奎斯特診斷 (DGX) 2023 Q1 法說會逐字稿

Welcome to the Quest Diagnostics First Quarter 2023 Conference Call. At the request of the company, this call is being recorded. (Operator Instructions).

歡迎來到 Quest Diagnostics 2023 年第一季度電話會議。應公司要求，對此次通話進行錄音。 （操作員說明）。

I would now like to introduce Shawn Bevec, Vice President of Investor Relations for Quest Diagnostics. Go ahead, please.

我現在想介紹 Quest Diagnostics 投資者關係副總裁 Shawn Bevec。請繼續。

Thank you, and good morning. I'm joined by Jim Davis, our Chairman, Chief Executive Officer and President; and Sam Samad, our Chief Financial Officer. During this call, we may make forward-looking statements and will 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. Risks and uncertainties 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.

謝謝，早上好。我們的董事長、首席執行官兼總裁 Jim Davis 也加入了我的行列；和我們的首席財務官 Sam Samad。在這次電話會議中，我們可能會做出前瞻性陳述，並將討論非 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。可能影響 Quest Diagnostics 未來結果的風險和不確定性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-Q 表格季度報告和 8-K 表格當前報告中描述的風險和不確定性.

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.

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。任何對基礎業務測試、收入或數量的引用均指我們的業務績效，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收益增長，都是複合年增長率。

Finally, revenue growth rates from acquisitions will be measured against our base business. Now here is Jim Davis.

最後，收購的收入增長率將根據我們的基礎業務進行衡量。現在是吉姆·戴維斯。

Thanks, Sean, and good morning, everyone. We're off to a strong start in 2023. Our base business grew double digits compared to prior year, driven by strong performance across physician and health system lab services. This morning, we announced the acquisition of Haystack Oncology. Later in my remarks, I'll describe how this transaction is aligned to the molecular genomics and oncology strategy we shared last month at Investor Day and how it positions us well in the fast-growing category of minimal residual disease testing.

謝謝，肖恩，大家早上好。我們在 2023 年有了一個良好的開端。我們的基礎業務與上一年相比增長了兩位數，這得益於醫生和衛生系統實驗室服務的強勁表現。今天早上，我們宣布收購 Haystack Oncology。在我稍後的發言中，我將描述這項交易如何與我們上個月在投資者日分享的分子基因組學和腫瘤學戰略保持一致，以及它如何使我們在快速增長的微小殘留病檢測類別中處於有利地位。

Now turning to the first quarter. Total revenues were $2.3 billion. Total base business revenue grew 10%, supported by base business volume growth of nearly 8%, and earnings per share were $1.78 on a reported basis and $2.04 on an adjusted basis. Now let's look at some of the highlights from the quarter.

現在轉向第一季度。總收入為 23 億美元。在基礎業務量增長近 8% 的支持下，基礎業務總收入增長了 10%，報告基礎上的每股收益為 1.78 美元，調整後的基礎上為 2.04 美元。現在讓我們來看看本季度的一些亮點。

The strong volume growth we experienced in our base business across all customer types, points to a continued return to care in the quarter. We saw a faster growth in a number of tests per requisition across a broad range of clinical test categories. This suggests more people are returning to the health care system for routine care after delaying care during the pandemic. Health plan volumes also continued to grow faster than the overall business. This trend is directly related to our ongoing efforts to partner with health plans to actively steer patients to high-quality lower-cost providers like Quest. Thereby saving money for the health plan, employers and plan members.

我們在所有客戶類型的基礎業務中都經歷了強勁的銷量增長，表明本季度繼續回歸護理。我們看到在廣泛的臨床測試類別中，每個申請的測試數量增長更快。這表明，在大流行期間延遲了醫療服務後，更多人正在返回醫療保健系統接受常規醫療服務。健康計劃數量的增長速度也繼續快於整體業務。這一趨勢與我們與健康計劃合作的持續努力直接相關，以積極引導患者使用像 Quest 這樣的高質量低成本供應商。從而為健康計劃、雇主和計劃成員節省資金。

During the first quarter, base revenues from health systems grew approximately 7%. At Investor Day, we said this book of business would grow at about 5% to 6% CAGR, and we're having success across the board with new wins in our reference and professional lab services offerings. Some of these highlights include: in February, we announced that we're helping Tower Health in Pennsylvania manage its laboratory supply chain in addition to performing reference testing. Our Northern Light Health PLS relationship began to ramp up in the quarter. Northern Light is a large integrated health system in Maine, where we are providing services for all 9 of its hospital labs and its cancer center. We also closed our acquisition of Northern Lights outreach lab assets.

第一季度，來自衛生系統的基本收入增長了約 7%。在投資者日，我們表示這本業務書將以約 5% 至 6% 的複合年增長率增長，並且我們在參考和專業實驗室服務產品方面取得了新的勝利，取得了全面的成功。其中一些亮點包括：2 月，我們宣布除了執行參考測試外，我們還幫助賓夕法尼亞州的 Tower Health 管理其實驗室供應鏈。我們與 Northern Light Health PLS 的關係在本季度開始加強。 Northern Light 是緬因州的一個大型綜合醫療系統，我們為其所有 9 個醫院實驗室和癌症中心提供服務。我們還完成了對北極光外展實驗室資產的收購。

Finally, we completed our strategic laboratory services acquisition with Newyork-Presbyterian, with new test volumes starting to flow into our Clifton, New Jersey laboratory earlier this month. This is the third outreach acquisition we completed in the last 6 months. As we enter the second quarter, our pipeline of new health system business remains strong, including many additional PLS opportunities.

最後，我們完成了與 Newyork-Presbyterian 的戰略實驗室服務收購，新的測試量本月早些時候開始流入我們位於新澤西州克利夫頓的實驗室。這是我們在過去 6 個月內完成的第三次外展收購。隨著我們進入第二季度，我們的新醫療系統業務渠道依然強勁，包括許多額外的 PLS 機會。

Now I'd like to say a few words about our announcement this morning regarding our planned acquisition of Haystack Oncology. Haystack is an early stage oncology company focused on minimal residual disease or MRD testing. Haystack has developed a highly sensitive liquid biopsy technology that can detect circulating DNA from residual or recurring tumor cells. The technology was licensed from Johns Hopkins where it was developed by genomics and cancer pioneers. Most patients treated for cancer must be monitored for years following surgery and initial treatment. This is because there's always the potential that some cancer was missed or may recur.

現在，我想就我們今天早上宣布的有關我們計劃收購 Haystack Oncology 的聲明說幾句話。 Haystack 是一家專注於微小殘留病或 MRD 檢測的早期腫瘤公司。 Haystack 開發了一種高度敏感的液體活檢技術，可以從殘留或複發的腫瘤細胞中檢測循環 DNA。該技術獲得約翰霍普金斯大學的許可，由基因組學和癌症先驅開發。大多數接受癌症治療的患者必須在手術和初始治療後進行多年監測。這是因為總有可能遺漏或可能複發某些癌症。

At Investor Day, we talked about Quest's strong position in the mature cancer areas of screening and diagnosis and that we will also play a leading role in therapy selection with our TSO-500 assay. Haystacks liquid biopsy technology, combined with our strengths in screening, pathology and sequencing will now position us to play a leading role in the fast-growing MRD category. We expect to focus initially on colorectal, breast and lung cancers and to start generating revenue next year.

