conceived as part of TOI's evolution in light of the increasingly complex drug and delegation landscape in which TOI operates, allowing us to further distance our capabilities and delivered value.

最後，今天下午，我們宣布 Jeff Langsam 博士將加入 TOI 團隊擔任首席臨床長。Jeff 加入公司之前曾在 Cigna 工作，在 Cigna 領導腫瘤學和專科藥學領域的全國性工作，在 TOI 任職期間，他將領導我們在治療學、利用管理和 MSO 實踐參與方面的工作。首席臨床長這個角色是 TOI 發展的一部分，考慮到 TOI 營運所處的藥物和授權環境日益複雜，這使我們能夠進一步發揮我們的能力並實現價值。

To this end, Dr. Langsam's role is designed as a net addition to TOI's central clinical infrastructure and is expected to remain collaborative but ultimately distinct from that of TOI's Chief Medical Officer, Dr. Yale Podnos, who will continue to serve as the chief clinician overseeing our provider staff. Last week, we also announced that TOI will be presenting clinical trial data at the American Society of Clinical Oncology, ASCO Annual Meeting later this month, which demonstrates the value and effectiveness of TOI's clinical model at reducing cost of care while driving improvements in Part A utilization for the patients that we serve.

為此，Langsam 博士的職責被設計為 TOI 中央臨床基礎設施的淨補充，預計將保持協作關係，但最終與 TOI 首席醫療官 Yale Podnos 博士的職責有所區別，後者將繼續擔任監督我們醫療服務人員的首席臨床醫生。上週，我們也宣布 TOI 將於本月稍後在美國臨床腫瘤學會 ASCO 年會上展示臨床試驗數據，這證明了 TOI 臨床模型在降低護理成本的同時推動我們服務的患者 A 部分利用率改善方面的價值和有效性。

With that, I will turn the call over to Rob to provide additional details on our Q1 performance and 2025 outlook.

接下來，我將把電話轉給 Rob，讓他提供有關我們第一季業績和 2025 年展望的更多詳細資訊。

Thanks, Dan, and good afternoon, everyone. Let's begin by reviewing our financial performance for the quarter. Consolidated revenue for Q1 2025 was $104.4 million, an increase of 10.3% compared to Q1 2024. The increase in revenue was driven primarily by a 24.2% growth in TOI Dispensary segment due to continued growth in the attachment of prescriptions to our patient visits. Notably, we saw our fee-for-service business return to growth during the first quarter, increasing 2.3% to $35.6 million in 2025 versus the prior year period.

謝謝，丹，大家下午好。讓我們先回顧一下本季的財務表現。2025 年第一季綜合營收為 1.044 億美元，較 2024 年第一季成長 10.3%。收入的增長主要得益於 TOI 藥房部門 24.2% 的增長，這歸因於患者就診時處方的持續增長。值得注意的是，我們的收費服務業務在第一季恢復成長，與去年同期相比，2025 年成長 2.3%，達到 3,560 萬美元。

We are encouraged by the positive patient and referral feedback on TOI's services. And our strong track record for high-quality care, combined with our value-oriented model, gives us confidence in our continued fee-for-service growth driven by patient choice and health system and community providers' patient referrals. Gross profit in Q1 of 2025 was $17.2 million, an increase of 44.1% compared to Q1 of 2024. This increase is attributed to improvement in revenue and margin in both capitation and fee-for-service with inpatient services as well as improvement in both revenue and margin and TOI's Dispensary segment.

病患和轉診者對 TOI 服務的正面回饋令我們感到鼓舞。我們在高品質護理方面的良好記錄，加上我們以價值為導向的模式，使我們對由患者選擇以及醫療系統和社區提供者的患者推薦推動的持續按服務收費增長充滿信心。2025 年第一季毛利為 1,720 萬美元，較 2024 年第一季成長 44.1%。這一增長歸因於住院服務的人頭費和按服務收費的收入和利潤的提高，以及 TOI 藥房部門的收入和利潤的提高。

Margin improvement in the first quarter for both patient services and Dispensary businesses is attributable to the recognition of a onetime rebate recognized over the fourth-quarter of 2024 and first-quarter of 2025 related to the renewal of a three-year contract with TOI's primary drug supplier. This is not expected to recur in future quarters, although we do expect the benefit of drug price increases to improve over the course of 2025. SG&A, including depreciation and amortization was $27.2 million in Q1 of 2025, a 9% decline compared to Q1 of 2024. As a percentage of revenue, SG&A, including depreciation and amortization, was 26% in the quarter, decreasing 560 basis points from Q1 of 2024.

