奎斯特診斷 (DGX) 2022 Q3 法說會逐字稿

Welcome to the Quest Diagnostics Third 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 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.

歡迎來到 Quest Diagnostics 2022 年第三季度電話會議。應公司要求，對此次通話進行錄音。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，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、轉發或轉播本次通話。

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 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; and Sam Samad, our Chief Financial Officer.

謝謝，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；候任首席執行官吉姆戴維斯；和我們的首席財務官 Sam Samad。

During this call, we may make forward-looking statements, and we'll discuss 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.

在這次電話會議中，我們可能會做出前瞻性陳述，並且我們將討論非 GAAP 措施。我們在收益新聞稿的表格中提供了非 GAAP 措施與可比 GAAP 措施的對賬。實際結果可能與預測結果存在重大差異。

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.

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 表年度報告和隨後在 10 表上提交的季度報告中描述的風險和不確定性-Q 和 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 pandemic severity and duration, health care insurer, government and client payer reimbursement for COVID-19 molecular tests, the pandemic's 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.

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、政府和客戶付款人對 COVID-19 的報銷的影響分子測試，大流行對美國醫療保健系統和美國經濟的影響；以及聯邦、州和地方政府對這一流行病的反應的時間、範圍和有效性，包括疫苗接種工作的影響，這些都是公司不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.

對於本次電話會議，報告的每股收益是指報告的稀釋每股收益，調整後的每股收益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。

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.

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收益增長，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進行衡量。

Now here is Steve Rusckowski.

現在是 Steve Rusckowski。

Thanks, Shawn, and thanks, everyone, for joining us today. While we had a strong third quarter, we drove 5% growth in the base business despite the impact of Hurricane Ian, and we delivered strong earnings despite inflationary pressures and investments in growth areas.

謝謝肖恩，也謝謝大家今天加入我們。雖然我們第三季度表現強勁，但儘管受到颶風伊恩的影響，我們仍推動基礎業務增長 5%，而且儘管存在通脹壓力和對增長領域的投資，我們仍實現了強勁的收益。

Based on our performance, we have raised our outlook for the remainder of 2022. We also made very good progress on our leadership transition, adding management depth and expertise to help us grow in important areas. As you know, Jim will assume the responsibilities as CEO and President on November 1, and I will remain as Executive Chairman.

根據我們的表現，我們提高了對 2022 年剩餘時間的展望。我們在領導層交接方面也取得了很好的進展，增加了管理深度和專業知識，以幫助我們在重要領域取得增長。如您所知，吉姆將於 11 月 1 日擔任首席執行官兼總裁，我將繼續擔任執行主席。

Before I turn it over to Jim, I'd like to say a few words about Saving Access for Laboratory Services Act, SALSA. If enacted, SALSA would fix PAMA and put the Medicare clinical laboratory fee schedule back on a sustainable path. Based on the efforts of our [trade] association, support for SALSA has broadened and continues to strengthen.

在我把它交給 Jim 之前，我想就 SALSA 實驗室服務法案的保存訪問說幾句話。如果頒布，SALSA 將修復 PAMA 並使 Medicare 臨床實驗室收費表重新走上可持續發展的道路。基於我們 [貿易] 協會的努力，對 SALSA 的支持已經擴大並繼續加強。

As you know, we are currently planning for a Medicare fee schedule reduction under PAMA of $80 million to $90 million in 2023; if Congress does not intervene again this year. However, the work we are doing is aimed at reducing or postponing that burden. Unfortunately, Congress has already acted 3 times to stop further cuts from going into place.

如您所知，我們目前計劃在 2023 年將 PAMA 下的 Medicare 費用計劃減少 8000 萬至 9000 萬美元；如果國會今年不再乾預。然而，我們正在做的工作旨在減輕或推遲這種負擔。不幸的是，國會已經採取了 3 次行動來阻止進一步削減。

It is therefore very important that we continue to build support for the enactment of SALSA when Congress returns to Washington after the election. As I transition to the Executive Chairman, I will remain actively engaged on this issue working with ACLA and other stakeholders.

因此，當國會在選舉後返回華盛頓時，我們繼續為頒布 SALSA 爭取支持是非常重要的。在我過渡到執行主席期間，我將繼續與 ACLA 和其他利益相關者一起積極參與解決這個問題。

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. On behalf of our 50,000 Quest colleagues, I would like to thank you for your leadership of Quest Diagnostics over the last 10 years. You turned around a company that was struggling and built shareholder value and transformed Quest into a trusted health care partner with a strong foundation for future growth.

謝謝，史蒂夫。我謹代表我們的 50,000 名 Quest 同事，感謝您在過去 10 年中對 Quest Diagnostics 的領導。您扭轉了一家苦苦掙扎的公司並建立了股東價值，並將 Quest 轉變為值得信賴的醫療保健合作夥伴，為未來的增長奠定了堅實的基礎。

I'm personally grateful for all the help and guidance and friendship that you shared during the transition. Thanks, Steve.

我個人非常感謝您在過渡期間提供的所有幫助、指導和友誼。謝謝，史蒂夫。

Turning to our results. Our base business grew year-over-year in the third quarter, with performance rebounding in August and September from the softer volume trends that we saw earlier in the year. In fact, before Hurricane Ian hit in September, we were seeing some of the highest base testing volumes we have ever experienced.

轉向我們的結果。我們的基礎業務在第三季度同比增長，8 月和 9 月的業績從我們今年早些時候看到的疲軟的銷量趨勢中反彈。事實上，在 9 月颶風伊恩襲擊之前，我們看到了一些我們經歷過的最高基礎測試量。

I'd like to thank our employees for their incredible efforts to restore our labs and PSCs for our patients and customers in the wake of Hurricane Ian, while also enduring personal loss of their homes and belongings. I'm also grateful to our employees outside of the impacted areas who stepped up to provide financial support to our colleagues in need. As many of you are aware, Florida is an important state for us.

我要感謝我們的員工在伊恩颶風過後為我們的患者和客戶恢復我們的實驗室和 PSC 所做的不可思議的努力，同時還要忍受個人失去家園和財產的痛苦。我還要感謝我們在受災地區以外的員工，他們挺身而出，為有需要的同事提供經濟支持。正如你們許多人所知，佛羅里達州對我們來說是一個重要的州。

During the quarter, we grew the base business revenues and continued to invest in advanced diagnostics and consumer-initiated testing. To help offset inflationary pressures, we have continued to pursue our operational excellence strategy and have been closely managing our cost structure through our Invigorate initiatives.

本季度，我們增加了基礎業務收入，並繼續投資於高級診斷和消費者發起的測試。為了幫助抵消通脹壓力，我們繼續追求卓越運營戰略，並通過我們的 Invigorate 計劃密切管理我們的成本結構。

In the third quarter, total revenues were $2.5 billion, earnings per share were $2.17 on a reported basis and $2.36 on an adjusted basis. Cash provided by operations was $502 million. COVID-19 testing revenues were $316 million in the third quarter, down 55% from 2021 and down 11% from the previous quarter.

第三季度總收入為 25 億美元，每股收益為報告基礎上的 2.17 美元和調整後的基礎上的每股收益 2.36 美元。運營提供的現金為 5.02 億美元。第三季度 COVID-19 檢測收入為 3.16 億美元，比 2021 年下降 55%，比上一季度下降 11%。

After plateauing in June and July, our COVID-19 molecular testing volumes steadily declined. We expect COVID-19 molecular volumes to average 10,000 to 15,000 per day in the fourth quarter.

在 6 月和 7 月趨於平穩後，我們的 COVID-19 分子檢測量穩步下降。我們預計 COVID-19 分子體積在第四季度平均每天 10,000 至 15,000。

In the third quarter, we continued to make progress executing our 2-point strategy to accelerate growth and drive operational excellence. Here are some highlights from the quarter. M&A continues to be a driver of growth. We recently announced an outreach lab purchase from Summa Health, a large integrated health care delivery system in Ohio.

在第三季度，我們繼續在執行我們的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。併購繼續成為增長的驅動力。我們最近宣布從 Summa Health 購買外展實驗室，Summa Health 是俄亥俄州的一家大型綜合醫療保健服務系統。

While this is a small acquisition, it's a positive indicator. We are seeing that hospital systems are more open to discussions than before the pandemic. Many large and small health systems face substantial financial and labor pressures that make our range of services very attractive. We're pleased with the activity in our M&A pipeline and hope to share additional news with you later this year.

雖然這是一筆小規模的收購，但卻是一個積極的指標。我們看到，與大流行之前相比，醫院系統對討論更加開放。許多大大小小的衛生系統都面臨著巨大的財政和勞動力壓力，這使得我們的服務範圍非常有吸引力。我們對併購管道中的活動感到滿意，並希望在今年晚些時候與您分享更多消息。

We also announced a professional lab services relationship with Lee Health, Southwest Florida's primary community owned health system, to provide supply chain expertise from 5 hospitals owned by Lee Health and selected outpatient centers. We will also continue to perform reference testing for Lee Health. Our implementation plans have been slightly delayed by Hurricane Ian, though we expect this relationship will have a positive impact on revenue growth in 2023.

我們還宣布與佛羅里達州西南部的主要社區擁有的衛生系統 Lee Health 建立專業實驗室服務關係，以提供來自 Lee Health 擁有的 5 家醫院和選定門診中心的供應鏈專業知識。我們還將繼續為 Lee Health 進行參考測試。我們的實施計劃因颶風伊恩而略有延遲，但我們預計這種關係將對 2023 年的收入增長產生積極影響。

Turning now to health plans. Both volumes and revenues continue to grow faster than our overall base business in the quarter. Value-based care relationships continue to gain traction. Not only does this yield benefit for health plans and their members, but also it enables us to gain share.

