奎斯特診斷 (DGX) 2022 Q2 法說會逐字稿

Good morning. Welcome to the Quest Diagnostics Second Quarter 2022 Conference Call. At the request of the company, this call is being recorded. The entire contents of the call, including the presentation and question-and-answer session that will follow, are the copyrighted property of Quest Diagnostics with all rights reserved. Any redistribution, retransmission or rebroadcast of this call in any form without the written consent of Quest Diagnostics is strictly prohibited.

早上好。歡迎來到 Quest Diagnostics 2022 年第二季度電話會議。應公司要求，本次通話正在錄音。電話會議的全部內容，包括隨後的演示和問答環節，均為 Quest Diagnostics 的版權財產，並保留所有權利。未經 Quest Diagnostics 書面同意，嚴禁以任何形式重新分發、轉播或轉播此電話。

Now I'd like to introduce Shawn Bevec, Vice President of Investor Relations for Quest Diagnostics. Go ahead, please.

現在我想介紹一下 Quest Diagnostics 投資者關係副總裁 Shawn Bevec。請繼續。

Thank you, and good morning. I'm joined by Steve Rusckowski, our Chairman, Chief Executive Officer and President; Jim Davis, CEO elect; Mark Guinan, Chief Financial Officer; and Sam Samad, our incoming Chief Financial Officer.

謝謝你，早上好。我們的董事長、首席執行官兼總裁 Steve Rusckowski 也加入了我的行列；吉姆戴維斯，首席執行官當選； Mark Guinan，首席財務官；以及即將上任的首席財務官 Sam Samad。

During this call, we may make forward-looking statements and will provide non-GAAP measures. We provide a reconciliation of non-GAAP measures to comparable GAAP measures in the tables to our earnings press release. Actual results may differ materially from those projected. Risks and uncertainties, including the impact of the COVID-19 pandemic that may affect Quest Diagnostics' future results include, but are not limited to, those described in our most recent annual report on Form 10-K and subsequently filed quarterly reports on Form 10-Q and current reports on Form 8-K.

在本次電話會議期間，我們可能會做出前瞻性陳述，並將提供非公認會計原則措施。我們在收益新聞稿的表格中提供了非公認會計原則措施與可比公認會計原則措施的對賬。實際結果可能與預測結果大不相同。風險和不確定性，包括可能影響 Quest Diagnostics 未來結果的 COVID-19 大流行的影響，包括但不限於我們最近的 10-K 表格年度報告以及隨後提交的 10 表格季度報告中描述的風險和不確定性-Q 和關於 8-K 表格的當前報告。

The company continues to believe that the impact of the COVID-19 pandemic on future operating results, cash flows and/or its financial condition will be primarily driven by the pandemic severity and duration, healthcare insurer, government, client payer reimbursement for COVID-19 molecular test, the pandemic impact on the U.S. health care system and the U.S. economy; and the timing, scope and effectiveness of federal, state and local governmental responses to the pandemic, including the impact of vaccination efforts, which are drivers beyond the company's knowledge and control.

該公司仍然認為，COVID-19 大流行對未來經營業績、現金流和/或其財務狀況的影響將主要受到大流行的嚴重程度和持續時間、醫療保險公司、政府、客戶付款人對 COVID-19 的報銷的影響分子檢測，大流行對美國醫療保健系統和美國經濟的影響；以及聯邦、州和地方政府應對大流行的時機、範圍和有效性，包括疫苗接種工作的影響，這是公司無法了解和控制的驅動因素。

For this call, references to reported EPS refer to reported diluted EPS and references to adjusted EPS refer to adjusted diluted EPS. Any references to base business, testing revenues or volumes refer to the performance of our business excluding COVID-19 testing. Growth rates associated with our long-term outlook projections, including total revenue growth, revenue growth from acquisitions, organic revenue growth and adjusted earnings growth are compound annual growth rates. Finally, revenue growth rates from acquisitions will be measured against our base business.

對於本次電話會議，對報告每股收益的引用是指報告的稀釋每股收益，對調整後每股收益的引用是指調整後的稀釋每股收益。對基礎業務、測試收入或數量的任何提及均指我們的業務表現，不包括 COVID-19 測試。與我們的長期前景預測相關的增長率，包括總收入增長、收購收入增長、有機收入增長和調整後的盈利增長，都是複合年增長率。最後，收購的收入增長率將根據我們的基礎業務來衡量。

Now here is Steve Rusckowski.

現在是史蒂夫·魯斯科夫斯基。

Thanks, Shawn, and thanks, everyone, for joining us today.

謝謝肖恩，謝謝大家今天加入我們。

We performed well in the quarter, growing our base business year-over-year while increasing our share of COVID-19 molecular testing since March. As we have said before, we believe demand for COVID-19 molecular testing is not going away anytime soon. It will continue into 2023.

我們在本季度表現良好，基礎業務同比增長，同時自 3 月以來增加了我們在 COVID-19 分子檢測中的份額。正如我們之前所說，我們相信對 COVID-19 分子檢測的需求不會很快消失。它將持續到2023年。

Based on our overall performance in the quarter and our expectations for the remainder of 2022, we have raised our full year guidance. We also made very good progress on our leadership transition. Jim will give you an update and take you through our second quarter highlights, and then Mark will take you through our financial performance in more detail before we get into your questions.

根據我們在本季度的整體表現和我們對 2022 年剩餘時間的預期，我們上調了全年指引。我們在領導層交接方面也取得了很好的進展。吉姆將為您提供最新信息並帶您了解我們第二季度的重點，然後馬克將帶您更詳細地了解我們的財務業績，然後再回答您的問題。

But before I turn it over to Jim, I'd like to say a few words about the saving access to Laboratory Services Act, now called Salsa, the important new federal laboratory legislation recently introduced in Congress as well as the U.S. Court of Appeals for the D.C. Circuit's recent ruling on our trade associations PAMA lawsuit.

但在我把它交給吉姆之前，我想對《實驗室服務法》（現稱為薩爾薩法）的節省訪問說幾句話，這是最近在國會和美國上訴法院提出的重要的新聯邦實驗室立法。華盛頓特區巡迴賽最近對我們行業協會 PAMA 訴訟的裁決。

We're grateful for the efforts of Senate and House members who introduced this legislation on both sides of the aisle. In our view, Salsa could fix PAMA permanently, setting the Medicare clinical lab fee schedule back on a sustainable path. In 2014, the intent of Congress when passing PAMA was to reform the Medicare clinical lab fee schedule to a single national fee schedule based on private payer rates for the clinical laboratory services. Unfortunately, the first round of data collection failed to collect the data from large significant segments of the marketplace. The result was billions of Medicare cuts over 3 years, with more on their way if Salsa is not passed.

我們感謝參議院和眾議院議員在過道兩邊提出這項立法的努力。在我們看來，Salsa 可以永久修復 PAMA，使 Medicare 臨床實驗室費用表重新走上可持續發展的道路。 2014 年，國會在通過 PAMA 時的意圖是將醫療保險臨床實驗室費用表改革為基於臨床實驗室服務私人付款人費率的單一國家費用表。不幸的是，第一輪數據收集未能從市場的重要部分收集數據。結果是 3 年內醫療保險削減了數十億美元，如果 Salsa 不通過，還會有更多削減。

Our trade association is coordinated to [congressional] meetings along with public advocacy efforts that involves collaboration with the provider and patient communities.

我們的行業協會與 [國會] 會議以及涉及與提供者和患者社區合作的公共宣傳工作進行協調。

Last week, the D.C. Circuit Court issued a decision in the PAMA lawsuit filed in 2017 by our trade association, ACLA. In short, the court sided with ACLA and called the CMS's exclusion of hospital price data "arbitrary and capricious." Importantly, this case has been rejected for procedural reasons, and this is the first opinion based on its merits. Unfortunately, the court is not requiring CMS to recalculate the flawed payment amounts. While disappointing, we believe this favorable ruling will give Congress additional strong grounds to finally fix PAMA's mini flaws by passing Salsa.

上週，華盛頓特區巡迴法院在我們的行業協會 ACLA 於 2017 年提起的 PAMA 訴訟中作出裁決。簡而言之，法院站在 ACLA 一邊，稱 CMS 排除醫院價格數據“武斷且反复無常”。重要的是，此案因程序原因被駁回，這是基於案情的第一個意見。不幸的是，法院沒有要求 CMS 重新計算有缺陷的付款金額。雖然令人失望，但我們相信這一有利的裁決將為國會提供更多強有力的理由，最終通過通過 Salsa 來解決 PAMA 的小缺陷。

Now I'd like to turn it over to Jim Davis.

現在我想把它交給吉姆戴維斯。

Thanks, Steve. Our base business performed well despite softer utilization trends, which we believe impacted us and the rest of the health care industry. I'm proud of the efforts our team has made to grow our share of COVID-19 molecular testing since the end of the first quarter. We also ramped our investments to further accelerate growth in the areas of advanced diagnostics and direct-to-consumer testing.

謝謝，史蒂夫。儘管使用趨勢疲軟，但我們的基礎業務表現良好，我們認為這影響了我們和其他醫療保健行業。自第一季度末以來，我為我們的團隊為增加 COVID-19 分子檢測份額所做的努力感到自豪。我們還加大了投資力度，以進一步加快高級診斷和直接面向消費者的測試領域的增長。

In the quarter, we announced the selection of our next CFO, Sam Samad. Sam joins us from Illumina, where he served as Chief Financial Officer for 5-plus years. As many of you know, he brings a depth of health care experience that will help us in many ways. Prior to Illumina, Sam held several financial and operational leadership roles at Cardinal Health and Eli Lilly and Company. Sam, welcome to Quest Diagnostics.

在本季度，我們宣布選擇下一任首席財務官 Sam Samad。 Sam 從 Illumina 加入我們，在那裡他擔任了 5 年多的首席財務官。正如你們許多人所知，他帶來了豐富的醫療保健經驗，這將在許多方面為我們提供幫助。在加入 Illumina 之前，Sam 在 Cardinal Health 和 Eli Lilly and Company 擔任過多個財務和運營領導職務。山姆，歡迎來到 Quest 診斷。

Thanks, Jim. It's an honor to join the Quest Diagnostics team. In previous roles, I had the opportunity to observe the many contributions Quest is making to health care. Just arriving less than 2 weeks ago, I've been impressed by the passion and dedication of everyone that I've met so far. I'd like to thank Mark Guinan for his partnership during this transition. I'm excited to be here.

謝謝，吉姆。很榮幸加入 Quest 診斷團隊。在以前的角色中，我有機會觀察 Quest 對醫療保健所做的許多貢獻。不到兩週前剛到，我對迄今為止遇到的每個人的熱情和奉獻精神印象深刻。我要感謝 Mark Guinan 在此過渡期間的合作。我很高興來到這裡。

Jim, I'll turn it back to you.

吉姆，我會把它還給你。

Thanks, Sam, and I look forward to working very closely with you.

謝謝，山姆，我期待與您密切合作。

Now turning to our performance in the second quarter. Total revenues were $2.5 billion. Earnings per share were $1.96 on a reported basis and $2.36 on an adjusted basis. Cash provided by operations was $402 million. COVID-19 testing revenues were approximately $355 million in the second quarter, down approximately 31% from 2021 and 41% from the previous quarter.

現在轉向我們在第二季度的表現。總收入為 25 億美元。報告的每股收益為 1.96 美元，調整後的每股收益為 2.36 美元。運營提供的現金為 4.02 億美元。第二季度 COVID-19 測試收入約為 3.55 億美元，比 2021 年下降約 31%，比上一季度下降 41%。

In July, with the spread of the BA4 and BA5 variance, we continue to see the demand for COVID-19 molecular testing, consistent with the volumes we reported in June.

7 月，隨著 BA4 和 BA5 差異的擴大，我們繼續看到對 COVID-19 分子檢測的需求，與我們 6 月報告的數量一致。

Our positivity rate has increased since March and approximately 25% of the tests we performed in the first 2 weeks of July were positive. We believe that the COVID-19 trends since March contributed to the softness we observed in the broader health care utilization.

