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Side-by-side financial comparison of HEALTHSTREAM INC (HSTM) 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 $79.7M, roughly 1.8× HEALTHSTREAM INC). On growth, Oncology Institute, Inc. posted the faster year-over-year revenue change (41.6% vs 7.4%). HEALTHSTREAM INC produced more free cash flow last quarter ($13.0M vs $2.2M). Over the past eight quarters, Oncology Institute, Inc.'s revenue compounded faster (22.5% CAGR vs 4.7%).
HealthStream Inc is a leading U.S.-based provider of workforce development, compliance, and training solutions tailored for the healthcare industry. It offers cloud-based platforms covering clinical skill training, talent management, patient safety education, and regulatory adherence tools, serving over 4,000 healthcare organizations including hospitals, clinics, and long-term care facilities nationwide.
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.
HSTM vs TOI — Head-to-Head
Income Statement — Q4 FY2025 vs Q4 FY2025
| Metric | | |
|---|---|---|
| Revenue | $79.7M | $142.0M |
| Net Profit | — | $-7.5M |
| Gross Margin | — | — |
| Operating Margin | 3.0% | -4.9% |
| Net Margin | — | -5.3% |
| Revenue YoY | 7.4% | 41.6% |
| Net Profit YoY | — | 43.0% |
| EPS (diluted) | $0.09 | $-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.
| Q4 25 | $79.7M | $142.0M | ||
| Q3 25 | $76.5M | $136.6M | ||
| Q2 25 | $74.4M | $119.8M | ||
| Q1 25 | $73.5M | $104.4M | ||
| Q4 24 | $74.2M | $100.3M | ||
| Q3 24 | $73.1M | $99.9M | ||
| Q2 24 | $71.6M | $98.6M | ||
| Q1 24 | $72.8M | $94.7M |
| Q4 25 | — | $-7.5M | ||
| Q3 25 | $6.1M | $-16.5M | ||
| Q2 25 | $5.4M | $-17.0M | ||
| Q1 25 | $4.3M | $-19.6M | ||
| Q4 24 | — | $-13.2M | ||
| Q3 24 | $5.7M | $-16.1M | ||
| Q2 24 | $4.2M | $-15.5M | ||
| Q1 24 | $5.2M | $-19.9M |
| Q4 25 | 3.0% | -4.9% | ||
| Q3 25 | 9.9% | -5.9% | ||
| Q2 25 | 7.9% | -9.4% | ||
| Q1 25 | 6.0% | -9.5% | ||
| Q4 24 | 6.3% | -11.9% | ||
| Q3 24 | 8.9% | -13.9% | ||
| Q2 24 | 6.2% | -16.6% | ||
| Q1 24 | 7.8% | -19.0% |
| Q4 25 | — | -5.3% | ||
| Q3 25 | 8.0% | -12.1% | ||
| Q2 25 | 7.2% | -14.2% | ||
| Q1 25 | 5.9% | -18.8% | ||
| Q4 24 | — | -13.1% | ||
| Q3 24 | 7.8% | -16.1% | ||
| Q2 24 | 5.8% | -15.7% | ||
| Q1 24 | 7.2% | -21.0% |
| Q4 25 | $0.09 | $-0.04 | ||
| Q3 25 | $0.20 | $-0.14 | ||
| Q2 25 | $0.18 | $-0.15 | ||
| Q1 25 | $0.14 | $-0.21 | ||
| Q4 24 | $0.16 | $-0.14 | ||
| Q3 24 | $0.19 | $-0.18 | ||
| Q2 24 | $0.14 | $-0.17 | ||
| Q1 24 | $0.17 | $-0.22 |
Balance Sheet & Financial Strength
Snapshot of each company's liquidity, leverage and book value from the latest quarter.
| Metric | | |
|---|---|---|
| Cash + ST InvestmentsLiquidity on hand | $36.2M | — |
| Total DebtLower is stronger | — | — |
| Stockholders' EquityBook value | $354.0M | $-15.7M |
| Total Assets | $520.4M | $164.7M |
| Debt / EquityLower = less leverage | — | — |
8-quarter trend — quarters aligned by calendar period.