第一季病患服務和藥局業務的利潤率提高歸因於 2024 年第四季和 2025 年第一季度確認的一次性回扣，該回扣與 TOI 的主要藥品供應商續簽三年合約有關。儘管我們確實預期藥品價格上漲帶來的好處將在 2025 年有所改善，但預計未來幾季不會再次出現這種情況。2025 年第一季度，包括折舊和攤提在內的銷售、一般及行政費用為 2,720 萬美元，與 2024 年第一季相比下降 9%。作為收入的百分比，包括折舊和攤銷在內的銷售、一般及行政費用在本季度為 26%，比 2024 年第一季下降了 560 個基點。

Loss from operations was $9.9 million, an improvement from an $18 million loss in Q1 of 2024. Net loss was $19.6 million in the quarter, an improvement of $303,000 compared to Q1 of 2024. Adjusted EBITDA was negative $5.1 million compared to negative $10.9 million in Q1 of 2024. Free cash flow was negative $3.9 million compared to negative $15.4 million in Q1 of 2024.

營業虧損為 990 萬美元，較 2024 年第一季的 1,800 萬美元虧損有所改善。本季淨虧損為 1,960 萬美元，與 2024 年第一季相比改善了 30.3 萬美元。調整後 EBITDA 為負 510 萬美元，而 2024 年第一季為負 1,090 萬美元。自由現金流為負 390 萬美元，而 2024 年第一季為負 1,540 萬美元。

Moving to the balance sheet. As of the end of Q1 2025, our cash and cash equivalents balance was $39.8 million. This represents an increase of $3.7 million of cash and cash equivalents compared to Q1 of 2024.

轉到資產負債表。截至 2025 年第一季末，我們的現金及現金等價物餘額為 3,980 萬美元。與 2024 年第一季相比，現金和現金等價物增加了 370 萬美元。

This is attributable to our capital raise completed in the first quarter as well as efforts to maximize efficiencies in working capital, particularly in accounts receivable and inventory management. Also, we were able to reduce our principal balance on our senior secured convertible note through our debt pay-down and debt-to-equity exchange agreement, reducing our quarterly cash interest payments by approximately $1 million annually. As Dan mentioned, in the first quarter, we successfully closed a private placement that resulted in gross proceeds of approximately $16.5 million and further contributes to our prioritization of organic growth and building working capital and liquidity to find TOI's ongoing growth. In conjunction with this transaction, a major shareholder entered into an exchange agreement, whereby approximately $4.1 million of aggregate principal amount of senior secured convertible notes were exchanged for common equivalent preferred stock and warrants for common stock.

這歸功於我們在第一季完成的融資以及最大限度提高營運資本效率的努力，特別是在應收帳款和庫存管理方面。此外，我們還能夠透過債務償還和債轉股協議減少優先擔保可轉換票據的本金餘額，從而每年減少季度現金利息支付約 100 萬美元。正如丹所提到的，在第一季度，我們成功完成了私募，總收益約為 1,650 萬美元，這進一步促進了我們優先考慮有機成長以及建立營運資本和流動性，以實現 TOI 的持續成長。配合此交易，一位大股東簽署了一項交換協議，根據該協議，總額約 410 萬美元的優先擔保可轉換票據本金將被交換為等值普通股優先股及普通股認股權證。

Turning to guidance. Following our strong first quarter results, we remain confident in our trajectory for the remainder of the year and are reaffirming our fiscal year 2025 guidance. As Dan mentioned earlier, we are outsourcing our clinical trials business to Helios clinical trials.

轉向指導。繼第一季取得強勁業績之後，我們對今年剩餘時間的發展軌跡充滿信心，並重申了 2025 財年的指導方針。正如丹之前提到的，我們正在將我們的臨床試驗業務外包給 Helios 臨床試驗。

Under the terms of the new arrangement, TOI will recognize revenue solely for our share of the profit, which will reduce our expected revenue for the year by $5 million. However, we are not revising our full year guidance as we anticipate the increased revenue from the Dispensary segment will offset this impact. Therefore, we continue to expect revenue in the range of $460 million to $480 million, adjusted EBITDA in the range of negative $8 million to negative $17 million, and free cash flow of negative $12 million to negative $21 million for the year.