自 3 月以來，我們的陽性率有所上升，我們在 7 月的前 2 週進行的檢測中約有 25% 呈陽性。我們認為，自 3 月以來的 COVID-19 趨勢導致我們在更廣泛的醫療保健利用中觀察到的疲軟。

As you've seen, we're successfully executing a strategy to increase our share of COVID-19 molecular testing. A key element of our strategy is to increase the number of testing access points through retail relationships. In addition to our CVS and Walmart relationships, we are now also collecting specimens at Rite Aid locations and the number of access points will continue to grow. Approximately half of our COVID-19 volume in the quarter came from retail channels.

如您所見，我們正在成功執行一項戰略，以增加我們在 COVID-19 分子檢測中的份額。我們戰略的一個關鍵要素是通過零售關係增加測試接入點的數量。除了我們與 CVS 和沃爾瑪的關係外，我們現在還在 Rite Aid 地點收集樣本，接入點的數量將繼續增長。本季度我們 COVID-19 銷量的大約一半來自零售渠道。

Quest is proud to have been selected by the CDC to participate in its increasing community access to testing, or ICATT program for COVID-19 testing. Through this program, qualified uninsured individuals can access COVID-19 molecular diagnostic testing for zero out-of-pocket costs. In addition, we're pleased to be the provider of COVID-19 PCR testing for qualified insured and uninsured customers of Rite Aid nationwide for zero out-of-pocket expense.

Quest 很自豪能夠被 CDC 選中參與其增加社區獲得測試的機會，或 ICATT 計劃以進行 COVID-19 測試。通過該計劃，合格的無保險個人可以零自付費用獲得 COVID-19 分子診斷測試。此外，我們很高興成為 COVID-19 PCR 檢測提供商，為全國 Rite Aid 的合格投保和未投保客戶提供零自付費用。

We now have approximately 6,000 COVID-19 patient access testing sites through retail relationships as well as our own patient service centers. Through these efforts, we estimate that we are performing approximately 8% of COVID-19 molecular testing in the U.S., up from approximately 4% in March.

我們現在有大約 6,000 名 COVID-19 患者通過零售關係以及我們自己的患者服務中心訪問測試站點。通過這些努力，我們估計我們在美國進行了約 8% 的 COVID-19 分子檢測，高於 3 月份的約 4%。

Finally, the public health emergency was extended into October, which will help us maintain our current level of reimbursement. Based on these factors, we raised our COVID-19 revenue guidance for full year 2022 to between $1.15 billion and $1.30 billion.

最後，突發公共衛生事件延長至 10 月，這將有助於我們維持目前的報銷水平。基於這些因素，我們將 2022 年全年的 COVID-19 收入指引提高到 11.5 億美元至 13 億美元之間。

Now turning to our base business. In the second quarter, we continued to make progress executing our two-point strategy to accelerate growth and drive operational excellence. Here are some highlights from the quarter. Our M&A funnel remains strong. We are in late-stage discussions with several hospital health systems on the purchase of their laboratory outreach business. This is in addition to our normal conversations we have with C-suite leaders on performing reference testing and providing professional lab services.

現在轉向我們的基礎業務。在第二季度，我們繼續在執行兩點戰略以加速增長和推動卓越運營方面取得進展。以下是本季度的一些亮點。我們的併購渠道依然強勁。我們正在與幾家醫院衛生系統就購買他們的實驗室外展業務進行後期討論。這是我們與高管就執行參考測試和提供專業實驗室服務進行的正常對話的補充。

While this pandemic paused some of these discussions, it has also created opportunities because of the financial and labor pressures that many hospital health systems are facing.

雖然這場大流行暫停了其中一些討論，但由於許多醫院衛生系統面臨的財務和勞動力壓力，它也創造了機會。

We continue to accelerate growth through health plan access. Excluding COVID-19, health plan volumes and revenues grew faster than our overall base business in the quarter. Health plans continue to see the value of working with us. Over the last 2 years, we have renewed 12 national and large regional health plan contracts with price increases. We expect more renewals with price increases this year.

我們繼續通過健康計劃訪問來加速增長。不包括 COVID-19，健康計劃的數量和收入在本季度的增長速度快於我們的整體基礎業務。健康計劃繼續看到與我們合作的價值。在過去的 2 年中，我們續簽了 12 個國家和大型區域健康計劃合同，價格上漲。我們預計今年會有更多的續訂價格上漲。

And we're proud to be selected as one of the UnitedHealthcare's preferred lab network providers for the fourth consecutive year, providing physicians and patients with improved access, quality and value.

我們很自豪連續第四年被選為 UnitedHealthcare 的首選實驗室網絡提供商之一，為醫生和患者提供更好的訪問、質量和價值。

Finally, we're pleased to share today that we have renewed our strategic relationship with Florida Blue. Florida continues to be an important large and growing state for us.

最後，我們今天很高興地與大家分享，我們已經更新了與佛羅里達藍的戰略關係。佛羅里達州對我們來說仍然是一個重要的、不斷發展的大州。

Earlier this month, the CMS Transparency in Coverage Final Rules became effective to help consumers know the cost of a covered item or service before receiving care. Beginning July 1, 2022, group health plans and issuers of group or individual health insurance are required to post pricing information for covered items and services. We are leveraging that data to ensure patients and employers are aware of the value we offer.

本月早些時候，CMS 承保範圍最終規則的透明度開始生效，以幫助消費者在接受護理之前了解承保項目或服務的成本。從 2022 年 7 月 1 日開始，團體健康計劃和團體或個人健康保險的發行人必鬚髮布承保項目和服務的定價信息。我們正在利用這些數據來確保患者和雇主了解我們提供的價值。

This trend will continue to gather momentum as more pricing transparency requirements will go into effect in the next 2 years. We believe that pricing transparency favors Quest Diagnostics, which powers affordable care. We do this by offering clinical innovation, enabling better clinical outcomes through our quality, speed and accuracy of test results, improving the patient experience with accessible and easy-to-use patient resources and finally, reducing the cost of care. We continue to ramp our investments in advanced diagnostics capabilities. In the quarter, we saw growth from hematology, prenatal genetics and pharma services. We also introduced Quest AD Detect, a blood test to aid in the early assessment of Alzheimer's disease. We are seeing good early adoption from both primary care physicians and neurologists.

隨著更多定價透明度要求將在未來 2 年內生效，這一趨勢將繼續增強。我們認為，定價透明有利於 Quest Diagnostics，它為負擔得起的醫療服務提供支持。為此，我們提供臨床創新，通過我們的測試結果的質量、速度和準確性實現更好的臨床結果，通過可訪問且易於使用的患者資源改善患者體驗，最後降低護理成本。我們繼續加大對先進診斷能力的投資。在本季度，我們看到血液學、產前遺傳學和製藥服務的增長。我們還推出了 Quest AD Detect，這是一種有助於早期評估阿爾茨海默病的血液測試。我們看到初級保健醫生和神經科醫生都很好地早期採用。

Finally, last week, we launched the lab developed molecular test to aid in the detection of monkeypox. The test can differentiate monkeypox from other orthopox viruses and we will be able to perform nearly 30,000 tests a week by the end of July. In addition, we can expand testing to other laboratories in our network to further increase capacity if needed.

最後，上週，我們啟動了實驗室開發的分子測試，以幫助檢測猴痘。該測試可以將猴痘病毒與其他正痘病毒區分開來，到 7 月底，我們將能夠每週進行近 30,000 次測試。此外，如果需要，我們可以將測試擴展到我們網絡中的其他實驗室，以進一步提高能力。

We continue to see growth in direct-to-consumer testing, thanks to our COVID-19 offerings and more importantly, our base business testing. Within the base business testing category, we saw strong growth from testosterone, comprehensive metabolic panels and Lyme disease. We're excited about upcoming improved digital experience, which we expect to debut later this year. We believe this improved experience will help us acquire, convert and retain more customers who visited QuestDirect digital platform. We expect to have much more to say about our improved digital experience before the end of this year.

由於我們的 COVID-19 產品，更重要的是，我們的基礎業務測試，我們繼續看到直接面向消費者的測試的增長。在基礎業務測試類別中，我們看到睾酮、綜合代謝組和萊姆病的強勁增長。我們對即將到來的改進的數字體驗感到興奮，我們預計將在今年晚些時候首次亮相。我們相信這種改進的體驗將幫助我們獲得、轉換和留住更多訪問 QuestDirect 數字平台的客戶。我們希望在今年年底之前對我們改進的數字體驗有更多的發言權。

The second part of our two-point strategy is to drive operational excellence. We remain focused on improving our operational quality, service and cost, thereby driving productivity gains. We have several initiatives underway to make this happen. Focused on attracting and retaining our people, optimizing our network, automating and digitizing our processes and getting paid for the work we do.

我們兩點戰略的第二部分是推動卓越運營。我們仍然專注於提高我們的運營質量、服務和成本，從而提高生產力。我們正在採取多項舉措來實現這一目標。專注於吸引和留住我們的員工、優化我們的網絡、自動化和數字化我們的流程以及為我們所做的工作獲得報酬。

Here are three examples. One, we're partnering with universities to help build our pipeline of expertise in medical technology, cytology and histology. We're also teaming up with a learning and development recruiting company to provide lobotomy certifications to prescreened candidates in exchange for a 2-year commitment to work at Quest.

這裡有三個例子。一，我們正在與大學合作，幫助建立我們在醫療技術、細胞學和組織學方面的專業知識管道。我們還與一家學習和發展招聘公司合作，為預篩選的候選人提供腦葉切除術認證，以換取在 Quest 工作的 2 年承諾。

Two, our schedule at check-in initiative, which encourages patients to make appointments has now expanded to 1,000 of our patient service sites. In one area, which has implemented the program, we are seeing a 20% decrease in average wait times as well as an improvement in patient satisfaction. We're also building the payment process into the digital customer experience which frees up our phlebotomists to focus on specimen collection, thereby increasing their capacity and improving the patient-employee experience.

第二，我們鼓勵患者進行預約的登記計劃計劃現已擴展到我們的 1,000 個患者服務站點。在已實施該計劃的一個地區，我們看到平均等待時間減少了 20%，患者滿意度也有所提高。我們還將支付流程構建到數字客戶體驗中，這讓我們的抽血師可以專注於標本採集，從而提高他們的能力並改善患者與員工的體驗。

Three, we continue to implement digital technology to provide end-to-end specimen tracking, including the arrival patterns that enable load leveling across the network which improves our productivity and provides greater transparency for our clients.

第三，我們繼續實施數字技術以提供端到端的樣本跟踪，包括實現網絡負載均衡的到達模式，從而提高我們的生產力並為我們的客戶提供更大的透明度。

We're not immune to the current inflationary environment and are managing through rising fuel and labor costs. Like many companies, higher-than-normal employee turnover in some job categories is impacting our ability to drive further productivity gains. However, these increased costs are in line with our expectations and are built into our guidance. We are expecting another year of solid Invigorate savings and productivity improvements to help offset these pressures.

我們不能倖免於當前的通貨膨脹環境，並且正在通過不斷上漲的燃料和勞動力成本進行管理。與許多公司一樣，某些工作類別中高於正常的員工流動率正在影響我們進一步提高生產力的能力。然而，這些增加的成本符合我們的預期，並納入我們的指導。我們預計 Invigorate 又將實現穩健的節約和生產力提高，以幫助抵消這些壓力。

Finally, I'm very proud of our recently released 2021 corporate responsibility report and invite you all to download it. You can find it on our website. Among the highlights, in 2021, we launched our first formal materiality assessment to help identify the most significant ESG topics to the company and our stakeholders. Also, to enhance the level of our ESG disclosures, we began reporting in accordance with the SASB guidelines.

最後，我對我們最近發布的 2021 年企業責任報告感到非常自豪，並邀請大家下載。您可以在我們的網站上找到它。在亮點中，我們在 2021 年啟動了第一次正式的重要性評估，以幫助確定對公司和我們的利益相關者最重要的 ESG 主題。此外，為了提高我們的 ESG 披露水平，我們開始按照 SASB 指南進行報告。

We're very proud of the contributions Quest is making to empower better health and grateful to our 50,000 colleagues who are making that vision a reality every day.

