What The Oncology Institute, Inc. told the SEC could break it.

TOI is substantially dependent on a single source for its oral/IV/injectable chemotherapy drug supply — one vendor was 98% of direct costs and drug purchases are ~84% of TOI PC total costs — leaving it unable to shift to alternatives if that supplier disrupts, raises prices or changes terms.

“We are substantially dependent on a single source of drug supplies, which is critical to the services the TOI PCs provide, or to which we have committed obligations to make purchases, sometimes at particular prices. Approximately 84% of the TOI PCs' total costs are related to drug purchases, including both oral and chemotherapy drugs,”

TOI relies on a limited number of payors for much of TOI PC revenue (its largest customer was ~14% of patient-services revenue in 2025); fee reductions, scope changes or payor creditworthiness issues could hurt revenue.

“our largest customer by revenue in 2025 represented approximately 14% of our patient services revenue.”

TOI posted a $60.6M net loss in 2025 and its Facility Agreement obligations (and senior secured convertible notes) are secured by a first-priority lien on substantially all personal property, including IP and subsidiary equity, constraining liquidity despite cash-burn-reduction efforts.

“our obligations under the Facility Agreement are guaranteed by a perfected, first-priority security interest in substantially all of our personal property, including our intellectual property and the equity ownership interests directly and indirectly held by us in our wholly-owned subsidiaries.”

TOI receives ~14% of patient-services revenue directly from Medicare and many private payors peg rates to Medicare or are themselves Medicare-Advantage funded, so Medicare/MA rate changes (CMS announced ~3.26% MA increase for 2026) materially affect results.

“The TOI PCs receive a significant portion of revenue directly from Medicare, which accounted for approximately 14% of our Patient Services revenue in 2025.”