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DATE
Thursday, May 7, 2026 at 5:30 p.m. ET
CALL PARTICIPANTS
- Chief Executive Officer — Daniel Virnich
- Chief Financial Officer — Rob Carter
- Chief Legal Officer — Minh Merchant
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TAKEAWAYS
- Total Revenue — $147.4 million, representing 41.2% year-over-year growth, driven by value-based contracts and Specialty Pharmacy expansion.
- Specialty Pharmacy Revenue — $87.5 million, up 77.6% year over year, fueled by a 103% increase in prescription fills and record Part D sales; average revenue per fill decreased by approximately 12% due to evolving mix.
- Patient Services Revenue — $59.1 million, up 11.3% year over year, with capitation accounting for $26.9 million (54% growth) and fee-for-service at $32.2 million (down approximately 10%).
- Profitability in Florida — “We are now generating a profit in the Florida market,” achieved through maturing capitated contracts and network expansion covering 25 counties, targeting approximately 200,000 Medicare Advantage (MA) lives in Q3.
- Medical Loss Ratio (MLR) in Florida — For the 2025 effective contracts, MLR is “slightly better than” the 85% target, indicating early success in cost management.
- Gross Profit — $23.3 million, up from $17.2 million, with an overall gross margin of 15.8%, down roughly 80 basis points year over year; Specialty Pharmacy gross margin held nearly flat at 19.2%.
- AI-enabled Operational Initiatives — The company remains on track for $2 million in 2026 operating expense savings from revenue cycle, prior authorization, and call center integration initiatives.
- Free Cash Flow Guidance — Raised to a range of $5 million-$15 million for the year, from prior guidance of negative $15 million to positive $5 million, attributed to favorable vendor negotiations.
- Adjusted EBITDA — Loss of $2.4 million versus a $5.1 million loss, reflecting sequential and year-over-year improvement; full-year guidance for positive adjusted EBITDA reaffirmed.
- Guidance Reaffirmed — 2026 full-year outlook maintained for total revenue ($630 million-$650 million), gross profit ($97 million-$107 million), adjusted EBITDA ($0-$9 million), and updated free cash flow ($5 million-$15 million).
- Provider Portal Rollout — Launch expected Q3, offering 100% of nonemployed providers access, aiming to bolster pathway adherence and ancillary service adoption, with potential but uncontemplated 2026 upside.
- Cash and Liquidity — Cash and equivalents totaled $30.3 million; senior secured convertible note principal remains at $85.9 million with refinancing discussions ongoing and update expected next quarter.
- CMS Enhancing Oncology Model (EOM) — Nearly $2 million saved in Medicare spending in period 3, demonstrating efficacy of integrated care approach and increased savings versus prior periods.
- Operating Expense Ratio — SG&A was $28.2 million or 19.1% of revenue, a 520 basis point year-over-year improvement, reflecting cost discipline and operating leverage.
SUMMARY
The Oncology Institute (TOI 0.86%) reported year-over-year revenue growth of 41.2%, highlighted by an accelerating shift toward value-based contracts and record performance in the Specialty Pharmacy segment. Management affirmed full-year fiscal 2026 guidance for top line, gross profit, and adjusted EBITDA, while raising free cash flow expectations due to successful vendor negotiations. Profitability in Florida was achieved ahead of plan, supported by strong MLR performance and expanded capitated lives, with the company preparing to cover 25 counties and approximately 200,000 Medicare Advantage members in the next quarter.
- Executives underscored the scalability of the care delivery model, with Daniel Virnich stating, “The MLR performance on the delegated capitation book of business, which we mentioned in the earnings call for the 2025 cohort, is performing slightly better than our target MLR of 85%, which is a great data point.”
- Rob Carter said, “attachment rate has exceeded our expectations in the year,” citing workflow changes as key drivers of increased prescription capture rates.
- AI-enabled initiatives remain a central focus, with $2 million in operational expense savings for fiscal 2026 on track and additional use cases in development but not yet included in long-range forecasts.
- The proprietary provider portal is expected to go live in Q3, creating new ancillary revenue opportunities outside of current guidance, particularly by targeting Part D prescription volumes among network providers.