現在轉向健康計劃。本季度銷量和收入的增長速度繼續快於我們的整體基礎業務。基於價值的護理關係繼續受到關注。這不僅為健康計劃及其成員帶來好處，而且還使我們能夠獲得份額。

We've begun to renew some of our value-based contracts with national health plans, while continuing to engage and expand our value-based footprint with other plans. Value-based relationships are appealing to health plans because it helps them reduce the overall cost of care, provides insights to better health outcomes and provides an exceptional value to members. We're on track to meet our goal of realizing 50% of our health plan revenues from value-based relationships by the end of next year.

我們已經開始與國家健康計劃續簽一些基於價值的合同，同時繼續參與並擴大我們與其他計劃的基於價值的足跡。基於價值的關係對健康計劃很有吸引力，因為它可以幫助他們降低整體護理成本，提供更好的健康結果的見解，並為會員提供非凡的價值。我們有望實現我們的目標，即到明年年底實現我們 50% 的健康計劃收入來自基於價值的關係。

Also as we continue to extend and renegotiate health plan agreements, we see increased volumes and pricing from these contracts. We're seeing a more favorable pricing environment. And over the last 2 years, the majority of our renewals have included stable to positive reimbursement.

此外，隨著我們繼續延長和重新談判健康計劃協議，我們看到這些合同的數量和價格都在增加。我們看到了更有利的定價環境。在過去的 2 年裡，我們的大部分續約都包括穩定到積極的報銷。

In advanced diagnostics, we saw growth from prenatal genetics and genomics sequencing services in the third quarter. We continue to make investments to strengthen our capabilities to accelerate growth in oncology and hematology, hereditary genetics, genomic sequencing services and pharma services.

在高級診斷方面，我們在第三季度看到了產前遺傳學和基因組學測序服務的增長。我們繼續投資以加強我們的能力，以加速腫瘤學和血液學、遺傳學、基因組測序服務和製藥服務的發展。

Just last week, we announced the addition of Mark Gardner, our Senior Vice President of Molecular Genomics and Oncology. In this new position, Mark, an established leader in molecular genomics, next-generation sequencing and oncology diagnostics, is responsible for driving growth and expanding our offerings in these areas.

就在上週，我們宣布了分子基因組學和腫瘤學高級副總裁 Mark Gardner 的加入。在這個新職位上，Mark 是分子基因組學、下一代測序和腫瘤學診斷領域的公認領導者，負責推動增長和擴大我們在這些領域的產品。

The investments we're making in consumer-initiated testing enabled us to recently launch a new e-commerce platform. The new site is more powerful and consumer friendly with a compelling user experience and a number of enhancements.

我們在消費者發起的測試方面所做的投資使我們能夠在最近推出一個新的電子商務平台。新網站功能更強大，對消費者更友好，具有引人入勝的用戶體驗和許多增強功能。

We're encouraged by the early success of the site in the first few weeks of its launch, and we expect to make further progress in the fourth quarter and in 2023 toward our goal of $250 million of annual consumer-initiated testing revenues by 2025.

我們對該網站在推出的前幾週取得的早期成功感到鼓舞，我們預計將在第四季度和 2023 年取得進一步進展，以實現到 2025 年消費者發起的年度測試收入達到 2.5 億美元的目標。

We also launched a new ad campaign to drive broader awareness of our consumer-initiated testing offerings, which cover everything from women's health test to allergy testing and sexually transmitted infections. Check out the new site at questhealth.com and look for the new ads.

我們還發起了一項新的廣告活動，以提高人們對我們由消費者發起的測試產品的更廣泛認識，這些產品涵蓋從女性健康測試到過敏測試和性傳播感染的方方面面。查看 questhealth.com 上的新網站並查找新廣告。

The second part of our 2-point strategy is to drive operational excellence. We remain focused on improving our operational quality, service and cost, thereby driving productivity gains and improving the customer experience. Here are a few examples.

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，從而提高生產力並改善客戶體驗。這裡有一些例子。

As COVID-19 volumes have declined, we've begun to repurpose some of our COVID-19 testing platforms to enhance our quality and reduce costs. Today, 75% of our patients are arriving at a PSC with an appointment compared to less than 25% just 3 years ago. This increased number of appointments allows us to flex our workforce to meet demand within a particular geography, which enables us to serve our patients faster.

隨著 COVID-19 數量的下降，我們已經開始重新調整我們的一些 COVID-19 測試平台的用途，以提高我們的質量並降低成本。今天，我們 75% 的患者是通過預約到達 PSC 的，而 3 年前這一比例還不到 25%。預約數量的增加使我們能夠靈活調整員工隊伍以滿足特定地區的需求，從而使我們能夠更快地為患者提供服務。

For patients who walk into a patient service center, our new schedule at check-in program sets expectations in the waiting room and balances the load for our phlebotomists. Walk-ins now self-register when they arrive and learn how long they'll need to wait. Our average wait time is approximately 5 minutes, which is roughly half the level since 2019.

對於走進患者服務中心的患者，我們在登記程序中的新時間表設定了候診室的期望值，並平衡了我們的抽血師的負荷。步行者現在可以在他們到達時自行登記，並了解他們需要等待多長時間。我們的平均等待時間約為 5 分鐘，大約是 2019 年以來水平的一半。

Finally, we continue to drive the use of automation and artificial intelligence to drive productivity gains to help offset inflationary pressures.

最後，我們繼續推動使用自動化和人工智能來提高生產率，以幫助抵消通脹壓力。

Now I'll turn it over to Sam, who will provide more details on our performance and share more insights on our updated guidance for the remainder of 2022.

現在我將把它交給 Sam，他將提供更多關於我們績效的細節，並分享更多關於我們 2022 年剩餘時間更新指南的見解。

Thanks, Jim.

謝謝，吉姆。

In the third quarter, consolidated revenues were $2.5 billion, down 10.4% versus the prior year. Base business revenues grew 5.1% to $2.17 billion, while COVID-19 testing revenues declined 55% to $316 million.

第三季度，綜合收入為 25 億美元，同比下降 10.4%。基礎業務收入增長 5.1% 至 21.7 億美元，而 COVID-19 測試收入下降 55% 至 3.16 億美元。

Revenues for Diagnostic Information Services declined 10.5% compared to the prior year. The decline reflected lower revenue from COVID-19 testing services versus the third quarter of 2021, partially offset by solid growth in our base testing revenue, despite the impact of Hurricane Ian at the end of the quarter.

與上一年相比，診斷信息服務的收入下降了 10.5%。這一下降反映了 COVID-19 測試服務的收入與 2021 年第三季度相比有所下降，儘管本季度末受到颶風伊恩的影響，但我們的基礎測試收入的穩健增長部分抵消了這一影響。

Total volume, measured by the number of requisitions, declined 6.2% versus the prior year. Acquisitions contributed 20 basis points to total volume. Total and organic base testing volumes increased 1.6% and 1.4%, respectively, versus the prior year.

以申請數量衡量的總數量比上一年下降了 6.2%。收購為總成交量貢獻了 20 個基點。與上一年相比，總測試量和有機測試量分別增長了 1.6% 和 1.4%。

The performance of our base business strengthened beginning in late July as COVID-19 cases and the positivity rate declined throughout August and September. The impact of Hurricane Ian represented a headwind of approximately 30 basis points to volume growth in the quarter.

隨著 COVID-19 病例和陽性率在整個 8 月和 9 月下降，我們的基礎業務的表現從 7 月下旬開始加強。颶風伊恩的影響對本季度的銷量增長造成了大約 30 個基點的不利影響。

COVID-19 testing volumes continued to decline during the third quarter. We resulted approximately 3.1 million molecular tests, down approximately 4 million tests and 0.4 million tests versus the prior year and second quarter, respectively. Our COVID-19 molecular volumes have averaged roughly 17,000 tests per day so far in October.

COVID-19 測試量在第三季度繼續下降。我們進行了大約 310 萬次分子測試，與去年和第二季度相比分別減少了大約 400 萬次和 40 萬次測試。 10 月份到目前為止，我們的 COVID-19 分子體積平均每天進行大約 17,000 次測試。

Revenue per requisition declined 5.1% versus the prior year driven primarily by lower COVID-19 molecular volumes. Base business revenue per req was up 3.3%. The more favorable pricing environment remained consistent with our expectations, with unit price reimbursement pressure of less than 50 basis points in the quarter.

每個申請的收入與上一年相比下降了 5.1%，這主要是由於 COVID-19 分子體積較低。每個請求的基礎業務收入增長了 3.3%。更有利的定價環境與我們的預期一致，本季度單價報銷壓力低於 50 個基點。

Reported operating income in the third quarter was $392 million or 15.8% of revenues compared to $652 million or 23.5% of revenues last year. On an adjusted basis, operating income was $423 million or 17% of revenues compared to $694 million or 25% of revenues last year. The year-over-year decline in adjusted operating income is primarily related to lower COVID-19 testing volume and investments to accelerate growth in our base business. We were also impacted by a higher portion of COVID-19 molecular testing volume from nontraditional retail channels, which carry additional expenses.

