奎斯特診斷 (DGX) 2023 Q2 法說會逐字稿

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

歡迎參加 Quest Diagnostics 2023 年第二季度電話會議。應公司要求，本次通話正在錄音。 （操作員說明）。

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

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

Thank you, and good morning. I'm joined by Jim Davis, our Chairman and 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.

謝謝你，早上好。我們的董事長兼首席執行官吉姆·戴維斯 (Jim Davis) 也加入了我的行列。和主席；以及我們的首席財務官 Sam Samad。在這次電話會議中，我們可能會做出前瞻性陳述，並將討論非公認會計準則措施。我們在收益新聞稿的表格中提供了非公認會計準則衡量指標與可比公認會計準則衡量指標的調節表。實際結果可能與預測結果存在重大差異。可能影響 Quest Diagnostics 未來業績的風險和不確定性包括但不限於我們最近的 10-K 表年度報告以及隨後提交的 10-Q 表季度報告和 8-K 表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.

對於本次電話會議，提及報告的每股收益是指報告的稀釋每股收益，提及調整後的每股收益是指調整後的稀釋每股收益。任何提及基礎業務、測試、收入或數量的內容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.

與我們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盈利增長，均為複合年增長率。

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

最後，收購帶來的收入增長率將根據我們的基礎業務來衡量。現在請聽吉姆·戴維斯的講話。

Thanks, Shawn, and good morning, everyone. We had strong base business performance in the second quarter with nearly double-digit revenue growth year-over-year. Demand for our services remains strong across all regions boosted by the collaborations we have formed with health plans, hospitals and physicians amid an environment where people are returning to care.

謝謝肖恩，大家早上好。我們第二季度的基礎業務表現強勁，收入同比增長近兩位數。在人們重返護理的環境中，由於我們與衛生計劃、醫院和醫生建立的合作，所有地區對我們服務的需求仍然強勁。

We are particularly encouraged by the revenue growth in our base business of nearly 10% from our health system customers. Also in the second quarter, we made substantial progress improving the profitability of our base business compared to the first quarter and prior year despite persistently high employee turnover.

我們的基礎業務來自醫療系統客戶的收入增長了近 10%，這尤其令我們感到鼓舞。同樣在第二季度，儘管員工流動率持續較高，但與第一季度和去年同期相比，我們的基礎業務盈利能力取得了實質性進展。

Total adjusted operating margin improved more than 170 basis points compared to the first quarter despite a decline of approximately $80 million in COVID revenue.

儘管新冠疫情收入下降了約 8000 萬美元，但調整後的總營業利潤率仍較第一季度提高了 170 個基點以上。

This morning, I'll discuss highlights from the second quarter, then Sam will provide more detail on our financial results and talk about our updated financial guidance for 2023.

今天早上，我將討論第二季度的亮點，然後 Sam 將提供有關我們財務業績的更多詳細信息，並討論我們更新的 2023 年財務指引。

Now let's turn to some of the highlights from the quarter. As we shared at Investor Day, our strategy is to drive growth by continuing to meet the evolving needs of our core customers, physicians, hospitals and consumers as they navigate the changing landscape in health care. We will enable this growth with an intense focus on faster-growing clinical areas, including molecular genomics and oncology.

現在讓我們來看看本季度的一些亮點。正如我們在投資者日分享的那樣，我們的戰略是通過繼續滿足我們的核心客戶、醫生、醫院和消費者在不斷變化的醫療保健領域不斷變化的需求來推動增長。我們將重點關注快速增長的臨床領域，包括分子基因組學和腫瘤學，以實現這一增長。

In addition, acquisitions will continue to be key drivers of our growth. Finally, our strategy includes driving operational improvements across the business with strategic deployment of automation and AI to improve quality, efficiency and service.

此外，收購將繼續成為我們增長的關鍵驅動力。最後，我們的戰略包括通過自動化和人工智能的戰略部署來推動整個企業的運營改進，以提高質量、效率和服務。

So let's review progress we've made in each one of these areas. In Physician Lab Services, we delivered strong base volume growth from physicians, largely through our partnerships with health plans, which have expanded our access to the market. A growing number of these involve value-based arrangements and are generating faster growth and share gains than the traditional relationships. These arrangements position us as a more strategic partner with health plans as we work together on leakage, shared savings and redirection programs.

那麼，讓我們回顧一下我們在這些領域中每一領域所取得的進展。在醫師實驗室服務方面，我們通過與健康計劃的合作，實現了醫師基數的強勁增長，這擴大了我們進入市場的機會。其中越來越多的關係涉及基於價值的安排，並且比傳統關係產生更快的增長和分享收益。這些安排使我們成為健康計劃方面更具戰略性的合作夥伴，因為我們在洩漏、共享儲蓄和重定向計劃方面共同努力。

In addition, NewYork-Presbyterian's recently acquired outreach assets brought us new volume from the physicians.

此外，紐約長老會醫院最近收購的外展資產為我們帶來了新的醫生數量。

In Hospital Lab Services, base revenue from health systems grew nearly 10% in the quarter. The Professional Lab Services business had a very strong quarter as we saw solid growth from both new and existing PLS relationships.

在醫院實驗室服務方面，來自衛生系統的基本收入本季度增長了近 10%。專業實驗室服務業務本季度表現非常強勁，我們看到新的和現有的 PLS 關係都實現了穩健增長。

We are particularly encouraged by progress with our new PLS partnerships with Northern Light Health, Lee Health and Tower Health. As hospitals continue to experience financial challenges, we are here to help whether through professional lab services, reference testing or purchasing the hospital's outreach assets. We are now seeing growing momentum with a significant pipeline of potential deals with large health systems.

我們與 Northern Light Health、Lee Health 和 Tower Health 建立新的 PLS 合作夥伴關係所取得的進展尤其令我們感到鼓舞。隨著醫院繼續面臨財務挑戰，我們通過專業實驗室服務、參考測試或購買醫院的外展資產來提供幫助。我們現在看到與大型衛生系統的大量潛在交易的勢頭不斷增強。

In Consumer Health, we had strong base business growth on questhealth.com. We continue to optimize our marketing efforts to target our customers more strategically and now expect consumer-initiated testing to be profitable through the balance of 2023.

在消費者健康領域，我們在 questhealth.com 上實現了強勁的基礎業務增長。我們繼續優化我們的營銷工作，以更具戰略性地瞄准我們的客戶，現在預計消費者發起的測試將在 2023 年剩餘時間內實現盈利。

Also during the quarter, we launched Genetic Insights, our first consumer-initiated genetics health test on questhealth.com. This saliva-based test leverages our expertise in Next-Generation Sequencing to analyze 3 dozen genes for inherited risk of conditions ranging from breast and colon cancer through carrier status for cystic fibrosis and Tay-Sachs. We are encouraged by initial demand for this new offering, which adds to our growing test options for health-minded consumers.

同樣在本季度，我們在 questhealth.com 上推出了 Genetic Insights，這是我們首個由消費者發起的基因健康測試。這種基於唾液的測試利用我們在下一代測序方面的專業知識來分析 3 打基因，以了解從乳腺癌和結腸癌到囊性纖維化和泰薩克斯病攜帶者狀態等疾病的遺傳風險。我們對這一新產品的最初需求感到鼓舞，這為我們為註重健康的消費者提供了越來越多的測試選擇。

As discussed at Investor Day in March, a key pillar of our strategy is to support faster growth across all customer segments through highly specialized advanced diagnostics. These offerings include molecular genomics and oncology tests such as germline testing to assess prenatal and hereditary genetic risk and somatic testing for tumor sequencing.

正如三月份投資者日所討論的，我們戰略的一個關鍵支柱是通過高度專業化的先進診斷來支持所有客戶群體的更快增長。這些產品包括分子基因組學和腫瘤學測試，例如評估產前和遺傳性遺傳風險的種系測試以及用於腫瘤測序的體細胞測試。

Advanced Diagnostics also encompasses other key areas, including neurology, women's reproductive health and cardiometabolic health. In neurology, we continue to achieve strong growth from our innovative Quest AD-Detect, portfolio of Alzheimer's blood tests, which help identify early indications of beta amyloid and ApoE status. AD-Detect strongly positions Quest to lead in this rapidly evolving Alzheimer's landscape. Emerging therapies for Alzheimer's represent a new era in treatment and testing for this disease. Like many diseases, early intervention in Alzheimer's may promote better outcomes.

高級診斷還涵蓋其他關鍵領域，包括神經病學、女性生殖健康和心臟代謝健康。在神經病學領域，我們通過創新的 Quest AD-Detect、阿爾茨海默氏症血液檢測產品組合繼續實現強勁增長，這有助於識別 β 澱粉樣蛋白和 ApoE 狀態的早期跡象。 AD-Detect 有力地定位了 Quest 在這一快速發展的阿爾茨海默病領域的領先地位。阿爾茨海默病的新興療法代表了該疾病治療和檢測的新時代。與許多疾病一樣，阿爾茨海默病的早期干預可能會帶來更好的結果。

Our AD-Detect portfolio enables accessible and convenient evaluation of Alzheimer's risk potentially at early stages and the monitoring of progression. AD-Detect is now available to our physician customers in the U.S., and we believe it also has the potential to generate strong consumer demand.