- Liquidity was stable, with active plans to refinance $85.9 million in convertible notes as management anticipates further updates in the coming quarter.
INDUSTRY GLOSSARY
- Capitated Revenue: Fixed, per-member, per-month payments received to manage patient care under risk-based contracts, emphasizing cost control and quality outcomes.
- Medical Loss Ratio (MLR): Ratio of total clinical expenses to premium or capitation revenue, indicating efficiency in healthcare cost management.
- MSO (Management Services Organization): Entity supporting clinics and providers with administrative, contracting, and infrastructure services, enabling efficient risk-sharing models.
- Part B/Part D: Medicare prescription drug benefit segments; Part B covers physician-administered drugs, while Part D governs oral and self-administered medications through standalone pharmacy benefit plans.
- CMS Enhancing Oncology Model (EOM): A Centers for Medicare & Medicaid Services initiative designed to enable episodic, total cost of care risk and value-based oncology care delivery.
- Attachment Rate: Proportion of eligible prescriptions filled within an owned or affiliated pharmacy network, reflecting the effectiveness of provider engagement and patient retention strategies.
Full Conference Call Transcript
Daniel Virnich: Thank you, Minh. Good afternoon, everyone, and thank you for joining our first quarter 2026 earnings call. I’m pleased to report a strong start to 2026 in the first quarter, driven by continued expansion and performance of our value-based contracts across markets and the ongoing growth of ancillary services, particularly our pharmacy business, which provides us with confidence to reaffirm our 2026 outlook for revenue and full year adjusted EBITDA profitability. As noted in our earnings release, we are also pleased to meaningfully update our free cash flow projections for the year to a positive range of $5 million to $15 million, reflecting our ongoing performance and improving economies of scale as we grow.
None of this would be possible without continued commitment to high-quality oncology care by our physicians and staff across the 5 states we operate in every day. There are a few key highlights from the quarter that I would like to now review. First, revenue of $147 million was up 41% year-over-year, driven by strong capitated revenue growth and record performance from our Specialty Pharmacy business. Record Part D sales drove pharmacy revenue up 78% in the quarter compared to the first quarter of 2025, reflecting overall growth in patient encounters and continued operational execution on prescription fills.
As a testament to the durability and replicability of our clinical model, we saved nearly $2 million in Medicare spending as part of the CMS Enhancing Oncology Model performance program in period 3, increasing the savings generated from the previous period, while maintaining the high-quality care we deliver to the members we serve in the community. We believe that this ongoing recognition from CMS underscores the clinical and economic value of TOI’s integrated approach to oncology care applied to all patient populations, not just capitated members. Turning now to operations. I would like to walk through some key updates from the first quarter.
Our work in Florida continues to be a critical proof point for our model in one of our newer markets, and I’m pleased to share meaningful progress on several fronts. We are now generating a profit in the Florida market. This is an important milestone that reflects the maturation of our capitated relationships in the state and validates the model we have been building. Our initial members under delegated capitation partnerships continue to show data points demonstrating excellent clinical outcomes, with MLR performing in line to slightly better than planned. As a reminder, we target a mature MLR of approximately 85% for new delegated capitation contracts, and we are now achieving that with our 2025 effective contracts in South Florida.
In terms of further near-term capitation growth, we anticipate expansion of existing plan partnerships across 11 additional counties for Medicare Advantage members in Q3, which will expand our TOI clinic and MSO network to cover effectively the entire Florida market to serve delegated capitation agreements across multiple health plans. This next phase of expansion encompassing Q3 will expand our total MA lives under delegated capitation arrangements to approximately 200,000 total lives across 25 total counties.
In addition to the capitated revenue associated with these new patients, this expansion is also expected to be a meaningful tailwind to our Part B pharmacy business as we capture the prescription volume, which will deliver faster, more convenient fills to our patients and value outside of capitation to our payor partners. To effectively support these important patient populations, we anticipate opening 7 new TOI clinics over the remainder of the year to ensure we are delivering the high-quality coordinated care that our patients deserve, and we will also add meaningfully to our contracted provider footprint across the state.