在投資者日，我們談到了 Quest 在篩查和診斷成熟癌症領域的強大地位，我們還將通過我們的 TSO-500 檢測在治療選擇方面發揮主導作用。 Haystacks 液體活檢技術，結合我們在篩查、病理學和測序方面的優勢，現在將使我們在快速增長的 MRD 類別中發揮領導作用。我們希望最初專注於結直腸癌、乳腺癌和肺癌，並在明年開始創收。

We are also encouraged by other recent developments in advanced diagnostics. In the area of brain health, we saw strong growth, which we attribute largely to our Quest AD detect Alzheimer's blood test. This proprietary test launched last year helps us assess the risk of Alzheimer's disease. We are now introducing additional tests to help us assess the inherited risk of Alzheimer's and provide personalized recommendations to lower risk.

我們也對高級診斷的其他最新發展感到鼓舞。在大腦健康領域，我們看到了強勁的增長，這主要歸功於我們的 Quest AD 檢測阿爾茨海默氏症血液測試。去年推出的這項專有測試幫助我們評估阿爾茨海默氏病的風險。我們現在正在引入額外的測試來幫助我們評估阿爾茨海默氏症的遺傳風險，並提供個性化的建議以降低風險。

We also saw strong growth in our advanced cardiometabolic portfolio, prenatal genetics, our blood-based tuberculosis screening and hepatitis B and C testing. We are encouraged by the CDC's recent decision to recommend onetime screening for hepatitis B. In consumer health, we continue to add to our test menu with new services, including long COVID and menopause testing. We also generated strong year-over-year volume growth in allergy and general health testing as consumers utilize our offerings as a complement to the care provided by their physician. In the coming months, we plan to launch a new consumer genetics panel as well.

我們還看到我們先進的心臟代謝產品組合、產前遺傳學、基於血液的結核病篩查以及乙型和丙型肝炎檢測的強勁增長。我們對 CDC 最近決定推荐一次性乙型肝炎篩查感到鼓舞。在消費者健康方面，我們繼續在我們的測試菜單中添加新服務，包括長期 COVID 和更年期測試。我們還在過敏和一般健康測試方面實現了強勁的同比增長，因為消費者使用我們的產品作為他們醫生提供的護理的補充。在接下來的幾個月裡，我們還計劃推出一個新的消費者遺傳學面板。

Turning to Invigorate. We are well on our way toward achieving our 3% annual productivity savings target. Here are some recent examples among the many contributors. We are improving the efficiency of our patient services network. In some cases, we're closing smaller draw sites and adding staff to larger, higher volume locations. At the same time, we're making it easier for walk-ins to register and be seen through our schedule at check-in service. We are adding new features to the preregistration process, which improves both collections and patient convenience. During the pandemic, we relied heavily on third-party logistics to supplement our own teams collections of COVID-19 tests and other specimens. COVID-19 volumes have declined and the labor market eases we are reducing our dependence on these vendors, which will generate savings for our logistics operations.

轉向振興。我們正在朝著實現每年 3% 的生產力節約目標邁進。以下是眾多貢獻者中最近的一些例子。我們正在提高患者服務網絡的效率。在某些情況下，我們會關閉較小的抽獎地點，並將工作人員添加到更大、更高容量的地點。同時，我們讓臨時入住者更容易登記，並在入住服務時通過我們的時間表看到。我們正在為預註冊流程添加新功能，這將改善收集和患者便利性。在大流行期間，我們嚴重依賴第三方物流來補充我們自己團隊收集的 COVID-19 測試和其他標本。 COVID-19 數量下降，勞動力市場緩和，我們正在減少對這些供應商的依賴，這將為我們的物流業務節省開支。

Finally, we're continuing to enhance our labor staffing models across our lab network to reflect post-pandemic total volumes and drive productivity. As we have said before, we continue to closely manage the cost of our corporate and support functions. The actions we've taken will start to help margins beginning in the second quarter.

最後，我們將繼續加強我們整個實驗室網絡的勞動力配置模型，以反映大流行後的總產量並提高生產力。正如我們之前所說，我們將繼續密切管理公司和支持職能的成本。我們採取的行動將從第二季度開始幫助提高利潤率。

Finally, I'd like to give you an update on where we are with Medicare clinical lab fee schedule cuts. As you know, PAMA cuts were suspended for 2023. We strongly support the recent bipartisan reintroduction of the legislation in Congress to fix PAMA through the Saving Access to Laboratory Services Act, or SALSA. We are working with our trade association on driving advocacy for SALSA through a campaign to stop lab cuts aimed at congressional outreach on the importance of lab services.

最後，我想向您介紹我們在 Medicare 臨床實驗室費用計劃削減方面的最新情況。如您所知，PAMA 削減計劃在 2023 年暫停。我們強烈支持最近兩黨在國會重新引入立法，以通過《節省實驗室服務訪問法案》或 SALSA 修復 PAMA。我們正在與我們的貿易協會合作，通過一項旨在停止實驗室削減的運動來推動 SALSA 的宣傳，目的是讓國會了解實驗室服務的重要性。

Now I'll turn it over to Sam to provide more details on our performance and our updated 2023 guidance. Sam?

現在，我將把它交給 Sam，以提供有關我們的績效和更新的 2023 年指南的更多詳細信息。薩姆？

Thanks, Jim. In the first quarter, consolidated revenues were $2.33 billion, down 10.7% versus the prior year. Base business revenues grew 10% to $2.21 billion, while COVID-19 testing revenues declined approximately 80% to $119 million. Revenues for Diagnostic Information Services declined 11.1% compared to the prior year, reflecting lower revenue from COVID-19 testing services versus the first quarter of 2022, partially offset by strong growth in our base business.

謝謝，吉姆。第一季度，合併收入為 23.3 億美元，同比下降 10.7%。基礎業務收入增長 10% 至 22.1 億美元，而 COVID-19 測試收入下降約 80% 至 1.19 億美元。診斷信息服務收入較上年下降 11.1%，反映出 COVID-19 檢測服務收入較 2022 年第一季度有所下降，部分被我們基礎業務的強勁增長所抵消。

Total volume, measured by the number of requisitions, declined 3.8% versus the prior year with acquisitions contributing 10 basis points the total volume. In the quarter, total base testing volumes grew 7.9% versus the prior year. To recall, our base testing volumes in the first quarter of last year were negatively impacted by surge in COVID-19 cases due to the spread of the Omicron variant. If we normalize for the impact of the easier comps due to the Omicron surge in Q1 '22, we estimate base volume growth at approximately 4%.

以申請數量衡量的總銷量較上年下降 3.8%，收購對總銷量貢獻了 10 個基點。本季度，基礎測試總量比上年增長 7.9%。回想一下，由於 Omicron 變體的傳播，我們去年第一季度的基礎測試量受到了 COVID-19 病例激增的負面影響。如果我們將由於 Omicron 在 22 年第一季度的激增而導致的更簡單的競爭的影響標準化，我們估計基本銷量增長約為 4%。

COVID-19 testing volumes continued to decline during the first quarter. We resulted approximately 1.3 million molecular tests in the quarter, down approximately 5 million tests versus Q1 of 2022. Revenue per requisition declined 7.7% versus the prior year, driven by lower COVID-19 molecular volume. Base business revenue per rec was up 2.3% due primarily to more tests per acquisition as well as positive payer and test mix. Unit price was roughly flat which was consistent with our expectations.

COVID-19 測試量在第一季度繼續下降。我們在本季度進行了大約 130 萬次分子測試，與 2022 年第一季度相比減少了大約 500 萬次測試。由於 COVID-19 分子體積較低，每個申請的收入比上一年下降了 7.7%。每條記錄的基本業務收入增長了 2.3%，這主要是由於每次收購的更多測試以及積極的付款人和測試組合。單價大致持平，符合我們的預期。

Reported operating income in the first quarter was $305 million or 13.1% of revenues compared to $513 million or 19.7% of revenues last year. On an adjusted basis, operating income was $350 million or 15% of revenues compared to $554 million or 21.2% of revenues last year. The year-over-year decline in adjusted operating income is related primarily to lower COVID-19 testing revenues, partially offset by growth in the base business.