第三季度報告的營業收入為 3.92 億美元，佔收入的 15.8%，而去年同期為 6.52 億美元，佔收入的 23.5%。在調整後的基礎上，營業收入為 4.23 億美元，佔收入的 17%，而去年為 6.94 億美元，佔收入的 25%。調整後營業收入的同比下降主要與 COVID-19 測試量減少以及為加速基礎業務增長而進行的投資有關。我們還受到來自非傳統零售渠道的更高比例的 COVID-19 分子檢測量的影響，這些渠道會產生額外費用。

Reported EPS was $2.17 in the quarter compared to $4.02 a year ago. Adjusted EPS was $2.36 compared to $3.96 last year. The impact of Hurricane Ian reduced adjusted EPS by approximately $0.05 in the third quarter. Year-to-date cash provided by operations was $1.38 billion in 2022 versus $1.75 billion in the prior year period.

本季度報告的每股收益為 2.17 美元，而一年前為 4.02 美元。調整後每股收益為 2.36 美元，而去年為 3.96 美元。颶風伊恩的影響使第三季度調整後的每股收益減少了約 0.05 美元。 2022 年年初至今運營提供的現金為 13.8 億美元，而去年同期為 17.5 億美元。

Turning to our updated guidance. Revenues are now expected to be between $9.72 billion and $9.86 billion. Base business revenues are expected to be between $8.38 billion and $8.45 billion. COVID-19 testing revenues are expected to be between $1.34 billion and $1.41 billion.

轉向我們更新的指南。現在預計收入在 97.2 億美元至 98.6 億美元之間。基礎業務收入預計在 83.8 億美元至 84.5 億美元之間。 COVID-19 測試收入預計在 13.4 億美元至 14.1 億美元之間。

Reported EPS is expected to be in a range of $8.52 to $8.72, and adjusted EPS to be in a range of $9.75 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.

報告的每股收益預計在 8.52 美元到 8.72 美元之間，調整後的每股收益在 9.75 美元到 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。

As you think about our updated guidance, please consider the following. We are assuming COVID-19 molecular volumes to average roughly 10,000 to 15,000 tests per day in the fourth quarter. We also believe this is a reasonable assumption for run rate COVID-19 molecular testing volumes heading into 2023.

當您考慮我們更新後的指南時，請考慮以下事項。我們假設 COVID-19 分子體積在第四季度平均每天進行大約 10,000 到 15,000 次測試。我們還認為，對於進入 2023 年的運行率 COVID-19 分子檢測量，這是一個合理的假設。

Last week, the public health emergency was extended another 90 days through mid-January. We therefore assume average reimbursement for COVID-19 molecular testing to hold relatively steady through the end of this year. We expect reimbursement to decline when the PHE expires, which we currently assume will happen in January.

上週，公共衛生緊急狀態又延長了 90 天至 1 月中旬。因此，我們假設 COVID-19 分子檢測的平均報銷在今年年底前保持相對穩定。我們預計 PHE 到期時報銷會下降，我們目前假設這將在 1 月份發生。

Given the timing of Hurricane Ian, the impact on our business has continued in the first couple of weeks of the fourth quarter. As a reminder, we are making investments this year to accelerate growth. We spent approximately $110 million through the third quarter, and we expect to invest more than $50 million in the fourth quarter primarily to support marketing and promotion of our new consumer-initiated testing platform.

鑑於颶風伊恩的時間，我們業務的影響在第四季度的前幾週仍在繼續。提醒一下，我們今年正在進行投資以加速增長。我們在第三季度花費了大約 1.1 億美元，我們預計在第四季度將投資超過 5000 萬美元，主要用於支持我們新的消費者發起的測試平台的營銷和推廣。

Finally, before getting to your questions, I wanted to say a few words about 2023. I know there's a lot of focus on EPS expectations for 2023. As you might expect, we aren't prepared to provide detailed 2023 guidance today.

最後，在回答您的問題之前，我想就 2023 年說幾句話。我知道很多人都關注 2023 年的每股收益預期。正如您所料，我們今天不准備提供詳細的 2023 年指導。

There are obviously a number of assumptions and dynamics to consider, but I see nothing that would prevent us from meeting the current consensus estimates for next year within a reasonable range of outcomes. We will continue to review our plans and assumptions, and provide our full 2023 guidance in early February.

顯然有許多假設和動態因素需要考慮，但我認為沒有什麼能阻止我們在合理的結果範圍內達到目前對明年的共識估計。我們將繼續審查我們的計劃和假設，並在 2 月初提供完整的 2023 年指導。

I will now turn it back to Steve.

我現在將把它轉回給史蒂夫。

Thanks, Sam. Well, to summarize, we accelerated growth in the base business year-over-year. We grew our base business revenue, while continuing to make investments, which position us well for the future. And we have raised our full year guidance based on our performance in the quarter and our expectations for the remainder of 2022.

謝謝，山姆。好吧，總而言之，我們加快了基礎業務的同比增長。我們增加了基礎業務收入，同時繼續進行投資，這為我們的未來做好了準備。我們已經根據本季度的表現和我們對 2022 年剩餘時間的預期提高了全年指導。

As Jim mentioned earlier, this will be my last earnings call as CEO and President, and I will remain as Executive Chairman. I'd like to thank all of you on this call for your interest in the company. I've enjoyed our many conversations over the last 10 years, and I thank you for your time and commitment to understand our business.

正如吉姆之前提到的，這將是我作為首席執行官兼總裁的最後一次財報電話會議，我將繼續擔任執行主席。我要感謝你們所有人對公司的興趣。在過去的 10 年裡，我很享受我們的許多談話，我感謝你花時間和承諾來了解我們的業務。

Finally, to the 50,000 colleagues of Quest Diagnostics, it's been the honor of my lifetime to serve as your CEO. Together, we have empowered better health with our insights, grown the business and provide a critical testing capacity through one of the most challenging health care crisis in our history. I will always be grateful of what you've done to serve our customers. Thank you.

最後，對於 Quest Diagnostics 的 50,000 名同事，擔任你們的 CEO 是我一生的榮幸。通過我們的洞察力，我們共同增強了健康水平，發展了業務，並通過我們歷史上最具挑戰性的醫療保健危機之一提供了關鍵的測試能力。我將永遠感謝您為我們的客戶服務所做的一切。謝謝你。

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) The first question in the queue is from Ann Hynes with Mizuho Securities.

（操作員說明）隊列中的第一個問題來自瑞穗證券的 Ann Hynes。

Can you hear me now?

你能聽到我嗎？

Yes.

是的。

Okay. Sorry about that. Okay. Steve, I just want to say congratulation on your retirement, and it has been a pleasure working with you all these years.

好的。對於那個很抱歉。好的。史蒂夫，我只想祝賀你退休，這些年來與你共事很愉快。

Thanks, Ann.

謝謝，安。

So my first question -- thanks for the color in 2023. Obviously, it was on top of investor minds. But just for modeling purposes, can you just maybe tell us what has changed directionally on the positive side and the negative side since you first provided that in 2019?

所以我的第一個問題——感謝 2023 年的顏色。顯然，這是投資者最關心的問題。但僅出於建模目的，您能否告訴我們自您在 2019 年首次提供以來在積極方面和消極方面發生了哪些方向性變化？

And maybe within that, your DTC program, I know it's a headwind to earnings this year. Do we expect it to become profitable in 2003? And maybe talk about the profitability profile in 2024. That would be great.

也許在你的 DTC 計劃中，我知道這是今年收益的逆風。我們預計它會在 2003 年盈利嗎？也許談談 2024 年的盈利狀況。那太好了。

Yes. Thanks, Ann. So let me start, and I'll have Sam fill in some color here.

是的。謝謝，安。那麼讓我開始吧，我會讓 Sam 在這裡填上一些顏色。

So look, there's a lot of changes since 2019, and I'll just talk about a few tailwinds and headwinds. From a tailwind standpoint, reimbursement has never been better, right? We were down approximately 50 basis points year-to-date.

所以看，自 2019 年以來發生了很多變化，我將只談一些順風和逆風。從順風的角度來看，報銷從未如此好，對吧？今年迄今為止，我們下跌了大約 50 個基點。

That's much -- a much better environment without PAMA than 2019 was, where we are historically losing over 100 basis points. And then PAMA was on top of that. So we feel much better about price going into 2023.

這太多了——沒有 PAMA 的環境比 2019 年要好得多，我們在歷史上損失了超過 100 個基點。然後 PAMA 是最重要的。因此，我們對進入 2023 年的價格感覺好多了。

Our base volumes are back above 2019 levels. In fact, it points during the quarter. In September, we exceeded the high point our February, January point of 2020. So feel good about that.

我們的基礎銷量回到了 2019 年的水平之上。事實上，它指向本季度。 9 月，我們超過了 2020 年 2 月、1 月的高點。對此感覺良好。

You mentioned investments in CIT, yes, that will be a tailwind going into 2023. We feel good about that. And then as you know, we've made investments in the business, investing in our advanced diagnostics portfolio, and we expect to get above growth -- above normal growth rates out of that side of our portfolio.

你提到了對 CIT 的投資，是的，這將是進入 2023 年的順風。我們對此感覺很好。然後如你所知，我們已經對業務進行了投資，投資於我們的高級診斷產品組合，我們希望在我們的投資組合中實現高於增長 - 高於正常增長率。

Now we're dealing with some headwinds as well, as you know. We built into our plan a third round of PAMA cuts, $80 million to $90 million next year. COVID, which we didn't obviously have in 2019, we expect going into next year, the early part of next year, we'll be at the 10 to 15 points.