根據新協議的條款，TOI 將僅確認我們應得的利潤份額作為收入，這將使我們今年的預期收入減少 500 萬美元。然而，我們不會修改全年指引，因為我們預期藥局部門的收入成長將抵消這種影響。因此，我們繼續預期全年營收在 4.6 億美元至 4.8 億美元之間，調整後 EBITDA 在負 800 萬美元至負 1,700 萬美元之間，自由現金流在負 1,200 萬美元至負 2,100 萬美元之間。

Additionally, we remain on track to deliver positive adjusted EBITDA in the fourth quarter. We will also be providing select guidance for the second quarter of 2025. In Q2, we expect adjusted EBITDA loss will be in the range of negative $4 million to negative $5 million. We expect the positive margin contribution of our fully Florida contract combined with increased encounter volume in radiation oncology and continued growth in our Dispensary segment will support the quarter-to-quarter improvement in adjusted EBITDA. All in all, we believe our execution to date with accelerating growth and improving profitability sets us up well to achieve our full year targets.

此外，我們仍有望在第四季度實現正調整後 EBITDA。我們還將提供 2025 年第二季的精選指導。在第二季度，我們預計調整後的 EBITDA 損失將在負 400 萬美元至負 500 萬美元之間。我們預計，佛羅裡達州全額合約的正利潤貢獻，加上放射腫瘤學診療量的增加以及藥房部門的持續增長，將支持調整後 EBITDA 的逐季改善。總而言之，我們相信，迄今為止的執行情況以及加速成長和提高獲利能力，為我們實現全年目標奠定了良好的基礎。

Before I wrap up, I'd like to briefly address two political headlines that have been topical recently. On the topic of tariffs and any possible impact on TOI, as it currently stands, we have not observed any impact related to tariffs or drug price inflation, and our pricing catalogs are fixed through the second quarter with our suppliers. We do not currently anticipate any trends in drug prices that will create risks to our or business performance, but we are continuing to closely monitor the situation, and we are actively evaluating country of origin for TOI's supply chain. Importantly, due to TOI's significant experience actively managing drug formulary as a core capability of our value-based care model, we do believe our clinical team has the ability to mitigate any potential impact from tariffs on individual drugs or manufacturers or it to materialize.

在結束之前，我想簡單談談最近熱門的兩個政治新聞。關於關稅及其對《印度時報》可能產生的影響，就目前情況而言，我們尚未觀察到與關稅或藥品價格上漲相關的任何影響，我們的定價目錄已與供應商在第二季度確定。我們目前預期藥品價格趨勢不會對我們或業務表現造成風險，但我們將繼續密切關注情況，並積極評估 TOI 供應鏈的原產國。重要的是，由於 TOI 在積極管理藥品處方集方面擁有豐富的經驗，這是我們基於價值的護理模式的核心能力，我們確實相信我們的臨床團隊有能力減輕關稅對個別藥品或製造商的任何潛在影響，或者使其實現。

On the topic of executive orders related to pharmaceutical pricing practices, while it's too early to draw any concrete conclusions on the outcome of drug regulation, I believe there are several factors that make TOI less susceptible to drug pricing impact. The size and scale of our capitated business where drug costs are inversely correlated with profits, the ability of TOI to control formulary in our clinics and influence formulary in our delegated network to manage drug pricing risk within clinical guidelines, and the multiple variables that contribute to fee-for-service and pharmacy drug margins, which constitute the spread between costs and reimbursement rather than the absolute cost of the drugs themselves. This spread relationship may or may not be impacted by any drug pricing reform.

關於與藥品定價實踐相關的行政命令，雖然現在對藥品監管的結果得出任何具體結論還為時過早，但我認為有幾個因素使得《印度時報》不太容易受到藥品定價的影響。我們的按人頭計費業務的規模和範圍（其中藥品成本與利潤成反比）、TOI 控制我們診所處方集和影響我們委託網絡中處方集以在臨床指南範圍內管理藥品定價風險的能力，以及影響按服務收費和藥房藥品利潤的多個變量，這些變量構成了成本和報銷之間的差額，而不是藥品本身的絕對成本。這種價差關係可能會或可能不會受到藥品定價改革的影響。

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. Looking to the remainder of the year, we will continue to build on our momentum through strong operational management, increased efficiencies and strategic market expansion. As we discussed today, we are executing against a near-term path to sustained cash flow positivity and profitability in the second half of 2025, setting up well to deliver profitable growth in 2026. Our organic fee-for-service growth, pharmacy attachment and existing value-based contract pipeline give me confidence in our strong trajectory, supporting our progress against our strategic priorities. We appreciate the continued support of our shareholders and the great work from our team as we execute against our plans to drive long-term shareholder value.

謝謝，羅布。展望今年剩餘時間，我們將繼續透過強有力的營運管理、提高效率和策略性市場擴張來維持發展勢頭。正如我們今天所討論的，我們正在按照近期目標實施，在 2025 年下半年實現持續的現金流正增長和盈利能力，為 2026 年實現盈利增長做好準備。我們的有機收費服務成長、藥房附件和現有的基於價值的合約管道讓我對我們強勁的發展軌跡充滿信心，支持我們在戰略重點方面取得進展。我們感謝股東的持續支持以及我們團隊的出色工作，我們正按照計劃推動長期股東價值。

With that, we're now ready to take your questions. Operator?