As I mentioned in our last call, we are preparing to launch our proprietary provider portal this summer, and I’m excited to share more detail on this important initiative. We see 2 primary benefits of the TOI portal. First, it is designed to further strengthen contracted provider engagement and drive continued adherence to our clinical pathways and quality initiatives. Pathway adherence is a meaningful lever for MLR performance, and we believe this tool will be an important driver of ongoing improvement. Second, over time, we intend to use the portal to provide access to ancillary services, including Part D dispensing, clinical trials and care navigation, all key components of our integrated care strategy and key profitability levers, as we grow.
There may also be an opportunity to pass on savings from our ancillary services to MSO providers, which will further drive engagement. Our Specialty Pharmacy business delivered an exceptional quarter and continues to be one of the strongest growth drivers across the enterprise. We filled a record number of scripts in the first quarter with Specialty Pharmacy revenue up 78% year-over-year at $87.5 million for the quarter, delivering $16.8 million of gross profit. This growth is being driven by a combination of higher patient volumes, continued optimization of pharmacy workflows across our network as well as ongoing efforts to reduce avoidable leakage to outside pharmacies.
Gross margin in our Specialty Pharmacy business also came in higher than anticipated in the quarter at 19.2%, driven primarily by efforts in TOI’s procurement function to manage drug pricing strategy and capitalize on our developed central clinical infrastructure via formulary pathways within the pharmacy. This is an area where we continue to see the benefit of our scale and distributor relationships, which will only be further enhanced as we grow. We are also working to expand pharmacy access in Florida to our delegated network members, which we believe broadens our ability to capture both Part B and D scripts from our delegated population.
We expect this to be available in the second half of this year and view it as an incremental opportunity on top of our core Part B dispensing strategy, not contemplated in our annual revenue guidance. We continue to make meaningful progress on our AI-enabled operational initiatives this quarter. As a reminder, last year, we launched 3 AI integration efforts focused on revenue cycle management, prior authorization services and our patient call center. I’m pleased to report that we remain on track to achieve the $2 million in operating expense savings we outlined for 2026.
These initiatives are not just delivering cost efficiencies, they are also improving the experience for our patients, providers and administrative teams, and we expect to build on them as we continue to scale. Finally, I’m pleased to welcome Minh Merchant to the Executive team as TOI’s new Chief Legal Officer. Minh will oversee all legal, compliance, regulatory and privacy matters as we continue to scale the platform. As a company that is expanding its managed care footprint, delegated arrangements and operational complexity, having a seasoned legal and compliance leader at the table is critical. Minh is a great addition, and we look forward to the contribution she will make as we continue to grow and strengthen the Executive team.
In summary, we are off to a strong start in 2026. Revenue growth of 41%, record pharmacy performance, profitability in Florida and a growing pipeline of capitated lives, gives us confidence that the momentum we built throughout 2025 is continuing into the new year. As we look ahead, our focus remains on operational execution and quality patient care, scaling our delegated capitation model, deepening payor partnerships and continuing to invest in the technology and operational capabilities that will drive sustainable profitability over the long term. With that, I’ll turn the call over to Rob to review the financials in more detail. Rob?
Rob Carter: Thanks, Dan, and good afternoon, everyone. I want to echo Dan’s comments on the continued momentum we’re building across the business as we progress through 2026. On the call today, I will review our first quarter financial results, provide an update on the balance sheet and liquidity and close with our updated guidance and outlook. Turning to financial performance. Total revenue for the first quarter was $147.4 million compared to $104.4 million in the prior year period, representing 41.2% year-over-year growth, a continuation of the strong momentum we have been building. Patient services revenue, which includes both our capitated and fee-for-service arrangements, was $59.1 million, representing 40.1% of total revenue and an 11.3% year-over-year increase.