如您所知，現在我們也在應對一些不利因素。我們將第三輪 PAMA 削減納入我們的計劃，明年削減 8000 萬至 9000 萬美元。 COVID，我們在 2019 年顯然沒有，我們預計進入明年，明年年初，我們將達到 10 到 15 點。

And we have some inflation that we certainly didn't see in 2019 that's running through our business. We estimated $0.05 to $0.08 a quarter. And we expect that inflation to continue into the early part of next year.

我們有一些我們在 2019 年肯定沒有看到的通貨膨脹正在貫穿我們的業務。我們估計每季度 0.05 至 0.08 美元。我們預計通貨膨脹將持續到明年年初。

Sam, any other color?

山姆，還有其他顏色嗎？

Yes. I think you've captured it well, Jim. I mean, again, we're going to give guidance in February. We wanted to just capture some of these maybe changed assumptions or at least varying assumptions.

是的。我認為你把握得很好，吉姆。我的意思是，我們將在二月份給出指導。我們只想捕捉其中一些可能改變的假設或至少是變化的假設。

But listen, there's nothing that I've seen so far -- we've seen so far that prevents us from meeting the current consensus estimates, again, within a reasonable range of outcomes.

但是聽著，到目前為止我沒有看到任何東西——我們到目前為止看到的任何東西都阻止我們在合理的結果範圍內達到當前的共識估計。

In terms of share repurchases, we have made share repurchases this year, $950 million throughout the first 3 quarters of the year, and that will provide a lift as well in terms of earnings next year.

在股票回購方面，我們今年前三個季度進行了 9.5 億美元的股票回購，這也將提振明年的收益。

Yes. And let me just make another comment about some of the investments we've made because I think there's a little bit of a misunderstanding about that adding to our cost and not helping us as we get into '23 and '24, and Ann, you alluded to that.

是的。讓我再對我們所做的一些投資發表評論，因為我認為在我們進入 23 年和 24 年時，人們對這會增加我們的成本並沒有幫助我們有一點誤解，安，你提到了那個。

So we've mentioned that this year, we'll be investing about $160 million. And as you recall, in 2021, we started the investments. We took some of the proceeds from COVID. It made roughly $0.25 billion worth of investments in 2 businesses, 1 of them is advanced diagnostics. And as Jim said and we've commented before, we have already started to see -- have faster growth rates because of those investments. And the second is our consumer-initiated testing.

所以我們已經提到，今年我們將投資約 1.6 億美元。您還記得，我們在 2021 年開始了投資。我們從 COVID 中獲得了一些收益。它對 2 項業務進行了價值約 2.5 億美元的投資，其中 1 項是高級診斷。正如吉姆所說，我們之前已經評論過，我們已經開始看到 - 由於這些投資，增長率更快。第二個是我們的消費者發起的測試。

And we will only make investments, as you would expect, if we expect to get a return. And so what you're going to see in 2023 is particularly around CIT. We're starting to get a return for that investment for CIT. And even though we don't report the financials, you'll see less of a drain on our earnings in 2023 because of the growth rate we will get from CIT, and that will be a tailwind for '23.

正如您所期望的那樣，如果我們希望獲得回報，我們只會進行投資。因此，您將在 2023 年看到的尤其是 CIT。我們開始從 CIT 的投資中獲得回報。即使我們不報告財務數據，您也會看到 2023 年我們的收益減少，因為我們將從 CIT 獲得的增長率，這將是 23 年的順風。

And you asked about 2024. We're not going to give exact details because we will throttle that investment, depending upon how fast the market grows and where we have some capacity to accelerate growth. And so we'll hold back on giving you an exact number about profitability, but we are going to get the return from that $250 million.

你問的是 2024 年。我們不會提供確切的細節，因為我們會限制投資，這取決於市場增長的速度以及我們有能力加速增長的地方。因此，我們不會向您提供有關盈利能力的確切數字，但我們將從這 2.5 億美元中獲得回報。

And let me just close by saying that $250 million, some of it is permanent because we're building these 2 businesses, advanced diagnostics and CIT, but some of it was temporal. And so when you think about modeling for '20 through '23, and you look at what you might expect for expenses from us for 2022, and these are total expenses, R&D and SG&A, what we have model and working on is actually expenses in '23 coming down versus 2022. So that's a change because some of these investments were temporal. So I'll just leave it there. Thank you.

最後，讓我說 2.5 億美元，其中一些是永久性的，因為我們正在建設這兩個業務，高級診斷和 CIT，但其中一些是暫時的。因此，當您考慮為 20 年到 23 年建模時，看看您可能對我們 2022 年的支出有何期望，這些是總支出、研發和 SG&A，我們擁有的模型和正在研究的實際上是支出'23 與 2022 年相比。所以這是一個變化，因為其中一些投資是暫時的。所以我就把它留在那裡。謝謝你。

Next question is from Kevin Caliendo with UBS.

下一個問題來自瑞銀的 Kevin Caliendo。

I actually want to expand on Steve's comment right there because thinking through this -- thinking through the guidance and getting to the numbers versus sort of what the run rate is coming out, there has to be a pretty meaningful amount of expenses coming out.

我實際上想在那裡擴展史蒂夫的評論，因為通過這個思考 - 通過指導思考並獲得數字與運行率的排序，必須有相當有意義的支出。

So of the $160 million, should we be thinking about that as like half of that goes away to get to sort of including PAMA, we're talking $80 million, $100 million of expenses that would need to come down, unless you think volumes are really to accelerate and the incremental margins on those? So can you maybe give us a little bit more on the expense side and how to think about modeling that? Is it just like percentage of that $160 million that comes out?

因此，在 1.6 億美元中，我們是否應該考慮將其中一半用於包括 PAMA，我們說的是需要減少的 8000 萬、1 億美元的費用，除非你認為數量是真的要加速和增量利潤率在那些？那麼，您能否在費用方面多給我們一些信息，以及如何考慮對其進行建模？它只是 1.6 億美元的百分比嗎？

Yes. Thanks, Kevin. And let me turn it to Sam, and he can give some color on that.

是的。謝謝，凱文。讓我把它轉給山姆，他可以給它一些顏色。

Yes. So Kevin, as you think about next year, I mean, yes, we are taking expenses down. So there's going to be some reductions as we look at expenses given the macro environment that we are in.

是的。所以凱文，當你想到明年時，我的意思是，是的，我們正在削減開支。因此，考慮到我們所處的宏觀環境，我們在考慮支出時將會有所減少。

I would not assume right now strategic investments necessarily coming down. That's not an assumption that I would make. And we also have our Invigorate program, where we expect that productivity in the business, and that's an ongoing program that we do -- that we have every year. But we are, in a way, reinvigorating Invigorate to have further productivity from the business.

我不認為現在戰略投資必然會下降。這不是我會做出的假設。我們還有我們的 Invigorate 計劃，我們希望在該計劃中提高業務生產力，這是我們每年都在進行的持續計劃。但在某種程度上，我們正在重振 Invigorate 以從業務中獲得更高的生產力。

So I think as you look at margins, you have to consider those things. We have maybe a consistent inflationary environment as the assumption wages increasing by -- salaries, wages and benefits increasing by 3% to 4%, but we are taking expenses down next year in other areas, and we are focusing on Invigorate.

所以我認為當你看利潤率時，你必須考慮這些事情。我們可能有一個持續的通貨膨脹環境，因為假設工資增長——薪水、工資和福利增長 3% 到 4%，但明年我們將在其他領域減少開支，我們將重點放在 Invigorate 上。

If maybe I can ask it a little bit different way. Your base margins, I know you don't think about base margins versus COVID margins, but we all try to model it that way. If we were to think about it, would you then think that base margins could look or be better than what they were in a pre-COVID setting?

如果也許我可以用不同的方式問它。你的基本利潤率，我知道你不會考慮基本利潤率與 COVID 利潤率，但我們都試圖以這種方式建模。如果我們考慮一下，您會認為基本利潤率看起來或比 COVID 之前的設置更好嗎？

Let's -- we should talk about kind of the assumptions that we have right now for 2022. We're not going to comment right now on base margins versus total COVID margins. But I think the way to think about it is the pricing environment is improving, so we are seeing less of an impact in terms of price reductions.

讓我們——我們應該談談我們現在對 2022 年的假設。我們現在不打算評論基本利潤率與 COVID 總利潤率。但我認為考慮它的方式是定價環境正在改善，因此我們看到降價方面的影響較小。

There is the PAMA impact for next year, but we are seeing historically low pricing pressure on our business, which, as we said in the quarter, was 50 basis points. So that's an improvement.

PAMA 對明年有影響，但我們看到我們業務的定價壓力處於歷史低位，正如我們在本季度所說，為 50 個基點。所以這是一個改進。

I talked about some of the cost reductions that we're going to make, and I talked about the Invigorate productivity savings that we're going to make. So we are going to definitely see some productivity improvement in the business, but I won't give a specific base margin number here.

我談到了我們將要進行的一些成本削減，我談到了我們將要進行的 Invigorate productivity 節省。所以我們肯定會看到業務生產率有所提高，但我不會在這裡給出具體的基本利潤率數字。

Next question is from Jack Meehan with Nephron Research.

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

I wanted to ask about utilization. So there was a lot of worry heading into the quarter because of the (inaudible) data, and your base growth actually accelerated to 5%. So I'm just curious what you think is going on here driving the relative outperformance versus what it looks like the market might be doing.