現在，我們就可以回答您的問題了。操作員？

(Operator Instructions)

（操作員指示）

David Larsen, BTIG.

BTIG 的 David Larsen。

Congratulations on a good start to the year. Can you talk a little bit about the gross profit growth of 44% year-over-year? What was the main driver of that?

恭喜您新的一年有一個好的開始。您能否談談毛利年增44%的原因？其主要驅動因素為何？

In my mind, that's obviously a very important metric, considering like, I think for 2024, gross profit actually maybe declined by 9% year-over-year. So thanks very much, driver of gross profit would be great.

在我看來，這顯然是一個非常重要的指標，考慮到我認為到 2024 年，毛利實際上可能比去年同期下降 9%。非常感謝，毛利的驅動力會很棒。

Yes, David, this is Rob. Thanks for the question. So a couple of things contributing to this. First off the bat is the onetime rebate that we mentioned that was attributable to a new contract signed with our primary distributor.

是的，大衛，這是羅布。謝謝你的提問。有幾件事導致了這個現象。首先，我們提到的一次性回扣是由於我們與主要經銷商簽訂了新合約。

The second piece is that, as you know, drug pricing changes quarterly. January is a big quarter for drug price changes. It was relatively favorable from what we've seen in previous years. So that, combined with some nice volume increases, particularly on the Dispensary side contributed to the pickup in overall margin.

第二點是，如你所知，藥品定價每季都會變動。一月份是藥品價格變動較大的季度。與我們前幾年看到的情況相比，這是相對有利的。因此，再加上銷售量的良好成長，特別是藥局的成長，促進了整體利潤的上升。

How much was the rebate for, please?

請問回扣是多少？

About $1.5 million.

約150萬美元。

$1.5 million, okay. It looks like your gross profit on a year-over-year basis was up more than $5 million, so there was still a very good growth beyond that, okay. And then can you talk a little bit about your fee-for-service revenue, please, your patient service revenue? Like the cap revenue, was that down 1% year-over-year and fee-for-service was up 2% year-over-year.

1.5 美元一百萬，好的。看起來你們的毛利與去年同期相比增加了 500 多萬美元，所以除此之外還有非常好的成長，好的。然後您能否談談您的按服務收費收入，即您的病患服務收入？與上限收入一樣，其同比下降了 1%，而按服務收費則同比增長了 2%。

I guess I would have thought there would have been more growth than that. And do I see 81 clinics compared to 87 clinics in the year ago period? Was there a change there? Just any thoughts around the patient service revenue growth, a little bit light to me on a year-over-year basis.

我猜我本來以為會有比這更多的成長。與去年同期的 87 家診所相比，今年的診所數量是 81 家嗎？那裡有變化嗎？關於患者服務收入成長的任何想法，與去年同期相比，對我來說有點輕鬆。

Yes, I'll start on the cap side. So as we've called out, the pipeline is robust, numerous launches. The most meaningful and impactful launch in March, that's the fully delegated contract in Florida. The impact of that will be seen to a much greater degree later in the year. Also a couple of other launches here in the next upcoming months that will also contribute significantly.

是的，我將從帽子那邊開始。正如我們所呼籲的，通路非常強大，並且有大量產品推出。三月最有意義、影響最大的啟動，就是佛羅裡達州的全面委託合約。其影響將在今年稍後顯現得更明顯。未來幾個月還將推出其他幾項產品，也將做出重大貢獻。

David, it's Dan Virnich. I can comment on the sites going from 87 to 81. Compared to this quarter a year ago, we closed a couple volume locations that were unprofitable for TOI, and you're seeing that reflected in the change from 87 to 81. However, I will call out that we've added over 30 additional MSO sites of care in the Florida market. So as you move to this hybrid employee MSO model in our delegated contracts, our total available sites of care actually went up.

大衛，我是丹‧維爾尼奇。我可以對從 87 到 81 的網站進行評論。與去年同期相比，我們關閉了幾家對 TOI 來說無利可圖的門市，您可以看到，從 87 家減少到 81 家，這一變化就反映了這一點。不過，我要指出的是，我們在佛羅裡達市場增加了 30 多個 MSO 護理站點。因此，當您在我們的委託合約中轉向這種混合員工 MSO 模型時，我們可用的護理站點總數實際上有所增加。

Right. I'll take earnings growth over revenue growth all day long, so okay, great. And then can you talk a little bit about your SG&A management? It looks like SG&A costs declined 11% year-over-year and by around 600 basis points of revenue, which is obviously great. Just what are your thoughts in terms of total SG&A savings expectations for 2025?