我們為 Quest 為改善健康所做的貢獻感到非常自豪，並感謝每天將這一願景變為現實的 50,000 名同事。

Now Mark will provide more details on our performance and share more insights on our updated guidance for the remainder of 2022.

現在，馬克將提供有關我們業績的更多詳細信息，並就我們在 2022 年剩餘時間的更新指導分享更多見解。

Thanks, Jim. In the second quarter, consolidated revenues were $2.45 billion, down 3.8% versus the prior year. Base business revenues grew 2.9% to $2.1 billion, while COVID-19 testing revenues declined approximately 31% to $355 million. Revenues for Diagnostic Information Services declined 3.6% compared to the prior year. The decline reflected lower revenue from COVID-19 testing services versus the second quarter of 2021, partially offset by growth in our base testing revenue.

謝謝，吉姆。第二季度，合併收入為 24.5 億美元，同比下降 3.8%。基礎業務收入增長 2.9% 至 21 億美元，而 COVID-19 測試收入下降約 31% 至 3.55 億美元。與上一年相比，診斷信息服務的收入下降了 3.6%。下降反映了 COVID-19 測試服務的收入與 2021 年第二季度相比有所下降，部分被我們的基礎測試收入的增長所抵消。

Total volume measured by the number of requisitions declined 1.4% versus the prior year. Acquisitions contributed approximately 100 basis points to total volume. Total base testing volumes increased approximately 2% versus the prior year. Excluding acquisitions, total base testing volumes grew less than 1%. As we have seen in prior COVID surges, we experienced some softening of base testing volumes beginning in April as COVID-19 cases began to rise again throughout the spring. COVID-19 testing volumes were stronger than expected during the second quarter.

以申請數量衡量的總交易量與去年相比下降了 1.4%。收購為總交易量貢獻了大約 100 個基點。與上一年相比，總基礎測試量增加了約 2%。不包括收購，總的基礎測試量增長不到 1%。正如我們在之前的 COVID 激增中看到的那樣，隨著 COVID-19 病例在整個春季再次開始上升，我們從 4 月開始經歷了基礎測試量的一些疲軟。第二季度的 COVID-19 檢測量強於預期。

Together with our JV partnership, Sonora Quest, we resulted approximately 3.7 million molecular tests. Quest alone resulted roughly 3.5 million molecular tests, down approximately 1.3 million tests and 2.8 million tests versus the prior year and first quarter, respectively. Our July COVID-19 molecular volumes have been consistent with the volumes we reported in June, averaging roughly 40,000 tests per day, excluding Sonora Quest.

與我們的合資企業 Sonora Quest 一起，我們進行了大約 370 萬次分子測試。僅 Quest 就進行了大約 350 萬次分子測試，與去年和第一季度相比分別減少了約 130 萬次和 280 萬次測試。我們 7 月份的 COVID-19 分子數量與 6 月份報告的數量一致，平均每天進行大約 40,000 次測試，不包括 Sonora Quest。

Revenue per requisition declined 2.6% versus the prior year, driven primarily by lower COVID-19 molecular volume. Base business revenue per req was up modestly.

與上一年相比，每份申請的收入下降了 2.6%，這主要是由於 COVID-19 分子體積減少。每個需求的基本業務收入小幅增長。

As we have highlighted in recent quarters, the pricing environment has improved with unit price reimbursement pressure of less than 50 basis points in the quarter. Reported operating income in the second quarter was $388 million, or 15.8% of revenues compared to $533 million or 20.9% of revenues last year. On an adjusted basis, operating income was $435 million or 17.7% of revenues compared to $584 million or 22.9% of revenues last year.

正如我們在最近幾個季度所強調的那樣，定價環境有所改善，本季度單價報銷壓力不到 50 個基點。第二季度報告的營業收入為 3.88 億美元，佔收入的 15.8%，而去年為 5.33 億美元，佔收入的 20.9%。經調整後，營業收入為 4.35 億美元，佔收入的 17.7%，而去年為 5.84 億美元，佔收入的 22.9%。

The year-over-year decline in adjusted operating income is primarily related to lower COVID-19 testing volume, a higher portion of COVID-19 molecular testing volume from nontraditional retail channels which carry additional expenses and logistics costs, investments to accelerate growth in our base business and slightly lower average reimbursement for COVID-19 molecular tests.

調整後營業收入的同比下降主要與較低的 COVID-19 檢測量、來自非傳統零售渠道的 COVID-19 分子檢測量的較高部分相關，這些渠道帶來額外的費用和物流成本，以及加速我們增長的投資基本業務和 COVID-19 分子檢測的平均報銷略低。

In the quarter, approximately half of our COVID-19 molecular volume came through our retail partners versus roughly 1/3 last year. We expect the mix of COVID-19 molecular volumes through this channel to continue to grow in the third quarter.

在本季度，我們大約一半的 COVID-19 分子量來自我們的零售合作夥伴，而去年這一比例約為 1/3。我們預計通過該渠道的 COVID-19 分子數量組合將在第三季度繼續增長。

Reported EPS was $1.96 in the quarter compared to $4.96 a year ago. Adjusted EPS was $2.36 compared to $3.18 last year. Year-to-date cash provided by operations was $882 million in 2022 versus $1.2 billion in the prior year period. Given the limited M&A activity, we repurchased $200 million in stock during the second quarter.

本季度報告的每股收益為 1.96 美元，而一年前為 4.96 美元。調整後的每股收益為 2.36 美元，而去年為 3.18 美元。 2022 年年初至今運營提供的現金為 8.82 億美元，而去年同期為 12 億美元。鑑於併購活動有限，我們在第二季度回購了 2 億美元的股票。

Now turning to our updated guidance. Revenues are now expected to be between $9.5 billion and $9.75 billion. Base business revenues are expected to be between $8.35 billion and $8.45 billion. COVID-19 testing revenues are expected to be between $1.15 billion and $1.3 billion. Reported EPS expected to be in a range of $8.24 to $8.64, and adjusted EPS to be in the range of $9.55 to $9.95. Cash provided by operations is expected to be at least $1.7 billion, and capital expenditures are expected to be approximately $400 million. Before concluding, I'll touch on some assumptions embedded in our updated 2022 guidance as well as some additional considerations. Our guidance assumes COVID-19 molecular volumes to average approximately 15,000 to 25,000 tests per day for the rest of the year. As we look toward 2023, we continue to assume our COVID-19 molecular testing run rate in the second half of 2022 continues into next year.

現在轉向我們更新的指南。現在預計收入將在 95 億美元至 97.5 億美元之間。基礎業務收入預計在 83.5 億美元至 84.5 億美元之間。 COVID-19 測試收入預計在 11.5 億美元至 13 億美元之間。報告的每股收益預計在 8.24 美元至 8.64 美元之間，調整後的每股收益在 9.55 美元至 9.95 美元之間。運營提供的現金預計至少為 17 億美元，資本支出預計約為 4 億美元。在結束之前，我將談談我們更新的 2022 年指南中包含的一些假設以及一些其他注意事項。我們的指導假設 COVID-19 分子體積在今年剩餘時間內平均每天進行約 15,000 至 25,000 次測試。展望 2023 年，我們繼續假設我們在 2022 年下半年的 COVID-19 分子測試運行率將持續到明年。

Last week, the public health emergency was again extended another 90 days through mid-October. We assume average reimbursement for COVID-19 molecular testing to hold relatively steady through this period. While the public health emergency could be renewed beyond October, additional extensions are not captured in our guidance.

上週，公共衛生緊急事件再次延長了 90 天至 10 月中旬。我們假設 COVID-19 分子檢測的平均報銷在此期間保持相對穩定。雖然公共衛生緊急事件可能會在 10 月之後延長，但我們的指南中並未包含額外的延期。

As Jim noted earlier, we have successfully grown our share of COVID-19 molecular testing through our retail partners, which accounted for approximately 50% of our COVID-19 molecular volume in the second quarter. As these retail partnerships continue to expand, we expect the mix through this channel to continue to grow throughout the remainder of the year. We continue to incur incremental costs to serve this channel.

正如 Jim 之前指出的，我們通過我們的零售合作夥伴成功地增加了 COVID-19 分子檢測的份額，這在第二季度約占我們 COVID-19 分子數量的 50%。隨著這些零售合作夥伴關係的不斷擴大，我們預計通過這一渠道的組合將在今年剩餘時間內繼續增長。我們繼續為該渠道服務而產生增量成本。

As COVID-19 positivity rates remain in the double digits, our ability to pull specimens for COVID-19 molecular testing continues to be limited. As a reminder, we are ramping investments to accelerate growth this year. We spent approximately $70 million in the first half of the year, and we expect these investments to continue to ramp in Q3 to support the launch of our new consumer site later this year. A portion of these stand-up IT costs are temporary, but variable marketing costs will increase following the launch of the new site. We'll also be adding additional headcount this year to support our consumer offering as well as bioinformatics capabilities within advanced diagnostics.

由於 COVID-19 陽性率保持在兩位數，我們提取樣本進行 COVID-19 分子檢測的能力仍然有限。提醒一下，我們正在加大投資以加速今年的增長。我們在今年上半年花費了大約 7000 萬美元，我們預計這些投資將在第三季度繼續增加，以支持我們今年晚些時候推出新的消費者網站。這些獨立 IT 成本的一部分是暫時的，但隨著新網站的推出，可變營銷成本將增加。今年我們還將增加額外的員工人數，以支持我們的消費者產品以及高級診斷中的生物信息學功能。

I will now turn it back to Steve.

我現在把它轉回給史蒂夫。

Thanks, Mark. As many of you know, this will be Mark's last earnings call as he is retiring next week. Mark, you've been a key member of our leadership team as we have transformed Quest and accelerated its growth. I'm grateful for everything you've done for the company, especially for the last 2.5 years of the pandemic. I would miss your partnership and consult as we navigated many challenges over nearly a decade. I wish you and your family, health and happiness as you approach the next chapter in your life. Thanks.

謝謝，馬克。眾所周知，這將是馬克下週退休後的最後一次財報電話會議。馬克，您一直是我們領導團隊的重要成員，因為我們已經轉變了 Quest 並加速了它的發展。我感謝您為公司所做的一切，尤其是在過去 2.5 年的大流行病中。當我們在近十年來應對許多挑戰時，我會想念您的合作夥伴關係和諮詢。祝您和您的家人身體健康，幸福快樂，迎接人生的新篇章。謝謝。

Thanks, Steve. Quest is a special place, and it has been an honor to serve as CFO for the last 9 years. Thanks to the analysts and investors on this call. I have enjoyed working with all of you. My family and I are excited for what lies ahead.

謝謝，史蒂夫。 Quest 是一個特殊的地方，在過去 9 年中擔任 CFO 一直是我的榮幸。感謝本次電話會議的分析師和投資者。我很高興與你們所有人一起工作。我和我的家人對即將發生的事情感到興奮。

Thanks, Mark. And to summarize, as Jim shared, we had another good quarter driven by our efforts through share of COVID-19 testing while we believe our base business performed in line with the software utilization trends we're seeing in health care. We have raised our full year guidance based on our performance in the quarter, and our expectations for the remainder of 2022.

謝謝，馬克。總而言之，正如 Jim 分享的那樣，我們在 COVID-19 測試份額方面的努力推動了我們另一個良好的季度，同時我們相信我們的基礎業務的表現符合我們在醫療保健領域看到的軟件使用趨勢。我們根據本季度的表現以及對 2022 年剩餘時間的預期，上調了全年指引。

Finally, we're grateful for the efforts of Senate and House members who introduced the saving access to Laboratory Services Act and fully support the passage of this important legislation.

最後，我們感謝參議院和眾議院議員的努力，他們引入了《實驗室服務法案》的儲蓄訪問權，並全力支持這項重要立法的通過。

Now we'd be happy to take any of your questions. Operator?

現在我們很樂意回答您的任何問題。操作員？

(Operator Instructions) Our first question comes from Brian Tanquilut with Jefferies.