我們的 AD-Detect 產品組合可以方便地評估早期阿爾茨海默病的潛在風險並監測進展情況。 AD-Detect 現已可供我們在美國的醫生客戶使用，我們相信它也有可能產生強勁的消費者需求。

In addition, we continue to see strong growth in our cardiometabolic, endocrinology, infectious disease and carrier and prenatal genetic screening services. In June, we completed our acquisition of Haystack Oncology, which positions us to enter the high-growth area of minimal residual disease or MRD testing. Haystack has developed a highly sensitive technique for early detection of residual or recurring cancer with the potential to improve outcomes for patients being treated for cancer.

此外，我們的心臟代謝、內分泌、傳染病、攜帶者和產前基因篩查服務繼續強勁增長。 6 月，我們完成了對 Haystack Oncology 的收購，這使我們能夠進入微小殘留病或 MRD 檢測的高增長領域。 Haystack 開發了一種高度靈敏的技術，用於早期檢測殘留或複發的癌症，有可能改善癌症患者的治療結果。

The integration of Haystack is on track, and we continue to expect to introduce our first MRD test in early 2024. We intend to launch this test from our Oncology Center of Excellence in Lewisville, Texas, where we also recently introduced our solid tumor expanded panel for tumor sequencing and therapy monitoring.

Haystack 的整合正在順利進行，我們繼續期望在 2024 年初推出我們的第一個 MRD 測試。我們打算在德克薩斯州路易斯維爾的腫瘤學卓越中心啟動這項測試，我們最近還在那裡推出了我們的實體瘤擴展面板用於腫瘤測序和治療監測。

I'd like to say a little more about our M&A strategy. Haystack is a capabilities acquisition. And as we've said, it will initially be dilutive for earnings per share. However, our primary focus in M&A continues to be on traditional hospital outreach purchases and tuck-in lab deals that are accretive to earnings in the first year.

我想多談談我們的併購策略。 Haystack 是一種能力獲取。正如我們所說，它最初會稀釋每股收益。然而，我們在併購方面的主要重點仍然是傳統的醫院外展採購和實驗室交易，這些交易可以增加第一年的收入。

To underscore what I said earlier, our M&A pipeline is robust as hospital systems faced continued margin pressures due to labor challenges and a shift from inpatient to outpatient care.

為了強調我之前所說的，我們的併購渠道很強勁，因為醫院系統由於勞動力挑戰和從住院治療到門診治療的轉變而面臨持續的利潤壓力。

Turning to operational and productivity improvement, our Invigorate program is well on its way to delivering our 3% annual productivity savings target. As we discussed at Investor Day, Invigorate includes deploying automation and AI to improve quality, efficiency and service. In the quarter, we implemented our automated microbiology solution in Lenexa, Kansas. Next up is Lewisville, Texas. When complete, 4 of our major laboratories will use automated microbiology lines with embedded artificial intelligence identifying positive and negative cases leading to improved quality and productivity.

在運營和生產力改進方面，我們的 Invigorate 計劃正在順利實現我們每年 3% 生產力節省的目標。正如我們在投資者日討論的那樣，Invigorate 包括部署自動化和人工智能來提高質量、效率和服務。本季度，我們在堪薩斯州萊內克薩實施了自動化微生物學解決方案。接下來是德克薩斯州路易斯維爾。完成後，我們的 4 個主要實驗室將使用帶有嵌入式人工智能的自動化微生物學生產線，識別陽性和陰性病例，從而提高質量和生產力。

We are also excited by results of a pilot in our Clifton lab that showed AI speed data collection in specimen processing and expect to implement this AI solution across all of our major regional labs later this year. In genomics, we're utilizing AI in bioinformatics to improve and speed variant classification and prioritization. These are just a couple of the many examples of our use of AI and automation to continuously improve our operations.

我們還對克利夫頓實驗室的試點結果感到興奮，該結果顯示了人工智能在樣本處理中的數據收集速度，並期望今年晚些時候在我們所有主要區域實驗室中實施該人工智能解決方案。在基因組學中，我們利用生物信息學中的人工智能來改進和加速變異分類和優先級排序。這些只是我們使用人工智能和自動化來不斷改進我們的運營的眾多示例中的幾個。

In addition, we believe generative AI has great potential to deliver insights and content not only to better target and serve customers, but also to create innovations that help standardize our lab operations. We are encouraged by preliminary results of pilots that use generative AI and our customer service center to automate call their sentiment analysis and quality control and in our marketing operations to improve market research and customer targeting.

此外，我們相信生成式人工智能具有巨大的潛力，可以提供見解和內容，不僅可以更好地定位和服務客戶，還可以創造有助於標準化我們實驗室運營的創新。我們對試點的初步結果感到鼓舞，這些試點使用生成式人工智能和我們的客戶服務中心來自動進行情緒分析和質量控制，並在我們的營銷運營中改善市場研究和客戶定位。

Now before I turn it over to Sam, I'll close by saying that we always knew 2023 would be a challenging year as we transitioned away from COVID-19 testing and supported the nation's return to care. Our dedicated employees on the front lines and everyone else who supports them, have done a magnificent job of bringing our purpose to life, working together to create a healthier world, one life at a time. I'm really proud to be leading this Quest Diagnostics' team.

現在，在我將其交給 Sam 之前，我最後要說的是，我們一直都知道 2023 年將是充滿挑戰的一年，因為我們從 COVID-19 測試過渡到支持國家恢復護理。我們在第一線的敬業員工和所有支持他們的人，為實現我們的目標做出了出色的工作，共同努力創造一個更健康的世界，一次一個人的生活。我非常自豪能夠領導 Quest Diagnostics 團隊。

And 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，以提供有關我們的表現和更新的 2023 年指導的更多詳細信息。薩姆？

Thanks, Jim. In the second quarter, consolidated revenues were $2.34 billion, down 4.7% versus the prior year. Base business revenues grew 9.5% to $2.3 billion while COVID-19 testing revenues declined approximately 88% to $41 million. Revenues for Diagnostic Information Services declined 4.9% compared to the prior year, reflecting lower revenue from COVID-19 testing versus the second quarter of 2022, partially offset by strong growth in our base business.

謝謝，吉姆。第二季度綜合收入為 23.4 億美元，比上年同期下降 4.7%。基礎業務收入增長 9.5%，達到 23 億美元，而 COVID-19 檢測收入下降約 88%，達到 4100 萬美元。診斷信息服務的收入與上一年相比下降了 4.9%，反映出與 2022 年第二季度相比，COVID-19 測試的收入有所下降，但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, grew 0.2% versus the prior year, with acquisitions contributing 50 basis points to total volume. Total base testing volumes grew 7.4% versus the prior year as we continue to see a broad-based return to care throughout the quarter. Revenue per requisition declined 4.9% versus the prior year, driven by lower COVID-19 molecular volume. Base business revenue per req was up 2.5% due to more tests per req, changes in test mix and benefits recognized with certain value-based arrangements.

以請購數量衡量的總交易量較上年增長 0.2%，其中收購對總交易量貢獻了 50 個基點。由於我們繼續看到整個季度廣泛的醫療恢復，基礎檢測總量比上年增長了 7.4%。由於 COVID-19 分子體積下降，每份申請的收入較上年下降 4.9%。由於每個請求的測試增多、測試組合的變化以及某些基於價值的安排所帶來的好處，每個請求的基本業務收入增長了 2.5%。

Unit price reimbursement was flat in the quarter, consistent with our expectations. Reported operating income in the second quarter was $348 million or 14.9% of revenues compared to $388 million or 15.8% of revenues last year. On an adjusted basis, operating income was $389 million or 16.7% of revenues compared to $435 million or 17.7% of revenues last year.

本季度的單價報銷持平，符合我們的預期。第二季度報告的營業收入為 3.48 億美元，佔收入的 14.9%，而去年為 3.88 億美元，佔收入的 15.8%。調整後的營業收入為 3.89 億美元，佔收入的 16.7%，而去年為 4.35 億美元，佔收入的 17.7%。

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. Compared to the first quarter, we made strong progress improving the profitability of the business. Adjusted operating margin expanded 170 basis points sequentially while total revenues were essentially flat versus Q1.

調整後營業收入同比下降主要與 COVID-19 檢測收入下降有關，但基礎業務的增長部分抵消了這一影響。與第一季度相比，我們在提高業務盈利能力方面取得了長足進步。調整後的營業利潤率環比擴大了 170 個基點，而總收入與第一季度基本持平。

We also absorbed higher SG&A costs related to an increase in the market value of the obligations in our supplemental deferred comp plan in the second quarter, which lowered adjusted operating margin by 30 basis points. This has no impact on EPS. We continue to closely manage the cost of our corporate and support functions. Since last fall, we have taken a series of actions to reduce support costs, which will save more than $100 million this year.