我想問一下利用率。因此，由於（聽不清）數據，進入本季度有很多擔憂，您的基本增長率實際上加速到 5%。所以我很好奇你認為這裡發生了什麼導致相對優於市場表現與市場可能正在做的事情。

Yes. So thanks, Jack. As we mentioned in the opening comments, our volumes improved every month through the third quarter. So July was weak, August was better and September, even with the hurricane impact, was obviously much better than the average that we reported.

是的。所以謝謝，傑克。正如我們在開場評論中提到的，我們的交易量在第三季度每個月都在增加。所以 7 月表現疲軟，8 月表現較好，9 月即使受到颶風影響，也明顯好於我們報告的平均水平。

In addition, we reported 5.1% revenue growth in the quarter on the base business, and a chunk of that did come from revenue per req. Despite a 50 basis point headwind on price, our clinical mix and business mix improved in the quarter, which contributed to that strong base performance.

此外，我們報告本季度基礎業務的收入增長了 5.1%，其中很大一部分確實來自每個請求的收入。儘管價格有 50 個基點的逆風，但我們的臨床組合和業務組合在本季度有所改善，這促成了強勁的基本業績。

And so we were happy with the utilization levels. Physician offices appear to be strong and even our health system segment, which is a combination of our reference testing and PLS, was also strong in the quarter.

因此，我們對利用率水平感到滿意。醫師辦公室似乎很強大，甚至我們的衛生系統部門（我們的參考測試和 PLS 的結合）在本季度也很強勁。

Maybe just trying to dig in a little bit more. I think everyone is trying to understand the market growth and share dynamics. Are you -- what's the -- what's your dialogue like with hospitals now around either outreach sales or more kind of reference were getting sent out? Are yoyu -- have you heard more about labor being an issue? Just any thoughts on all that would be great.

也許只是想多挖一點。我認為每個人都在試圖了解市場增長和份額動態。你是——什麼——你現在與醫院圍繞外展銷售或更多類型的參考進行的對話是怎樣的？ yoyu——你聽說過更多關於勞動是一個問題嗎？任何關於這一切的想法都會很棒。

Sure, Jack. So I can tell you that our opportunities with health systems has never been stronger on multiple fronts. Now in the quarter, we announced the Summa Health outreach acquisition. Summa is a health system in Akron, Ohio. We announced a PLS -- new PLS relationship with Lee Health in Florida. And the funnel of opportunities continues to grow.

當然，傑克。所以我可以告訴你，我們在衛生系統方面的機會在多個方面從未如此強大。現在在本季度，我們宣布了對 Summa Health outreach 的收購。 Summa 是俄亥俄州阿克倫市的一個衛生系統。我們宣布了 PLS——與佛羅里達州 Lee Health 建立新的 PLS 關係。機會的漏斗繼續增長。

There's not a day that goes by that we don't read in one of the journals about health systems reporting margin pressures and exacerbated by some of the pressures they have with wages, particularly on the nursing side.

我們無時無刻不在其中一份期刊中讀到有關衛生系統報告利潤壓力的文章，並且由於他們在工資方面的一些壓力而加劇，尤其是在護理方面。

So it's very opportunistic for us to go into health systems and explain to them how we can help them reduce their lab spend by upwards of 10% to 15% to 18%. And so -- or monetize their outreach book of business to provide some cash infusion to them. So it's an opportunistic time for us.

因此，我們進入衛生系統並向他們解釋我們如何幫助他們將實驗室支出減少 10% 至 15% 至 18% 是非常有機會的。因此 - 或者通過他們的外展業務獲利，為他們提供一些現金注入。所以這對我們來說是一個機會主義的時刻。

Next question is from Erin Wright with Morgan Stanley.

下一個問題來自摩根士丹利的 Erin Wright。

Could you give us an update on your relationships and negotiations with the commercial payers and offset in terms of pricing dynamics there? And where are we at in terms of those preferred relationships helping to steer volume?

您能否向我們提供有關您與商業付款人的關係和談判的最新信息，並在定價動態方面進行抵消？在那些有助於控制交易量的首選關係方面，我們處於什麼位置？

And do initiatives such as United Laboratory benefit management at Optum that was more recent, does that have any impact on your business at all? I believe it's targeting some over testing on the esoteric side.

United Laboratory 等最近在 Optum 進行的有益管理的舉措是否對您的業務有任何影響？我相信它的目標是在深奧的方面進行一些過度測試。

Yes. So thank you, Erin. So our relationships with commercial payers, if you want to measure the output of the relationship, again, we'll turn to the pricing environment. It's never been better. We are only down 50 basis points in the quarter. And you go back to 2018, 2019, we were losing 100 basis points.

是的。所以謝謝你，艾琳。所以我們與商業支付者的關係，如果你想衡量這種關係的輸出，我們將再次轉向定價環境。從來沒有這麼好過。我們在本季度僅下降了 50 個基點。回到 2018 年、2019 年，我們損失了 100 個基點。

We've also said that the majority of the negotiations we've had with payers over the last 2 years have resulted in either flat to positive price increases, and so we consider that a victory.

我們還說過，在過去兩年中，我們與付款人進行的大部分談判都導致價格持平或上漲，因此我們認為這是一場胜利。

Our -- we've also said that the number of value-based relationships that we're entering into, meaning that there's opportunities for us to create value for them and earn value back for us by working very closely with the likes of UnitedHealthcare and Anthem.

我們 - 我們還說過，我們正在建立的基於價值的關係的數量，這意味著我們有機會通過與 UnitedHealthcare 和國歌。

And we work together as teams, and we target physicians that are using out-of-network labs. We target physicians that are using expensive health system labs. And collectively, our teams work this day in and day out. And yes, we've been able to move recs from high-priced institutions to better quality, lower priced labs like Quest Diagnostics.

我們作為團隊一起工作，我們的目標是使用網絡外實驗室的醫生。我們的目標是使用昂貴的衛生系統實驗室的醫生。總的來說，我們的團隊日復一日地工作。是的，我們已經能夠將 recs 從高價機構轉移到質量更好、價格更低的實驗室，如 Quest Diagnostics。

Yes. Two comments on Jack's question and Erin's. First of all, our plan is to gain share. And so one element of gaining share is the relationships with health plans. And we do believe we're making progress, and that progress will continue as we pick up more share, particularly with the nationals.

是的。關於傑克的問題和艾琳的問題的兩條評論。首先，我們的計劃是獲得份額。因此，獲得份額的一個因素是與健康計劃的關係。我們確實相信我們正在取得進展，並且隨著我們獲得更多份額，特別是與國民的份額，這種進展將繼續下去。

I just want to make sure we remind you that, that 50 basis point is not exclusive to commercial payer pricing, but all pricing. So commercial payer pricing is within it, and that has improved, to Jim's comment, vastly versus where we were.

我只是想確保我們提醒您，50 個基點不是商業付款人定價所獨有的，而是所有定價。因此，商業付款人的定價就在其中，而且根據吉姆的評論，這與我們以前的情況相比已經有了很大的改善。

But we have price pressure with client relationships, with physicians. We have price concessions with hospital reference work. So there's other price concessions in that number. But on the commercial payer side, it's less than 50 basis points, and much improved on where it was years ago.

但我們在客戶關係和醫生方面面臨價格壓力。我們有醫院參考工作價格優惠。所以這個數字還有其他價格優惠。但在商業支付方面，它不到 50 個基點，比幾年前有了很大改善。

Next question is from Brian Tanquilut with Jefferies.

下一個問題來自 Jefferies 的 Brian Tanquilut。

Congrats on the quarter. So as I think about just the core testing, obviously, COVID is declining here. How should we be thinking about your outlook here for 2023, especially given economic backdrop that we're seeing and the broader inflation trends that we're seeing and how that's impacting the consumer, essentially the patients?

祝賀這個季度。因此，當我只考慮核心測試時，很明顯，COVID 在這方面正在下降。我們應該如何看待您對 2023 年的展望，尤其是考慮到我們所看到的經濟背景和我們所看到的更廣泛的通脹趨勢，以及這將如何影響消費者，尤其是患者？

Yes. So thanks, Brian, for the question. The way I would think about it is, again, COVID continues to come down. Although we may be at an inflection point here on COVID, too early to tell. But obviously, these 2 new variants, the BQ.1 nd BQ1.1, are growing in terms of concern. It's now 11%, 12% of all new cases higher in the East, reported to be over 20% in the New York City area. But as of now, we're thinking 10,000 to 15,000 a day as we go into next year.

是的。所以，謝謝布賴恩提出的問題。我的想法是，COVID 再次下降。儘管我們可能正處於 COVID 的拐點，但現在下結論還為時過早。但顯然，這 2 個新變體 BQ.1 和 BQ1.1 的關注度正在增加。現在是 11%，在東部所有新病例中佔 12%，據報導在紐約市地區超過 20%。但截至目前，我們正在考慮進入明年時每天 10,000 到 15,000 個。

We reported that our base business, the volumes recovered as we moved through the third quarter. We expect that trend to continue. And -- but remember, physicians are only part of it. Again, we feel great about opportunities to help our health system partners, whether it's additional reference testing or PLS.

我們報告說，我們的基礎業務，隨著我們進入第三季度，銷量有所恢復。我們預計這一趨勢將繼續下去。而且——但請記住，醫生只是其中的一部分。同樣，我們很高興有機會幫助我們的衛生系統合作夥伴，無論是額外的參考測試還是 PLS。

And then we feel great about our acquisition funnel, and we're looking at several outreach opportunities. We announced one that closed, but stay tuned. There should be some more announcements as we get into the early part of next year.

