TOI

TOI has a genuine top-line story: revenue compounded from $203M (FY2021) to $503M (FY2025), up 27.8% last year, and it now manages ~2.0M patients across 65 practices in five states under value-based contracts. But five straight years of losses (the lone exception a $152K breakeven in FY2022) show the model has yet to prove it can price oncology risk profitably — the MD&A's own risk factors concede that under the TOI PCs' value-based agreements 'the cost of providing services will exceed our compensation' as 'oncology costs rise,' the core reason net income is still -$60.6M on a -12.1% net margin.

The balance sheet is where this crosses from 'unprofitable grower' to 'avoid.' Stockholders' equity is negative (-$15.7M) against a -$271M accumulated deficit, liabilities ($180M) exceed total assets ($165M), and cash fell 32.4% to $33.6M. With operating cash flow at -$24.6M, that is roughly a year of runway before another raise — and shares already grew 30.5% in a single year, so existing holders face continued dilution or added debt on top of $77.4M long-term debt. Revenue concentration in a 'limited number' of health plans, IPAs and PBMs (any of which can drop the TOI PCs from networks) plus Medicare reimbursement risk compound the fragility.