第一季度報告的營業收入為 3.05 億美元，佔收入的 13.1%，而去年為 5.13 億美元，佔收入的 19.7%。在調整後的基礎上，營業收入為 3.5 億美元，佔收入的 15%，而去年為 5.54 億美元，佔收入的 21.2%。調整後營業收入的同比下降主要與 COVID-19 測試收入下降有關，但部分被基礎業務的增長所抵消。

Reported EPS was $1.78 in the quarter compared to $2.92 a year ago. Adjusted EPS was $2.04 compared to $3.22 last year. Cash from operations was $94 million in the first quarter versus $480 million in the prior year period. The decline in operating cash flow was primarily related to lower operating income and an additional payroll cycle during the quarter versus the prior year.

本季度報告的每股收益為 1.78 美元，而一年前為 2.92 美元。調整後每股收益為 2.04 美元，而去年為 3.22 美元。第一季度的運營現金為 9400 萬美元，而去年同期為 4.8 億美元。經營現金流量的下降主要與營業收入下降和本季度與上一年相比增加的工資單週期有關。

Now turning to our updated full year 2023 guidance. Revenues are now expected to be between $8.93 billion and $9.08 billion. Base business revenues are expected to be between $8.78 billion and $8.88 billion, COVID-19 testing revenues are expected to be between $150 million and $200 million. Reported EPS is expected to be in a range of $7.52 to $8.02. And adjusted EPS to be in a range of $8.45 to $8.95. Cash from operations is expected to be at least $1.3 billion and capital expenditures are expected to be approximately $400 million.

現在轉向我們更新的 2023 年全年指南。現在預計收入在 89.3 億美元至 90.8 億美元之間。基礎業務收入預計在 87.8 億美元至 88.8 億美元之間，COVID-19 測試收入預計在 1.5 億美元至 2 億美元之間。報告的每股收益預計在 7.52 美元至 8.02 美元之間。調整後的每股收益在 8.45 美元至 8.95 美元之間。運營現金預計至少為 13 億美元，資本支出預計約為 4 億美元。

Here are some things to consider for the remainder of the year. We have lowered our COVID-19 revenue guidance which now assumes very modest COVID-19 revenue following the end of the public health emergency in May. COVID-19 molecular volumes have declined faster than we expected over the last several weeks and we now expect minimal volume contribution from the retail channel post-PHE. We have raised our base business revenue guidance to reflect stronger base volume trends and the recent close of the Newyork-Presbyterian transaction. We expect the Haystack Oncology transaction to close in the second quarter. Our updated EPS guidance reflects the expected dilution from this transaction in 2023. We expect this deal to be modestly dilutive to EPS over the next 3 years and accretive to earnings by 2026. We anticipate Haystack Oncology to begin contributing revenue in 2024 and to have a positive ROIC by the end of 2025.

以下是今年剩餘時間需要考慮的一些事項。我們已經降低了我們的 COVID-19 收入指導，現在假設在 5 月份公共衛生緊急情況結束後 COVID-19 收入非常適中。過去幾週，COVID-19 分子體積的下降速度比我們預期的要快，我們現在預計 PHE 後零售渠道的體積貢獻最小。我們提高了基本業務收入指引，以反映更強勁的基本銷量趨勢和紐約長老會交易最近的結束。我們預計 Haystack Oncology 交易將在第二季度完成。我們更新後的 EPS 指引反映了該交易在 2023 年的預期稀釋。我們預計該交易將在未來 3 年適度稀釋 EPS，並在 2026 年之前增加收益。我們預計 Haystack Oncology 將在 2024 年開始貢獻收入，並有一個到 2025 年底，ROIC 為正。

With that, I will now turn it back to Jim.

有了這個，我現在將它轉回給吉姆。

Thanks, Sam. To summarize, we're off to a strong start in 2023 and our base business grew double digits compared to prior year. We are excited about our announced acquisition of Haystack Oncology. With Haystack, we expect to build on our strengths in cancer screening and diagnosis to play a leading role in the higher growth areas of MRD detection. And finally, we're well on our way towards generating our targeted 3% Invigorate savings and productivity improvements. Now we'd be happy to take your questions. Operator?

謝謝，山姆。總而言之，我們在 2023 年開局良好，我們的基礎業務與上一年相比增長了兩位數。我們對宣布收購 Haystack Oncology 感到興奮。借助 Haystack，我們希望利用我們在癌症篩查和診斷方面的優勢，在 MRD 檢測的更高增長領域發揮主導作用。最後，我們正在朝著實現 3% Invigorate 儲蓄和提高生產力的目標邁進。現在我們很樂意回答您的問題。操作員？

(Operator Instructions) Our first question comes from Ann Hynes of Mizuho Securities.

（操作員說明）我們的第一個問題來自瑞穗證券的 Ann Hynes。

Great. My question is focused on the base volume growth, which was strong. And in your commentary, you talked about health plans that you're gaining more market share there and you are winning more market share. I think you said with reference labs. So -- maybe can you give us more detail on that? Is it existing health care partners? Do you have a new health care partner is your relationship with existing partners may be changing? And I'm just trying to figure out how much is a return to normal versus maybe actual market share you could be gaining.

偉大的。我的問題集中在基礎銷量增長上，這是強勁的。在你的評論中，你談到了健康計劃，你在那裡獲得了更多的市場份額，並且贏得了更多的市場份額。我想你說的是參考實驗室。所以 - 也許你能給我們更多的細節嗎？它是現有的醫療保健合作夥伴嗎？您有新的醫療保健合作夥伴嗎？您與現有合作夥伴的關係可能會發生變化嗎？我只是想弄清楚恢復正常與您可能獲得的實際市場份額相比有多少。

Yes. Our growth in the quarter, again, 10% base revenue growth was strong across all channels, our physician segment and our health systems segment. Now within the health systems segment, we look at our reference business and our PLS business. Our reference business was powered by growth from existing accounts as well as we had several new big wins that you actually win those deals in previous quarters, but the start-up was in the first quarter.

是的。我們在本季度的增長再次表明，10% 的基本收入增長在所有渠道、我們的醫生部門和我們的衛生系統部門都很強勁。現在在衛生系統領域，我們著眼於我們的參考業務和我們的 PLS 業務。我們的參考業務是由現有客戶的增長推動的，而且我們有幾項新的重大勝利，你實際上在前幾個季度贏得了這些交易，但啟動是在第一季度。

On the PLS side, our Professional Lab Services, our growth at existing sites, same-store sales was very strong. But we also added, as you know, a couple of new PLS sites, both in the fourth quarter that were ramping up and in the first quarter. Those were lead health in Florida, as I mentioned in the script, Tower Health and then Northern Light in Maine, a multi-hospital health system up in Northern Maine continued to ramp up in the first quarter. So broad-based growth physician business was very strong, health system business strong and PLS certainly helped the average growth rate in the quarter.

在 PLS 方面，我們的專業實驗室服務、我們在現有站點的增長、同店銷售非常強勁。但是，如您所知，我們還在第四季度和第一季度增加了幾個新的 PLS 站點。正如我在劇本中提到的，這些是佛羅里達州的主要醫療保健機構，Tower Health 和緬因州的 Northern Light，緬因州北部的一個多醫院醫療保健系統在第一季度繼續增加。因此，基礎廣泛的增長醫生業務非常強勁，健康系統業務強勁，PLS 無疑有助於本季度的平均增長率。

Our next question comes from Patrick Donnelly of Citigroup.