然後我們對我們的收購渠道感覺很好，我們正在尋找幾個外展機會。我們宣布了一個關閉，但敬請期待。隨著我們進入明年初，應該會有更多的公告。

And I'll just remind you all that there is a correlation between COVID volumes and our base business. And so as COVID improves, we believe that could help our base business, and we clearly started to see that in Q3.

我只想提醒大家，COVID 數量與我們的基礎業務之間存在相關性。因此，隨著 COVID 的改善，我們相信這可以幫助我們的基礎業務，我們顯然在第三季度開始看到這一點。

And to some extent, as we've talked before, we have somewhat of a natural hedge because if COVID goes out and base softens, we have seen that in the past. And therefore, the improving COVID situation should be a tailwind on base growth going forward.

在某種程度上，正如我們之前所說，我們有某種自然的對沖，因為如果 COVID 消失並且基數走軟，我們過去已經看到過這種情況。因此，COVID 形勢的改善應該會推動未來的基礎增長。

And as we said before, most of our major markets have recovered. We still have not seen full recovery in New York City, and we still believe that we'll gradually step-by-step improve over the next couple of years. We'll go back to where we were in 2019. So that's the only -- the major metropolitan area that we haven't seen full recovery. So from an overall perspective, the COVID direction should be favorable to base.

正如我們之前所說，我們的大部分主要市場都已經恢復。我們還沒有看到紐約市的全面復甦，我們仍然相信我們會在未來幾年逐步逐步改善。我們將回到 2019 年的狀態。所以這是唯一一個我們還沒有看到完全復甦的主要大都市區。所以從整體來看，COVID方向應該是有利於基地的。

Next question is from A.J. Rice with Credit Suisse.

下一個問題來自 A.J.瑞士信貸的大米。

And best wishes, Steve, in the future there. It's a pleasure working together.

最好的祝愿，史蒂夫，在未來。一起工作很愉快。

Thanks, A.J.

謝謝，A.J.

Maybe just to talk a little bit about capital deployment. You're talking about -- obviously, you did a lot on the share repurchase year-to-date, as you mentioned, so that continues to be part of the story. You've got these hospital opportunities.

也許只是談談資本配置。你在談論 - 顯然，正如你所提到的，你今年迄今在股票回購方面做了很多工作，所以這仍然是故事的一部分。你有這些醫院的機會。

There are other M&A potentially tuck-in deals out there. And then some of the investments, consumer direct and so forth. Does that -- how do you see capital priorities and capital deployment as we exit this year and think about the next year or 2?

還有其他潛在的併購交易。然後是一些投資，消費者直銷等等。那是——當我們今年退出並考慮明年或兩年時，你如何看待資本優先級和資本部署？

Yes. Thanks, A.J., for the question. This is Sam. So as you think about our position right now, we've generated $1.38 billion of operating cash flow through 3 quarters of the year. We're sitting on very healthy amount of cash of $700 million.

是的。謝謝，A.J.，提出這個問題。這是山姆。因此，當您考慮我們現在的狀況時，我們在今年 3 個季度產生了 13.8 億美元的運營現金流。我們坐擁 7 億美元的非常健康的現金。

When you think about our capital deployment philosophy, it's very consistent. We said that we're going to return the majority of our free cash flow back to shareholders. And we're going to focus on making sure that, obviously, we invest in the business. That's -- we talked about the strategic investments. This year, we expect to make $160 million of strategic investments.

當您考慮我們的資本部署理念時，它是非常一致的。我們說過，我們將把大部分自由現金流返還給股東。我們將專注於確保，顯然，我們投資於業務。那就是——我們談到了戰略投資。今年，我們預計將進行 1.6 億美元的戰略投資。

We've -- net of the $400 million of capital, whatever free cash flow that we have, we're going to return back to shareholders in the form of dividends, in the form of share repurchases and M&A.

我們已經——扣除 4 億美元的資本，無論我們擁有多少自由現金流，我們都將以股息、股票回購和併購的形式返還給股東。

Now to the extent -- I think we have a robust pipeline of M&A transactions and opportunities, as Jim mentioned. To the extent that -- we're going to be very disciplined about M&A though. I mean, to the extent that we don't have accretive deals that we believe really add strategic value to us and produce the -- and meet the ROIC threshold that we have and are accretive, then we're going to return back that cash in terms of share repurchases.

現在，正如吉姆提到的，我認為我們擁有強大的併購交易和機會渠道。在某種程度上 - 我們將對併購非常有紀律。我的意思是，如果我們沒有我們認為真正為我們增加戰略價值並產生 - 並達到我們擁有和增值的 ROIC 門檻的增值交易，那麼我們將返還現金在股份回購方面。

Next question is from Pito Chickering with Deutsche Bank.

下一個問題來自德意志銀行的 Pito Chickering。

And Steve, thanks for all of your help over the years. I mean, I've just got a different question. So the fourth quarter guidance of $1.91 annualizes to $7.64 and has a good guide for the improved base pricing business as well as strong code pricing.

史蒂夫，感謝你多年來的幫助。我的意思是，我只是有一個不同的問題。因此，第四季度 1.91 美元的指導年化為 7.64 美元，並且對改進的基本定價業務以及強大的代碼定價有很好的指導。

So as we put $0.50 PAMA in that one, that would be the launch pad into 2023 is 7 13, which seems like a pretty big gap versus 8 50 consensus number or so. Can you give us some more color on how to bridge that gap between 7 13 and 8 50 between revenue growth and cost cutting?

因此，當我們在其中投入 0.50 美元的 PAMA 時，到 2023 年的發射台是 7 13，這與 8 50 左右的共識數字相比似乎差距很大。你能給我們更多關於如何彌合收入增長和成本削減之間 7 13 和 8 50 之間的差距的顏色嗎？

Yes. Thanks, Pito. And let me start, and then I'll have Sam pipe in here. So first, our long-term guidance on the growth rate of the company remains. We expect to grow our top line on the base business 4% to 5%, and we expect to get nice margin accretion off of that 4% to 5%. So we still feel good about that 4% to 5% next year.

是的。謝謝，皮托。讓我開始，然後我會讓 Sam 在這裡吹煙斗。因此，首先，我們對公司增長率的長期指導仍然存在。我們預計基礎業務的收入將增長 4% 至 5%，並且我們預計將從 4% 至 5% 中獲得可觀的利潤增長。所以我們仍然對明年 4% 到 5% 的增長感到滿意。

Obviously, we've said 2% -- roughly 2 percentage points of that can come from acquisition. We've said we've got a great list, a good funnel of both tuck-ins from outreach as well as a few, what I would call, deals that enhance our capabilities, filling some gaps in our portfolio. So feel good about that.

顯然，我們已經說過 2%——其中大約 2 個百分點來自收購。我們已經說過，我們有一個很好的清單，一個很好的漏斗，既有外展的收入，也有一些我稱之為增強我們能力的交易，填補了我們投資組合中的一些空白。所以感覺很好。

We also feel good about our Invigorate program and continuing to work that, as Sam said, reinvigorating our Invigorate program to offset some of the margin pressures that we've seen from inflation. So we feel good about it. We feel good about the investments that we're making in ADx, and we've said that consumer-initiated testing next year should be a tailwind to us.

我們也對我們的 Invigorate 計劃感到滿意，並繼續努力，正如 Sam 所說，重振我們的 Invigorate 計劃以抵消我們從通貨膨脹中看到的一些利潤率壓力。所以我們對此感覺很好。我們對我們在 ADx 上的投資感到滿意，我們已經說過明年消費者發起的測試應該對我們有利。

And then finally, as Sam and Steve said, we are fine-tuning the cost structure, and we'll make the necessary rebalances in the cost structure to deliver what we need to deliver next year. So we feel good about it.

最後，正如 Sam 和 Steve 所說，我們正在微調成本結構，我們將在成本結構中進行必要的重新平衡，以交付我們明年需要交付的產品。所以我們對此感覺很好。

Yes, maybe I'll add a couple of comments to Jim's. So just -- we're not going to give you, obviously, guidance right now, but just maybe directionally give you some things also to build into or to think about as you build your model for next year.

是的，也許我會在 Jim 的評論中添加一些評論。所以，很明顯，我們現在不會給你指導，但可能會定向地給你一些東西，以便在你為明年構建模型時構建或思考。

Expense reduction is an important one. Jim mentioned that. The fact that the CIT investments will drive growth in that consumer segment, and so they will be less dilutive as you look at next year versus this year.

減少開支是一個重要的方面。吉姆提到過。事實上，CIT 投資將推動該消費領域的增長，因此與今年相比，明年它們的稀釋性會更小。

The fact that when you think about pricing, it's a definitely improving environment for us. As we've said, 50 basis points in Q3, so that's additional number that maybe some of you used, the 1% pricing -- negative pricing impact is no longer the case in terms of what we're seeing because of all the things that we talked about around value-based contracts with the health plans.

事實上，當您考慮定價時，這對我們來說絕對是一個改善的環境。正如我們所說，第三季度 50 個基點，所以這可能是你們中的一些人使用的額外數字，即 1% 的定價——由於所有事情，就我們所看到的情況而言，負面定價影響已不再存在我們圍繞與健康計劃的基於價值的合同進行了討論。

And then when you think about COVID, I mean, COVID is -- obviously, the assumption going into 2023 is that it's 10,000 to 15,000. There's variability around that, but that's our assumption right now. And the 10,000 to 15,000 is -- so it's coming down, COVID testing is coming down. There's an improvement in the base business as a result of that.