（操作員說明）我們的第一個問題來自 Jefferies 的 Brian Tanquilut。

Mark, congrats on the upcoming retirement and thanks for all the help over the years. So I guess, just my question on the base business, I mean, you called out some of the softness, right? I mean do you guys think that it's more COVID driven with the current mini surge that we're seeing? Or just any color you can share with us on that?

馬克，祝賀即將退休，並感謝多年來的所有幫助。所以我想，只是我關於基礎業務的問題，我的意思是，你提到了一些軟性，對吧？我的意思是，你們是否認為我們所看到的當前小幅激增更多是由 COVID 驅動的？或者只是你可以與我們分享的任何顏色？

And maybe I guess, Steve, taking it a little bit further, how are you thinking about the business today as we face a recession down the road in terms of the defensiveness of the volumes and the business overall as we get past COVID?

也許我猜，史蒂夫，更進一步，你如何看待今天的業務，因為我們在過去的 COVID 之後，在交易量和整體業務的防禦性方面面臨衰退的道路上？

Yes, sure. So thanks, Brian, for the question. So as we indicated, we were a little softer in the second quarter where the base business than what we expected in the second quarter. And we do believe there's a relationship, as we have said before, between pickup in COVID infections, and the amount of people that are going into their physicians and to some extent, what's happening with hospitals, even though that's a secondary slowdown, if at all.

是的，當然。所以謝謝，布賴恩，這個問題。因此，正如我們所指出的，我們在第二季度的基礎業務比我們在第二季度的預期要疲軟一些。正如我們之前所說，我們確實相信，在 COVID 感染的增加與就醫的人數以及在某種程度上與醫院發生的事情之間存在關係，即使這是二次放緩，如果在全部。

And the second part of your question is longer term with worries about a potential slowdown in our economy and approaching recession. What's our view on that, and we're taking a hard look at what happened over the last 10 to 15 years of our business. And things did change quite a bit over the last decade, as you know. The first -- over the last recession, the big -- Great Recession, 2008, we have in parallel with that, the Affordable Care Act. We also had changes with health care policy, and we had PAMA, so there's a lot of other effects.

你問題的第二部分是長期的，擔心我們的經濟可能放緩並接近衰退。我們對此有何看法，我們正在認真研究過去 10 到 15 年我們業務中發生的事情。如您所知，在過去十年中，情況確實發生了很大變化。第一次——在上一次經濟衰退中，大——2008 年的大衰退，與此並行的是平價醫療法案。我們還對醫療保健政策進行了更改，並且我們有 PAMA，因此還有很多其他影響。

And so yes, we do believe there may be some impact in our business related to a slowdown in the economy and the recession. We do believe that we're so essential through the delivery of health care and the need for health care going forward that we believe that utilization will continue to be reasonable throughout any up and down in an economic cycle. So -- but we're taking a look at it and we're seeing if there's any differences this time around, as you know, maybe people were saying this is an unusual set of circumstances given what's happened with health care and what's happened in the economy over the last 2 to 3 years.

所以是的，我們確實相信經濟放緩和衰退可能會對我們的業務產生一些影響。我們確實相信，通過提供醫療保健和未來對醫療保健的需求，我們是如此重要，以至於我們相信在經濟周期的任何起伏中，利用率將繼續保持合理。所以 - 但我們正在研究它，我們正在看看這一次是否有任何差異，正如你所知，也許人們會說這是一個不尋常的情況，考慮到醫療保健發生了什麼以及發生了什麼過去 2 到 3 年的經濟狀況。

So Jim, anything you'd like to add to what we see with our base business?

那麼吉姆，您想在我們的基礎業務中添加任何內容嗎？

Yes, Steve, what I would add is, look, we're in close touch with the payers. And the payers have indicated to us, and you saw UnitedHealthcare's announcement earlier this week, that they saw softer utilization of health care services as well. In addition to that, we track a group of Quest accounts that we know are 100% loyal to us. We call it our same-store sales analysis. And we noticed in the quarter that it was basically flat, those accounts that are 100% loyal.

是的，史蒂夫，我要補充的是，看，我們與付款人保持密切聯繫。付款人已經向我們表示，你看到了本週早些時候 UnitedHealthcare 的公告，他們也看到醫療保健服務的使用更加疲軟。除此之外，我們還跟踪一組我們知道 100% 忠誠於我們的 Quest 帳戶。我們稱之為同店銷售分析。我們在本季度注意到基本持平，那些忠誠度為 100% 的賬戶。

So the other thing we look at is just the mix business. And we noticed our general health and wellness panels grew at a lower rate than some of our infectious disease, non-COVID infectious disease and chronic care types of testing that we do. So we -- based on all that information, we come to the conclusion that the base was certainly softer this quarter.

所以我們看到的另一件事就是混合業務。我們注意到，我們的總體健康和健康小組的增長速度低於我們所做的某些傳染病、非 COVID 傳染病和慢性護理類型的測試。所以我們 - 基於所有這些信息，我們得出的結論是，本季度的基數肯定會更加疲軟。

[id="-1" name="Operator" />

[id="-1" name="操作員" />

Our next question is from A.J. Rice with Credit Suisse.

我們的下一個問題來自 A.J.瑞信的賴斯。

I want to offer my congratulations to Mark and best wishes, and welcome, aboard, Sam. Look forward to working with you. Maybe I'll just pivot over to talk about margins. Obviously, within the base business, you've called out some inflationary pressures. They seem like they've been manageable. But you also talked about the Invigorate savings and they're largely offsetting it. I wonder if you could just sort of comment on how you're viewing base business margins? And then I'm assuming also on the COVID-related testing. As long as the PHE is in place, that margin is stable, but has there been any reason to think that, that has changed? We get the aggregate margin, but I'm wondering about the underlying trends there. If you could just comment on it and how much that factored into your back half guidance outlook as well? Any changes?

我想向 Mark 表示祝賀和最良好的祝愿，並歡迎 Sam。期待與您合作。也許我會轉過頭來談談利潤。顯然，在基礎業務中，您已經提出了一些通脹壓力。他們似乎已經可以管理了。但是你也談到了 Invigorate 的儲蓄，他們在很大程度上抵消了它。我想知道您是否可以就您如何查看基本業務利潤率發表評論？然後我還假設與 COVID 相關的測試。只要 PHE 到位，這個邊際就很穩定，但有沒有理由認為這種情況發生了變化？我們得到了總利潤，但我想知道那裡的潛在趨勢。如果您可以對此發表評論，那麼這在您的後半指導前景中也有多少影響？任何變化？

Thanks, A.J., for the questions. Let me start with COVID. So as I mentioned in my prepared remarks, when you look at our COVID business, the good news was a lot more volume, a lot more revenue, a lot more dollars of operating margin. However, with that also goes less pooling, a larger mix shift towards the retail outlets, which have higher expenses. And then we have had some slight erosion versus last year on average reimbursement a couple of dollars, not anything super significant. So the margin percentage was less but still, its contribution to the bottom line from COVID was much higher.

謝謝 A.J. 的提問。讓我從 COVID 開始。因此，正如我在準備好的講話中提到的那樣，當您查看我們的 COVID 業務時，好消息是更多的銷量、更多的收入和更多的營業利潤。然而，隨之而來的是更少的匯集，更多的混合轉向費用更高的零售店。然後，與去年相比，我們平均報銷了幾美元，而不是什麼特別重要的東西。因此，利潤率百分比較低，但它對 COVID 底線的貢獻要高得多。

As we look into the back half at this point, we don't know where the positivity rates are going to go, but we've not assumed a material change in the amount of pooling. We would expect to continue with the current mix or potentially grow that as a proportion of our total COVID volumes. So within the ranges, that's kind of how we're seeing the balance of the year play out on COVID.

當我們在這一點上查看後半部分時，我們不知道陽性率會去哪裡，但我們並沒有假設匯集量發生重大變化。我們預計將繼續使用當前的組合，或者可能將其作為我們總 COVID 量的比例增加。因此，在這些範圍內，這就是我們看到今年餘下時間在 COVID 上的表現。

So if the positivity rate drops down and the positive rate, I'm looking at Jim here, has been as high as we've seen through the pandemic, now a lot more people are doing rapid antigen testing and so on, we believe that the cases are underreported. But we believe that the prevalence of COVID right now is extremely high. And so in the earlier answer that we provided to Brian around the base business, there has been a historical negative correlation between those. And we do believe that the base business has absolutely been impacted by the surge in COVID. We just aren't sure how long it will last.

因此，如果陽性率下降並且陽性率，我在這裡看吉姆，一直與我們在大流行中看到的一樣高，現在有更多的人在進行快速抗原檢測等等，我們相信這些案件被少報。但我們認為，目前 COVID 的流行率非常高。因此，在我們之前圍繞基礎業務向布賴恩提供的答案中，它們之間存在歷史上的負相關。我們確實相信基礎業務絕對受到了 COVID 激增的影響。我們只是不確定它會持續多久。

On the base business, we've shared that as we built our plan and the ranges for 2022, we built in a higher SWB, salary work benefits assumption that was in our guidance. And certainly, that's something we control, and that's really within expectations. We have a couple of billion dollars that we have long-term contracts. And so really not exposed to inflation in a short window for that. But then we have some other costs where we don't have long-term contracts, and there are things that everybody is familiar with and you've heard from other companies as well, things like fuel, things like housekeeping, security, temporary labor. And so those areas have been a little more inflationary than we would have anticipated going into the year. The good news is those are in our results year-to-date during our guidance.

在基礎業務方面，我們已經分享了在製定 2022 年計劃和範圍時，我們建立了更高的 SWB，工資工作福利假設，這是我們的指導。當然，這是我們可以控制的，這確實在預期之內。我們有幾十億美元的長期合同。因此，在短期內確實不會受到通貨膨脹的影響。但是我們還有一些其他成本，我們沒有長期合同，有些事情大家都很熟悉，你也從其他公司聽說過，比如燃料，比如家政、安保、臨時工.因此，這些領域的通脹率比我們今年預期的要高一些。好消息是，在我們的指導期間，這些都是我們今年迄今為止的結果。

We're not expecting that to go away immediately. We certainly hope it's not long-term inflation unlike where if you have wage inflation, you generally expect will continue. If you add contractual inflation with your key suppliers around reagents and other things that might be longer term as well or certainly a couple of years. We don't know how long this spike is going to last. But I can tell you, it's probably like $0.05 to $0.08 a quarter in the first half, and we're not expecting that to change. We hope it might but in the guidance that we provided. So hopefully, that's helpful, A.J.

我們不希望這種情況立即消失。我們當然希望這不是長期通脹，不像如果你有工資通脹，你通常預計會持續下去。如果您與您的主要供應商就試劑和其他可能長期或肯定幾年的事情增加合同通脹。我們不知道這個峰值會持續多久。但我可以告訴你，上半年可能每季度 0.05 到 0.08 美元，我們預計這種情況不會改變。我們希望它可以，但在我們提供的指導下。所以希望這會有所幫助，A.J.

And A.J., just so it's clear. You all know that the Emergency Act has been extended and so we're assuming in our guidance that will be extended through October, but we're not assuming in our guidance that it extends past October until we have certainty around that, okay? So that is the assumption and what we've just provided for guidance for the remainder of the year.

還有 A.J.，很清楚。你們都知道緊急法案已經延長，所以我們在指導中假設將延長到 10 月，但我們不會在指導中假設它會延長到 10 月，直到我們確定這一點，好嗎？這就是我們剛剛為今年剩餘時間提供指導的假設和內容。

And I think since you asked, A.J., Jim, why don't you comment a little bit about the opportunities we still see around the bigger rate, and you mentioned in our opening remarks about the things we have changed. But why don't you chat a little bit about why we're still bullish on the prospects of improving productivity.