我們的下一個問題來自花旗集團的 Patrick Donnelly。

This might be one for Sam. Just on the margin side. As we look at the base margins back in COVID shaking out somewhere around 13% I guess when you look at the go forward, even getting into next year, kind of approaching that 17% type number. Can you just talk about, I don't know if it's a bridge or just the just the progression towards that how you work your way towards that particularly as COVID continues to come out of the model a little bit. I just want to focus on that base margin piece and how we think about the step up there.

這可能是給山姆的。就在邊際。當我們回顧 COVID 的基本利潤率時，我想當你展望未來時，即使進入明年，也接近 17% 的類型數字。你能不能談談，我不知道這是一座橋樑，還是只是你如何努力實現這一目標的進展，特別是當 COVID 繼續從模型中脫穎而出時。我只想專注於基本保證金部分以及我們如何考慮那裡的步驟。

Sure, Patrick. Thanks for the question. So listen, we had 15% operating margins in Q1. I'll talk about some of the drivers in terms of -- to your question, looking forward and how we get to that approximately 17% that we guided to on Investor Day, and we're still committed to that approximately 17% number that we guided for 2023. So here are some key drivers.

當然，帕特里克。謝謝你的問題。所以聽著，我們在第一季度的營業利潤率為 15%。我將根據您的問題、展望未來以及我們如何達到我們在投資者日指導的大約 17% 來談論一些驅動因素，我們仍然致力於實現大約 17% 的數字我們指導了 2023 年。所以這裡有一些關鍵驅動因素。

First of all, Q1 margins came in on the base business strong. And overall, as expected, we had a negative impact from COVID revenues, both coming down more precipitously than expected, but also the mix on COVID. We saw more testing done at the PLS sites than at other sites, which are lower cost for us. But in terms of Q1 came in as expected. As we look forward, we suspect to see a few things help margins. First of all, keep in mind, Q1 is usually our weakest quarter as well. But as we look forward, you expect Invigorate savings to our productivity improvements to ramp up, and that has already started but will ramp up over the course of the year.

首先，第一季度的利潤來自基礎業務強勁。總的來說，正如預期的那樣，我們受到了 COVID 收入的負面影響，既下降得比預期的更陡峭，也包括 COVID 的組合。我們看到在 PLS 站點進行的測試比在其他站點進行的測試更多，這對我們來說成本更低。但就 Q1 而言，符合預期。展望未來，我們懷疑會看到一些有助於提高利潤率的因素。首先，請記住，第一季度通常也是我們最弱的季度。但正如我們所期待的那樣，您希望 Invigorate 節省的成本會增加，以提高我們的生產力，這已經開始，但會在今年內增加。

We said our SG&A reductions of approximately $100 million will really take effect more so in Q2 onwards. And so that will help margins going forward as well. We're seeing, as I said, good strong base business growth and volume that's going to help us. We're seeing good tailwind from pricing. Our pricing environment is the best that it's ever been. We're seeing a modest benefit from pricing this year compared to the 50 basis point headwind that we saw last year. And before that, we used to have even more headwind than that. So all of those factors, as you look forward in terms of productivity, in terms of SG&A improvement, in terms of volume growth, give us confidence about getting to that 17%.

我們說，我們減少約 1 億美元的 SG&A 將在第二季度開始真正生效。因此，這也將有助於提高利潤率。正如我所說，我們看到良好的基礎業務增長和銷量將對我們有所幫助。我們從定價中看到了良好的順風。我們的定價環境是有史以來最好的。與我們去年看到的 50 個基點逆風相比，我們看到今年定價帶來的好處不大。在此之前，我們曾經遇到過比這更大的逆風。因此，所有這些因素，正如您在生產力、SG&A 改進和銷量增長方面所期待的那樣，讓我們有信心達到 17%。

Yes. The last thing I'd add, Patrick, is our test mix in the quarter was strong. Our investments in advanced diagnostics continue to pay off. We saw, as I said in the script, really nice growth in advanced cardiometabolic testing, prenatal genetics, hep B, hep C. So these are all margin accretive types of tests. So we feel good about that.

是的。帕特里克，我要補充的最後一件事是我們在本季度的測試組合很強大。我們在高級診斷方面的投資繼續獲得回報。正如我在劇本中所說，我們看到了先進的心臟代謝測試、產前遺傳學、乙肝、丙肝的非常好的增長。所以這些都是利潤增加類型的測試。所以我們對此感覺很好。

Our next question comes from Brian Tanquilut of Jefferies.

我們的下一個問題來自 Jefferies 的 Brian Tanquilut。

Congrats on the quarter, question for you guys. As I think about the call out you made on tests for rec being up in the quarter, maybe if you can give us some color on what is driving that and how you think that will progress going forward yes, that's correct.

恭喜本季度，向你們提問。當我想到你在本季度進行的 rec 測試中發出的呼籲時，也許你可以給我們一些關於推動它的因素以及你認為這將如何向前發展的顏色，是的，這是正確的。

So I think there's evidence of a strong return to care. So I just said that our advanced testing portfolio was certainly up in the quarter. We also saw just strong growth in routine testing, routine cardiometabolic lipid panels, chemistry panels and things like that. Generally, general health and wellness visit has high test per req because you're testing across the entire human body. So I think our test per req were really powered by that.

所以我認為有證據表明護理有很強的回歸。所以我只是說我們的高級測試組合在本季度肯定有所增加。我們還看到常規測試、常規心臟代謝脂質組、化學組等方面的強勁增長。通常，一般健康和保健訪問根據要求進行高測試，因為您正在對整個人體進行測試。所以我認為我們的每個請求測試都是由它驅動的。

Our next question comes from Elizabeth Anderson Evercore ISI.

我們的下一個問題來自 Elizabeth Anderson Evercore ISI。

I was wondering if you could talk more about your visibility into pricing and contract renewals, particularly with payers this year. Sort of -- how far along are you at to the renewals and sort of what incrementally have you been seeing? Or is it sort of similar to what you called out on the current trends?

我想知道您是否可以更多地談談您對定價和合同續籤的了解，尤其是今年的付款人。有點——你在更新方面走了多遠，你看到了什麼？或者它有點類似於你對當前趨勢的呼籲？

Sure. So I think as everybody knows, in general, our contracts with commercial payers average on 3 to 5 years. So on average, every year, we're going to renegotiate about 25% of our health plans contracts. We're now 1/3 of the way through the year, and we've progressed nicely on 2 of the contracts that have been renewed. We have a few more to do throughout the rest of the year. So what I would tell you is, look, we have a great value story. Consistently, we're able to move reacquisitions from high-priced institutions, health systems and out-of-network labs into Quest Diagnostics. And we try to negotiate incentives for doing that. And when we do that work, we get paid incremental value.

當然。所以我想眾所周知，一般來說，我們與商業付款人的合同平均為 3 到 5 年。因此，平均而言，每年我們將重新談判約 25% 的健康計劃合同。今年已經過去了 1/3，我們在續籤的 2 份合同上進展順利。在今年餘下的時間裡，我們還有一些事情要做。所以我要告訴你的是，看，我們有一個很有價值的故事。一貫地，我們能夠將高價機構、衛生系統和網絡外實驗室的重新收購轉移到 Quest Diagnostics 中。我們試圖就這樣做的激勵措施進行談判。當我們做這項工作時，我們會獲得增量價值。

So these value-based contracts are on the rise. And we certainly make the case around inflation and things like that. But as I've said in the past, we don't lead with that. We lead with the fact that we offer great value, and we want to get paid for that value. So negotiations are going well. We said in the quarter that price was flat which we haven't been able to say in a long time. Q4, we were down 50 basis points. Q1 were flat. So we continue to make improvement and expect to make improvement throughout the rest of the year.