然後當你想到 COVID 時，我的意思是，COVID 是——顯然，到 2023 年的假設是 10,000 到 15,000。周圍存在可變性，但這是我們現在的假設。 10,000 到 15,000 - 所以它正在下降，COVID 測試正在下降。因此，基礎業務有所改善。

But also the fact that with the PHE ending, at least our assumption is that it ends in January, even though that average reimbursed price comes down, that's not a straight impact to margin because we have costs that we incur in the nontraditional retail channels right now that will no longer -- that we will no longer incur after the end of the PHE emergency. So you can't also take the margin on COVID as being completely impacted by that price reimbursed -- or by that reimbursement decrease.

但事實上，隨著 PHE 的結束，至少我們的假設是它在 1 月份結束，即使平均報銷價格下降，這也不會直接影響利潤率，因為我們在非傳統零售渠道中產生了成本現在，在 PHE 緊急情況結束後，我們將不再發生這種情況。因此，您不能也認為 COVID 的利潤率完全受到報銷價格或報銷減少的影響。

And Pito, remember that our base business is growing in '23. So when you think about modeling it off the fourth quarter, remember, the base will grow, okay? And then secondly, just to underscore Jim's comments is this company and will continue under Jim and Sam's leadership has a long track record of productivity improvements.

還有 Pito，請記住我們的基礎業務在 23 世紀不斷增長。所以當你考慮在第四季度建模時，請記住，基數會增長，好嗎？其次，為了強調吉姆的評論，這家公司將繼續在吉姆和薩姆的領導下，在提高生產力方面有著長期的記錄。

And so Jim, in his prepared remarks, talked about our operational excellence program. And we have a specific program called Invigorate, and that Invigorate program is to drive 3% productivity.

因此，吉姆在他準備好的發言中談到了我們的卓越運營計劃。我們有一個名為 Invigorate 的特定計劃，該 Invigorate 計劃旨在提高 3% 的生產力。

So when you think about 2023 and you think about potentially getting a PAMA cut, you need to think about the expense reduction, base growth as well as Invigorate offsetting some of the inflationary pressure as well as potentially a PAMA cut.

因此，當您考慮 2023 年並考慮可能削減 PAMA 時，您需要考慮費用減少、基礎增長以及 Invigorate 抵消部分通脹壓力以及潛在的 PAMA 削減。

And I can tell you, we've highlighted this before in our investor presentations, there's a lot more room for us to drive productivity, particularly around augmentation and digitization going forward. And Jim will be driving that as he leads the company.

我可以告訴你，我們之前在投資者介紹中強調了這一點，我們還有更多空間來提高生產力，特別是在未來的增強和數字化方面。吉姆將在領導公司時推動這一點。

Next question is from Patrick Donnelly with Citi.

下一個問題來自花旗的 Patrick Donnelly。

Maybe one on a similar vein, at least on the cost side, just in terms of some of the labor retention, labor inflation that you guys have seen, can you just talk about, I guess, where we are in that process?

也許一個類似的脈絡，至少在成本方面，就你們所看到的一些勞動力保留和勞動力通脹而言，我想你們能談談我們在這個過程中的位置嗎？

And then secondarily, kind of on the back of that, the supply chain as well. I know it's been a bit of -- kind of issues pop up, and you guys handled them well. Has that plateaued, getting better? Maybe just a little bit of color there would be helpful.

其次，在某種程度上，供應鏈也是如此。我知道這有點——突然出現了一些問題，你們處理得很好。是否已經趨於平穩，好轉了？也許只是一點點顏色會有幫助。

Yes. So thanks, Patrick. So first, on the labor inflation, so what we're seeing this year is between 3% and 4%. And our plan next year is to have a merit increase of roughly 3% across the company. But we would expect to have to make some other equity adjustments along the way.

是的。所以謝謝，帕特里克。首先，關於勞動力通脹，我們今年看到的通脹率在 3% 到 4% 之間。我們明年的計劃是讓整個公司的業績增長大約 3%。但我們預計在此過程中必須進行一些其他股權調整。

So I think from a planning modeling standpoint, that 3% to 4% range still feels good from a labor utilization. But I'll tell you, on our employee retention and attrition is that it has stabilized here in the third quarter, albeit it's stabilized at a higher level than we would like, which obviously affects productivity.

因此，我認為從規劃建模的角度來看，從勞動力利用率來看，3% 到 4% 的範圍仍然感覺不錯。但我會告訴你，關於我們的員工保留和流失，它在第三季度已經穩定下來，儘管它穩定在比我們想要的更高的水平，這顯然會影響生產力。

So we continue to work really hard on making Quest the employer of choice. And it's not just about wages. There's a lot of other things, as you can imagine, that go into that.

因此，我們繼續努力使 Quest 成為首選雇主。這不僅僅是關於工資。正如您可以想像的那樣，還有很多其他的東西。

In terms of inflation on the supplies and materials front, we purchased north of $2 billion worth of, what we call, pre-analytical and analytical supplies. And on that roughly $2 billion, about 80% of it is locked up in terms of it's under contract. And most of those contracts that we've entered into in previous years actually do not contain price indexes or price going up. If anything, through the contract period, sometimes, prices improve.

就供應和材料方面的通貨膨脹而言，我們購買了價值超過 20 億美元的我們稱之為預分析和分析用品。在這大約 20 億美元中，大約 80% 是根據合同鎖定的。我們前幾年簽訂的大部分合同實際上不包含價格指數或價格上漲。如果有的話，在合同期內，有時價格會提高。

So we feel good about that. But 20% of roughly $2 billion is a big number that is not completely locked up, and that's where we do see some inflationary pressures. In addition to the pre-analytical and analytical supplies, we have a lot -- we have roughly $800 million, $900 million of other spend, that is logistics, professional services, janitorial services, travel, living expenses.

所以我們對此感覺很好。但大約 20 億美元中的 20% 是一個沒有完全鎖定的大數字，這就是我們確實看到一些通脹壓力的地方。除了預分析和分析用品，我們還有很多——我們有大約 8 億美元，9 億美元的其他支出，即後勤、專業服務、清潔服務、差旅、生活費用。

So all of that is really not under contract, and that's where we see the majority of inflation in our business today. Will it get better next year? Will it get worse next year? Hard to predict. But everything that the Fed is doing will hopefully slow those inflationary pressures that we are seeing. But again, we're committed, and we work real hard for our Invigorate program to offset as much of this as we possibly can.

所以所有這些實際上都沒有根據合同，這就是我們今天看到我們業務中大部分通貨膨脹的地方。明年會好起來嗎？明年會更糟嗎？很難預測。但美聯儲正在做的一切有望減緩我們所看到的通脹壓力。但是，我們再次承諾，我們非常努力地為我們的 Invigorate 計劃工作，以盡可能多地抵消這種影響。

Next question is from Derik De Bruin with Bank of America.

下一個問題來自美國銀行的 Derik De Bruin。

Steve, thanks for all your time and patience with me. I appreciate over the years.

史蒂夫，感謝你對我的所有時間和耐心。這些年來我很感激。

Thank you.

謝謝你。

I guess, just a couple of questions since a lot might have been answered already. But are you expecting any sort of relief or you're expecting this for the past and sort of like your update on PAMA?

我想，只是幾個問題，因為很多問題可能已經得到了回答。但是您是否期待任何形式的緩解，或者您期待過去的這種情況，有點像您對 PAMA 的更新？

And then a follow-up on that for another one. As we sort of head into a recession and inflation picks up, I mean, are you seeing any increase in bad debt from your customers? Any concerns on people opting not to pay bills as they're sort of struggling right now?

然後是另一個跟進。當我們進入衰退和通貨膨脹率上升時，我的意思是，您是否看到客戶的壞賬有所增加？人們對選擇不支付賬單的人有任何擔憂，因為他們現在有點掙扎嗎？

So let's start with the SALSA, PAMA comment. So as we've said for many years now, you should plan on a PAMA cut in 2023. That's what we assumed. And until we have news, that's better than that. We should assume that.

因此，讓我們從 SALSA、PAMA 的評論開始。因此，正如我們多年來所說的那樣，您應該計劃在 2023 年削減 PAMA。這就是我們的假設。在我們有消息之前，這比那更好。我們應該假設。

Number 2 is, in my prepared remarks, I talked about the effort on SALSA. What I'll add to those comment is the support -- congressional support, and this is on both sides of the aisle, and both in the House and in the Senate is very strong. So there is alignment that we need to have a permanent fix to the implementation of PAMA.

第二，在我準備好的發言中，我談到了在 SALSA 上所做的努力。我要補充的是這些評論的支持——國會的支持，這在兩黨，眾議院和參議院都非常強大。因此，一致認為我們需要永久修復 PAMA 的實施。

But as you can imagine, Washington is busy. There's a lot of topics on the table, and we're trying to find a vehicle that we can attach it to. And I would expect, if we were successful with SALSA, it will be late in this year, but we'll know that. And also it's going to cost money, so we're in the process of getting a score from CBO, and there needs to be a [pay for]. So we're working through that.