正確的。我會整天專注於獲利成長而不是收入成長，所以，好吧，太好了。然後可以稍微談談您的銷售、一般和行政費用管理嗎？看起來銷售、一般及行政費用較去年同期下降了 11%，收入下降了約 600 個基點，這顯然是件好事。您對 2025 年銷售、一般及行政費用 (SG&A) 總節省預期有何看法？

Yes. We remain committed to keeping SG&A roughly flat for 2025, which I think is important to note, given our overall projections on growth for the organization. We've been very disciplined in our approach related to vendor and labor management and continue to seek ways to operate our business more efficiently. We have a number of initiatives going on in the technologies as well, where we are going to -- looking to engage agentic AI and some key workflow processes over the next 12 to 18 months, which we believe will drive even greater efficiencies and manage down our SG&A as a percent of revenue.

是的。我們仍然致力於在 2025 年保持銷售、一般及行政費用 (SG&A) 基本持平，考慮到我們對組織成長的整體預測，我認為這一點很重要。我們在供應商和勞動力管理方面採取非常嚴謹的方法，並繼續尋求更有效地經營業務的方法。我們在技術領域也正在進行多項計劃，我們將在未來 12 到 18 個月內尋求採用代理 AI 和一些關鍵工作流程，我們相信這將進一步提高效率並降低銷售、一般和行政費用佔收入的百分比。

Okay. And then in 2024, there was a pretty significant impact from DIR fees. I did not hear you mention those on this call. Are we now past DIR fees or is that still a potential headwind this year?

好的。然後在 2024 年，DIR 費用的影響相當顯著。我沒有聽到你在這次通話中提到這些。我們現在已經不再需要支付 DIR 費用了嗎？或者這仍然是今年的一個潛在阻力？

No, we are past DIR fees. DIR fees, as they used to exist, no longer do. It's all priced at a point of sale. The impact that we saw last year was overall reimbursement pressure as that change went into effect. And so that's behind us and things are looking significantly better relative to last year.

不，我們已經過了 DIR 費用。以前存在的 DIR 費用現在不再存在。所有商品均在銷售點定價。去年我們看到的影響是，隨著這項變更的生效，整體報銷壓力加大。這已經是過去式了，而且與去年相比，情況明顯好轉。

So that was a $15 million drag on revenue and EBITDA last year and you have completely sort of lapped that. Is that correct?

因此，這對去年的收入和 EBITDA 造成了 1500 萬美元的拖累，而您已經完全彌補了這一損失。對嗎？

That's right, that's right. What we consider as Dispensary margins going forward are steady state.

對呀對呀。我們認為未來藥局的利潤率將保持穩定。

Okay, good. And then there was one large payer contract that I think was maybe 11% of revenue. That kind of disappeared in 2024. I think you've fully lapped that.

好的，很好。然後有一份大額付款合同，我認為大概佔收入的 11%。那種東西在 2024 年就消失了。我認為你已經完全理解了這一點。

And what I'm also hearing from you is you're actually entering into -- I think you highlighted four new arrangements this quarter, and we should see patient service revenue ramp as we progress through the year because of these new contracts. Is that correct?

我還聽到您說，您實際上正在達成——我認為您在本季度強調了四項新安排，由於這些新合同，我們應該會看到患者服務收入在今年內有所增加。對嗎？

That's correct, yes. That was in reference to the new capitated contracts signed as part of our value-based arrangements. But all of those are tied to fee-for-service revenue that flows through our Dispensary. And then we are seeing additional growth in just fee-for-service patient services revenue.

是的，沒錯。這是指作為我們基於價值的安排的一部分而簽署的新的按人頭計費合約。但這一切都與流經我們藥局的按服務收費收入有關。然後，我們看到按服務收費的患者服務收入進一步成長。

Can you provide a little color around why that contract ended? And just like the purpose of that question, as you know, are there any other contracts in '25 that might be (inaudible) how is your relationship with some of the largest plans that you're working with?

您能否稍微解釋一下該合約終止的原因？就像這個問題的目的一樣，如您所知，'25 年是否還有其他合約可能（聽不清楚）您與您正在合作的一些最大計劃的關係如何？

Yes. Yes, it was contracted with contract where we had kind of a mutually agreeable termination related to a number of disputes. So we, overall, have a very stable contract portfolio. We've got an incredibly low historical contract turn rate and do a lot to manage our client relationships and show the value that we provide. So I don't anticipate any likely termination as we progress through 2025.