因此，這些基於價值的合同正在增加。我們當然會圍繞通貨膨脹和類似的事情進行論證。但正如我過去所說，我們不會以此為首。我們領先的事實是我們提供巨大的價值，並且我們希望為該價值獲得報酬。所以談判進展順利。我們在本季度表示價格持平，但我們已經很長時間沒能說了。第四季度，我們下跌了 50 個基點。第一季度持平。因此，我們繼續進行改進，並希望在今年餘下的時間裡進行改進。

Our next question comes from Kevin Caliendo of UBS.

我們的下一個問題來自瑞銀的 Kevin Caliendo。

Congrats on the Haystack acquisition. Can you maybe talk through the process there? Why now? Why this company talk through any -- I know there's some regulatory and commercial milestones this company has coming up? And also maybe just talk through how we should think about the dilution in terms of modeling it and where that would show up through the P&L.

祝賀 Haystack 收購。你能談談那裡的過程嗎？為什麼現在？為什麼這家公司會談論任何 - 我知道這家公司已經出現了一些監管和商業里程碑？而且也許只是討論我們應該如何考慮在建模方面的稀釋以及它會通過 P&L 顯示在哪裡。

Yes. So let me just have Sam address the dilution first, and then I'll come back and talk about why Haystack and why now, Sam?

是的。所以讓我先讓 Sam 解決稀釋問題，然後我會回來談談為什麼 Haystack 以及為什麼現在，Sam？

Yes. So Kevin, first of all, thanks for the question. So we said this deal will be modestly dilutive this year and modestly dilutive for the next 3 years and will be actually accretive for us in terms of earnings in 2026. We haven't shared exactly how dilutive it is for 2023, but let me give you a couple of maybe nuggets or qualitative directional comments. First of all, in terms of our overall guidance, as you saw, we kept our guidance midpoint the same. We narrowed the guidance by $0.10 on EPS. So I'm referring here specifically to adjusted EPS. The drivers of that were improved base business, which is taking us higher, lower COVID, which is going the other way, and some modest dilution from the Haystack acquisition.

是的。所以凱文，首先，感謝你提出這個問題。所以我們說這筆交易今年會適度稀釋，未來 3 年會適度稀釋，實際上會增加我們在 2026 年的收益。我們還沒有分享它在 2023 年的具體稀釋程度，但讓我給你可能有一些掘金或定性的定向評論。首先，就我們的總體指導而言，正如您所見，我們保持了指導中點不變。我們將每股收益的指導範圍縮小了 0.10 美元。所以我在這里特別指的是調整後的每股收益。其驅動因素是基礎業務的改善，這使我們變得更高、更低的 COVID，這是相反的，以及 Haystack 收購帶來的一些適度稀釋。

But all in all, if you put all those together, we're still at the midpoint of the adjusted EPS guidance that we were last quarter. In terms of going forward, the annualized EPS dilution from Haystack next year is actually less than what we expect to see this year. So it starts to improve. It's -- next year is the peak dilution for the deal. And in '25, the dilution is lower. So it's actually a year-over-year EPS improvement. And then in 2026, as I said, it's accretive for us from an EPS perspective. ROIC wise, as I said, it turns positive by the end of '25. And we expect it to have a -- it definitely clears our hurdle for ROIC expectations in the next 5 years.

但總而言之，如果將所有這些放在一起，我們仍處於上個季度調整後每股收益指引的中點。就未來而言，明年 Haystack 的年化 EPS 稀釋實際上低於我們今年的預期。所以它開始改善。這是 - 明年是交易的峰值稀釋。而在 25 年，稀釋度更低。所以這實際上是每股收益的同比增長。然後在 2026 年，正如我所說，從 EPS 的角度來看，它對我們來說是增值的。正如我所說，在 ROIC 明智的情況下，到 25 年底它會變成積極的。我們希望它有一個 - 它肯定會在未來 5 年內清除我們對 ROIC 預期的障礙。

Yes. So Kevin, let me talk a little bit now about why Haystack and why now? So first, as we talked about at Investor Day, when we are looking to close a capability gap, if you will, in our portfolio, the first thing we do is we reach out to our IBD partners. And over the last several years, we've had deep discussions. We know what their road maps are. And we didn't think that was a pathway to follow to get into this space, at least in the next several years, let's just say. Over the last 3 years, we've had many discussions with many of the players in the MRD space. We got to know Haystack over the last year. We think they have the lowest limits of detection of any MRD assay out there in terms of just raw numbers. They can detect one part per million, meaning you have a million floating dead -- cells as they die, they release DNA, that fragments of DNA. And there's a lot of DNA in your bloodstream. And these guys with this assay can find one fragment of cancer DNA per a million parts.

是的。那麼凱文，現在讓我談談為什麼選擇 Haystack 以及為什麼現在？因此，首先，正如我們在投資者日談到的那樣，當我們尋求縮小能力差距時，如果你願意，在我們的投資組合中，我們做的第一件事就是聯繫我們的 IBD 合作夥伴。在過去的幾年裡，我們進行了深入的討論。我們知道他們的路線圖是什麼。而且我們不認為這是進入這個領域的途徑，至少在接下來的幾年裡，我們只是說。在過去的 3 年裡，我們與 MRD 領域的許多參與者進行了多次討論。我們在去年認識了 Haystack。我們認為，就原始數據而言，它們的檢測限是所有 MRD 檢測的最低限度。它們可以檢測到百萬分之一，這意味著你有一百萬個漂浮的死細胞——當細胞死亡時，它們會釋放 DNA，即 DNA 片段。你的血液中有很多 DNA。這些使用這種檢測方法的人可以在每百萬份中找到一個癌症 DNA 片段。

That is an incredibly low limits of detection. The sensitivity of the assay at Landmark is very, very high, 80% to 90%. And so we think it's a best-in-class assay. The work they've done on some of their preliminary trials, 450 patients across 23 Australian centers. I'd refer you to the New England Journal of Medicine article in June of 2022.

這是一個令人難以置信的低檢測限。 Landmark 檢測的靈敏度非常非常高，達到 80% 到 90%。因此我們認為這是一流的檢測方法。他們在一些初步試驗中所做的工作涉及 23 個澳大利亞中心的 450 名患者。我建議您參閱 2022 年 6 月發表在《新英格蘭醫學雜誌》上的文章。

So we think it's the right assay, the right time, as you know, CMS is reimbursing for these assays, and we think we can scale it. We think we can drive our further commercial reimbursement. The last thing I would say is, look, it is a tumor-informed assay and when you're looking for a needle in a Haystack, hence their name, when you're looking for a needle in a Haystack, you actually want to know what the needle looks like. And hence, we believe that the tumor-informed assay is a much stronger assay than an uninformed assay.

所以我們認為這是正確的檢測，正確的時間，正如你所知，CMS 正在為這些檢測報銷，我們認為我們可以擴展它。我們認為我們可以推動我們進一步的商業報銷。我要說的最後一件事是，看，這是一種腫瘤信息化驗，當你在大海撈針中尋找針頭時，因此他們的名字，當你在大海撈針中尋找針頭時，你實際上想要知道針的樣子。因此，我們認為腫瘤信息化驗比非信息化化驗強得多。

One other thing, just to wrap up on the financials Kevin, back to your question around dilution. I do want to mention for the longer term, we are committed to the Investor Day guidance that we gave around long-range guidance, which said mid-single-digit revenue growth and high single-digit EPS growth. The Haystack acquisition actually modestly improves on that as well. So I just wanted to provide this for the long-term guidance given that we just shared it at an Investor Day not too long ago.