我想既然你問了，A.J.，Jim，你為什麼不評論一下我們仍然看到的更高利率的機會，你在我們的開場白中提到了我們已經改變的事情。但是你為什麼不聊一聊為什麼我們仍然看好提高生產力的前景。

Yes. So A.J., as we've talked in the past, there's still certainly a lot of opportunity around automation of manual processes in the laboratory. I touched on in my comments around some of the automated check-in procedures. So we've long had appointment scheduling. What we've added recently is when a patient walks into the PSC without an appointment, you actually go to the check in and you -- and if the wait room is full, you schedule an appointment at that point. And what we've seen is it really does help productivity in the PSC, as well as if the patient leaves, they may not come back to Quest. If they make an appointment to come back in 2 hours or the next day, we feel like the patient retention is better. But automation, the use of artificial intelligence in terms of readouts of manual curves and laboratories, all of that work continues.

是的。所以 A.J.，正如我們過去所說，在實驗室手動流程自動化方面肯定還有很多機會。我在評論中談到了一些自動登記程序。所以我們早就有預約安排了。我們最近添加的是，當患者未經預約而走進 PSC 時，您實際上是去辦理登機手續，而您——如果候診室已滿，您可以在那時安排預約。我們看到的是，它確實有助於提高 PSC 的工作效率，而且如果患者離開，他們可能不會再回到 Quest。如果他們預約在 2 小時內或第二天回來，我們覺得患者保留更好。但是自動化，在手動曲線和實驗室讀數方面使用人工智能，所有這些工作仍在繼續。

And then I'd tell you, the other thing that will help continue to drive productivity is our work around retention of our employees. So our productivity, like all companies, we're seeing a much higher increase in turnover. We feel like it is stabilized, albeit at a higher point. So as we now drive retention higher and turnover lower that will certainly help our productivity efforts in the back half of the year.

然後我會告訴你，有助於繼續提高生產力的另一件事是我們圍繞留住員工的工作。所以我們的生產力，就像所有公司一樣，我們看到營業額的增長要高得多。我們覺得它已經穩定了，儘管處於更高的點。因此，隨著我們現在提高留存率和降低營業額，這肯定會有助於我們在下半年提高生產力。

And I just want to add one thing about [peace] in the back half. Steve talked about the potential for the PHE to not be extended which at this point, we're not assuming it does extend. But I want to remind people that the price drop is not a full margin drop because when we get to beyond the PHE, first off, there's not absolute certainty, but most people would expect the positivity rate will be significantly lower. We can pool a lot more. So we can get some margin offset there dollar-wise.

我只想在後半區添加關於[和平]的一件事。 Steve 談到了 PHE 不擴展的可能性，在這一點上，我們不假設它確實擴展了。但我想提醒人們，價格下降並不是全部利潤下降，因為當我們超過 PHE 時，首先，並沒有絕對的確定性，但大多數人預計陽性率會顯著降低。我們可以匯集更多。所以我們可以在美元方面獲得一些保證金抵消。

And then the second one is that the retail relationships that we have will change in the structure. We know how that's going to work. And basically, the significant costs we're incurring right now to get that volume for the retail outlets will go away because it's only permitted under the PHE. It's complicated, but it will go away. So while the value per requisition will drop to whatever price we end up with, and people have talked about the CMS rate that was originally published and certainly, that's potential, over time, that's not all a margin hit because there's some other costs that go away.

然後第二個是我們擁有的零售關係將在結構上發生變化。我們知道這將如何運作。基本上，我們現在為零售店獲得該數量而產生的巨大成本將消失，因為它僅在 PHE 下允許。這很複雜，但它會消失。因此，雖然每次申請的價值會下降到我們最終得到的任何價格，而且人們已經談到了最初發布的 CMS 費率，當然，隨著時間的推移，這是有潛力的，但這並不是所有的利潤損失，因為還有一些其他成本離開。

So we still will make a decent percentage margin, certainly fewer dollars per patient encounter. But I just want to make sure people are clear that COVID profitability doesn't fall completely off the cliff when the PHE goes away.

因此，我們仍然會獲得可觀的百分比利潤，每次遇到患者的費用肯定會減少。但我只是想確保人們清楚，當 PHE 消失時，COVID 的盈利能力不會完全跌落懸崖。

Our next question is from Jack Meehan with Nephron Research.

我們的下一個問題來自 Nephron Research 的 Jack Meehan。

First, Sam, congrats. I think you're going to be a great for the Quest. And Mark, of course, really enjoyed working together. But before you go, I do have more margin questions for you here.

首先，山姆，恭喜。我認為你會成為 Quest 的佼佼者。當然，馬克真的很喜歡一起工作。但在你走之前，我確實有更多的保證金問題要問你。

Let me go otherwise, Jack, Thanks.

讓我走，傑克，謝謝。

Of course. So specifically, can you just talk about what was the COVID testing margin in the quarter? Or how did it compare to the overall margin? And I guess what I'm trying to get into is just like how much of the sequential step down in earnings might have been related to the margin impacts you've talked about?

當然。所以具體來說，你能談談本季度的 COVID 測試利潤率是多少嗎？或者它與整體利潤率相比如何？我想我想了解的是，收益的連續下降有多少可能與你所說的利潤率影響有關？

Yes. So Jack, as you know, we don't provide specific margins on subsegments of our business. But what I can give you directionally is I referred to half of our volume coming from retail channels or nontraditional channels and we talked about dollar-wise, what the incremental cost per counter is there.

是的。所以傑克，如你所知，我們不提供我們業務子部分的特定利潤。但我可以給你的指導是我提到了我們一半的銷量來自零售渠道或非傳統渠道，我們談到了美元，每個櫃檯的增量成本是多少。

A year ago, in the second quarter, it was about 1/3 of our volume. So you can see that's pretty significant. In the second quarter last year, we did quite a bit of pooling, and that's varied in the interim quarters between that and now, but there was quite a bit of pooling last year because the positivity rate had fallen -- very well. I think many of us by June of last year were thinking this might have been behind us before Delta hit us. And this quarter, we expected in our plans to do quite a bit of pooling, but in reality, it was not a large amount. So that should give you a little bit of idea.

一年前，在第二季度，它大約是我們交易量的 1/3。所以你可以看到這是非常重要的。去年第二季度，我們進行了相當多的合併，從那時到現在的中間季度有所不同，但去年有相當多的合併，因為陽性率下降了——非常好。我認為到去年 6 月，我們中的許多人都認為這可能在達美航空襲擊我們之前就已經過去了。本季度，我們預計在我們的計劃中會進行相當多的匯集，但實際上，這並不是一個很大的數量。所以這應該給你一點想法。

The other thing I did mention a couple of dollars erosion on the average reimbursement. So I think you got all the pieces, not going to provide a specific number, but that should help you understand. But I think the key thing is that the dollars we earned off COVID was much better than our plans. And that's -- and we expect it to continue, and that's why we're rising guidance. So while the percentage was worse, the dollar bottom line was better.

我提到的另一件事是平均報銷損失了幾美元。所以我認為你已經掌握了所有內容，不會提供具體的數字，但這應該有助於你理解。但我認為關鍵是我們從 COVID 中賺到的錢比我們的計劃要好得多。這就是 - 我們預計它會繼續下去，這就是我們提高指導的原因。因此，雖然百分比更差，但美元的底線更好。

Yes, Jack, as you know, in Q1, we did about $600 million worth of COVID. And in the second quarter that we're talking about right now, it was roughly $350 million. So that was a material change in COVID. And as Mark has gone through, there's a lot more dynamics in what the margin is in COVID. But essentially, that sequential compare and our margin drop is primarily related to the drop in COVID testing.

是的，傑克，如您所知，在第一季度，我們處理了價值約 6 億美元的 COVID。在我們現在談論的第二季度，大約是 3.5 億美元。所以這是COVID的重大變化。正如馬克所經歷的那樣，COVID 的利潤空間有很多動態變化。但本質上，這種連續比較和我們的利潤率下降主要與 COVID 測試的下降有關。

Got it. If I can squeeze in one more on the core business. What are your expectations for merit increases and SW&B this year? Have that changed at all?

知道了。如果我能在核心業務上再擠一擠。您對今年的加分和 SW&B 有什麼期望？這完全改變了嗎？

Jim, do you want to take that?

吉姆，你想拿那個嗎？

No, it hasn't changed at all, Jack. We said 3% to 4% for the year. We're still within that guidance. We've already provided the merit increase for the year. We do that annually in the April time frame. So it's already in the Q2 numbers for sure.

不，它根本沒有改變，傑克。我們說今年是 3% 到 4%。我們仍在該指導範圍內。我們已經提供了本年度的加分。我們每年都會在 4 月的時間範圍內這樣做。所以它肯定已經在第二季度了。

Yes. As Jim referenced, the vast majority of our increase has already taken place. Certainly, like all other companies, we have some off-cycle adjustments based on promotions and other things. But most of the "inflationary headwinds" in SWB were incurred in the second quarter.

是的。正如吉姆所提到的，我們的大部分增長已經發生。當然，像所有其他公司一樣，我們會根據促銷和其他因素進行一些非週期調整。但 SWB 的大部分“通脹逆風”發生在第二季度。

So if you look sequentially, that's one of the drivers of margin reduction first quarter to second quarter. That's been a historical event as well. That's not new. But we don't anticipate going forward to see significant inflation beyond kind of the run rate we were on in Q2.

因此，如果您按順序查看，這是第一季度到第二季度利潤率下降的驅動因素之一。這也是一個歷史事件。這並不新鮮。但我們預計未來不會出現超出我們在第二季度的運行率的顯著通脹。

Jim and I actually in a couple of financial conferences try to dimensionalize what's going on with our wage bill. And we talked about of the 50,000 people that the most pressure we see is what there really are real frontline people, and they're primarily what we call specimen processors. When the specimens come into our laboratories, they do the sorting, it's a tough job. It's at night, and we're paying them, we think, fairly, and we've increased that for their hourly wages. And the second is couriers.

吉姆和我實際上在幾個財務會議上試圖對我們的工資單上發生的事情進行維度分析。我們談到了 50,000 人，我們看到的最大壓力是真正的一線人員，他們主要是我們所說的標本加工者。當標本進入我們的實驗室時，他們會進行分類，這是一項艱鉅的工作。現在是晚上，我們正在公平地支付他們，我們認為，我們已經增加了他們的小時工資。第二個是快遞員。

And to give you an idea because it is the area of most pressure, roughly, it's about 10% to 11% of our workforce salary, okay? So -- and at the same time, it represents a larger percentage of our workforce count of the 50,000 people. So that's where we have the most pressure. So even if that number went up, considerably, you get an idea of the impact that would have on our margins. So that's where we see the most pressure, okay?

給你一個想法，因為這是壓力最大的領域，大約是我們員工工資的 10% 到 11%，好嗎？所以 - 同時，它代表了我們 50,000 人的勞動力總數的更大比例。所以這是我們壓力最大的地方。因此，即使這個數字大幅上升，您也會對我們的利潤產生的影響有所了解。所以這是我們看到最大壓力的地方，好嗎？

Our next question is from Patrick Donnelly with Citi.

我們的下一個問題來自花旗銀行的 Patrick Donnelly。

Sam, looking forward to continue to work with you and not to put you on the spot on your first call here. But I'm sure on the way in, as you know, there's a lot of questions as you've seen on this call already in terms of the margin and the margin profile going into kind of next year as we work our way through kind of the high margin COVID coming out, some of the expenses around DTC and retail, wage inflation. I guess when you came in and Mark, feel free in to chime in obviously, but Sam, I guess how did you get comfortable with that? It would just be helpful maybe to hear your perspective on that as I'm sure it was a key consideration, something you dug into on your way in, and I know investors are hyper focused on that piece as well. So if you're willing, I would love to hear your general thoughts on kind of how we work our way through the margin side as we kind of work our way into next year.

山姆，期待繼續與您合作，而不是在您第一次來這裡時讓您陷入困境。但我敢肯定，正如你所知，正如你在本次電話會議上看到的那樣，在保證金和明年的保證金情況方面存在很多問題，因為我們正在努力通過種類高利潤的 COVID 出現，一些 DTC 和零售費用，工資通脹。我想當你進來馬克時，顯然可以隨意插話，但是山姆，我想你是怎麼適應的？聽聽您對此的看法可能會有所幫助，因為我確信這是一個關鍵的考慮因素，您在進入的過程中會深入研究，而且我知道投資者也非常關注該部分。因此，如果您願意，我很想听聽您對我們如何在邊際方面工作的一般想法，因為我們正在努力進入明年。

Yes. Patrick, thanks for the welcome, and I look forward to working with you and the rest of the folks on the call as well. Listen, it's really early days. I've been here in -- I'm in my second week here. So all I can tell you is coming in, obviously, we're in a challenging environment right now. But Quest has an incredible reputation with incredible people that really provide a significant value to health care. So I've been so far really impressed with the passion that I've seen people here, the knowledge and the contributions that I think we can make in health care.

