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Side-by-side financial comparison of AMERICAN COASTAL INSURANCE Corp (ACIC) and Oncology Institute, Inc. (TOI). Click either name above to swap in a different company.

Oncology Institute, Inc. is the larger business by last-quarter revenue ($142.0M vs $86.4M, roughly 1.6× AMERICAN COASTAL INSURANCE Corp). AMERICAN COASTAL INSURANCE Corp runs the higher net margin — 30.8% vs -5.3%, a 36.0% gap on every dollar of revenue. On growth, Oncology Institute, Inc. posted the faster year-over-year revenue change (41.6% vs 9.0%). AMERICAN COASTAL INSURANCE Corp produced more free cash flow last quarter ($70.9M vs $2.2M). Over the past eight quarters, Oncology Institute, Inc.'s revenue compounded faster (22.5% CAGR vs 13.9%).

United Property & Casualty Insurance Company, Inc. is an American property and casualty insurance company with headquarters in Florida. It writes commercial, residential, homeowners’, and flood insurance policies in several coastal states.

Oncology Institute, Inc. is a specialized healthcare enterprise focused on delivering patient-centric, evidence-based oncology care services, including advanced treatment regimens, clinical trial access, and supportive care programs. It primarily operates across the United States, serving patients with diverse cancer diagnoses and partnering with care teams to improve treatment outcomes.

ACIC vs TOI — Head-to-Head

Bigger by revenue
TOI
TOI
1.6× larger
TOI
$142.0M
$86.4M
ACIC
Growing faster (revenue YoY)
TOI
TOI
+32.6% gap
TOI
41.6%
9.0%
ACIC
Higher net margin
ACIC
ACIC
36.0% more per $
ACIC
30.8%
-5.3%
TOI
More free cash flow
ACIC
ACIC
$68.7M more FCF
ACIC
$70.9M
$2.2M
TOI
Faster 2-yr revenue CAGR
TOI
TOI
Annualised
TOI
22.5%
13.9%
ACIC

Income Statement — Q4 FY2025 vs Q4 FY2025

Metric
ACIC
ACIC
TOI
TOI
Revenue
$86.4M
$142.0M
Net Profit
$26.6M
$-7.5M
Gross Margin
Operating Margin
43.2%
-4.9%
Net Margin
30.8%
-5.3%
Revenue YoY
9.0%
41.6%
Net Profit YoY
437.1%
43.0%
EPS (diluted)
$0.54
$-0.04

Green = leading value per metric. Periods may differ when fiscal calendars don't align.

8-Quarter Revenue & Profit Trend

Side-by-side quarterly history. Quarters aligned by calendar period so offset fiscal years line up.

Revenue
ACIC
ACIC
TOI
TOI
Q4 25
$86.4M
$142.0M
Q3 25
$90.4M
$136.6M
Q2 25
$86.5M
$119.8M
Q1 25
$72.2M
$104.4M
Q4 24
$79.3M
$100.3M
Q3 24
$82.1M
$99.9M
Q2 24
$68.7M
$98.6M
Q1 24
$66.6M
$94.7M
Net Profit
ACIC
ACIC
TOI
TOI
Q4 25
$26.6M
$-7.5M
Q3 25
$32.5M
$-16.5M
Q2 25
$26.4M
$-17.0M
Q1 25
$21.3M
$-19.6M
Q4 24
$4.9M
$-13.2M
Q3 24
$28.1M
$-16.1M
Q2 24
$19.1M
$-15.5M
Q1 24
$23.6M
$-19.9M
Operating Margin
ACIC
ACIC
TOI
TOI
Q4 25
43.2%
-4.9%
Q3 25
46.1%
-5.9%
Q2 25
41.8%
-9.4%
Q1 25
34.8%
-9.5%
Q4 24
11.2%
-11.9%
Q3 24
43.9%
-13.9%
Q2 24
35.1%
-16.6%
Q1 24
45.9%
-19.0%
Net Margin
ACIC
ACIC
TOI
TOI
Q4 25
30.8%
-5.3%
Q3 25
35.9%
-12.1%
Q2 25
30.6%
-14.2%
Q1 25
29.6%
-18.8%
Q4 24
6.2%
-13.1%
Q3 24
34.2%
-16.1%
Q2 24
27.8%
-15.7%
Q1 24
35.4%
-21.0%
EPS (diluted)
ACIC
ACIC
TOI
TOI
Q4 25
$0.54
$-0.04
Q3 25
$0.65
$-0.14
Q2 25
$0.53
$-0.15
Q1 25
$0.43
$-0.21
Q4 24
$0.10
$-0.14
Q3 24
$0.57
$-0.18
Q2 24
$0.39
$-0.17
Q1 24
$0.48
$-0.22

Balance Sheet & Financial Strength

Snapshot of each company's liquidity, leverage and book value from the latest quarter.