另一件事，只是為了總結凱文的財務狀況，回到你關於稀釋的問題。從長遠來看，我確實想提一下，我們致力於圍繞長期指導給出的投資者日指導，其中表示中等個位數的收入增長和高個位數的每股收益增長。 Haystack 的收購實際上也適度改善了這一點。所以我只是想提供這個作為長期指導，因為我們剛剛在不久前的投資者日分享了它。

Our next question comes from Jack Meehan of Nephron Research.

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

I wanted to want to stick with the Haystack deal very interesting, great tech, pricing is pretty reasonable to other deals in the space. I had a few more questions for you. First is in terms of coverage, I just wanted to confirm, I assume is the plan to go through MolDx there? Then number two, do you think reimbursement looks similar to other MRD tests on the market? And then finally, can you just comment, are there any royalties attached to the deal?

我想堅持 Haystack 的交易，非常有趣，技術很棒，定價與該領域的其他交易相比非常合理。我還有幾個問題要問你。首先是在覆蓋範圍方面，我只是想確認一下，我假設那裡有通過 MolDx 的計劃嗎？那麼第二，您認為報銷看起來與市場上的其他 MRD 測試相似嗎？最後，您能否評論一下，這筆交易是否有任何特許權使用費？

Yes. So yes, Jack, first, thanks for the question. Yes, on MolDX, absolutely plan to go that route. Look, what we have to do is finish the commercialization of the assay. We'll be doing that for the rest of this year. We plan on bringing the assay up in one of our large oncology testing facilities. As you know, there is limited coverage for medicare and medicare advantage patients as dictated by CMS. Two companies have coverage for that today. I would also tell you -- there's a handful of Blue's company, the Blue's plans that are reimbursing for the test.

是的。所以是的，傑克，首先，謝謝你的提問。是的，在 MolDX 上，絕對計劃走那條路。看，我們要做的是完成檢測的商業化。我們將在今年餘下的時間裡這樣做。我們計劃在我們的大型腫瘤測試設施之一中進行檢測。如您所知，根據 CMS 的規定，醫療保險和醫療保險優勢患者的承保範圍有限。今天有兩家公司對此進行了報導。我還要告訴你——有少數 Blue 的公司，Blue 的計劃正在為測試報銷。

So similar to NIPT, remember, NIPT started out very high-risk women, very limited coverage. And we as well as some other industry members drove that throughout the commercial payers, and that test is wide open to women today. So that's our plan. On the royalty question, look, as we mentioned in the comments, the -- some of the original IP came out of John Hopkins. I'm not going to disclose our royalty payments. But as you can imagine, there's intellectual property that comes with this, and there's modest royalties that will come with it.

與 NIPT 非常相似，請記住，NIPT 開始於非常高風險的女性，覆蓋範圍非常有限。我們以及其他一些行業成員在整個商業付款人中推動了這一點，並且該測試今天對女性開放。這就是我們的計劃。關於版稅問題，看，正如我們在評論中提到的，一些原始 IP 來自約翰霍普金斯大學。我不會透露我們的特許權使用費。但正如您可以想像的那樣，隨之而來的是知識產權，並且隨之而來的是適度的特許權使用費。

Our next question comes from Erin Wright of Morgan Stanley.

我們的下一個問題來自摩根士丹利的 Erin Wright。

Great. Two-part question. Just first on basic routine testing. Where are we now relative to pre-COVID baseline levels? Are we fully back to normal here? And then on capital deployment. I understand there's a balance of capital deployment dedicated to the innovation assets like Haystack, but how rich is the pipeline now for the tuck-in deals around hospitals, their local players? And have you seen any changes in the urgency around those types of deals?

偉大的。兩部分的問題。首先是基本的例行測試。相對於 COVID 之前的基線水平，我們現在處於什麼位置？我們這裡完全恢復正常了嗎？然後是資本部署。我知道有專門用於像 Haystack 這樣的創新資產的資本部署平衡，但現在圍繞醫院及其當地參與者的收購交易的管道有多豐富？您是否看到圍繞這些類型的交易的緊迫性有任何變化？

Yes. So our routine testing levels are above pre-COVID levels, whether you look at our volume versus all of 2019 or you look at our volume versus the first 2 months of 2020, we're substantially above that. So the recovery is no longer really even a topic of discussion for us. In terms of the funnel of opportunities on the health system side, namely outreach deals is stronger than ever. And I think now that COVID is behind us, the deal completion will start to accelerate. So we feel good about what's in the funnel. They generally take a while to negotiate. You got to get a lot of people on board, pathologists on board, referring physicians. But once you get them all on board, it can move quickly.

是的。因此，我們的常規測試水平高於 COVID 之前的水平，無論您是看我們的數量與 2019 年全年的數量相比，還是看我們的數量與 2020 年前兩個月的數量相比，我們都大大高於該水平。因此，復甦不再是我們真正討論的話題。就衛生系統方面的機會漏斗而言，即外展交易比以往任何時候都更強大。而且我認為現在 COVID 已經過去，交易完成將開始加速。所以我們對漏斗中的內容感覺良好。他們通常需要一段時間來談判。你必須讓很多人參與進來，包括病理學家和轉診醫生。但是一旦你讓他們都參與進來，它就可以快速移動。

Our next question comes from Pito Chickering of Deutsche Bank.

我們的下一個問題來自德意志銀行的 Pito Chickering。

You've got Kieran Ryan on here for Pito. Just going back to margins, I was just wondering if you could talk a little bit about FTE, wage inflation, hiring and turnover, how that ran in 1Q compared to what you're seeing in the second half of 2022? And then just kind of how that fits into getting back to that 17% margin next year?

你已經讓 Kieran Ryan 替 Pito 上場了。回到利潤率，我只是想知道你是否可以談談 FTE、工資通脹、招聘和營業額，與你在 2022 年下半年看到的情況相比，第一季度的情況如何？那麼這與明年回到 17% 的利潤率有什麼關係呢？

Yes. So the guidance we gave for the year, we said our wage inflation would be in the 3% to 4% range. No surprises there. We still feel good about that overall guidance that we set for the year. Our turnover rates have improved from Q1 of last year. Sequentially, for most job categories, it improved from Q4 to Q1, and we continue to see the trend back towards a normalized attrition rate, when I say normalized sort of pre-COVID levels. It does not get back to those levels unlike volume, but it is trending in the right direction, and we feel good about where our wage inflation was in the first quarter and for the year.

是的。因此，我們給出了今年的指導，我們說我們的工資通脹將在 3% 到 4% 的範圍內。那裡沒有驚喜。我們仍然對我們為今年設定的總體指導感到滿意。我們的離職率比去年第一季度有所提高。隨後，對於大多數工作類別，它從第 4 季度到第 1 季度有所改善，我們繼續看到趨勢回到正常化的流失率，當我說正常化的 COVID 前水平時。與數量不同，它沒有回到那些水平，但它正朝著正確的方向發展，我們對第一季度和全年的工資通脹情況感到滿意。

Yes. And I'll just mention a couple of things real quick. I mean productivity in terms of the Invigorate actions that we have helps also offset that, which is how we get to the margin target that we have. And I think you mentioned, Kieran that the 17% next year actually our guidance is to get to approximately 17% this year in terms of operating margin. So I just want to be clear on that.

