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Starling Oncology, Inc.

STLN

10 stories

$692M Market cap · 2026-10-21

@BlueDuckCap 2 clicks

BDC on X

This is a big deal. Strategic acquisition and verticalization of value based oncology care continues leaving $STLN as uniquely scare and thus strategic from here. AONC has no speciality pharma piece and yet is getting bought for 17x gross profit. $STLN is the last multi state actually-acquirable platform. What's left outside STLN is subscale: Utah Cancer Specialists (~40), Cancer Care Northwest (~30), Western Michigan (~30), plus Levitate Ridge's early West Coast platform. There are 2,000+ oncology groups in the US, but almost none with multi-state density. Cardinal has the smallest footprint and no VBC capability, which makes it the most plausible remaining strategic — followed by a payer (Carelon, Optum) or PE. Key point is that we believe $STLN is the much better asset and putting the 17x gross profit acquisition multiple on runrate 2027 estimates gets us ~$25 stock. Not advice.
@BlueDuckCap 1 click

BDC on X

Had to re-listen to $STLN (frmr $TOI) call this am. Outstanding results, execution, and overall outlook. Numbers going way higher. The multiple should too. Dan and Rob turned this from a distressed equity to a best in class growth story with ripping revenues, positive FCF and ebitda, a debt refi, rebrand, and multiple market launches on the come. Just incredible execution. Well done! FWIW - and this is not advice, but we think $STLN headed to mid teens in the next 6-12 months....150-250% upside based on our math, which is just an opinion.
@BlueDuckCap

BDC on X

From the $TOI Q4 call: “That’s actually a very important question and something that we continue to try to drive clarity with our investors on, which is the MA rate cycle and sort of pressure that you’ve seen health plans and full risk, medical groups that are getting a percent of premium face is actually a tailwind for TOI.Our top line Medicare Advantage reimbursement is not a percent of total premium. It’s not impacted by risk adjustment. In fact, pressure on the top line for payers generally causes them to reach out more proactively when it comes to seeking opportunities to provide great care for their patients and good access while also driving improvement in utilization. And so from that perspective, that actually helps our growth. So we tend to get lumped into some of those macro issues with payers, but I just want to make it very clear that, that is actually probably a good thing for TOI.”

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