是的。帕特里克，感謝您的歡迎，我也期待與您以及電話會議上的其他人一起工作。聽著，現在還很早。我來過這裡——我在這裡的第二週。所以我只能告訴你，很明顯，我們現在正處於一個充滿挑戰的環境中。但 Quest 在真正為醫療保健提供重要價值的令人難以置信的人中享有令人難以置信的聲譽。所以到目前為止，我對在這裡看到人們的熱情、我認為我們可以在醫療保健方面做出的知識和貢獻印象深刻。

So I'm going to punt a little bit on your question because it's really early days and really ask Mark to more comment on it, but I'm very excited about how we can work through these challenges. But it's really early days, Patrick. I'm in my second week here. So I'll let maybe Mark talk about it more.

所以我要對你的問題稍加評論，因為現在還很早，真的要求馬克對此發表更多評論，但我對我們如何應對這些挑戰感到非常興奮。但現在還為時尚早，帕特里克。我在這裡的第二週。所以我會讓馬克多談一談。

Yes. So Patrick, appreciate the question. We know where people's heads are at right now around the business and that's where ours are as well. So I can assure you we're spending a lot of time on that. We've spent a lot of time on that.

是的。所以帕特里克，感謝這個問題。我們知道人們的頭腦現在在業務中的位置，這也是我們的位置。所以我可以向你保證，我們在這方面花費了很多時間。我們在這方面花了很多時間。

There's a number of things that we generally control. And then there are some things that are a little bit less in our control. So we do our best to forecast those things. We put together ranges. And then we -- I think and believe we're very transparent with you about how those things play out. So you get a sense of, okay, well, what really is going on in the business?

我們通常可以控制許多事情。還有一些事情是我們無法控制的。因此，我們盡最大努力預測這些事情。我們把範圍放在一起。然後我們 - 我認為並相信我們對您非常透明地了解這些事情的結果。所以你會感覺到，好吧，好吧，業務中到底發生了什麼？

And because of that, I believe that, generally, we've not surprised people. And we've given you delivered on your expectations. We've given you timely updates. We've given you interim information. And based on my time with Sam and I think the team here, I would expect that to continue. So you would expect that with my departure that we're not going to change the way we talk to, the way we share, give all those updates. I think everybody appreciates what a great job Shawn does and know they can call them any time, any place and get him and he'll be as transparent as possible.

正因為如此，我相信，一般來說，我們並沒有讓人們感到驚訝。我們已經滿足了您的期望。我們已為您提供及時更新。我們已經為您提供了臨時信息。根據我與 Sam 相處的時間以及我認為這裡的團隊，我希望這種情況會繼續下去。所以你會期望，隨著我的離開，我們不會改變我們交談的方式，我們分享的方式，提供所有這些更新。我認為每個人都欣賞肖恩所做的出色工作，並且知道他們可以在任何時間、任何地點給他們打電話並找到他，他會盡可能地透明。

So really, I think what it comes down to is, I believe we're focused on the right things. And also, I believe we do our best job of being as transparent as possible around all those key drivers.

所以說真的，我認為歸根結底是，我相信我們專注於正確的事情。而且，我相信我們會盡最大努力使所有這些關鍵驅動因素盡可能透明。

Yes, that's helpful. I appreciate it guys. And then Steve, maybe a quick one. You've continued to talk about more constructive conversations with some of the covering lives and payers. Can you just talk about, I guess, the kind of outlook on pricing? It seems as confident as you guys have sounded on that front in years. Maybe just talk about how you're feeling on the pricing side given some of those payer conversations?

是的，這很有幫助。我很感激伙計們。然後是史蒂夫，也許很快。您繼續與一些報導生活和付款人談論更具建設性的對話。我猜你能談談定價前景嗎？這似乎和你們多年來在這方面聽起來一樣自信。考慮到一些付款人的談話，也許只是談談你在定價方面的感受？

Yes. So thanks for the question. And we are very pleased with the progress we have made with all payers and where we are today versus when I started, which was over 10 years ago. We've got a network now that is the strongest network that we've ever had. And I would say our relationship with all the significant payers, national and regional is very strong. And they are increasingly realizing that it's good for their membership and good for their competitiveness in the market to have us in the network, and we bring a lot of value. And so we're entirely focused on what we call powering affordable care, which is consistent with what Jim has driven in the company around making sure that we have great quality, great service and a great experience.

是的。所以謝謝你的問題。我們對與所有付款人取得的進展以及我們今天所處的位置以及我在 10 多年前開始時所取得的進展感到非常滿意。我們現在擁有一個網絡，這是我們曾經擁有的最強大的網絡。我想說我們與所有重要的付款人，國家和地區的關係非常牢固。他們越來越意識到，讓我們加入網絡對他們的會員資格和市場競爭力有好處，我們帶來了很多價值。因此，我們完全專注於我們所謂的為負擔得起的護理提供動力，這與吉姆在公司中推動確保我們擁有優質、優質服務和優質體驗的理念是一致的。

And you heard earlier from Jim as we continue to push on just working smarter, and by working smarter, we're getting more productivity, but we're also going to have a better product. And payers understand that. And so as Jim mentioned, we have gotten some increases from the payers over the last several negotiation rounds. We continue to believe that is something we're going to continue to push for because we do bring a lot of value in the marketplace. And we're very competitive in the marketplace.

您之前從 Jim 那裡聽到，我們繼續推動更聰明地工作，通過更聰明地工作，我們將獲得更高的生產力，但我們也將擁有更好的產品。付款人明白這一點。正如吉姆所說，在過去的幾輪談判中，我們從付款人那裡得到了一些增加。我們仍然相信這是我們將繼續推動的事情，因為我們確實在市場上帶來了很多價值。我們在市場上非常有競爭力。

And so if you look at the price effect that we saw in the quarter and what we have typically said in the past historically, remember, historically, we said you should plan at about 100 basis points with the price effect. Well, in this quarter, in the last quarter, we've actually saw less than that. And that's the best position we bet in. And I will share within that envelope, the commercial payer portion of it is significantly less than where we've been historically. But we still see pressure with price, with our hospital business, with our client bill business and that's in that envelope as well. But on the commercial payer side, we're in a very different place than we were before.

因此，如果您查看我們在本季度看到的價格效應以及我們過去通常所說的歷史，請記住，從歷史上看，我們說您應該計劃在大約 100 個基點的價格效應。好吧，在本季度，在上一季度，我們實際上看到的比這要少。這是我們下注的最佳位置。我將在這個信封內分享，其中的商業付款人部分明顯低於我們歷史上的水平。但是我們仍然看到價格壓力，我們的醫院業務，我們的客戶賬單業務，這也在那個信封裡。但在商業付款人方面，我們所處的位置與以前截然不同。

And I'll share with you a part of Jim and I on my transition is Jim and I are going into the nationals and the regional payers, and we're talking about what we've done in the past and more importantly, what we're doing in the future. We just had a meeting last week with one of the national payers and they see us as a much more significant player in the marketplace than what people think about us as, which is a laboratory. We're much more of the lab. We actually help them improve the value of health care going forward. So a much better place than where we were in a good place right now.

我將與您分享吉姆和我在過渡期間的一部分，吉姆和我將進入國民和地區付款人，我們正在談論我們過去所做的事情，更重要的是，我們'在未來做。上週我們剛剛與一個國家付款人舉行了一次會議，他們認為我們是市場上的重要參與者，而不是人們對我們的看法，即實驗室。我們更像是實驗室。我們實際上幫助他們提高未來醫療保健的價值。所以比我們現在的好地方要好得多。

And so what I will add is that we really moved the needle on commercial. Over the last couple of years, we've talked about more pricing pressure in the client bill, which is, as Steve referenced the hospital and then in some cases, where we contract directly with physicians. But instead of being a headwind on price, I will tell you that starting next year and going forward, I would expect that -- to be at least neutral, if not a tailwind. So we've moved it from a major headwind to be at least neutral and more likely positive. So wanted to dimensionalize a little more why you're hearing the positive comments for us.

所以我要補充的是，我們確實推動了商業廣告的發展。在過去的幾年裡，我們在客戶賬單中談到了更多的定價壓力，也就是說，正如史蒂夫提到的醫院，然後在某些情況下，我們直接與醫生簽約。但是，與其成為價格的逆風，我會告訴你，從明年開始並展望未來，我希望這至少是中性的，如果不是順風的話。因此，我們已將其從主要逆風轉變為至少是中性的，更有可能是積極的。所以想進一步說明為什麼您會聽到對我們的積極評價。

And it's in really recognition of what Steve said, which is our strategic value to them. We're not a commoditized provider of a laboratory result. There's so much more to how we're helping them and then these value-based contracts that we referenced were based on performance, we can earn a better payment for ourselves. And so because of that, we really, really moved the environment and the relationships with the commercial payers.

這是對史蒂夫所說的話的真正認可，這是我們對他們的戰略價值。我們不是實驗室結果的商品化提供者。我們幫助他們的方式還有很多，然後我們引用的這些基於價值的合同是基於績效的，我們可以為自己賺取更好的報酬。正因為如此，我們真的，真的改變了環境以及與商業支付者的關係。

Our next question is from Pito Chickering with Deutsche Bank.

我們的下一個問題來自德意志銀行的 Pito Chickering。

Mark, it's a pleasure working with you over these years. And Sam, I look forward to working with you in the future. Quick two part on the inflation side. So the first one is a follow-up on the pricing question that you just gave. Can you quantify what the better commercial rates are for 2023 because you priority locked it in at this point versus 2022?

馬克，很高興與您合作這些年。還有山姆，我期待著在未來與你合作。充氣方面的快速兩部分。因此，第一個問題是對您剛剛提出的定價問題的跟進。您能否量化 2023 年更好的商業費率是什麼，因為與 2022 年相比，您此時優先鎖定它？

And then a follow-up on A.J.'s question just to make sure I understand, you were seeing an additional $0.05 to $0.08 of inflationary pressures. Was that more or less than you expected when you guys gave guidance on the fourth quarter call? And then on previous calls, you talked about sort of the 2023 EPS of $8.50. Should we add those inflationary pressures against that $8.50? Or can you offset those with increased efficiency as well as the new recent COVID retail agreements you've done?

然後跟進 A.J. 的問題，以確保我理解，你看到了額外的 0.05 至 0.08 美元的通脹壓力。當你們在第四季度電話會議上給出指導時，這比你預期的多還是少？然後在之前的電話會議上，您談到了 2023 年每股收益 8.50 美元。我們是否應該在 8.50 美元的基礎上加上通脹壓力？或者您能否抵消那些提高效率的措施以及您最近簽訂的新 COVID 零售協議？

Well, thanks for all the questions, Pito. I'll start with 2023. We've not locked down our plan. And if we did, we generally don't give specific guidance until our fourth quarter earnings call. And I'll leave it to the management team. I'll be leaving exactly when they decide to do that, but we're not going to comment any specifics around 2023.

好吧，謝謝所有的問題，皮托。我將從 2023 年開始。我們還沒有鎖定我們的計劃。如果我們這樣做了，我們通常不會在第四季度財報電話會議之前給出具體指導。我會把它留給管理團隊。我會在他們決定這樣做的時候離開，但我們不會在 2023 年左右評論任何細節。

In terms of the amount of the increases, again, I'm not going to dimensionalize. We don't have a planned lockdown. But we have enough contracts that are already set for next year and enough progress on some that are either, as we referenced like Florida Blue or some others that are getting close to being locked down for renewal that I have confidence to say what I said, which is, this is not going to be a next year for us on a price perspective...