是的。我會很快提到幾件事。我的意思是，就我們所採取的振興行動而言，生產力也有助於抵消這一點，這就是我們達到我們所擁有的利潤率目標的方式。我想你提到過，基蘭，明年的 17% 實際上我們的指導是今年的營業利潤率達到大約 17%。所以我只想澄清一下。

Our next question comes from Andrew Brackmann of William Blair.

我們的下一個問題來自威廉·布萊爾的安德魯·布拉克曼。

Maybe just to go back to Haystack for a minute and appreciate all the commentary today on that. But can you maybe just sort of talk about any expectations for a halo effect that this can create for you guys commercially. And I guess just as you sort of think about that, how are you thinking about any changes to the commercial strategy just between calling on pathologists and then the oncologists here?

也許只是想回到 Haystack 上一分鐘，欣賞一下今天關於它的所有評論。但是，您能否談談對這可以在商業上為你們創造的光環效應的任何期望。我想就像你在想的那樣，你如何考慮在拜訪病理學家和腫瘤學家之間對商業策略的任何改變？

Yes. So good question. Absolutely a halo effect. Remember at Investor Day, we said in 2022, ex-COVID, we had $8.4 billion in revenue. And of that $8.4 billion, $1 billion of that is in the cancer space. And we said about half of that or $0.5 billion is in the screening space, routine screening, PSA, Pap Smears, HPV, some common cancer markers, but we then said that the other $0.5 billion is anatomical pathology. So we have the spec. And once we have that specimen, it is only logical for the medical oncologists to start to -- once it's declared cancer, the next question, post-surgery is there still cancer cells in this human being. Or the next question, if the answer to that is yes, and then there's therapy. The next question is, did the therapy work? Do we still see remnants of DNA from the tumor?

是的。好問題。絕對是光環效果。記得在投資者日，我們說過在 2022 年，在 COVID 之前，我們的收入為 84 億美元。在這 84 億美元中，有 10 億美元用於癌症領域。我們說其中大約一半或 5 億美元用於篩查領域、常規篩查、PSA、子宮頸抹片檢查、HPV 和一些常見的癌症標誌物，但我們隨後說另外 5 億美元用於解剖病理學。所以我們有規範。一旦我們有了那個標本，內科腫瘤學家就順理成章地開始——一旦它被宣佈為癌症，下一個問題，手術後這個人體內是否仍然存在癌細胞。或者下一個問題，如果答案是肯定的，然後就是治療。下一個問題是，治療有效嗎？我們還能看到腫瘤的 DNA 殘留物嗎？

So we think this absolutely fits into our overall cancer strategy in Quest Diagnostics today. in particular, again, there is a halo effect. We will own the block. We will own the specimen and doing the testing on that for both treatment monitoring as well as treatment selection, we think, is just a natural. Now from a commercial standpoint, we have a pretty mature oncology distribution today that calls on pathologists and medical oncologists. And yes, we are absolutely going to strengthen that team as we finish the commercialization of this assay and to have a more robust channel calling into the medical oncologist space. So good question.

所以我們認為這絕對符合我們今天在 Quest Diagnostics 中的整體癌症戰略。特別是，再次出現光環效應。我們將擁有該街區。我們將擁有標本並對其進行測試以進行治療監測和治療選擇，我們認為這很自然。現在從商業的角度來看，我們今天有一個非常成熟的腫瘤學分佈，需要病理學家和醫學腫瘤學家。是的，我們絕對會在完成該檢測的商業化後加強該團隊，並建立一個更強大的渠道進入腫瘤內科領域。好問題。

Our next question comes from A.J. Rice of Credit Suisse.

我們的下一個問題來自 A.J.瑞士信貸大米。

Maybe 2 quick, ones here, if I could slip them in. The strong rebound in the base business line. We've talked for a while about the fact that the New York region had not come back as quickly as other regions. Did you see any outsized performance there that's contributing to the strong base business? Or was the strength pretty much across the board geographically? And then you didn't do anything on the buyback front this quarter. I know you've got Haystack now and you've got hospital deals. I wondered what's your thought about additional share repurchases as we progress through the year.

也許 2 快，在這裡，如果我能把它們放進去的話。基礎業務線的強勁反彈。我們已經討論了一段時間，即紐約地區沒有像其他地區那樣迅速恢復。您是否看到任何有助於強大基礎業務的超常表現？還是地理上的實力幾乎全面？然後你本季度在回購方面沒有做任何事情。我知道你現在有 Haystack 並且你有醫院交易。我想知道隨著我們今年的進展，您對額外的股票回購有何看法。

Yes. So on your first question, I'll let Sam take the second part. Again, 10% revenue growth on the base business in the quarter, 8% volume growth. I mentioned that health systems was 7%. So our physician book of business actually grew higher than that if you do that math. And the answer is we saw strong growth across all of our regions. Did the Northeast grow at a faster rate, slightly faster rate, yes. So we saw maybe a bit of a rebound there.

是的。所以關於你的第一個問題，我會讓 Sam 來回答第二部分。同樣，本季度基礎業務收入增長 10%，銷量增長 8%。我提到衛生系統是 7%。因此，如果您進行數學計算，我們的醫生業務實際上會增長得更高。答案是我們在所有地區都看到了強勁的增長。東北是不是發展的快一點，速度稍微快一點，是的。所以我們在那裡看到了一點反彈。

But look, our comparisons now in the Northeast region are with 2022. There's been population shifts that some of that population is just not going to come back to the Northeast. Now we see a stronger growth -- continued stronger growth in the Southeast and the Southwest, and that very much could represent some population shift that we're seeing in the country. The last thing I'd mention, although it didn't influence our Q1 numbers, we did mention the startup of our Newyork-Presbyterian outreach deal that's going well. It's going to be a strong contributor to growth in the East region and will be a strong contributor to our overall growth for the rest of the year. So Sam, do you want to take that?

但是看，我們現在在東北地區進行的比較是與 2022 年的情況。人口已經發生變化，其中一些人口不會再回到東北地區。現在我們看到更強勁的增長——東南部和西南部持續更強勁的增長，這在很大程度上代表了我們在該國看到的一些人口變化。我要提到的最後一件事，雖然它沒有影響我們第一季度的數字，但我們確實提到了我們的紐約長老會外展協議的啟動進展順利。它將成為東部地區增長的重要貢獻者，並將成為我們今年剩餘時間整體增長的重要貢獻者。山姆，你想接受嗎？

Yes. A.J. On the buyback, so what's assumed in our guidance in terms of adjusted EPS is that we will offset equity dilution in terms of share buybacks. So we'll do enough to offset equity dilution. We are still committed to returning the majority of our free cash flow to shareholders through dividends and buybacks. So that's still our commitment. We communicated it on our Investor Day. We're obviously still committed to it.

是的。 A.J.在回購方面，我們在調整後每股收益方面的指導假設是，我們將抵消股票回購方面的股權稀釋。因此，我們將採取足夠措施來抵消股權稀釋。我們仍然致力於通過股息和回購將大部分自由現金流返還給股東。所以這仍然是我們的承諾。我們在投資者日傳達了它。我們顯然仍然致力於此。

But we also said that we're going to scale share buybacks up and down depending on also the M&A pipeline and the impact that might have on growth and driving our strategy and also our long-term growth. We had -- in the quarter, we talked about or at least recently, we talked about Newyork-Presbyterian and the fact that, that's a $275 million capital deployment. We talked about now today, Haystack, and that's an additional capital deployment of $300 million. So we've had good progress here on the M&A front. So that's also why we didn't do any share buybacks in Q1.

