Is The Oncology Institute, Inc. overvalued or undervalued?

As of 10 May 2023, the valuation grade for The Oncology Institute, Inc. has moved from attractive to risky, indicating a shift in perception regarding its financial health. The company appears to be overvalued, particularly given its significant negative ratios, including a Price to Book Value of 48.83 and an EV to EBITDA of -6.34. Additionally, its ROCE stands at a troubling -113.07%, reflecting severe inefficiencies in capital utilization.
In comparison to its peers, The Oncology Institute's EV to EBITDA ratio of -8.88 is considerably worse than Nutex Health, Inc., which has a very attractive EV to EBITDA of 1.88, highlighting a stark contrast in operational performance. Other risky peers like LifeMD, Inc. and The Joint Corp. also exhibit negative EV to EBITDA ratios, but none approach the extreme levels seen with The Oncology Institute. Despite a remarkable year-to-date stock return of 948.54%, which significantly outperformed the S&P 500's 12.22%, the long-term outlook remains concerning, especially given the negative returns over the past three and five years.