再說一次，就增加的數量而言，我不打算進行維度化。我們沒有計劃的封鎖。但是我們已經為明年制定了足夠的合同，並且在一些合同方面取得了足夠的進展，正如我們提到的佛羅里達藍或其他一些接近被鎖定以續約的合同，我有信心說出我所說的話，也就是說，從價格的角度來看，這對我們來說不會是明年……

So just to add to that, so what you're hearing from us is, yes, we hear your comments about inflation. And yes, we have inflationary pressure. And yes, we're managing that. But what you're also hearing from us is we're in a better price position than we've been in. You need to think about that too and thinking about the prospect of what we're going to do in '23. We're not going to provide guidance. But we still feel confident with what we shared at Investor Day in 2021 around the prospects of what we're going to do going forward.

補充一點，你從我們這裡聽到的是，是的，我們聽到了你對通貨膨脹的評論。是的，我們有通脹壓力。是的，我們正在管理它。但是您還從我們那裡聽到的是，我們的價格狀況比以往更好。您也需要考慮這一點，並考慮我們在 23 年將要做什麼的前景。我們不會提供指導。但我們仍然對我們在 2021 年投資者日分享的關於我們未來將要做的事情的前景充滿信心。

And yes, so I was going to continue that what you're hearing from us is what's happening now, Pito. And the $0.05 to $0.08 is more inflation than we would have anticipated. However, other things have changed as well. Most notably, we did a lot more COVID. So we delivered a lot more earnings. So just like we don't expect the high level of COVID, and we could be wrong to expect and continue into 2023.

是的，所以我要繼續說你從我們那裡聽到的就是現在正在發生的事情，Pito。 0.05 美元到 0.08 美元的通貨膨脹比我們預期的要高。然而，其他事情也發生了變化。最值得注意的是，我們做了更多的 COVID。所以我們帶來了更多的收益。因此，就像我們不期望高水平的 COVID 一樣，我們期望並持續到 2023 年可能是錯誤的。

Also, we'd be really disappointed if the inflation we're seeing in the noncontracted areas were to carry to 2023. But even if it does, we've got multiple pieces that are moving, including a better pricing environment in the commercial book. So in no way, shape or form, are we saying that when you put all these together, that, that $8.50 or in that range is not something we're still confident in.

此外，如果我們在非合同領域看到的通脹持續到 2023 年，我們會感到非常失望。但即使確實如此，我們也有多個方面正在發生變化，包括商業賬簿中更好的定價環境.因此，無論如何，形狀或形式，我們不是說當你把所有這些放在一起時，那個 8.50 美元或在那個範圍內不是我們仍然有信心的東西。

Our next question is from Ricky Goldwasser with Morgan Stanley.

我們的下一個問題來自摩根士丹利的 Ricky Goldwasser。

Mark, wishing you best of luck in the future and really enjoyed working with you. So thank you for all the color always and your patience.

馬克，祝你未來好運，真的很喜歡和你一起工作。所以感謝你一直以來的所有顏色和你的耐心。

In terms of the question, I just want to go back to the utilization environment. I mean you gave some color there, but what we're hearing from the managed care companies is that the softness that they're seeing is the ER visits and inpatient admissions, which shouldn't really have an impact on lab testing, right, if it's more outside the four walls of the hospitals. So can you maybe give us color on where are you seeing softness in utilization by geography and maybe by end market, i.e., what type of test? And how do you think about it, right, sort of 2.5 years into the pandemic? What's structural in the software utilization versus transition in your view?

關於問題，我只想回到使用環境。我的意思是你在那裡給了一些顏色，但我們從管理式醫療公司那裡聽到的是，他們看到的是急診室就診和住院病人，這不應該真的對實驗室測試產生影響，對，如果它在醫院的四堵牆之外。那麼，您能否告訴我們您在哪些地方看到了地理和終端市場的使用疲軟，即什麼類型的測試？您如何看待它，對，大流行已經過去了 2.5 年？在您看來，軟件使用與轉換的結構是什麼？

If I can just start quickly and then I'll pass it on to Jim. So Ricky, our source is not just seeing their medical loss ratios. But I'd point to two things in addition to what Jim talked about earlier, which is our same-store sales as we call it.

如果我能快速開始，然後我會把它傳給吉姆。所以瑞奇，我們的消息來源不僅僅是看到他們的醫療損失率。但除了 Jim 之前所說的之外，我還要指出兩件事，即我們所說的同店銷售。

So one is we actually get data from the payers, okay, in total. So we know how many patient encounters they had for laboratory work. We know what our volume was and we can see that. The good news is we continue to gain share in those commercial books. However, we continue to see their total volume has been down, certainly in the second quarter. So it's payer data that's being provided by them to us that is the confidence to say, utilization has dipped in our space.

所以一個是我們實際上從付款人那裡獲得數據，好吧，總的來說。所以我們知道他們在實驗室工作中遇到了多少病人。我們知道我們的音量是多少，我們可以看到這一點。好消息是我們繼續在這些商業書籍中獲得份額。但是，我們繼續看到它們的總銷量一直在下降，當然是在第二季度。因此，正是他們向我們提供的付款人數據，我們才有信心說，我們的空間利用率已經下降。

The other one is I'd point to the [Xyphondata] data, which is based on billings of other independent labs. And if you look at that, that certainly suggests that utilization is down. So while you may be hearing its emergency room and inpatient, the data that we have and the best data we have also suggests that the market in which we operate is also depressed in the second quarter.

另一個是我會指出 [Xyphondata] 數據，該數據基於其他獨立實驗室的帳單。如果你看一下，那肯定表明利用率下降了。因此，儘管您可能聽到它的急診室和住院病人，但我們擁有的數據和我們擁有的最佳數據也表明，我們經營的市場在第二季度也處於低迷狀態。

And the second part is, remember COVID and we're 2 years into it. And every time COVID infections go up, our base business comes down some. And if you think about a physician and what they need to do to run their offices and as you know, a large portion of our business is through physicians in their offices, if there's call outs of their staff or if their patients are missing their appointments because they are now infected, it affects volume. So there's no question there's a correlation.

第二部分是，記住 COVID，我們已經研究了 2 年。每次 COVID 感染增加時，我們的基礎業務都會下降一些。如果您考慮一下醫生以及他們需要做什麼來運營他們的辦公室，並且如您所知，我們的很大一部分業務是通過他們辦公室的醫生，如果他們的員工有呼叫或者他們的患者錯過了他們的約會因為他們現在被感染了，所以會影響音量。所以毫無疑問存在相關性。

And the good news for us is when that happens, our COVID business goes up, right? So Jim, why should...

對我們來說，好消息是當這種情況發生時，我們的 COVID 業務就會上升，對嗎？那麼吉姆，為什麼要...

Ricky, the last thing I'd say is we're not immune to hospital. The inpatient work -- remember, we get $1 billion a year in reference work. We have another $0.5 billion in PLS. So when inpatient and outpatient procedures are down, that certainly does affect our business on the health system, hospital side.

瑞奇，我要說的最後一件事是我們不能對醫院免疫。住院工作——請記住，我們每年獲得 10 億美元的參考工作。我們還有 5 億美元的 PLS。因此，當住院和門診程序減少時，這肯定會影響我們在衛生系統和醫院方面的業務。

On the physician office side, again, we closely look at a set of accounts spread across the country that we know are 100% loyal to Quest, and we measure that we call it same-store sales. Again, our general health and wellness panels from a mix standpoint, were certainly lower than some of our chronic disease panels in the quarter.

在醫師辦公室方面，我們再次仔細研究了遍布全國的一組賬戶，我們知道這些賬戶 100% 忠誠於 Quest，我們將其稱為同店銷售額。同樣，從混合的角度來看，我們的一般健康和保健面板肯定低於本季度我們的一些慢性病面板。

And then the last thing, geographic mix. We've talked and it hasn't changed dramatically that our book of business in New York City is down still low to mid-double digits. On the other hand, we see incredibly strong growth in the southern part of the country, in the southeast portion as well as the southwest and parts of the West. So if there's been a population migration out of New York City into the southeast, then we're certainly seeing some of that in our business.

然後是最後一件事，地理組合。我們已經談過了，但我們在紐約市的商業賬簿仍然下降到兩位數中低位，但並沒有發生太大變化。另一方面，我們看到該國南部、東南部以及西南部和西部部分地區的增長令人難以置信。因此，如果有人口從紐約市遷移到東南部，那麼我們肯定會在我們的業務中看到其中的一些。

Our next question is from Derik De Bruin with Bank of America.

我們的下一個問題來自美國銀行的 Derik De Bruin。

This is John on for Derik. And thanks for all the colors and thanks for being out the initiatives [for renew] you were going to ask. But in addition to that, and in addition to the price increases you're expecting and the plan to clamp down the employee turnover, how should we think about the incremental spend in 2023? Are you thinking about ramping these down to offset the inflationary pressure?

這是德里克的約翰。並感謝所有的顏色，並感謝您提出您要提出的[更新]倡議。但除此之外，除了您預期的價格上漲和遏制員工流動的計劃之外，我們應該如何考慮 2023 年的增量支出？您是否正在考慮降低這些以抵消通脹壓力？

And on PAMA, could you just remind us what your expectations are in '23, especially if nothing else happens on the legislative front?

在 PAMA 上，您能否提醒我們您對 23 年的期望是什麼，尤其是在立法方面沒有發生任何其他事情的情況下？

Yes. So in terms of 2023, as Mark said, there's a lot of moving parts at this point. We're committed to investments in advanced diagnostics. We're committed to investments in our consumer direct consumer initiated testing business. Obviously, we can modulate those things if we see inflation getting worse. But at this point, we can't give you any further guidance than what we've given you around those. We're committed to advanced diagnostics, we're committed to our clinical -- our consumer direct -- consumer-initiated testing business. In terms...

是的。因此，正如馬克所說，就 2023 年而言，此時有很多活動部分。我們致力於投資先進的診斷技術。我們致力於投資於我們的消費者直接消費者發起的測試業務。顯然，如果我們看到通貨膨脹變得更糟，我們可以調整這些事情。但在這一點上，除了我們在這些方面為您提供的指導之外，我們無法為您提供任何進一步的指導。我們致力於先進的診斷，我們致力於我們的臨床 - 我們的消費者直接 - 消費者發起的測試業務。在條款...

So just to add to that, because we've commented on this before, it's important to think about this as you think about '23. We started to make investments in 2020 to accelerate growth beyond what we had already invested in to accelerate growth. So think about '20 and '21 and now we're at to '22. And we obviously would not make investments unless we thought there would be a return. And so therefore, you have heard from us, you're seeing growth rates in advanced diagnostics that have come up, you've heard about us feeling good about our consumer-initiated testing, growing faster than we have seen growing in the past. And as you think about '23, you should think about the improvements you're going to see in those two businesses in relationship with that in what we invested.

所以補充一下，因為我們之前已經對此發表過評論，所以在考慮 23 年時考慮這一點很重要。我們在 2020 年開始進行投資，以加速增長，超出我們已經投資的加速增長。所以想想'20和'21，現在我們到了'22。除非我們認為會有回報，否則我們顯然不會進行投資。因此，您從我們那裡聽說，您看到了先進診斷的增長率，您聽說我們對我們的消費者發起的測試感覺良好，增長速度超過了我們過去看到的增長速度。當您考慮 23 年時，您應該考慮您將在這兩項業務中看到的與我們投資的業務相關的改進。

And so therefore, you should not think about this as headwinds because you really think about it as tailwinds because we will get a return on those investments we made over the last several years. Jim?

因此，您不應將其視為逆風，因為您確實將其視為順風，因為我們將在過去幾年中所做的那些投資中獲得回報。吉姆?

Yes. You asked about PAMA. And we've said that it's in our 2023 guidance outlook that we provided at this point, and we've said it's about a $90 million headwind.

是的。你問過PAMA。我們已經說過，這是我們此時提供的 2023 年指導展望，我們已經說過這大約是 9000 萬美元的逆風。

So the only thing I would add is that, to Steve's point, when you ask our investments ramping down, I think there's two ways to think of investments. One is what's the P&L net impact and what is the level of spend. So we, at Investor Day, talked about growing our direct consumer business to $0.5 billion by 2025. That is still our intention.