Metric
ACIC
ACIC
TOI
TOI
Cash + ST InvestmentsLiquidity on hand
$198.8M
Total DebtLower is stronger
$150.0M
Stockholders' EquityBook value
$317.6M
$-15.7M
Total Assets
$1.1B
$164.7M
Debt / EquityLower = less leverage
0.47×

8-quarter trend — quarters aligned by calendar period.

Cash + ST Investments
ACIC
ACIC
TOI
TOI
Q4 25
$198.8M
Q3 25
$267.9M
Q2 25
$315.5M
Q1 25
$167.2M
Q4 24
$137.0M
Q3 24
$183.1M
Q2 24
$229.4M
$9.9M
Q1 24
$285.4M
$29.8M
Total Debt
ACIC
ACIC
TOI
TOI
Q4 25
$150.0M
Q3 25
Q2 25
Q1 25
Q4 24
$150.0M
Q3 24
Q2 24
Q1 24
Stockholders' Equity
ACIC
ACIC
TOI
TOI
Q4 25
$317.6M
$-15.7M
Q3 25
$327.2M
$-12.3M
Q2 25
$292.3M
$-9.0M
Q1 25
$260.9M
$5.1M
Q4 24
$235.7M
$3.6M
Q3 24
$259.6M
$15.5M
Q2 24
$223.1M
$29.2M
Q1 24
$204.0M
$41.3M
Total Assets
ACIC
ACIC
TOI
TOI
Q4 25
$1.1B
$164.7M
Q3 25
$1.2B
$163.6M
Q2 25
$1.3B
$159.8M
Q1 25
$1.2B
$164.0M
Q4 24
$1.2B
$172.7M
Q3 24
$1.1B
$179.2M
Q2 24
$1.3B
$179.6M
Q1 24
$1.1B
$204.5M
Debt / Equity
ACIC
ACIC
TOI
TOI
Q4 25
0.47×
Q3 25
Q2 25
Q1 25
Q4 24
0.64×
Q3 24
Q2 24
Q1 24

Cash Flow & Capital Efficiency

How much cash each business actually produces after reinvestment. Cash flow is harder to manipulate than net income.

Metric
ACIC
ACIC
TOI
TOI
Operating Cash FlowLast quarter
$71.0M
$3.2M
Free Cash FlowOCF − Capex
$70.9M
$2.2M
FCF MarginFCF / Revenue
82.0%
1.5%
Capex IntensityCapex / Revenue
0.2%
0.7%
Cash ConversionOCF / Net Profit
2.67×
TTM Free Cash FlowTrailing 4 quarters
$-27.8M

8-quarter trend — quarters aligned by calendar period.

Operating Cash Flow
ACIC
ACIC
TOI
TOI
Q4 25
$71.0M
$3.2M
Q3 25
$-35.6M
$-12.6M
Q2 25
$127.9M
$-10.2M
Q1 25
$26.4M
$-5.0M
Q4 24
$243.5M
$4.2M
Q3 24
$-9.0M
$819.0K
Q2 24
$126.4M
$-15.7M
Q1 24
$124.5M
$-15.9M
Free Cash Flow
ACIC
ACIC
TOI
TOI
Q4 25
$70.9M
$2.2M
Q3 25
$-13.2M
Q2 25
$-11.4M
Q1 25
$26.3M
$-5.3M
Q4 24
$243.5M
$2.4M
Q3 24
$-9.0M
$417.0K
Q2 24
$-17.5M
Q1 24
$-16.5M
FCF Margin
ACIC
ACIC
TOI
TOI
Q4 25
82.0%
1.5%
Q3 25
-9.7%
Q2 25
-9.5%
Q1 25
36.5%
-5.1%
Q4 24
307.2%
2.4%
Q3 24
-10.9%
0.4%
Q2 24
-17.7%
Q1 24
-17.4%
Capex Intensity
ACIC
ACIC
TOI
TOI
Q4 25
0.2%
0.7%
Q3 25
0.0%
0.4%
Q2 25
0.0%
1.0%
Q1 25
0.1%
0.3%
Q4 24
0.0%
1.8%
Q3 24
0.0%
0.4%
Q2 24
0.0%
1.9%
Q1 24
0.0%
0.6%
Cash Conversion
ACIC
ACIC
TOI
TOI
Q4 25
2.67×
Q3 25
-1.10×
Q2 25
4.84×
Q1 25
1.24×
Q4 24
49.23×
Q3 24
-0.32×
Q2 24
6.63×
Q1 24
5.27×

Financial Flow Comparison

Revenue → gross profit → operating profit → net profit for each company.

Revenue Breakdown by Segment

ACIC
ACIC

Segment breakdown not available.

TOI
TOI

Other$82.1M58%
Fee For Service$36.3M26%
Capitated Revenue$23.6M17%

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