我們還吸收了與第二季度補充遞延補償計劃中義務市場價值增加相關的較高SG&A成本，這使調整後的營業利潤率降低了30個基點。這對每股收益沒有影響。我們繼續密切管理公司和支持職能的成本。自去年秋天以來，我們採取了一系列行動來降低支持成本，今年將節省超過 1 億美元。

Those savings largely began in Q2, and we're on track with our estimates in the quarter. Frontline employee turnover improved marginally earlier this year, but the pace of improvement has not met our expectations, and it remains well above historical levels. We continue to feel the effects of the tight labor market, which has had an impact on productivity and wages.

這些節省大部分是在第二季度開始的，我們在本季度的預期符合預期。今年早些時候，一線員工流動率略有改善，但改善速度並未達到我們的預期，仍遠高於歷史水平。我們繼續感受到勞動力市場緊張的影響，這對生產率和工資產生了影響。

Turnover continues to be a drag on productivity despite the strong base business growth. Reported EPS was $2.05 in the quarter compared to $1.96 a year ago. Adjusted EPS was $2.30 compared to $2.36 last year. Cash from operations year-to-date was $538 million versus $882 million in the prior year period. The decline in operating cash flow was primarily related to lower operating income.

儘管基礎業務增長強勁，但營業額仍然拖累生產力。本季度報告的每股收益為 2.05 美元，而去年同期為 1.96 美元。調整後每股收益為 2.30 美元，去年為 2.36 美元。年初至今的運營現金為 5.38 億美元，而去年同期為 8.82 億美元。經營現金流量下降主要與營業收入下降有關。

Turning to our updated full year 2023 guidance. Revenues are now expected to be between $9.12 billion and $9.22 billion. Base business revenues are expected to be between $8.92 billion and $9.02 billion. COVID-19 testing revenues are expected to be approximately $200 million. Reported EPS is expected to be in a range of $7.52 to $7.92 and adjusted EPS to be in a range of $8.50 to $8.90. Cash from operations is expected to be at least $1.3 billion, and capital expenditures are expected to be approximately $400 million.

轉向我們更新的 2023 年全年指引。目前預計收入在 91.2 億美元至 92.2 億美元之間。基礎業務收入預計在 89.2 億美元至 90.2 億美元之間。 COVID-19 檢測收入預計約為 2 億美元。預計報告每股收益將在 7.52 美元至 7.92 美元之間，調整後每股收益將在 8.50 美元至 8.90 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。

There are some things to consider for the remainder of the year. We've raised our base business revenue guidance to reflect our strong performance through the first half and our expectations for the remainder of the year. Note that the year-over-year comparison for the base business becomes more difficult in the second half of 2023 as we begin to lap some PLS wins later in the year. Also, we are not expecting demand for respiratory panels to be as strong as we saw in last year's flu season, which could be a headwind to revenue of nearly 100 basis points in the back half.

今年剩餘時間裡有一些事情需要考慮。我們提高了基本業務收入指引，以反映我們上半年的強勁業績以及對今年剩餘時間的預期。請注意，基礎業務的同比比較在 2023 年下半年變得更加困難，因為我們在今年晚些時候開始取得一些 PLS 勝利。此外，我們預計呼吸面板的需求不會像去年流感季節那樣強勁，這可能會導致下半年收入下降近 100 個基點。

We expect revenue and adjusted EPS to be more even in the third and fourth quarters, which is a slight departure from our typical earnings seasonality due to the following factors: Unit price reimbursement is expected to improve in the back half. Our CIT business turned profitable in Q2 and is expected to be more accretive to both revenue and earnings as we move throughout the second half of 2023. And cost actions taken throughout the first half of the year will continue to improve the overall profitability of the business.

我們預計第三季度和第四季度的收入和調整後每股收益將更加均勻，這與我們典型的盈利季節性略有不同，原因如下： 預計下半年單價補償將有所改善。我們的 CIT 業務在第二季度實現盈利，預計隨著 2023 年下半年的推進，收入和收益將更加增加。上半年採取的成本行動將繼續提高業務的整體盈利能力。

Finally, as I noted earlier, we continue to experience higher frontline turnover and a tight labor market, which has had an impact on productivity and wages. Higher SG&A costs related to our supplemental deferred comp plan also lowered the operating margin by 30 basis points in the first half of 2023, but had no impact on EPS. As a result, our updated guidance reflects an adjusted operating margin of approximately 16.5% for the full year.

最後，正如我之前指出的，我們繼續經歷更高的一線流動率和緊張的勞動力市場，這對生產力和工資產生了影響。與我們的補充遞延補償計劃相關的較高的 SG&A 成本也使 2023 年上半年的營業利潤率降低了 30 個基點，但對每股收益沒有影響。因此，我們更新後的指引反映出全年調整後的營業利潤率約為 16.5%。

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

現在，我將把它轉回給吉姆。

Thanks, Sam. To summarize, we had strong base business performance in the second quarter with nearly double-digit revenue growth as our collaborations with health plans, hospitals and physicians enabled us to benefit from strong demand amid a broad return to care.

謝謝，薩姆。總而言之，我們在第二季度擁有強勁的基礎業務表現，收入增長近兩位數，因為我們與健康計劃、醫院和醫生的合作使我們能夠從廣泛的護理恢復過程中的強勁需求中受益。

We made substantial progress improving the profitability of our base business compared to the first quarter and prior year. This was slightly offset by persistently high employee turnover, which weighs on productivity and increases cost. And finally, our updated guidance reflects our expectations for revenue growth and improved profitability in the base business. Now we'd be happy to take your questions. Operator?

與第一季度和去年同期相比，我們在提高基礎業務盈利能力方面取得了實質性進展。持續較高的員工流動率略微抵消了這一影響，員工流動率影響了生產力並增加了成本。最後，我們更新的指導反映了我們對基礎業務收入增長和盈利能力提高的預期。現在我們很樂意回答您的問題。操作員？

(Operator Instructions). And our first question comes from Jack Meehan with Nephron Research.

（操作員說明）。我們的第一個問題來自 Nephron Research 的 Jack Meehan。

I wanted to start and ask about kind of the health plan commentary. Is it possible to tease out how much of this growth could be share gain related versus just strong underlying demand and somewhat related, we have heard more discussion about national payers being more active around payment integrity. I was just curious if you're seeing that at all, could that be a positive or negative for Quest?

我想開始詢問有關健康計劃的評論。是否有可能弄清楚這種增長有多少可能與份額收益相關，而不是與強勁的潛在需求相關，並且在某種程度上相關，我們聽到了更多關於國家付款人在支付誠信方面更加積極的討論。我只是很好奇你是否看到了這一點，這對 Quest 來說是積極還是消極？

Yes. Thanks, Jack. So it's always hard to discern in this industry what is share gain versus demand return to care and things like that. We don't get perfect data on it. But our sense is it's some of both. On the share gain side, we look closely at our growth through each of the commercial payers. And when we see gains that are above and beyond the average and we see the benefits of those programs, those value-based programs that we work with them, which is around leakage. It's around focusing on physicians that are using out-of-network labs, we see the benefits of those programs, and therefore, conclude its share gain. Certainly, there's been some strong return to care.

是的。謝謝，傑克。因此，在這個行業中，總是很難辨別什麼是份額收益，什麼是需求回報以及類似的事情。我們沒有得到完美的數據。但我們的感覺是兩者兼而有之。在份額收益方面，我們通過每個商業付款人密切關注我們的增長。當我們看到高於平均水平的收益時，我們看到這些計劃的好處，我們與他們合作的那些基於價值的計劃，這是圍繞洩漏的。它圍繞著使用網絡外實驗室的醫生，我們看到了這些計劃的好處，因此得出了其份額增長的結論。當然，護理工作已經有了一些強勁的恢復。

On the Payment Integrity side, I can tell you that, look, it's a never-ending effort here in Quest Diagnostics to continuously work denials, to make sure that we understand the payer policies, what are the diagnostic [pros] that support those policies and then work back through our physician base to make sure that the tests that they're ordering are appropriate tests. So we haven't seen any discernible impact with some of those policies you're referring to. But we work collaboratively with the payers to understand them and then work back with our physician base to try to correct any errors.

在支付完整性方面，我可以告訴您，看，Quest Diagnostics 不斷努力否認，以確保我們了解付款人政策，支持這些政策的診斷[優點]是什麼然後通過我們的醫生庫進行回溯，以確保他們訂購的測試是適當的測試。因此，我們還沒有看到您提到的某些政策產生任何明顯的影響。但我們與付款人合作以了解他們，然後與我們的醫生群體合作以嘗試糾正任何錯誤。

Super. Sam, one question on margins. Sorry if I missed this. What is the guide now assume for margins for the year? And can you just talk about what you're assuming in terms of the pace of productivity improvement?