是的。是的，這是一份合同，我們雙方就一些爭議達成了雙方同意的終止協議。因此，總體而言，我們擁有非常穩定的合約組合。我們的歷史合約週轉率非常低，我們做了很多工作來管理客戶關係並展示我們所提供的價值。因此，我預計到 2025 年不會出現任何終止的情況。

Okay. And then do you have any thoughts on IV margins? I think that was a little bit of a headwind early last year. Just any thoughts there?

好的。那麼，您對 IV 邊緣有什麼看法？我認為這是去年年初的一個小小的逆風。有什麼想法嗎？

Yes. Similar to Dispensary, what we've seen so far based on the year pricing is favorable to what we were expecting, certainly favorable to 2024. The general progression that we see throughout the year is improvement in overall margins, and so things are going slightly better than planned there.

是的。與藥局類似，到目前為止，根據年度定價，我們看到的情況符合我們的預期，當然也有利於 2024 年。我們全年看到的整體進展是整體利潤率的提高，因此情況比計劃的要好一些。

Okay, that's great. And then you mentioned tariffs and this executive order and then there's also the most favored nation clause or executive order that may or may not get through. So if drug prices, let's say, go up by 25% across the board, is that good or is that bad for The Oncology Institute? Because higher drug prices would eventually result in more revenue and probably more margin for you in your fee-for-service book. Is that correct?

好的，太好了。然後你提到了關稅和這項行政命令，還有最惠國條款或行政命令可能會或可能不會通過。那麼，如果藥品價格全面上漲 25%，這對腫瘤研究所來說是好事還是壞事？因為更高的藥品價格最終會為您帶來更多的收入，並可能為您帶來更多的按服務收費的利潤。對嗎？

Yes. Yes, that's exactly right.

是的。是的，完全正確。

And in Dispensary. And it's mainly Medicare Part B as in boy, not Medicare Part D, is that correct?

和藥房。而且主要是 Medicare B 部分，而不是 Medicare D 部分，對嗎？

Sorry, mainly in terms of what?

抱歉，主要是指什麼方面？

In terms of reimbursement for fee-for-service revenue and also --

在報銷服務費收入方面，--

Yes, that's correct. I mean, hypothetically, it would impact B and D.

是的，正確。我的意思是，假設它會影響 B 和 D。

Okay, okay. It looks like a pretty good quarter. Congrats on a good start to the year.

好的，好的。看起來這是一個相當不錯的季度。恭喜您今年有一個好的開始。

Yuan Zhi, B. Riley Securities.

袁志，B. Riley證券。

Dan, maybe we can start with the recent report by UnitedHealth. It was reported that the seniors within their Medicare Advantage plan used health care services twice as much as last year. I want to check if you noticed similar trends within oncology practice or is it related to some other diseases or surgery practice?

丹，也許我們可以從聯合健康最近的報告開始。據報道，享受醫療保險優勢計劃的老年人使用的醫療保健服務比去年增加了一倍。我想檢查您是否注意到腫瘤學實踐中的類似趨勢，或者它是否與其他疾病或外科手術實踐有關？

Yes, I can't speak to what other drivers might be associated with that. What I can say is that we track that on a very close basis for the oncology care needs of the populations we serve and when seeing a jump to the that United mentioned, I don't know if that's driven by other drugs outside of oncology or other utilization trends, which have been more unfavorable than expected.

是的，我無法說出其他司機是否與此有關。我可以說的是，我們密切追蹤我們所服務人群的腫瘤護理需求，當看到聯合提到的增長時，我不知道這是否是由腫瘤學以外的其他藥物或其他利用趨勢所驅動，這些趨勢比預期的更為不利。

Yes, maybe a follow-up question here. So they also reported the enrolled patients are sicker. I guess my question is two-part. Did you notice similar trends there and to when you negotiate a value-based contract with there, is it based on historical data from insurance companies? Or is it based on your own database and external service to reflect the latest patient profile?

是的，也許這裡有一個後續問題。因此他們也報告稱，入組患者的病情更加嚴重。我想我的問題分為兩個部分。您是否注意到那裡有類似的趨勢？當您與他們協商基於價值的合約時，它是否基於保險公司的歷史數據？還是基於您自己的資料庫和外部服務來反映最新的患者資料？

Yes. So for the first part of the question, we haven't noticed the change in prevalence or average stage of cancer patients we're treating. So that would correlate to a care population that hasn't pivoted that we've noticed. In terms of pricing, we do that based off of historical utilization up through the most recent period before we make a contract effective. So we have a pretty recent trend on utilization.