Within patient services, capitated revenue grew 54% year-over-year to $26.9 million, driven by new market momentum and the continued ramp of our delegated arrangements in Florida. Fee-for-service was $32.2 million, down approximately 10% year-over-year despite increasing visit volumes, reflecting the impact of mix driven by active drug formulary management, more conservative reserves against collections and modest pricing pressure in the IV drug channel. Capitation now represents approximately 45.6% of patient services revenue, up from roughly 33% a year ago, underscoring the ongoing shift in our revenue mix toward value-based care. Specialty Pharmacy revenue was $87.5 million, representing 59.4% of total revenue and growing 77.6% year-over-year.
This was driven by a 103% increase in the number of prescription fills, reflecting the continued strength in fill rates as we bring new capitated lives onto the platform, partly offset by approximately a 12% decrease in average revenue per fill as our mix continues to evolve. Gross profit for the first quarter was $23.3 million compared to $17.2 million in the first quarter of 2025, reflecting continued top line expansion across both segments. Overall, gross margin was 15.8% compared to 16.5% in the prior year.
The roughly 80 basis point decline is primarily the result of a nonrecurring rebate we recognized in the first quarter of last year as well as the natively lower margin profile of the delegated business as it increases as a proportion of TOI revenue. Patient services gross profit was $5.7 million compared to $6 million in the first quarter of 2025. Patient services gross margin was 9.7% compared to 11.3% a year ago, a decrease of approximately 163 basis points. The year-over-year decline is primarily the result of new ramping delegated contracts and our aforementioned conservative fee-for-service reserve approach. Specialty Pharmacy gross profit was $16.8 million, growing 78.1% year-over-year from $9.4 million in the prior year period.
Gross margin was essentially flat at 19.2% versus 19.1% a year ago, evidencing TOI’s ability to maintain unit economics as the pharmacy scales its distribution and adapts to an evolving pricing environment, including the phase-in of the Inflation Reduction Act. Our expanded utilization management program, which we refer to as TOI Pathways, now covers our entire drug portfolio, including the pharmacy versus historically only our Part B drugs, which continues to support margin stability, and we see further opportunity in this area as we increase scale. Turning to operating expenses. Total SG&A for the first quarter was $28.2 million or 19.1% of total revenue compared to $25.4 million or 24.3% of revenue in the same period a year ago.
That represents approximately a 520 basis point improvement year-over-year, reflecting continued cost discipline and the operating leverage inherent in our model as we continue to scale. We see further leverage ahead as we scale and are planning to launch AI pilots around prior authorization optimization and a next-generation call center later this year. Adjusted EBITDA for the first quarter was a loss of $2.4 million, favorable to a loss of $5.1 million a year ago. As we noted on our call last quarter, Q1 is seasonally our most challenging period. Deductible resets and annual drug cost increases create natural headwinds that take time to work through.
We are pleased with the year-over-year improvement and remain confident in delivering positive adjusted EBITDA for the full year, driven by the continued ramp of our Florida delegated arrangements, our growing Specialty Pharmacy platform and our continued cost discipline and push towards AI and automation in our central operations. We ended the quarter with $30.3 million in cash and cash equivalents compared to $33.6 million at year-end 2025. Our senior secured convertible note principal outstanding was $85.9 million, unchanged from year-end with a maturity date of August 9, 2027. I want to note that we are in late-stage discussions regarding the refinance of the notes and expect to provide an update during the second quarter.
Operating cash flow for the quarter was negative $2.3 million compared to negative $5 million in the first quarter of 2025, reflective of the operating losses during each of those respective periods. Turning to guidance. We are reiterating our full year 2026 outlook for revenue, gross profit and adjusted EBITDA and are raising our free cash flow outlook to reflect favorable terms from vendor renegotiations as we continue to realize the benefits of our scale.
For the full year, we expect revenue of $630 million to $650 million with approximately $150 million of capitated revenue, gross profit of $97 million to $107 million, adjusted EBITDA of $0 to positive $9 million and free cash flow is now in the range of positive $5 million to $15 million compared to our previous outlook of a loss of $15 million to positive $5 million. For the second quarter, we anticipate adjusted EBITDA in the range of a loss of $1 million to positive $1 million, reflecting seasonal improvement as deductibles are satisfied and the continued ramp of our Florida delegated lives.