所以我唯一要補充的是，史蒂夫的觀點是，當你問我們的投資逐漸減少時，我認為有兩種方式來考慮投資。一是損益淨影響是什麼，支出水平是多少。因此，我們在投資者日討論了到 2025 年將我們的直接消費者業務增長到 5 億美元。這仍然是我們的意圖。

So as you can imagine, over the next several years, including 2023, we're expecting significant revenue growth. And in order to drive that revenue growth, we believe we need to spend more. However, the good news is that a lot of 2020 and 2021 was pre-revenue, pre-contribution margin. And as we go ahead, we would expect the net impact to actually be less and to be less of a headwind.

因此，您可以想像，在接下來的幾年中，包括 2023 年，我們預計收入將出現顯著增長。為了推動收入增長，我們相信我們需要花更多的錢。然而，好消息是，2020 年和 2021 年的很多都是預收入、預貢獻邊際。隨著我們繼續前進，我們預計淨影響實際上會更小，而且阻力也會更小。

So really, we're going to be investing less on the bottom line, but spending more money to drive that accelerated growth. And then obviously, when we get to the scale and size that we're aspiring to, then we expect a healthy margin on that business.

所以真的，我們將減少對底線的投資，但花更多的錢來推動加速增長。然後很明顯，當我們達到我們渴望的規模和規模時，我們預計該業務的利潤率會很高。

Our next question is from Matt Larew with William Blair.

我們的下一個問題來自 Matt Larew 和 William Blair。

This is actually [Madelin Malman] on for Matt Larew. Just going off of the previous question for your investments into the base business. I know previously, you've given a number around $160 million for this year. Do you anticipate it's still being about that? Has inflation driven that cost higher? Any color you have there?

這實際上是馬特·拉魯 (Matt Larew) 的 [Madelin Malman]。剛剛結束上一個問題，您對基礎業務的投資。我以前知道，您今年已經給出了大約 1.6 億美元的數字。你預計它仍然是關於那個嗎？通貨膨脹是否推高了成本？你那裡有什麼顏色嗎？

And then my other question, just speaking to your investments in advanced diagnostics. You mentioned that you are ahead of schedule for your anticipated 8% growth. Is that still the case?

然後是我的另一個問題，只是談談您在高級診斷方面的投資。您提到您提前實現了預期的 8% 增長。還是這樣嗎？

Sure. So let me take part of it, then I'm sure either Steve or Jim will jump in. So first of all, inflation really hasn't impacted the level of investment in a material way. And we're on track to spend about what we told you previously.

當然。所以讓我參與其中，然後我相信史蒂夫或吉姆都會加入。所以首先，通貨膨脹並沒有以物質方式影響投資水平。我們正在按計劃使用我們之前告訴過您的內容。

As I referenced a minute ago, we haven't put our final plans together. But at this point, I would expect we're going to spend more next year. And we're going to spend more in marketing, but we're going to spend a lot less and not much at all in the IT platform creation. So it's really going to be tied a very high variable cost and highly tied to revenue growth, and we'll monitor, as Jim says, and I'm sure Sam and Jim will be all over is to make sure we're making the progress and to make sure we don't get the spending ahead of ourselves. But if we do what we expect to do, and we need to do to get to $0.5 billion by 2025, the spending will continue to go up.

正如我在一分鐘前提到的那樣，我們還沒有製定最終計劃。但在這一點上，我預計明年我們會花更多的錢。我們將在營銷上花費更多，但我們將在 IT 平台創建上花費更少，甚至一點也不多。所以這真的會與非常高的可變成本和收入增長密切相關，正如吉姆所說，我們將進行監控，我相信山姆和吉姆會全力以赴，以確保我們正在進步，並確保我們不會把支出提前。但是，如果我們按照我們的預期去做，並且我們需要到 2025 年達到 5 億美元，那麼支出將繼續增加。

The only other dimension I want to mention here is because when we talk about investments in the base business, there's a little nuance here. Advanced diagnostics absolutely is the base business. But really this consumer business is new. So while a lot of the work we do is similar to what we've done historically in our base business, it's really a new business category or opportunity. And some of it may cannibalize what would have otherwise come through our traditional channels. But we do believe that a lot of it is actually incremental to the overall amount of volume that we perform.

我想在這裡提到的唯一其他方面是因為當我們談論對基礎業務的投資時，這裡有一點細微差別。高級診斷絕對是基礎業務。但實際上，這種消費業務是新的。因此，雖然我們所做的很多工作與我們在基礎業務中過去所做的工作相似，但它確實是一個新的業務類別或機會。其中一些可能會蠶食原本通過我們傳統渠道獲得的東西。但我們確實相信，其中很多實際上是我們執行的總音量的增量。

Jim or Steve, you want to...

吉姆或史蒂夫，你想...

Yes. So as you know, we don't generally give you numbers every quarter about different segments of our business. In advanced diagnostics, we generally give you an annual update, and we'll do that again. But we keep on indicating that we believe we are making progress of getting to a higher level of growth, as we indicated in our Investor Day in '21. We feel good about the progress. And we gave you a number in the beginning of the year.

是的。如您所知，我們通常不會在每個季度向您提供有關我們業務不同部分的數字。在高級診斷中，我們通常會為您提供年度更新，並且我們會再次這樣做。但我們繼續表示，我們相信我們正在取得更高水平的增長，正如我們在 21 年的投資者日中指出的那樣。我們對進展感覺良好。我們在年初給了你一個數字。

And the same is true about our consumer initiated testing. We periodically give you an update to show that we're making progress. So we're feeling good about the investments made, the returns we'll get. And again, you should see more returns in our '23 guidance or the expectations around that because we believe they still remain to be good opportunities.

我們的消費者發起的測試也是如此。我們會定期為您提供更新，以表明我們正在取得進展。因此，我們對所做的投資以及我們將獲得的回報感覺良好。再一次，你應該在我們的 '23 指導或圍繞它的期望中看到更多回報，因為我們相信它們仍然是很好的機會。

And just to clarify, the target that we outlined at the Investor Day for the direct-to-consumer business was $250 million by 2025.

澄清一下，我們在投資者日為直接面向消費者的業務概述的目標是到 2025 年達到 2.5 億美元。

My apologies.

我很抱歉。

Our last question will come from Rachel Vatnsdal with JPMorgan.

我們的最後一個問題將來自摩根大通的 Rachel Vatnsdal。

So can you spend a minute talking about the monkeypox market? You flagged in your prepared remarks that Quest was 1 of the 5 labs that was selected by the CDC to expand testing capacity and you guys are going to have roughly 30,000 testing capacity for a week. So can you just walk us through the market opportunity there? And then is this contemplated in the guidance at all?

那麼你能花一分鐘談談猴痘市場嗎？您在準備好的評論中指出，Quest 是 CDC 選擇擴大檢測能力的 5 個實驗室之一，你們將在一周內擁有大約 30,000 個檢測能力。那麼你能帶我們了解一下那裡的市場機會嗎？那麼指導中是否考慮到了這一點？

Jim will handle that.

吉姆會處理的。

Yes. So at this point, it's hard to anticipate what the market opportunity has been or will be. I can tell you, our testing volumes at this point are modest. If we've done 500, 600 tests that would be on the high side. However, it is growing. And we do see growth. We've only had the test up and running for 2 weeks. And over that 2-week period, it's grown day by day.

是的。所以在這一點上，很難預測市場機會已經或將會是什麼。我可以告訴你，我們目前的測試量是適中的。如果我們進行了 500、600 次測試，那將是偏高的。然而，它正在增長。我們確實看到了增長。我們只啟動並運行了 2 週的測試。在這 2 週的時間裡，它每天都在增長。

Right now, we're not yet approved for New York state. We expect that to happen within the next week or 2. I'm sure you're reading that, that is where the major outbreak is in New York City. So we would expect to participate in that market. But most of our volume at this point is coming actually off of the West Coast. And so we'll keep you updated on what we're seeing.

目前，我們尚未獲准進入紐約州。我們預計這將在下週或兩週內發生。我相信您正在閱讀，這就是紐約市的主要爆發地點。因此，我們希望參與該市場。但此時我們的大部分交易量實際上來自西海岸。因此，我們會及時通知您我們所看到的內容。

Great. And then in line of the (inaudible) environment, can you just walk us through some initial color on how you're considering use of cash between share repurchases, dividends and then M&A?

偉大的。然後根據（聽不清）環境，您能否簡單介紹一下您如何考慮在股票回購、股息和併購之間使用現金？

Sure. So we're going to continue with what we've done. And what that is, is that between the dividend and we've already gotten there this year with the share repurchases to deliver a majority of our free cash flow to our shareholders. And with the $1.7 billion guidance and $400 million of capital, says at least $650 million between the dividend share repurchases, and we already covered that.

當然。所以我們將繼續我們已經完成的工作。那就是，在股息和我們今年已經通過股票回購將大部分自由現金流提供給股東之間。憑藉 17 億美元的指導和 4 億美元的資本，在股息股票回購之間至少有 6.5 億美元，我們已經涵蓋了這一點。

As we've also shared, we rather do M&A than share repurchases because we have some very rigorous financial parameters around the deals that we do. And so it's really going to be situational quarter-by-quarter. It may be different. Jim referenced that we have a deep pipeline and actually also commented that we have some negotiations that are well advanced. So I think we'd all be very disappointed if we didn't execute some deals before the end of the year. Don't know the exact timing of those. But certainly, as I said, I'd rather spend more on M&A, and I know Steve would, and you'll hear from Sam and Jim as they take over the reins, their view, but I wouldn't expect it to materially change.

正如我們也分享的那樣，我們寧願進行併購而不是股票回購，因為我們對我們所做的交易有一些非常嚴格的財務參數。所以這真的會是一個季度一個季度的情況。它可能會有所不同。吉姆提到我們有一個很深的管道，實際上還評論說我們有一些非常先進的談判。所以我認為如果我們沒有在年底之前執行一些交易，我們都會非常失望。不知道這些的確切時間。但可以肯定的是，正如我所說，我寧願在併購上花更多的錢，我知道史蒂夫會這樣做，你會聽到山姆和吉姆接任時的看法，他們的觀點，但我不希望它在實質上改變。

So really no change to what we've done in the past. And at this point, no specific plans for cash deployment because we're really -- it's really dependent on that progression of the M&A.

所以真的沒有改變我們過去所做的事情。在這一點上，沒有具體的現金部署計劃，因為我們真的 - 這真的取決於併購的進展。

Okay. So thank you, everyone. And again, thank you, Mark, for your time here at Quest. We're going to miss you, and we wish you well. So thanks, everyone, for joining the call. We appreciate all your questions and support, and we'll see you in our travels. Have a good day.

好的。所以謝謝大家。再次感謝您，馬克，感謝您在 Quest 的時間。我們會想念你的，我們祝你一切順利。非常感謝大家加入電話會議。我們感謝您提出的所有問題和支持，我們旅途中再見。祝你有美好的一天。

Thank you for participating in the Quest Diagnostics Second Quarter 2022 Conference Call. A transcript of prepared remarks on this call will be posted later today on Quest Diagnostics' website at www.questdiagnostics.com. A replay of the call may be accessed online at www.questdiagnostics.com/investor or by phone at (888) 5660439 for domestic callers or (203) 3693045 for international callers. Telephone replays will be available from approximately 10:30 a.m. Eastern Time on July 21, 2022, until midnight Eastern Time, August 4, 2022. Have a great day. Goodbye.

感謝您參加 Quest Diagnostics 2022 年第二季度電話會議。今天晚些時候將在 Quest Diagnostics 的網站 www.questdiagnostics.com 上發布有關本次電話會議的準備好的講話稿。可通過 www.questdiagnostics.com/investor 在線訪問電話重播，或撥打 (888) 5660439（國內來電者）或 (203) 3693045（國際來電者）訪問電話。從東部時間 2022 年 7 月 21 日上午 10:30 到東部時間 2022 年 8 月 4 日午夜，將提供電話重播。祝您有美好的一天。再見。