是的。因此，對於問題的第一部分，我們沒有註意到我們正在治療的癌症患者的盛行率或平均階段的變化。因此，這與我們注意到的尚未轉變的照護人群有關。在定價方面，我們根據合約生效前最近一段時間的歷史利用率來定價。因此，我們在利用率方面有一個相當新的趨勢。

And then we factor in a cost trend related to historical drug price changes as well in our forward-looking utilization. So that's pretty real-time as far as how it's contributing to the pricing of our contracts.

然後，我們將與歷史藥品價格變化相關的成本趨勢也考慮在我們的前瞻性利用中。因此，就其對我們合約定價的影響而言，這是相當即時的。

Yes, got it. So on your new territory part, is there any metrics you can share on the progress to fill up the capacities in your Florida clinics, whether it is the lives under management in terms of overall capacity or patients encountered?

是的，明白了。那麼，關於您的新領土部分，您是否可以分享一些有關填補佛羅裡達州診所容量的進展指標，無論是總體容量方面管理的生命還是遇到的患者？

I'm so sorry, Yuan, could you please repeat the first part of the question?

非常抱歉，袁先生，您能重複問題的第一部分嗎？

Yes. Is there any metrics you can share on the progress to fill up capacities in your Florida clinics?

是的。您能否分享一些佛羅裡達州診所容量填補進展的指標？

Yes, absolutely. So we track -- we project encounters by market and by detail by clinic across our portfolio as we forecast each year. And we are tracking right to plan in terms of capacity fill in both our legacy markets and then the newer markets like Florida.

是的，絕對是。因此，我們會進行追蹤——我們會按照我們每年的預測，按市場和診所的具體情況來預測我們投資組合中的遭遇。我們正在按照計劃正確追蹤傳統市場和佛羅裡達等新興市場的產能填充情況。

There is some additional upside, we believe, in the back half of this year related to some contract wins which are in the pipeline but not in the forecast. So all is going to plan as far as capacity.

我們認為，今年下半年還會有一些額外的好處，這與一些正在醞釀但不在預測中的合約有關。因此，就容量而言，一切都在按計劃進行。

Yes, got it. Maybe one last question from me. Just to clarify, do you aim to have cash flow positivity and profitability in the second half of 2025 versus 4Q 2025 from your last earnings call? Was there any change there?

是的，明白了。我還有最後一個問題。需要澄清的是，您上次收益電話會議上所說的「2025 年第四季」和「2025 年下半年」的目標分別是現金流為正和獲利嗎？那裡有什麼變化嗎？

No change to guide. We expect full cash flow and adjusted EBITDA positivity in Q4 of 2025.

指南無變化。我們預計 2025 年第四季將實現全部現金流量和調整後的 EBITDA 為正。

(Operator Instructions)

（操作員指示）

Bill Sutherland, The Benchmark Company.

比爾·薩瑟蘭（Bill Sutherland），基準公司。

Most of mine have been asked. But going back to a couple of the key business metrics. The slight decline in the lives under value-based contracts, is that related to that contract you were talking about that went away last year?

我的大部分問題都被問過了。但回顧幾個關鍵的業務指標。價值型合約下的生命力略有下降，這是否與您所說的去年取消的合約有關？

Yes, exactly. It's measured by lives, that is a decrease. But I would just keep in mind that there is a product mix in every contract, and that specific contract had a heavy predominance of medical and commercial lives, which are high numbers, but low PMPM reimbursement typically versus our newer markets where we're signing MA-only contracts, which are lower lives but higher reimbursement.

是的，確實如此。如果以生命來衡量，那就是減少了。但我要記住，每份合約中都有一種產品組合，而特定的合約在醫療和商業生命方面占主導地位，這些生命數量很高，但 PMPM 報銷通常較低，而我們在較新的市場中只簽署 MA 合同，這些生命數量較低但報銷較高。

Got it. Any important renewals coming up as far as contracts?

知道了。就合約而言，有任何重要的續約嗎？

Nothing significant to mention, no. Most of our relationships are multiyear. Many of them date back over 10 years. They typically ought to renew. And then yes, there's no significant renewals in the near future.

沒有什麼重要的事情值得一提，沒有。我們大多數的關係都是多年的。其中許多可以追溯到 10 多年前。他們通常應該更新。是的，近期不會有重大的續約。

And then the guidance for the year, is there any pipeline conversion that you need to execute to do the numbers or is it basically all set up at this point?

然後是今年的指導，是否有任何管道轉換需要執行才能完成數字，或者基本上所有都已設定好？

Yes, we don't need any additional value-based contracts that are in the pipeline to achieve guidance. So any additional wins that are in the pipeline would be upside to what we've guided to.