極好的。薩姆，有一個關於邊緣的問題。抱歉，如果我錯過了這個。現在指南對本年度利潤率的假設是多少？您能否談談您對生產力提高速度的假設？

Yes. Thanks, Jack. So we are assuming for the year, operating margins to be at approximately 16.5%. In terms of productivity, you've seen good benefits from our Invigorate program. And we expect those to, if anything, continue for the rest of the year and even accelerate in Q3 and Q4. So we are seeing good momentum on our Invigorate programs. We're seeing the $100 million of SG&A savings that we've talked about. We're seeing those materialize as of the beginning of Q2, and they will continue for the rest of the year as well for a total year impact of $100 million.

是的。謝謝，傑克。因此，我們假設今年的營業利潤率約為 16.5%。在生產力方面，您已經從我們的 Invigorate 計劃中看到了巨大的好處。我們預計這些趨勢（如果有的話）將在今年剩餘時間內持續下去，甚至在第三季度和第四季度加速。因此，我們看到 Invigorate 計劃的良好勢頭。我們已經看到我們所討論的 SG&A 節省了 1 億美元。我們看到這些在第二季度初開始實現，並且將在今年剩餘時間內持續下去，全年影響總額將達到 1 億美元。

On the other side, we are also seeing, as you heard in the prepared remarks, a tough labor and turnover and macro environment. So turnover continues to persist to be higher than we expected, and that's driving pressure also on margins. But we are expecting approximately 16.5% for the year in terms of OM.

另一方面，正如您在準備好的發言中所聽到的那樣，我們也看到了嚴峻的勞動力、人員流動和宏觀環境。因此，營業額繼續高於我們的預期，這也給利潤率帶來了壓力。但我們預計今年 OM 的增長率約為 16.5%。

Yes. Jack, I would just add, obviously, you can see the base -- you can see the margin improvement from Q1 to Q2. That comes through pretty clear. You can do the math on the base margin improvements from Q2 of last year to Q2 of this year, when you make the assumptions on the drop-down of the COVID revenue, which you've -- you're in the range with the numbers you've used in the past. So we're really pleased with the base margin improvement from Q2 of last year to Q2 of this year and very pleased with the improvement from Q1 of this year to Q2 of this year.

是的。傑克，我想補充一點，顯然，你可以看到基數 - 你可以看到從第一季度到第二季度的利潤率改善。這很清楚。當你對新冠疫情收入下降做出假設時，你可以計算一下從去年第二季度到今年第二季度的基本利潤率改善情況，你已經在這個範圍內了您過去使用過的號碼。因此，我們對去年第二季度到今年第二季度的基本利潤率改善感到非常滿意，並對今年第一季度到今年第二季度的改善感到非常滿意。

Our next question is from Elizabeth Anderson with Evercore ISI.

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

Congrats on a good quarter. My question is, I realized there was a ton of noise this quarter on the deferred comp and how that nets out. How -- could one -- what is your assumption in terms of what's embedded in your guidance for the back half of the year? I appreciate that it can be different based on what happens to the future stock price. But I just want to understand whether it's sort of continuing the forecast of last year's trajectory into this year or 2Q going forward or what have you?

祝賀季度表現良好。我的問題是，我意識到本季度關於延期補償以及其結果如何產生了大量噪音。您對今年下半年的指導中包含的內容有何假設？我明白，根據未來股價的變化，情況可能會有所不同。但我只是想知道，這是否是對去年軌蹟的預測延續到今年或第二季度，或者你有什麼？

And then secondarily, how do you think about you mentioned the labor productivity and sort of the still elevated turnover. So how do you think about sort of the cost benefit of analysis of perhaps like investing more in wages or something like that versus the productivity gains that you would -- you could potentially receive from that?

其次，您如何看待您提到的勞動生產率和仍然較高的營業額。那麼，您如何看待分析的成本效益（例如更多地投資於工資或類似的東西）與您可能從中獲得的生產率的提高？

Okay. Thanks, Liz, and I appreciate the congrats. So let me talk about DCP deferred compensation, and I'll turn to Jim for productivity and some of the trade-offs that you're referring to there. So in terms of DCP, let me just clarify what it is and the impact.

好的。謝謝，莉茲，我很感激你的祝賀。那麼，讓我談談 DCP 遞延薪酬，我將向 Jim 尋求生產力以及您提到的一些權衡。那麼就DCP而言，我先澄清一下它是什麼以及影響。

So first of all, the expense that we saw, which impacts SG&A is the -- related to the increase in the market value of obligations in our supplemental deferred comp plan. That does not have an impact on EPS because it is offset on the nonoperating income line with a benefit. So it's a net neutral on EPS, but it does impact operating margin. Sometimes we don't see it materially impact us. It's related to market movements.

首先，我們看到的影響SG&A的費用是與我們補充遞延補償計劃中義務市場價值的增加有關。這不會對每股收益產生影響，因為它通過收益抵消了非營業收入線。因此，它對每股收益呈淨中性，但確實會影響營業利潤率。有時我們看不到它對我們產生實質性影響。這與市場走勢有關。

This quarter, it impacted us materially to the tune of 30 basis points impact on operating margin percent. So if you exclude that, it would be our operating margin percent would have been 17%. If you compare it to last year, because last year, and this is where it gets maybe a bit more complicated. But last year, we actually had a benefit in terms of expenses on -- related to deferred compensation, plan market value -- the fair market value change. And so compared to last year Q2, it's an impact of 1%.

本季度，它對我們的運營利潤率產生了 30 個基點的重大影響。因此，如果排除這一點，我們的營業利潤率為 17%。如果你將其與去年進行比較，因為去年，這就是情況可能變得更加複雜的地方。但去年，我們實際上在與遞延薪酬、計劃市場價值相關的費用方面受益於公平市場價值變化。與去年第二季度相比，影響為 1%。

So actually, if you compare Q2 2023 OM versus Q2 2022 OM, we would have been relatively flat in terms of operating margin percent quarter-over-quarter last year even despite the drop in COVID revenues, a significant drop to the tune of approximately $300 million that we saw year-over-year in terms of COVID revenues.

因此，實際上，如果將 2023 年第二季度的 OM 與 2022 年第二季度的 OM 進行比較，我們的營業利潤率在去年季度環比上會相對持平，儘管新冠疫情收入有所下降，大幅下降了約 300 美元就新冠肺炎收入而言，我們看到同比增長了 100 萬美元。

Now as you look towards the rest of the year, Liz, we don't forecast deferred compensation plan. I mean that's not something that we forecast. We assume it's a net neutral impact, both on the P&L, on EPS and on operating margin. So the impact that we saw in the first half, which is roughly about 50 basis points of operating margin or 30 basis points, I should say, is carried through for the rest of the year. And so that 16.5% full year operating margin is impacted by the DCP in the first half. So that's the best way I can characterize it.

現在，莉茲，當你展望今年剩餘時間時，我們預計不會有遞延薪酬計劃。我的意思是這不是我們的預測。我們假設這對損益表、每股收益和營業利潤率均產生淨中性影響。因此，我們在上半年看到的影響，即營業利潤率大約 50 個基點，或者我應該說 30 個基點，將在今年剩餘時間延續。因此，上半年 16.5% 的全年營業利潤率受到 DCP 的影響。這是我描述它的最好方式。

Yes. And Liz, on the labor front, at Investor Day, we showed a chart that said pre-COVID, our turnover of what we call our frontline roles, which is phlebotomy, logistics, specimen processing, our call centers, was in the 14% range, our total turnover. We showed a chart that said in the fourth quarter, it was upwards of 23%. It's come down modestly in the first part of the year, but still hasn't come down to the levels, obviously, pre-COVID or to where we would like them. Now you're right. It's a trade-off between increasing wage rates and the price -- and the cost you pay for this turnover. We've estimated that each turnover, each person can cost us upwards of $8,000 to $10,000 depending on the role. And that's simply the lost productivity or the time it takes to get somebody from day 1 to as efficient in that role as a person who's been in the role for 2-plus years.

是的。莉茲，在勞工方面，在投資者日，我們展示了一張圖表，顯示在新冠疫情之前，我們所謂的一線角色的流動率，即放血、物流、標本處理、我們的呼叫中心，在 14% 左右。範圍，我們的總營業額。我們展示了一張圖表，顯示第四季度增長了 23%。今年上半年略有下降，但顯然仍未降至新冠疫情之前的水平或我們希望的水平。現在你是對的。這是提高工資率和價格之間的權衡——以及你為這種營業額支付的成本。我們估計，根據職位的不同，每個人的每次流動可能會花費我們 8,000 至 10,000 美元以上的成本。這只是生產力的損失，或者是讓某人從第一天開始就能夠像在該職位上工作了兩年多的人一樣高效所需的時間。

So it's about $8,000 to $10,000 which if you do the math on that, could have upwards of a $20 million impact in the second half of this year. Now we're at the high end of our wage rate guidance that we gave. We said 3% to 4%. We're certainly at that high end. And if we need to make adjustments, we obviously look at the ROI on that. And we're faced with those decisions. And in certain markets, we will make adjustments to get the turnover to a place that we're comfortable with.