但正如你想像的那樣，華盛頓很忙。桌面上有很多主題，我們正在嘗試找到可以附加它的車輛。我希望，如果我們在 SALSA 上取得成功，那將在今年晚些時候，但我們會知道的。而且它會花錢，所以我們正在從 CBO 獲得分數，並且需要 [付費]。所以我們正在努力解決這個問題。

But I could tell you, the alignment and the support of my colleagues throughout this industry has never been stronger, and we're going through grassroots efforts to send letters into Washington. So really, a full-court press to get SALSA over the goal line.

但我可以告訴你，我在整個行業的同事們的團結和支持從未像現在這樣強大，我們正在通過基層努力向華盛頓發送信件。真的，全場緊逼讓 SALSA 越過球門線。

Now if we don't -- or we're not successful with SALSA, the question is, could we get another year of relief. We've got them in the past. Again, I'm not going to indicate that we're going to get that again. But if we don't get SALSA, there obviously will be a pivot to ask for another year of relief, and we'll push on that. But again, we're not planning that in our 2023 planning.

現在，如果我們不這樣做——或者我們在 SALSA 方面沒有取得成功，那麼問題是，我們能否再得到一年的緩解。我們過去有過。同樣，我不會表示我們將再次獲得它。但如果我們得不到 SALSA，顯然會有一個支點要求再減免一年，我們將繼續努力。但同樣，我們並沒有在 2023 年的計劃中對此進行計劃。

Jim, do you want to cover the second piece?

吉姆，你想報導第二部分嗎？

Yes. So Derik, your question on are we seeing an uptick in our patient concession rate or patients unless we pay (inaudible) no, we're not seeing any impact as of yet on that. In fact, our patient concessions have actually improved rate -- has actually improved year-over-year, and we're going to build it into next year.

是的。所以 Derik，你的問題是我們是否看到我們的患者讓步率或患者有所上升，除非我們支付（聽不清）不，我們目前還沒有看到任何影響。事實上，我們的患者讓步實際上提高了速度——實際上同比有所提高，我們將把它建立到明年。

We do a lot of things to work this, and we work it real hard. We have what we call real-time adjudication. So a patient comes into our PSC. We take the requisition, and we can literally adjudicate that claim, ex the payment coming to us.

我們為此做了很多事情，而且我們非常努力地工作。我們有所謂的實時裁決。因此，患者進入我們的 PSC。我們接受申請，我們可以從字面上裁定該索賠，除了我們收到的付款。

So we know real-time what tests on that requisition are going to be approved or denied, and we know what the patient balance is. And then we provide multiple ways for that patient to pay the bill or give us a form of payment, so that when the claim is adjudicated, we know how to charge the patient.

因此，我們實時知道該申請的哪些測試將被批准或拒絕，並且我們知道患者余額是多少。然後我們為該患者提供多種支付賬單的方式或給我們一種付款方式，以便在裁定索賠時，我們知道如何向患者收費。

We're working on things to actually move that whole process upstream. So when the patient makes an appointment and that requisition has already been delivered to us, because the physician has sent into us electronically, we can do that pre-adjudication, if you will, as the patient is making an appointment online.

我們正在努力將整個流程向上游移動。因此，當患者預約並且申請已經發送給我們時，因為醫生已經通過電子方式發送給我們，如果您願意，我們可以進行預裁定，因為患者正在網上預約。

So even before they come into the PSC, we can pre-adjudicate that claim. We're going to build the capability to do that. And so it improves our PSC productivity as well as gives the patient knowledge of what they're going to be billed before they walk into the PSC.

因此，即使在他們進入 PSC 之前，我們也可以預先裁定該聲明。我們將建立這樣做的能力。因此，它提高了我們的 PSC 生產力，並讓患者在進入 PSC 之前了解他們將要支付的費用。

So lots of things we're doing to make it easier to pay, to inform the patient, and all of those things help our patient concession rate.

我們正在做很多事情來讓支付變得更容易，通知病人，所有這些都有助於我們的病人讓步率。

And the last question in the queue is from Eric Coldwell with Baird.

隊列中的最後一個問題來自 Baird 的 Eric Coldwell。

I'm going to come back to a topic that's been hit a few times, but maybe ask a different way. The base revenue per requisition, very, very strong here. I know we've heard a lot of comments on pricing improving or really being less bad, down 50 bps, which would, I think, imply that your mixed component and other components must have been something more like 4% growth on a per test basis.

我將回到一個被點擊過幾次的話題，但也許會以不同的方式提問。每個申請的基本收入在這裡非常非常強勁。我知道我們聽到了很多關於定價改善或確實不那麼糟糕的評論，下降了 50 個基點，我認為這意味著您的混合組件和其他組件在每次測試中一定有大約 4% 的增長基礎。

So I'm curious if you can quantify for us or give us some qualitative color on what type of mix improvement you saw. What categories of testing were you seeing the number of test per requisition go up this quarter more than normal?

所以我很好奇你是否可以為我們量化或給我們一些關於你看到的混合改進類型的定性顏色。您發現本季度每個申請的測試數量比往常增加了哪些類別的測試？

Was there a changing impact from PLS volumes in the numbers this quarter? Or were there some nuances with value-based contracts that maybe you aren't fully understood by the Street that could have been driving some of this upside mix driven revenue per req? I know I'm throwing a lot at you, but it feels like that was a pretty big number. So I want to dig into it.

本季度的 PLS 數量是否對數字產生了變化的影響？或者是否存在一些基於價值的合同的細微差別，您可能沒有被華爾街完全理解，這些細微差別可能會推動這種上行組合驅動的按需收入？我知道我向你扔了很多東西，但感覺這是一個相當大的數字。所以想深究一下。

Yes. So thanks, Eric. So as you know, there's a lot of things that go into the rev req calculation. So let's take price per test out because we already said that it was down about 50 basis points. So your math is directionally correct. All of the things were up about 3.8% in the quarter.

是的。所以謝謝，埃里克。如您所知，rev req 計算涉及很多因素。所以讓我們把每次測試的價格拿出來，因為我們已經說過它下降了大約 50 個基點。所以你的數學方向是正確的。本季度所有這些都上漲了約 3.8%。

There's really 3 very different types of mix that enter into that. There's clinical mix, business mix and payer mix. And from -- let me just start with clinical mix. I'll just tell you that the investments we're making in advanced diagnostics are paying off. We're getting a higher mix of molecular and other genetic and advanced based tests. Hematology was good. Some of our cancer testing, really good in the quarter.

確實有 3 種非常不同的混合類型。有臨床組合、業務組合和付款人組合。從——讓我從臨床組合開始。我只想告訴你，我們在高級診斷方面的投資正在取得回報。我們正在獲得更多的分子和其他遺傳和高級測試的組合。血液學很好。我們的一些癌症測試在本季度非常好。

From a business mix standpoint, there's a lot of things there. First, from a commercial payer standpoint, there's a mix of cap in fee for service. And -- we'll just tell you, in the quarter, fee for service was better, and cap was less. And if cap is less, that -- obviously, you get a fixed payment. So that certainly helped us.

從業務組合的角度來看，那裡有很多東西。首先，從商業付款人的角度來看，服務費用有多種上限。而且 - 我們只是告訴你，在本季度，服務費更好，上限更低。如果 cap 更少，那 - 顯然，你會得到固定付款。所以這當然對我們有幫助。

Our health systems business was -- actually, just a pure reference, was good in the quarter, and that tends to mix up our rev per req.

我們的衛生系統業務——實際上，只是一個純粹的參考，在本季度表現良好，這往往會混淆我們的每項要求。

And then finally, there's payer mix issues, what portion is coming from commercial, what portion is coming from Medicare, what portion is coming from Medicaid, and that was favorable in the quarter.

最後，還有付款人組合問題，哪些部分來自商業，哪些部分來自醫療保險，哪些部分來自醫療補助，這在本季度是有利的。

And then finally, CIT, our consumer-initiated testing business, has a higher revenue per req. The pricing is better in that market, and we're getting some lift from our CIT business. So a lot of factors go into it, but that's kind of the summary of it.

最後，CIT，我們的消費者發起的測試業務，每個請求的收入更高。那個市場的定價更好，我們從 CIT 業務中得到了一些提升。所以它涉及很多因素，但這就是它的總結。

Okay. I think that was the last question. Again, thank you for your support over the years. If you added up the math, this is my 42nd call. It's been a pleasure working with all of you. Thank you for all your support. And I'm sure you're going to be seeing me around in our travels. So thank you, and have a great day.

好的。我認為這是最後一個問題。再次感謝您多年來的支持。如果你把數學加起來，這是我的第 42 個電話。很高興與大家一起工作。感謝你的支持。我相信你會在我們的旅行中看到我。所以謝謝你，祝你有美好的一天。

Thank you for participating in the Quest Diagnostics third 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.

感謝您參加 Quest Diagnostics 2022 年第三季度電話會議。今天晚些時候，將在 Quest Diagnostics 的網站 www.questdiagnostics.com 上發布關於此次電話會議的準備好的發言稿。

A replay of the call may be accessed online at www.questdiagnostics.com/investor or by phone at (203) 369-3609 for international callers or (888) 566-0462 for domestic callers.

可在 www.questdiagnostics.com/investor 在線訪問通話重播，國際用戶可撥打 (203) 369-3609，國內用戶可撥打 (888) 566-0462。

Telephone replays will be available from approximately 10:30 a.m. Eastern Time on October 20, 2022, until midnight Eastern Time, November 3, 2022. Thank you, and goodbye.

電話重播將於 2022 年 10 月 20 日東部時間上午 10:30 左右開始，直到東部時間 2022 年 11 月 3 日午夜為止。謝謝，再見。