We expect momentum to build through the remainder of the year and remain confident in our commitment to full year positive adjusted EBITDA. With that, I’ll turn the call over to Dan for his closing remarks. Dan?
Daniel Virnich: Thank you, Rob, and thank you to everyone for your continued interest in the world-class community oncology solution we are building at TOI. I’m pleased to reaffirm our revenue and EBITDA guidance for the year as well as meaningful improvements in free cash flow. Our initiatives on creating a world-class provider portal and using technology to drive OpEx efficiencies will continue to drive our story as a leader in high-quality coordinated oncology care while delivering profitability for shareholders. Before opening the call to questions, I want to thank our patients for putting their trust in our ability to deliver high-quality care and to thank our physicians, clinicians and employees across The Oncology Institute.
Their unwavering focus on delivering high-quality oncology care in the community is what continues to drive the progress we are seeing across the business. With that, I’ll turn the call back to the operator for questions. Operator?
Operator: [Operator Instructions] We’ll take our first question from David Larsen with BTIG.
David Larsen: Congratulations on another great quarter. Can you talk a little bit about your delegated risk arrangements in Florida? Did I hear you correctly when I — I think I heard you say you now cover the entire state. And then just any color around risk, like the trend, the medical expense trend, how it’s performing relative to expectations? And I think I heard you say that you’re profitable in Florida?
Daniel Virnich: Dave, thanks for the great questions. Regarding the first question, yes, we will be network adequate across 25 counties by the start of Q3 of this year, so July 1. That coincides with the expansion of multiple health plan agreements, which in total encompass about 200,000 MA lives across those counties in the delegated capitation model. The MLR performance on the delegated capitation book of business, which we mentioned in the earnings call for the 2025 cohort, is performing slightly better than our target MLR of 85%, which is a great data point. And we’ll continue to update that as these additional lives enter the risk cohort.
And then yes, on a 4-wall EBITDA basis, that Florida market is now profitable due to all this growth.
David Larsen: Daniel, I didn’t quite hear the MLR percent. Did you say it was 85%, slightly better than 85%?
Daniel Virnich: That’s correct. Yes.
David Larsen: Okay. And then like Evolent Health, for example, I think this morning reported an MLR of 93%. What, in your view, causes such a significant delta? So why are you performing so much better than them in your opinion, at a high level without obviously having access to their data?
Daniel Virnich: Yes. I mean I can’t really speak to exactly why they would be at our level, but there is obviously differences in the care delivery model with us having a hybrid employed and network care delivery approach and kind of very tight control over care delivery and patient experience in our employed clinics. I think that would be definitely one aspect of it as well as the high engagement we’re seeing on the network providers through our portal and pathway integration.
David Larsen: And then in the delegated model, are you bearing risk for Part D? And can you push those delegated lives through your own specialty pharmacy? And if you don’t bear risk, I would imagine that would be a benefit to your pharmacy?
Daniel Virnich: Yes, that’s exactly right. Yes, the only take risk on Part B, as in boy, Part D as in dog, is fee-for-service revenue at that a little bit over 19% margin that we called out, which flows through our pharmacies and dispensaries. And those bills apply to both capitated as well as noncapitated lives. So it’s an additional economic benefit to the capitated members coming to us for care. There is the additional added benefit of us having a pharmacy in that 4 practices in the network that deliver Part B, as in boy, medications, which are part of our risk, we can deliver those at our pricing, which is beneficial given our scale.
David Larsen: Just one more. Sorry to keep asking questions, I’ll hop back in the queue, but just one more. Did I hear you say you were talking to additional health plans in the Florida market beyond Elevance?
Daniel Virnich: Yes. We’re talking to additional health plans in Florida as well as other markets as well for the delegated capitation model. So we’ll have additional updates for that in the next earnings call, but we are seeing a lot of opportunity and momentum around that specific delegated capitation model kind of across markets.
David Larsen: Okay. Congrats on the great quarter.
Operator: We’ll take our next question from Matthew Shea with Needham.