因此，如果您計算一下，大約為 8,000 至 10,000 美元，今年下半年可能會產生超過 2000 萬美元的影響。現在我們正處於我們給出的工資率指導的高端。我們說3%到4%。我們當然處於高端。如果我們需要進行調整，我們顯然會考慮投資回報率。我們面臨著這些決定。在某些市場，我們將進行調整，以使營業額達到我們滿意的水平。

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

我們的下一個問題來自 A.J.瑞信的大米。

Maybe just to pivot over and ask you about your Health System Business. I think last quarter, you said in aggregate, it was growing about 70%. And this quarter, the press release says it's just under 10%. And I suspect with NewYork-Presbyterian and so forth coming online fully in the back half, it might be even higher than 10%. When you think about your margin targets and what you're shooting for, can you comment on how the growth in that side of the business is impacting margins and the opportunity? And if there's any updated thoughts on the pipeline that you're seeing, maybe give us that as well.

也許只是轉過身來詢問您有關您的醫療系統業務的情況。我認為上個季度，你說總體增長了 70% 左右。新聞稿稱本季度這一比例略低於 10%。我懷疑隨著紐約長老會醫院等醫院在下半年全面上線，這一比例可能會高於 10%。當您考慮您的利潤目標和目標時，您能否評論一下這方面業務的增長如何影響利潤和機會？如果您對管道有任何更新的想法，也可以告訴我們。

Yes. Thanks, A.J. Just on the NewYork-Presbyterian book of business, when we buy that outreach book of business, it actually is in our Physician bucket, not our Health System bucket, because it's physician offices, and we build third-party payers for that.

是的。謝謝，A.J.就紐約長老會商業名錄而言，當我們購買外展商業名錄時，它實際上是在我們的醫生桶中，而不是在我們的醫療系統桶中，因為它是醫生辦公室，我們為此建立了第三方付款人。

Our Health System business in the quarter was really helped by the PLS side. Our reference book of business was strong as well, but our PLS growth was very, very strong. excited by the 3 deals that we mentioned in the script with Tower Health, Lee Health and Northern Lights being some of the newer ones. So it was -- that generated substantially more growth in the quarter.

我們本季度的醫療系統業務確實得到了 PLS 方面的幫助。我們的商業參考書也很強大，但我們的 PLS 增長非常非常強勁。對我們在劇本中提到的 3 筆交易感到興奮，其中 Tower Health、Lee Health 和 Northern Lights 都是較新的交易。正是如此——這在本季度帶來了大幅增長。

Now as we've always said, PLS has slightly lower operating margins than our normal physician office book of business. But we really like the ROIC on that, okay? So it's got a strong return on capital and that's why we continue to do this. So in terms of the outlook, our funnel of opportunities is strong. We hope to have more closed in the second half of this year on both the PLS side as well as new reference wins. So we're optimistic that the Health Systems portion of our business will continue to grow.

現在，正如我們一直所說的，PLS 的營業利潤率略低於我們正常的醫生辦公室業務。但我們真的很喜歡這方面的投入資本回報率，好嗎？因此它具有很強的資本回報率，這就是我們繼續這樣做的原因。因此，就前景而言，我們的機會渠道很強大。我們希望今年下半年 PLS 方面能有更多的成果，並取得新的參考勝利。因此，我們樂觀地認為我們業務的健康系統部分將繼續增長。

Yes. And one additional comment, A.J. So with regards to the expectations in the second half on PLS, as Jim said, we are seeing strong growth in that business. In the second half, from a year-over-year perspective, we had some big wins in the first half of last year as well that ramped up in the second half of last year. So from a year-over-year perspective, we do lap some of those PLS wins and that mutes our revenue growth to some extent. But we're seeing really great momentum on the PLS side of the business.

是的。還有一條補充評論，A.J.因此，對於 PLS 下半年的預期，正如 Jim 所說，我們看到該業務的強勁增長。下半年，從同比的角度來看，我們在去年上半年取得了一些重大勝利，並且在去年下半年取得了一些重大勝利。因此，從同比的角度來看，我們確實取得了一些 PLS 的勝利，這在一定程度上抑制了我們的收入增長。但我們看到 PLS 業務方面的強勁勢頭。

Our next question is from Patrick Donnelly with Citi.

我們的下一個問題來自花旗集團的帕特里克·唐納利。

Sam, again, that 16.5%, is that now the right number to work off in terms of the long-term guide? And you talked about a few of the moving parts, the unit pricing, maybe looking a little better, labor hitting it. Any of these things onetime that would wear off? And then on that pricing, I know you guys negotiate kind of 1/4 of the contracts annually. Can you just talk about the pricing environment at the moment?

Sam，再說一遍，16.5%，現在這個數字是根據長期指南計算的正確數字嗎？你談到了一些變化的部分，單位定價，也許看起來好一點，勞動力的影響。這些東西有沒有一次性就會消失的？然後就定價而言，我知道你們每年談判 1/4 的合同。您能簡單談談目前的定價環境嗎？

Yes. No, it's -- so the 16.5% would be the launching point if you're thinking about the 3-year outlook, Patrick, and the improvement that we guided in the -- in Investor Day, which is the 75 to 150 basis point improvement. That's still the right number to be thinking about longer term off of the 16.5% launching point at the end of this year.

是的。不，所以，帕特里克，如果你考慮 3 年前景，以及我們在投資者日指導的改進，即 75 至 150 個基點，那麼 16.5% 將是啟動點改進。從今年年底的 16.5% 啟動點來看，這個數字仍然是考慮長期目標的正確數字。

In terms of a couple of things that you mentioned, onetime items I think we talked about the DCP, which was more significant in Q2 and for the first half of the year, maybe you can call that onetime. But although it is recurring, but we don't forecast for it. Sometimes it's a benefit. Sometimes it's a negative in terms of an operating margin percent. Last year, in the first half, it was actually a benefit. This year in the first half, it's a negative.

就你提到的幾件事而言，我認為我們談論了 DCP，這在第二季度和今年上半年更為重要，也許你可以稱之為一次性。儘管它會反復出現，但我們並沒有對其進行預測。有時這是一種好處。有時，就營業利潤率而言，它是負值。去年上半年，其實是有效益的。今年上半年，這是一個負面的情況。

Pricing environment is very good. It's really good. We're seeing good momentum with the health plan value-based contract arrangements that we have. And we expect the pricing environment actually in the second half, where the pricing benefit in the second half to improve versus the first half.

定價環境非常好。真的很棒。我們看到基於健康計劃價值的合同安排勢頭良好。我們預計下半年的定價環境實際上會比上半年有所改善。

Now as we think about '24, we've talked about before that PAMA is still an uncertainty. And so until we have more certainty around whether there's another PAMA delay or a SALSA bill that gets passed, there's still some uncertainty there for '24.

現在，當我們思考'24時，我們之前已經討論過PAMA仍然是一個不確定性。因此，在我們更加確定是否會再次推遲 PAMA 或 SALSA 法案是否獲得通過之前，24 週年仍然存在一些不確定性。

The next question is from Brian Tanquilut with Jefferies.

下一個問題來自 Jefferies 的 Brian Tanquilut。

Congrats on the quarter. Sam, maybe I'll follow up just on Patrick's question, right? So as I think about your previous comments on 2024 guidance or targets for operating margin, does this push out what you had previously kind of guided to for 2024? And maybe kind of related to that, as I think about the $100 million of corporate savings that you've outlined that began in Q2. I mean is there more to squeeze or is it sort of the target run rate and we're just going to see it flow through the P&L into next year as well?

恭喜本季度。薩姆，也許我會跟進帕特里克的問題，對嗎？因此，當我思考您之前對 2024 年指導或營業利潤率目標的評論時，這是否超出了您之前對 2024 年的指導？也許與此相關，因為我想到了您概述的從第二季度開始的 1 億美元企業節省。我的意思是，是否還有更多需要擠壓的地方，或者這是否是目標運行率，我們只會看到它也通過損益表流入明年？

Yes. So with regards to -- thank you, Brian, first of all, for the question. So with regards to 24, we didn't guide 24. We gave some long-term targets around what we expect our operating margin to look like over the next 3 years as we continue to execute on productivity improvements, Invigorate and apply cost savings into the business. The $100 million that you referred to, which, by the way, next year will be part of our run rate. So we wouldn't expect to see an improvement year-over-year in '24 versus '23 because we're -- except for maybe 1 quarter.