但我們也表示，我們將根據併購管道以及可能對增長和推動我們的戰略以及我們的長期增長產生的影響，上下擴大股票回購規模。我們已經 - 在本季度，我們談到或至少最近，我們談到了紐約長老會以及事實上，這是一項 2.75 億美元的資本部署。我們今天談到了現在，Haystack，這是 3 億美元的額外資本部署。因此，我們在併購方面取得了良好進展。所以這也是我們在第一季度沒有進行任何股票回購的原因。

And our final question comes from Derik De Bruin of Bank of America.

我們的最後一個問題來自美國銀行的 Derik De Bruin。

This is John on for Derik. I wanted to ask about the consumer-initiated testing business in terms of contribution, if you're allowed to say how much contribution you saw on in terms of sales and how much of an impact is made on the margins. Just curious if that's something I should look out for in terms of the margin progression here.

這是約翰替德里克。我想從貢獻的角度詢問消費者發起的測試業務，如果你被允許說出你在銷售方面看到了多少貢獻以及對利潤產生了多大的影響。只是好奇，就這裡的保證金進展而言，這是否是我應該注意的事情。

Yes. So we are really happy with our consumer-initiated testing performance in the quarter. It showed nice growth from -- progressive growth from Q4. And so I'm going to talk about the growth, COVID obviously declined in that segment of our business as well. The majority of our CIT business now is our routine-based business. We saw a nice progression from Q4 to Q1. We are happy with that. We saw nice progression Q1 to Q1, really nice progression there. We continue to be excited about a couple of growth categories within CIT.

是的。因此，我們對本季度消費者發起的測試表現非常滿意。它顯示出良好的增長——從第四季度開始逐步增長。所以我要談談增長，COVID 在我們業務的這一部分也明顯下降了。現在，我們的大部分 CIT 業務都是常規業務。我們看到了從第四季度到第一季度的良好進展。我們對此很滿意。我們看到 Q1 到 Q1 的進展非常好，那裡的進展非常好。我們繼續對 CIT 中的幾個增長類別感到興奮。

Number one, you've probably read allergy season has really taken off and taken off early. So seeing some nice growth there. just our general health and wellness offering in CIT was really strong in the quarter. And we surveyed some of those general health and wellness customers and found some interesting things. One of the main reasons they're coming to Quest and paying out of pocket is because patients were -- consumers patients were having a hard time getting in to see their physicians. We're hearing about 3-month delays to get to see their doctor. So rather than wait to see their doctor and get their lab testing, they just come in because they want to know.

第一，你可能已經讀過過敏季節真的開始了，而且提前結束了。所以看到那裡有一些不錯的增長。只有我們在 CIT 中提供的一般健康和保健服務在本季度非常強勁。我們調查了一些一般健康和保健客戶，發現了一些有趣的事情。他們來 Quest 並自掏腰包的主要原因之一是因為患者——消費者患者很難去看醫生。我們聽說要延遲 3 個月才能去看他們的醫生。因此，與其等著看醫生和進行實驗室檢測，他們只是因為想知道而進來。

And then finally, I'd say our STD category continues to exhibit very strong growth. The CDC just declared again several types of STDs, gonorrhea syphilis at epidemic levels. They also indicated that 50% of all new cases that they're seeing across the country are aged 15 to 24. And that's a segment that wants to remain anonymous and just pay out of pocket for lots of reasons.

最後，我想說我們的 STD 類別繼續呈現非常強勁的增長。 CDC 剛剛再次宣布幾種類型的 STD，淋病梅毒處於流行水平。他們還表示，他們在全國看到的所有新病例中有 50% 年齡在 15 至 24 歲之間。由於很多原因，這一群體希望保持匿名並自掏腰包。

Finally, as we've said about margins, our CIT business is going to be less dilutive this year than it was last year. And I think you can assume that each quarter through the year.

最後，正如我們所說的利潤率，我們的 CIT 業務今年的稀釋性將低於去年。我認為你可以假設一年中的每個季度。

Yes. So John, just to add to that, it is dilutive in Q1 to margins. But as Jim said, it's going to improve throughout the year. So that's another aspect of why our margins overall improve, although this one is more modest.

是的。所以約翰，補充一點，它在第一季度稀釋了利潤率。但正如吉姆所說，全年都會有所改善。所以這是我們的利潤率整體提高的另一個方面，儘管這個方面更為溫和。

Operator is there any more questions?

接線員還有問題嗎？

All right. Well, I want to thank everyone for joining today, some really exciting news here. But let me just summarize, look, we're off to a really strong start here in 2023. Our base business performed stronger than expected, stronger than we expected in the quarter. We feel really, really good about that. And it's certainly offsetting some of the COVID decline that we saw in the quarter. Second, hopefully, you can tell, we're really excited about the Haystack Oncology. We think that technology is the right technology. But more importantly, it's the right team. We're really impressed with the team that will join Quest Diagnostics.

好的。好吧，我要感謝大家今天的加入，這裡有一些非常令人興奮的消息。但讓我總結一下，看，我們在 2023 年有了一個非常強勁的開端。我們的基礎業務表現強於預期，強於我們本季度的預期。我們對此感覺非常非常好。這肯定抵消了我們在本季度看到的一些 COVID 下降。其次，希望你能看出來，我們對 Haystack Oncology 感到非常興奮。我們認為技術是正確的技術。但更重要的是，這是正確的團隊。我們對將加入 Quest Diagnostics 的團隊印象深刻。

And as you know, in these types of acquisitions, it's not just investing in the technology and really investing in a group of people and a team, and we feel really, really good about that. We feel great about the MRD space and we believe it's starting to mature from both a physician ordering perspective as well as from a reimbursement perspective.

正如你所知，在這些類型的收購中，它不僅僅是投資於技術，而是真正投資於一群人和一個團隊，我們對此感覺非常非常好。我們對 MRD 空間感覺很好，我們相信它從醫生訂購的角度和報銷的角度開始成熟。

And then finally, we're well on our way to generating the Invigorate savings that are needed to offset wage inflation, and we feel good about the progress we're making there. So again, thanks for joining in, and we look forward to seeing you out on the road over the next few months and joining us at our next earnings call in July. So thanks for joining, and have a great day.

最後，我們正在努力產生抵消工資通脹所需的 Invigorate 儲蓄，我們對我們在這方面取得的進展感到滿意。再次感謝您的加入，我們期待著在接下來的幾個月中與您相見，並在 7 月的下一次財報電話會議上與我們見面。感謝您的加入，祝您有美好的一天。

Thank you for participating in the Quest Diagnostics First Quarter 2023 Conference Call. A transcript of prepared remarks on this call will be posted later today on Diagnostics website at www.questdiagnostics.com. A replay of call may be accessed online at www.questdiagnostics.com/investor or by phone at (203) 369-0200 for international callers or (866) 363-1835 for domestic callers. Telephone replays will be available from approximately 10:00 a.m. Eastern Time on April 25, 2023, and until midnight, Eastern Time, May 9, 2023. Goodbye.

感謝您參加 Quest Diagnostics 2023 年第一季度電話會議。今天晚些時候，將在 Diagnostics 網站 www.questdiagnostics.com 上發布關於此次電話會議的準備好的評論記錄。可在 www.questdiagnostics.com/investor 在線訪問通話重播，國際來電者可撥打 (203) 369-0200，國內來電者可撥打 (866) 363-1835。電話重播將於 2023 年 4 月 25 日東部時間上午 10:00 左右開始，直至 2023 年 5 月 9 日東部時間午夜。再見。