是的，我們不需要任何正在進行的基於價值的額外合約來實現指導。因此，任何即將取得的額外勝利都將超出我們的預期。

Okay. And finally, just an interesting trend, and I'm not sure if -- it's not really part of your model. But I keep hearing from health systems about trying to do more of the cancer cases in the home with everything else. How does that trend kind of segue with your business, if at all?

好的。最後，這只是一個有趣的趨勢，我不確定——它實際上不是您模型的一部分。但我不斷聽到衛生系統表示，正在嘗試透過其他方式在家中治療更多癌症病例。如果有的話，這種趨勢與您的業務有何關聯？

Yes. I mean, I think it would be a very positive trend for TOI if more cancer care was delivered in the home. We work pretty closely with our payer partners and trying to find innovative ways to deliver therapeutics in the home. I'd say it's much easier than the oral specialty side than it is with infusables.

是的。我的意思是，我認為如果更多的癌症治療能夠在家中進行，這對 TOI 來說將是一個非常積極的趨勢。我們與付款方合作夥伴密切合作，並嘗試尋找創新方法在家中提供治療。我想說的是，它比口腔專科方面要容易得多，比輸液方面要容易得多。

But that being said, there's no reason why we can't achieve that as a future state.So again, that gets back to our mission to deliver higher level of care in the community and something we would definitely want to be a part of.

但話雖如此，我們沒有理由不能在未來實現這一目標。所以，這又回到了我們的使命，在社區中提供更高水準的護理，也是我們絕對希望參與其中的事情。

Got it, okay. Nice quarter.

知道了，好的。不錯的季度。

Robert LeBoyer, Noble Capital Markets.

羅伯特‧勒博耶 (Robert LeBoyer)，Noble Capital Markets。

Congratulations on a nice quarter. My question has to do with the number of lives under contract and covered by the managed care policies. The previous number was 1.9 million. It looks like you're adding 100,000 in the first and second quarter and then another 80,000 in Nevada after July 1.

恭喜本季取得良好業績。我的問題與合約管理下的和管理醫療政策覆蓋的生命數量有關。此前的數字是190萬。看起來你們在第一季和第二季增加了 10 萬人，然後在 7 月 1 日之後在內華達州又增加了 8 萬人。

So is that just simply additive to the 1.9 million or is there some more nuanced way to project the number of lives that are covered?

那麼，這僅僅是對 190 萬的簡單補充，還是有更細緻的方法來預測受保障的生命數量？

No, it is additive. That's the right way of thinking about it. The nuance in terms of modeling the financial impact would be where those lives are located. And so as we've talked about before in some of our, there is a higher PMPM for contracts in Nevada and Florida than there is in California due to the overall cost of care. So that would be the one nuance to consider.

不，它是添加劑。這才是正確的思考方式。在模擬財務影響方面的細微差別在於這些人的生活所在地。正如我們之前所討論過的，由於整體護理成本的原因，內華達州和佛羅裡達州的合約 PMPM 高於加利福尼亞州。所以這是一個需要考慮的細微差別。

Okay, great. And in terms of seasonality or any kind of other trends that you see throughout the year, have you noticed anything in the first quarter versus other quarters throughout the year at this point?

好的，太好了。就季節性或您全年看到的任何其他趨勢而言，您是否注意到第一季與全年其他季度相比有什麼不同？

Yes. So our first quarter is always seasonally the lowest in terms of encounter volume. And so that's part of the whole picture when you're looking at the full year guide. We knew that it would be the lowest quarter in terms of revenue, the worst quarter in terms of adjusted EBITDA loss. And so we expect to see progressive improvement quarter-over-quarter both due to seasonality as well as the addition of new contracts and lives and account for growth.

是的。因此，就接觸量而言，我們的第一季始終是季節性最低的。因此，當您查看全年指南時，這就是整體情況的一部分。我們知道這將是收入最低的季度，也是調整後 EBITDA 損失最嚴重的季度。因此，我們預期季度將比季逐步改善，這不僅是由於季節性因素，也是由於新合約和新生命的增加，並佔成長的因素。

Okay, good. And just one last question. In terms of the top three plans and clients that you have, what would be the percentage of each of the top three in terms of revenues?

好的，很好。最後一個問題。就您擁有的前三大計劃和客戶而言，前三名分別佔收入的百分比是多少？

As a percent of cap revenue, it's probably about 20%, if you're looking at the top three contracts.

如果你看一下前三份合同，那麼作為上限收入的百分比，它可能約為 20%。

(Operator Instructions) Okay, there are no further questions at this time. And with that, this does conclude today's teleconference. We thank you for your participation. You may disconnect your lines at this time.

（操作員指示）好的，現在沒有其他問題了。今天的電話會議到此結束。我們感謝您的參與。現在您可以斷開線路。