是的。所以關於——首先謝謝你，布萊恩，提出這個問題。因此，關於 24，我們沒有指導 24。我們圍繞未來 3 年內我們預期的營業利潤率制定了一些長期目標，因為我們將繼續執行生產力改進、激勵並將成本節約應用到這生意。順便說一句，你提到的 1 億美元明年將成為我們運行費用的一部分。因此，我們預計 24 年與 23 年相比不會出現同比改善，因為我們——除了 1 個季度之外。

But I would say the 16.5%, as I mentioned to Patrick, becomes the launching point for the future. And we do expect with continued Invigorate offsetting inflation with the cost reductions in the business that we've applied and now will continue and that are generating the expected improvements, we do expect to drive improvement in our operating margins long term. There is the uncertainty about PAMA, which is what drives the range of either 75 to 150 basis points improvement over the 3 years.

但我想說，正如我向帕特里克提到的，16.5% 成為未來的起點。我們確實預計，隨著我們已經實施的、現在將繼續實施的業務成本削減措施持續抵消通脹，並產生預期的改善，我們確實預計將長期推動我們營業利潤率的改善。 PAMA 存在不確定性，這也是推動 3 年來 75 至 150 個基點改善的原因。

Yes. Then in terms of the cost take out $100 million. Look, we're always looking to be the most efficient we can and obviously, spend every dollar as wisely as we can. But we're also going to continue to invest in this business. We've made strong investments in CIT. And I think as you heard in our script, it's paying off for us. We've got really nice growth out of that. It's now turned profitable.

是的。那麼就成本而言，拿出1億美元。聽著，我們一直在尋求盡可能提高效率，而且顯然，我們會盡可能明智地花每一美元。但我們也將繼續投資這項業務。我們對 CIT 進行了大量投資。我認為正如您在我們的劇本中聽到的那樣，這為我們帶來了回報。我們從中得到了非常好的增長。現在已經扭虧為盈了。

The Alzheimer's test that we've brought to market that requires investment, and we're going to continue to invest in that space. We're going to continue to invest in molecular genomics and oncology because we're getting growth in that space. And with the Haystack acquisition, we're going to continue to invest there to try to get the test to market as quickly as possible and build a stronger presence. So we're always going to balance the 2. But we're investing in this business for the future.

我們推向市場的阿爾茨海默病測試需要投資，我們將繼續在該領域進行投資。我們將繼續投資分子基因組學和腫瘤學，因為我們正在該領域取得增長。通過收購 Haystack，我們將繼續在那裡投資，以盡快將測試推向市場並建立更強大的影響力。因此，我們總是要平衡兩者。但我們正在為未來投資這項業務。

The next question is from Pito Chickering with Deutsche Bank.

下一個問題來自德意志銀行的 Pito Chickering。

There's been a big debate among both the corporates and investors on the sustainability of the current trends of utilization. Can you sort of talk about what you're seeing in July and sorry if I missed this, but how much of the 2Q organic growth was sort of organic versus the PLS transactions? And how should we think about organic growth continuing in the back half of the year?

企業和投資者對於當前利用趨勢的可持續性存在著激烈的爭論。您能談談您在 7 月看到的情況嗎？如果我錯過了這一點，抱歉，第二季度的有機增長有多少是有機增長與 PLS 交易相比？我們應該如何看待下半年持續的有機增長？

Yes. So we're optimistic that the growth will continue here. In the second half of the year, July to date has been strong consistent with what we saw in June. We generally don't break apart our PLS growth from the growth in our core business. We've said externally that our PLS growth is -- our PLS business is about a $600 million franchise. We said the health system market grew at 10%, PLS grew north of that, reference grew less than that.

是的。因此，我們對這裡的增長將持續感到樂觀。今年下半年，7 月至今表現強勁，與 6 月的情況一致。我們通常不會將 PLS 的增長與核心業務的增長分開。我們對外表示，我們的 PLS 增長是——我們的 PLS 業務約為 6 億美元的特許經營權。我們說醫療系統市場增長了 10%，PLS 增長高於該數字，參考增長低於該數字。

So I think you can get a sense for what that contributes to our total growth. But we're optimistic on the prospects with our health systems. The funnel of PLS opportunities remain strong. Health systems need our help, and we think we've got a great offering that helps meet their needs.

因此，我認為您可以了解這對我們總體增長的貢獻。但我們對衛生系統的前景持樂觀態度。 PLS 機會的漏斗仍然強勁。衛生系統需要我們的幫助，我們認為我們已經提供了很好的產品來幫助滿足他們的需求。

And Pito, maybe I can give a couple of additional comments on sort of second half versus first half, which is I think, where you're driving at here. So listen, we've had a great first half, close to 10% revenue growth. But as you think about the second half, there are a couple of things to keep in mind. First of all, we had some easier compare in the first half versus 2022. Obviously, we were in the midst of COVID, base business was impacted by that. So there was some easier compare in the first half that we don't expect to repeat in the second half.

皮托，也許我可以就下半場與上半場的情況發表一些額外的評論，我認為，你在這裡開車。聽著，我們上半年的收入增長非常好，接近 10%。但當你思考下半場時，有幾件事需要記住。首先，我們將上半年與 2022 年進行了一些比較。顯然，我們正處於新冠疫情期間，基礎業務受到了影響。因此，上半場有一些比較容易的比較，我們預計下半場不會重複。

On the prepared remarks, we talked about the COVID flu panel, which is about a 1% negative impact on growth in the second half, definitely compared to the first half. We talked about lapping some PLS wins, which also has a muting effect on our growth in the second half. So when you factor all of these combined, obviously, you can look at our implied growth in the second half based on guidance and it's well lower than the first half, and it's driven by some of these factors that I just gave you.

在準備好的發言中，我們談到了新冠肺炎疫情，與上半年相比，這對下半年的增長產生了約 1% 的負面影響。我們談到了一些 PLS 的勝利，這也對我們下半年的增長產生了抑製作用。因此，當您將所有這些因素結合起來時，顯然，您可以根據指導來查看我們下半年的隱含增長，它遠低於上半年，並且是由我剛剛向您提供的一些因素推動的。

In terms of July, we are still seeing higher than our traditional utilization. So we're still encouraged by what we're seeing in terms of utilization in July. So -- but we're being appropriately conservative in the second half in terms of what the utilization would look like.

就七月份而言，我們仍然看到高於傳統的利用率。因此，我們仍然對 7 月份的利用率感到鼓舞。所以，但我們在下半年的利用率方面會適當保守。

The next question is from Andrea Alfonso with UBS.

下一個問題來自瑞銀集團 (UBS) 的安德里亞·阿方索 (Andrea Alfonso)。

It's Kevin Caliendo. So I guess, if I can just bridge all this, if we just take -- go back to the starting point with 17% and then the operating margin then went to 16.8% with Haystack, now it's 16.5%, and we had this sort of onetime issue in the quarter with DCP, which took that down. But you're also calling out some labor trend issues. Maybe -- is the delta the expectation around the labor cost and churn? Like is there a way to quantify that? And should we expect that to continue going forward? I'm just trying to bridge all of these things and then think about the impact of '24 how we get the sort of margin expansion that was originally expected for '24 with these sort of headwinds that are playing out?

我是凱文·卡林多。所以我想，如果我能彌補這一切，如果我們只是回到起點 17%，然後 Haystack 的營業利潤率達到 16.8%，現在是 16.5%，我們就有了這樣的情況本季度曾與 DCP 發生過一次問題，該問題已被取消。但您也提出了一些勞動力趨勢問題。也許——三角洲是對勞動力成本和流失率的預期嗎？有沒有辦法量化這一點？我們是否應該期望這種情況繼續下去？我只是想彌合所有這些事情，然後思考 24 年的影響，我們如何在 24 年面臨這些逆風的情況下實現最初預期的利潤擴張？

Yes, Kevin, let me take the labor piece, and then I'll turn it over to Sam here. So on a previous question, we talked about pre-COVID, our attrition rate of our frontline positions was in the 14% range. In December, Q4 it was 23%. The chart we showed at Investor Day in March, it's slightly better than that. We have quantified it. We've said it's about $8,000 to $10,000 per employee. And in the second half of the year, we think it can be upwards of a $20 million impact versus where we would want it to be at this point in the year.

是的，凱文，讓我把勞務費拿走，然後我會把它交給山姆。在上一個問題中，我們談到了新冠疫情之前，我們一線崗位的流失率在 14% 左右。 12 月第四季度為 23%。我們在三月份投資者日展示的圖表比那要好一些。我們已經對其進行了量化。我們說過每位員工的工資約為 8,000 至 10,000 美元。我們認為今年下半年的影響可能會超過 2,000 萬美元，而我們今年此時的預期影響則可能高達 2000 萬美元。

So now, is the labor market is easy? Unemployment rate sits at 3.6% right now. The Fed has signaled that they're trying to actually get the unemployment rate back upwards of up to 4.1%, 4.5%. The interest rates are going to take a notch up again today. So we think there's going to be easing in the markets going forward, but it's hard to predict. And so right now, I think we're being appropriately conservative on the guidance in the second half.