Matthew Shea: Nice start to the year guys. Maybe first on dispensary, really, really impressive growth there and it sounds like volume driven by a mix of membership and continued attachment rates. I guess any additional color there? Membership seems pretty self-explanatory, but maybe on the attachment rate side, are these coming in ahead of expectations? And if so, my understanding is this is mostly driven by provider education. So is there anything you would call out on the provider education side that’s been notable in helping drive this growth?
Rob Carter: Matt, it’s Rob. Yes, attachment rate has exceeded our expectations in the year. The workflow changes that we implemented last year, I think they’re continuing to pay dividends. And so that work progresses. I think as you look at the rest of the year, I think you can expect some improvement quarter-over-quarter as we continue to refine those workflows and as additional value-based lives come on the platform.
Matthew Shea: Okay. Got it. That’s helpful. And then maybe on the proprietary network portal, good to hear that, that remains on track for the Q2 launch. But maybe as we think about the pacing of the rollout, I would assume that will be sort of a provider-by-provider, market-by-market. But maybe how should we think about the cadence of that? And where are you hoping to get to in terms of provider coverage by year-end? And then given it can strengthen the provider engagement and drive adherence to the clinical pathway, it seems like a nice lever to drive MLR.
So curious if you’ve built in any financial benefits to the 2026 guide or if we should think about that as more of a 2027 event?
Rob Carter: Yes, absolutely. So when we roll out the portal, which we’re anticipating in Q3, that’s going to be immediately accessible to 100% of the nonemployed providers across our delegated contract network. So basically, all of Florida will have access to it in the MSO side of our business. We already see good adherence to pathways or care pathways for Part B medications by those providers, but I think this will drive additional adherence because it will just create additional visibility and control over those providers to access our formulary and pathways.
We — As we called out in the earnings call, the additional, I guess, P&L upside related to that portal, which we anticipate will happen this year, but is not contemplated in our current guidance, would be related to Part D fills. Recall that our current Part D fills are all from our employed physician base. There are no Part D fills flowing through to our MSO providers through implementation of e-prescribing in the portal and Part D formulary visibility.
We hope to catch some Part D growth as well through our MSO network in the second half of this year, but we haven’t specifically guided to that or included in the forecast given timing as well as lack of visibility into attach rate on that.
Matthew Shea: Okay. Got it. Okay. That’s super helpful clarification that the patient portal can help with that Part D. Okay. And then maybe last one for me before I jump back in the queue. So the 200,000 lives target in Florida for July 1, I guess, thinking back to the last earnings call or sort of where I had you guys in Q1, I had 70,000 lives in the Elevance partnership and then 22,000 from Humana and CarePlus, so call it, 90,000 in change. Maybe help me bridge the difference from there to 200,000? Is that all Elevance? It sounded like maybe you alluded to some other payers in there as well?
Just kind of trying to get a sense of ultimately what sort of wins drove that expansion?
Daniel Virnich: Yes. So we’ve opted not to disclose the specific health plans as additional lives are coming through, but it’s effectively an incremental 130,000 MA lives with major carriers in Florida.
Operator: We’ll take our next question from Yuan Zhi with B. Riley.
Yuan Zhi: Congrats on a strong quarter. Maybe a question to Rob first. Can you give me more color on the substantial $20 million free cash flow improvement since the adjusted EBITDA and the gross margin guidance didn’t change? Maybe specifically comment on the timing of this cash flow improvement?
Rob Carter: Yes. Thanks for the question. So this is the direct result of negotiations that have been underway now for several months with some key suppliers, in particular, on the drug side of things. This is an advantage that we have as we continue to grow and scale. We have opportunities for leverage, and we’re able to take advantage of that in a very, very meaningful way. And so very excited about the outlook there.
Yuan Zhi: And on the Florida expansion, do you right now have the — have your fully owned clinics ready to enter all these 25 counties in Florida under the dedicated model?
Daniel Virnich: Yes, it’s Dan. That is underway right now. We need to see by the time we go live with those additional lives that we’ll have our clinics in place to adhere to our sort of ratio of employed clinics, MSO providers in the additional counties where we will be taking risk.