| Q4 25 | $36.2M | — | ||
| Q3 25 | $53.5M | — | ||
| Q2 25 | $52.1M | — | ||
| Q1 25 | $77.3M | — | ||
| Q4 24 | $59.5M | — | ||
| Q3 24 | $57.5M | — | ||
| Q2 24 | $46.1M | $9.9M | ||
| Q1 24 | $52.4M | $29.8M |
| Q4 25 | $354.0M | $-15.7M | ||
| Q3 25 | $349.2M | $-12.3M | ||
| Q2 25 | $350.6M | $-9.0M | ||
| Q1 25 | $362.8M | $5.1M | ||
| Q4 24 | $359.4M | $3.6M | ||
| Q3 24 | $355.5M | $15.5M | ||
| Q2 24 | $349.2M | $29.2M | ||
| Q1 24 | $344.9M | $41.3M |
| Q4 25 | $520.4M | $164.7M | ||
| Q3 25 | $499.9M | $163.6M | ||
| Q2 25 | $500.1M | $159.8M | ||
| Q1 25 | $524.0M | $164.0M | ||
| Q4 24 | $510.8M | $172.7M | ||
| Q3 24 | $502.8M | $179.2M | ||
| Q2 24 | $499.6M | $179.6M | ||
| Q1 24 | $511.6M | $204.5M |
Cash Flow & Capital Efficiency
How much cash each business actually produces after reinvestment. Cash flow is harder to manipulate than net income.
| Metric | | |
|---|---|---|
| Operating Cash FlowLast quarter | $13.2M | $3.2M |
| Free Cash FlowOCF − Capex | $13.0M | $2.2M |
| FCF MarginFCF / Revenue | 16.3% | 1.5% |
| Capex IntensityCapex / Revenue | 0.3% | 0.7% |
| Cash ConversionOCF / Net Profit | — | — |
| TTM Free Cash FlowTrailing 4 quarters | $59.6M | $-27.8M |
8-quarter trend — quarters aligned by calendar period.
| Q4 25 | $13.2M | $3.2M | ||
| Q3 25 | $18.0M | $-12.6M | ||
| Q2 25 | $5.0M | $-10.2M | ||
| Q1 25 | $27.1M | $-5.0M | ||
| Q4 24 | $11.2M | $4.2M | ||
| Q3 24 | $19.1M | $819.0K | ||
| Q2 24 | $6.5M | $-15.7M | ||
| Q1 24 | $20.9M | $-15.9M |
| Q4 25 | $13.0M | $2.2M | ||
| Q3 25 | $17.9M | $-13.2M | ||
| Q2 25 | $2.7M | $-11.4M | ||
| Q1 25 | $26.0M | $-5.3M | ||
| Q4 24 | $11.0M | $2.4M | ||
| Q3 24 | $18.8M | $417.0K | ||
| Q2 24 | $6.3M | $-17.5M | ||
| Q1 24 | $20.2M | $-16.5M |
| Q4 25 | 16.3% | 1.5% | ||
| Q3 25 | 23.4% | -9.7% | ||
| Q2 25 | 3.6% | -9.5% | ||
| Q1 25 | 35.4% | -5.1% | ||
| Q4 24 | 14.8% | 2.4% | ||
| Q3 24 | 25.8% | 0.4% | ||
| Q2 24 | 8.8% | -17.7% | ||
| Q1 24 | 27.8% | -17.4% |
| Q4 25 | 0.3% | 0.7% | ||
| Q3 25 | 0.1% | 0.4% | ||
| Q2 25 | 3.1% | 1.0% | ||
| Q1 25 | 1.4% | 0.3% | ||
| Q4 24 | 0.3% | 1.8% | ||
| Q3 24 | 0.4% | 0.4% | ||
| Q2 24 | 0.2% | 1.9% | ||
| Q1 24 | 1.0% | 0.6% |
| Q4 25 | — | — | ||
| Q3 25 | 2.96× | — | ||
| Q2 25 | 0.93× | — | ||
| Q1 25 | 6.25× | — | ||
| Q4 24 | — | — | ||
| Q3 24 | 3.34× | — | ||
| Q2 24 | 1.55× | — | ||
| Q1 24 | 4.01× | — |
Financial Flow Comparison
Revenue → gross profit → operating profit → net profit for each company.
Revenue Breakdown by Segment
HSTM
| Subscription Services | $77.0M | 97% |
| Professional Services | $2.7M | 3% |
TOI
| Other | $82.1M | 58% |
| Fee For Service | $36.3M | 26% |
| Capitated Revenue | $23.6M | 17% |