那麼現在勞動力市場容易嗎？目前失業率為 3.6%。美聯儲已表示他們正在努力讓失業率真正回升至 4.1% 至 4.5%。今天利率將再次上調。因此，我們認為未來市場將會放緩，但這很難預測。所以現在，我認為我們對下半年的指導採取了適當的保守態度。

Yes. And so Kevin, let me give you some commentary around second half versus first half margins and why you should have confidence in the margin outlook that we gave, the approximately 16.5% for the year.

是的。因此，凱文，讓我對下半年與上半年的利潤率進行一些評論，以及為什麼您應該對我們給出的利潤率前景（今年約為 16.5％）充滿信心。

So first of all, and just to remind everybody, in Q2, our margins expanded by 170 basis points sequentially despite an $80 million drop in COVID, roughly $80 million drop in COVID. So we had some great momentum in terms of operating margin.

首先，想提醒大家的是，在第二季度，儘管新冠疫情導致的收入下降了 8000 萬美元，但我們的利潤率仍環比增長了 170 個基點，大約下降了 8000 萬美元。因此，我們在營業利潤率方面取得了巨大的進步。

As we look towards second half versus first half, here are some of the dynamics that you should factor. Our CIT business, which was net dilutive on operating margins in the first half, becomes accretive in the second half. So we expect to see that business -- as we're very encouraged by the momentum and it becomes actually, it's become profitable in Q2, and it's going to be accretive for the second half of the year. Pricing is a net -- also net accretive and will continue to improve in the second half, and it's definitely a step-up from the first half.

當我們展望下半年與上半年時，以下是您應該考慮的一些動態。我們的企業所得稅業務在上半年對營業利潤率產生了淨攤薄作用，但在下半年卻有所增加。因此，我們期望看到該業務 - 因為我們對這一勢頭感到非常鼓舞，而且實際上，它在第二季度實現了盈利，並且將在今年下半年實現增值。定價是淨的——也是淨增值的，並將在下半年繼續改善，而且絕對比上半年有所提高。

SG&A, we started to achieve those $100 million annualized savings in Q2. And so we expect to achieve the remainder in Q3 and Q4, we didn't have that benefit in Q1 of this year. We talked about DCP, and I don't want to focus too much on that, but it was a headwind in the first half, which we don't expect in the second half. Offsetting that is the fact that we have some lower COVID revenues in the second half because right now per our guidance, we're expecting approximately $40 million in the second half, which is definitely well south of the $160 million that we achieved in the first.

SG&A，我們在第二季度開始實現 1 億美元的年度節省。因此，我們預計將在第三季度和第四季度實現剩餘目標，但我們在今年第一季度沒有獲得這種好處。我們談到了DCP，我不想過多關注這一點，但它在上半場是一個逆風，我們預計在下半場不會出現這種情況。抵消這一影響的是，我們下半年的新冠疫情收入有所下降，因為目前根據我們的指導，我們預計下半年收入約為 4,000 萬美元，這絕對遠遠低於我們上半年實現的 1.6 億美元。

So -- but as you look at this momentum of all of these things, plus the ramp-up of Invigorate improvements that we expect to see in the second half -- and yes, there is some Haystack dilution, which is to the tune of about $0.15 to $0.20 for the year. But as you look at all of these factors, we are very confident about the ability to achieve the outlook that we gave in terms of operating margins.

所以 - 但當你看到所有這些事情的勢頭，加上我們預計在下半年看到的 Invigorate 改進的加速 - 是的，有一些 Haystack 稀釋，這與年約 0.15 至 0.20 美元。但當你考慮所有這些因素時，我們對實現我們給出的營業利潤率前景的能力非常有信心。

Kevin, the last thing I'd add is when you think about price in this business, we tend to always think about commercial payers, Medicare and Medicaid. You have to remember that there's another $2.5 billion on an annual basis where we price directly to Health Systems, to Physicians. And then we have $800 million worth of other businesses between employer solutions, our drug testing business, our wellness business, and our ExamOne business, which serves life insurance companies.

凱文，我要補充的最後一件事是，當你考慮這個行業的價格時，我們往往總是想到商業付款人、醫療保險和醫療補助。您必須記住，每年還有 25 億美元是我們直接向衛生系統和醫生定價的。然後，我們還有價值 8 億美元的其他業務，包括雇主解決方案、藥物測試業務、健康業務和為人壽保險公司提供服務的 ExamOne 業務。

So we are getting price in those segments of our business. And as Sam indicated, our price performance will be better in the second half than it was in the first half primarily from the lift we're getting on that side of our portfolio.

因此，我們正在獲得這些業務領域的價格。正如薩姆指出的那樣，我們下半年的價格表現將比上半年更好，這主要是因為我們投資組合的這一方面得到了提升。

And our next question is from Lisa Gill with JPMorgan.

我們的下一個問題來自摩根大通的麗莎·吉爾。

I just want to go back to your earlier comments around value-based care where you talked about leakage out-of-network opportunities. But can you maybe just talk about how you see this over time and how you see the evolution of value-based care as it pertains to lab. Is this a margin-enhancing opportunity or just more of a volume opportunity? One, how do I think about that? And then just secondly, I've heard you talk about the pipeline of Health Systems. Is there any way to size what that current pipeline looks like?

我只想回到您之前關於基於價值的護理的評論，其中您談到了網絡外洩漏的機會。但您能否談談您如何看待這一問題，以及您如何看待與實驗室相關的基於價值的護理的演變。這是一個提高利潤的機會還是只是一個增加銷量的機會？一，我對此有何看法？其次，我聽你談論過衛生系統的管道。有什麼方法可以確定當前管道的大小嗎？

Yes. So on the first question, I just want to make sure we're not confusing terminology here, value-based care and value-based incentives. So when we talk about value-based care, these are generally arrangements where Medicare has put lives directly into these ACO reach programs for Medicare Advantage plans delegate lives into large integrated physician groups.

是的。因此，關於第一個問題，我只是想確保我們沒有混淆這裡的術語：基於價值的護理和基於價值的激勵。因此，當我們談論基於價值的護理時，這些通常是 Medicare 將生命直接納入這些 ACO 覆蓋計劃的安排，而 Medicare Advantage 計劃則將生命委託給大型綜合醫生群體。

Now in both of those situations, we are contracting directly with these ACO REACH organizations and directly with these large physician groups. And we believe that those value-based care programs that Medicare and Medicare Advantage are driving are very good for the lab business because generally, they delegate lives at a fixed price, and in fact, labs become much more useful in terms of helping physicians ensure that diseases and conditions do not progress. So we feel good about that.

現在，在這兩種情況下，我們都直接與這些 ACO REACH 組織以及這些大型醫生團體簽訂合同。我們相信，醫療保險和醫療保險優勢正在推動的那些基於價值的護理計劃對實驗室業務非常有利，因為一般來說，它們以固定價格委託生命，事實上，實驗室在幫助醫生確保疾病和狀況不會進展。所以我們對此感覺良好。

I think what we're generally -- when we talk about the health plans and we talk about these things called value-based incentives. So these are programs that we structure with the health plans to help them reduce leakage to out-of-network labs and to help us redirect requisitions that are flowing into more expensive health system laboratories and have those requisitions flow directly into Quest Diagnostics.

我認為，當我們談論健康計劃時，我們通常會談論基於價值的激勵措施。因此，我們與衛生計劃一起制定了這些計劃，以幫助他們減少向網絡外實驗室的洩漏，並幫助我們重新定向流入更昂貴的衛生系統實驗室的申請，並將這些申請直接流入 Quest Diagnostics。

So when we are successful in those efforts, there can be value-based incentives that we earn when we help them earn the -- when we achieve those targets of reducing leakage and moving work from higher-priced hospital labs into independent labs like Quest Diagnostics. So we seek to do more of both of those programs, value-based care programs with ACO REACH and these value-based incentive programs with our large payers.

因此，當我們在這些努力中取得成功時，當我們幫助他們實現減少洩漏並將工作從價格較高的醫院實驗室轉移到像 Quest Diagnostics 這樣的獨立實驗室時，我們就能獲得基於價值的激勵。 。因此，我們尋求更多地開展這兩個計劃，即與 ACO REACH 合作的基於價值的護理計劃以及與我們的大付款人合作的基於價值的激勵計劃。

And our last question is from Eric Coldwell with Baird.

我們的最後一個問題來自 Eric Coldwell 和 Baird。

I have 2. First one, a bit higher level, more strategic. So United Healthcare Preferred Lab Network was updated in July. I saw that they removed Mayo, but were there any other notable changes in that contract or your relationship there? And then broadly on that same topic, what's the outlook for other MCO opportunities to narrow networks or move the National Labs like you and LabCorp into, say, more preferred roles? Are there opportunities being discussed in the market today?