Yuan Zhi: Got it. And one last question on the Specialty Pharmacy. Can you clarify, are you able to dispense drugs outside of oncology, considering this patient may have other comorbidity or disease that may need oral drug?
Daniel Virnich: Yes. So at this time, our Specialty Pharmacy really focuses on oncology-specific medications, both oncolytics as well as medications that support chemotherapy pathways or oncolytic pathways exclusively. We don’t prescribe for non-oncology conditions or non-hematology conditions.
Operator: [Operator Instructions] Our next question comes from Robert LeBoyer with NOBLE Capital Markets.
Robert LeBoyer: Congratulations on another nice quarter. My question has to do with the CMS enhancing oncology model, and you mentioned saving $2 million in Medicare spending as part of the program during one of the periods. Could you just elaborate on what the model measures and put the $2 million in perspective in terms of spending per patient, spending on the total, maybe tie in the medical loss ratios and if there’s any information on how that compares with other providers, that would be helpful, too?
Daniel Virnich: Robert, great question. So that — the savings performance was in periods 2 and 3 of the enhancing oncology model, which, as I think most people know is the next iteration of the oncology care model that CMMI had for a number of years. It’s an episodic total cost of care risk model. So a little bit different than Part B capitation, although the principles are the same, adherence to value-based therapeutics and then implementation of our high-value cancer care program, which is specifically designed for Part A avoidance, which is part of the risk in the EOM model.
We don’t have numbers off the top of our head in terms of MLR performance or total risk pool for that cohort. We can certainly follow up on that. So we’ll have a set absolute savings amount at this time.
Robert LeBoyer: Okay. Great. And in terms of the portal that you mentioned, are there any particular things that you could point to or discuss in terms of how that would change the providers’ actions or whether that would save money, keep them on track, monitor what they’re doing or just exactly how that would work?
Daniel Virnich: Yes, absolutely. The portal is meant to be a centralized hub for our utilization management efforts. So all network providers that are helping serve our capitated partnerships in terms of patient care will be submitting their prior authorizations for care into that portal to get a UM decision made by our medical directors. Once that decision is made, then that authorization is approved or there’s a peer-to-peer or a change request. It also offers a centralized hub where we’ve got a high degree of visibility into all of our pathways to help drive additional formulary adherence.
And then as mentioned, it’s got the added benefit of being a path to get network providers to engage in ancillary services like pharmacy and clinical trials.
Operator: We’ll take a follow-up question from Matthew Shea with Needham.
Matthew Shea: Appreciate the follow-up. Maybe, Dan, thinking longer term on AI and beyond 2026, sort of last quarter, you noted you’re just starting to scratch the surface on use cases and capabilities of Agentic AI and that there were a number of sort of integration opportunities out into the future. So maybe as we think about you moving beyond those 3 initial buckets that you’ve highlighted for 2026, are there any other potential areas that are top of mind?
And as we think about you maybe going after some of those and looking out to the 2028 targets, is there anything contemplated in those targets in terms of AI efficiencies beyond sort of the initial $2 million that you’ve outlined for 2026?
Rob Carter: Yes. So to hit the second question first, no, our long-range kind of forecast that we issued in January did not contemplate additional AI efficiencies, so very conservative. The $2 million that we forecast into 2026 is really just scratching the surface on integration into those 3 core functions: call center; RCM; and prior auth. I mean it’s moving quickly in terms of the capabilities of Agentic AI in all 3 of those functions. So I do believe there will be substantial opportunity to expand upon those savings and drive additional OpEx efficiencies over the next 2 to 3 years.
Additional use cases at this point, we do believe there’s a good use case in the care navigation side of what we do as well with our high-value cancer care program. It’s kind of a — because it’s highly protocolized, it’s perfectly set up for that use case, which would obviously drive efficiencies in terms of labor costs to implement and scale that program over patients that are appropriate. And I’m sure there’s many others. But I’d say just even the 3 core use cases that we have going right now, we are far from maximizing the savings and sort of efficiency opportunity amongst those 3.
Operator: Thank you. At this time, there are no further questions in queue. This brings us to the end of today’s meeting. We appreciate your time and participation. You may now disconnect.