我有2個。第一個，級別更高一點，更具戰略性。因此 United Healthcare Preferred Lab Network 在 7 月份進行了更新。我看到他們解雇了梅奧，但是這份合同或你們之間的關係還有其他顯著的變化嗎？然後，從廣義上講，關於同一主題，其他 MCO 機會縮小網絡或將像您和 LabCorp 這樣的國家實驗室轉移到更受歡迎的角色，其前景如何？今天市場上是否正在討論機會？

Yes. So on the first part of your question, we did not note any other notable changes with respect to the preferred lab network. We still remain part of that preferred plan network, and that's our plan going forward. In terms of narrowing networks, when we speak to all our commercial payers, we always think it's better, from their perspective, to have both independent labs in network that actually improves their ability to make sure that requisitions are going to lower cost, lower price environments, which is good for the payer. It's good for the employer, and it's good for the patient. And so we don't see any change in that trend to narrow networks that restrict access to independent laboratories.

是的。因此，在您問題的第一部分，我們沒有註意到首選實驗室網絡方面的任何其他顯著變化。我們仍然是該首選計劃網絡的一部分，這就是我們未來的計劃。就縮小網絡而言，當我們與所有商業付款人交談時，我們始終認為，從他們的角度來看，在網絡中擁有兩個獨立實驗室會更好，這實際上提高了他們確保申請成本更低、價格更低的能力環境，這對付款人有利。這對雇主有好處，對病人也有好處。因此，我們沒有看到限制訪問獨立實驗室的狹窄網絡的趨勢有任何變化。

Now having said that, there's laboratories that play on the fringe that could be expensive single-type test environments. And I think the payers are always looking at specialty labs versus independent labs that can do some of that specialty work as well.

話雖如此，有些實驗室處於邊緣，可能是昂貴的單一類型測試環境。我認為付款人總是關注專業實驗室和也可以做一些專業工作的獨立實驗室。

Okay. My other question, and I apologize if I think you got close to answering this a few times, and I've been toggling a couple of events this morning. But did you quantify or could you quantify the reduction in investment spending seen year-over-year in the second quarter and also the portion of the incremental $100 million plus cost action that you actually captured in 2Q. So we have a sense on what's left for the rest of the year.

好的。我的另一個問題，如果我認為你已經幾次接近回答這個問題，我很抱歉，今天早上我一直在切換幾個事件。但是，您是否量化了或者能否量化第二季度投資支出同比減少的情況，以及您在第二季度實際捕獲的 1 億美元增量加上成本行動的部分。因此，我們對今年剩餘時間的情況有所了解。

Yes. Sure, Eric. So no, we didn't quantify the reduction in investment spend. We did have lower investment spend in Q2 versus Q2 of last year, but we haven't quantified how much it is.

是的。當然，埃里克。所以不，我們沒有量化投資支出的減少。與去年第二季度相比，我們第二季度的投資支出確實有所下降，但我們尚未量化具體數額。

With regards to the SG&A benefits and the $100 million, I think the assumption that you can make is it's about 1/3 of that $100 million that was realized in Q2 and we expect the same to occur in Q3 and Q4.

關於 SG&A 福利和 1 億美元，我認為您可以做出的假設是，這大約是第二季度實現的 1 億美元的 1/3，我們預計第三季度和第四季度也會出現同樣的情況。

Yes. I just want to remind, we're going to continue to invest for growth in this business. As we mentioned, again in the script, we've invested in CIT, and we're really starting to see the fruits of that investment. We look at a metric called return on ad spend, it's now positive. So we're going to continue to invest there because we believe it's driving growth, and it's now driving profitable growth.

是的。我只是想提醒一下，我們將繼續投資以促進這項業務的增長。正如我們在腳本中再次提到的，我們投資了 CIT，並且我們確實開始看到該投資的成果。我們研究了一個稱為廣告支出回報率的指標，現在它是積極的。因此，我們將繼續在那裡投資，因為我們相信它正在推動增長，而且現在正在推動盈利增長。

We talked about our Alzheimer's portfolio of tests. We're going to continue to invest in that area. These blood-based tests, we have the AB42, 40 test up and running. We have the ApoE up and running. These are blood-based tests. These are going to be more useful than CSF or PET scans and less costly to the environment.

我們討論了我們的阿爾茨海默病測試組合。我們將繼續在該領域進行投資。這些基於血液的測試，我們已經啟動並運行了 AB42、40 測試。我們已啟動並運行 ApoE。這些是基於血液的測試。這些將比腦脊液或 PET 掃描更有用，而且對環境的成本更低。

We're going to continue to invest in the molecular side of our business. We're going to continue to invest in the oncology business. And that's going to -- all of these things are going to position us for the higher growth segments of the laboratory industry and ensure our long-term outlook.

我們將繼續投資於我們業務的分子方面。我們將繼續投資腫瘤業務。所有這些都將使我們能夠進入實驗室行業更高增長的領域，並確保我們的長期前景。

We did have one more question come in. Our last question is from Derik De Bruin with Bank of America.

我們確實還有一個問題。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. We talked about this quite a bit, but talked about the focus of the M&A pipeline will be on the deals you've traditionally done before. And it seems you certainly have plenty to come in the coming quarters and you have lots of balance. And of course, you're investing in Alzheimer's portfolio and whatnot. But as you look to launch your first MRD product in 2024, could you talk about potential deals or products that you can -- you see would complement your current oncology portfolio that you don't have in your current internal pipeline?

這是約翰替補德里克。我們對此進行了很多討論，但談到併購渠道的重點將放在您之前傳統上完成的交易上。看起來你在接下來的幾個季度肯定會有很多事情要做，並且你有很多平衡。當然，你正在投資阿爾茨海默氏症投資組合等等。但是，當您希望在 2024 年推出您的第一個 MRD 產品時，您能否談談您認為可以補充您當前內部管道中沒有的當前腫瘤產品組合的潛在交易或產品？

Well, we think with the combination of Haystack, which, as you noted, is centered on minimally residual disease testing post cancer diagnosis. And we brought up our own internal assay for therapy selection. So from a therapy monitoring and therapy selection standpoint, we believe we're very well positioned for future growth. We continue to invest on the genetics side of our business, hereditary genetics, genetic offerings for diagnostic purposes and then the family planning and prenatal genetics is also an area that continues to receive focus.

嗯，我們認為與 Haystack 相結合，正如您所指出的，它的重點是癌症診斷後的微量殘留疾病檢測。我們提出了自己的內部檢測方法來選擇治療方法。因此，從治療監測和治療選擇的角度來看，我們相信我們已經為未來的增長做好了充分的準備。我們繼續投資於我們業務的遺傳學方面、遺傳遺傳學、用於診斷目的的基因產品，然後計劃生育和產前遺傳學也是繼續受到關注的領域。

So we believe we're well positioned on the cancer side. We continue to make some investments on the genetic side and that's where the -- we think we're well positioned. Now again, our focus right now, we'll continue to focus on hospital outreach deals and other small tuck-ins that are accretive to our business.

所以我們相信我們在癌症方面處於有利地位。我們繼續在基因方面進行一些投資，我們認為我們在這方面處於有利地位。現在，我們現在的重點是，我們將繼續關注醫院外展交易和其他有助於我們業務增長的小額投資。

That was our last question.

這是我們最後一個問題。

All right. Well, thank you, everyone. We -- again, I believe we had a strong quarter here. The outlook for the second half. We've taken up our revenue guidance, feel good about that, and thank you for supporting Quest Diagnostics. Have a great day.

好的。嗯，謝謝大家。我們——再次，我相信我們在這裡度過了一個強勁的季度。下半年展望。我們已經接受了收入指導，對此感到滿意，並感謝您對 Quest Diagnostics 的支持。祝你有美好的一天。

Thank you for participating in the Quest Diagnostics Second Quarter 2023 Conference Call. A transcript of prepared remarks on this call will be posted later today on Quest Diagnostics website at www.questdiagnostics.com. A replay of the call may be accessed online at www.questdiagnostics.com/investor or by phone at (203) 369-3035 for international callers or (888) 566-0058 for domestic callers. Telephone replays will be available from approximately 10:30 a.m. Eastern Time on July 26, 2023, until midnight Eastern Time, August 9, 2023. Goodbye.

感謝您參加 Quest Diagnostics 2023 年第二季度電話會議。本次電話會議的準備發言稿將於今天晚些時候發佈在 Quest Diagnostics 網站 www.questdiagnostics.com 上。您可以通過 www.questdiagnostics.com/investor 在線查看通話重播，或者撥打 (203) 369-3035（國際來電者）或 (888) 566-0058（國內來電者）。電話重播將於 2023 年 7 月 26 日東部時間上午 10:30 左右開始，直至 2023 年 8 月 9 日東部時間午夜。再見。