奎斯特診斷 (DGX) 2024 Q2 法說會逐字稿

Welcome to the Quest Diagnostics Second Quarter 2024 Conference Call. At the request of the company, this call is being recorded. the entire contents of the call, including the presentation and question-and-answer session that will follow, are the copyrighted property of Quest Diagnostics with all rights reserved. Any redistribution, retransmission or rebroadcast of this call in any form without the written consent of Quest Diagnostics is strictly prohibited.

歡迎參加 Quest Diagnostics 2024 年第二季電話會議。應本公司要求，本次通話正在錄音。電話會議的全部內容，包括隨後的演示和問答環節，均為 Quest Diagnostics 的版權財產，保留所有權利。未經 Quest Diagnostics 書面同意，嚴禁以任何形式重新分發、轉發或轉播本次通話。

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

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

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.

謝謝你，早安。我們的董事長、執行長兼總裁吉姆戴維斯 (Jim Davis) 也加入了我的行列。以及我們的財務長 Sam Samad。

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.

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較公認會計準則衡量指標的調整表。

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 reports on Form 10-Q and current reports on Form 8-K.

實際結果可能與預測結果有重大差異。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新的 10-K 表年度報告以及隨後提交的 10-Q 表報告和 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 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 consolidated revenue growth, revenue growth from acquisitions, organic revenue growth and adjusted earnings growth are compound annual growth rate. Finally, revenue growth rates from acquisitions will be measured against our base business.

對於本次電話會議，提及報告的每股盈餘是指報告的稀釋每股盈餘，提及調整後的每股盈餘是指調整後的稀釋每股盈餘。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績效，不包括 COVID-19 測試。與我們的長期前景預測相關的成長率，包括綜合收入成長、收購收入成長、有機收入成長和調整後獲利成長，均為複合年增長率。最後，收購帶來的收入成長率將根據我們的基礎業務來衡量。

Now here is Jim Davis.

現在請聽吉姆戴維斯的演講。

Thanks, Shawn, and good morning, everyone. We delivered another strong quarter with base business revenue growth of nearly 4% and total revenue growth of 2.5% as well as continued improvement in productivity and profitability in the base business. This performance is due to growth of new physician and hospital customers or favorable test mix that includes greater adoption of advanced diagnostics and continued strength in health care utilization. We also made progress improving our operational quality and efficiency through greater use of automation and AI.

謝謝肖恩，大家早安。我們又實現了強勁的季度業績，基礎業務收入成長近 4%，總營收成長 2.5%，基礎業務的生產力和獲利能力持續改善。這一業績歸功於新醫生和醫院客戶的成長或有利的測試組合，包括更多地採用先進的診斷技術和醫療保健利用的持續優勢。我們也透過更多地使用自動化和人工智慧，在提高營運品質和效率方面取得了進展。

In addition, we're excited to announce four acquisitions that meet our criteria for growth profitability and returns and that will enable us to expand in strategic growth areas. Our planned acquisition of LifeLabs, a trusted name in laboratory services for millions of Canadians will enable us to grow in Canada, which has a population that is growing and aging faster than in the US LifeLabs is especially strong in two of Canada's largest and fastest-growing provinces British Columbia and Ontario, which collectively account for about half of the country's population.

此外，我們很高興地宣布四項收購符合我們的成長獲利能力和回報標準，並使我們能夠在策略成長領域進行擴張。我們計劃收購LifeLabs（一個為數百萬加拿大人提供實驗室服務的值得信賴的品牌），這將使我們能夠在加拿大發展，加拿大的人口增長和老齡化速度比美國更快。最快的兩個國家尤其強大：不列顛哥倫比亞省和安大略省的人口不斷增長，這兩個省的人口約佔全國的一半。

We are familiar with the Canadian market, having delivered reference testing to many providers there for over 20 years. LifeLabs has been one of those reference partners for about a decade, so we know firsthand that their business team and reputation is strong and provides a solid foundation for growth. We expect to complete the transaction by the end of this year. Our recently announced acquisition of select lab assets of Alina Health a leading nonprofit health system will enable us to extend our reach in Minneapolis and throughout Minnesota and Wisconsin.

我們熟悉加拿大市場，20 多年來一直為那裡的許多提供者提供參考測試。 LifeLabs 大約十年來一直是這些參考合作夥伴之一，因此我們直接知道他們的業務團隊和聲譽很強，並為成長提供了堅實的基礎。我們預計今年年底完成交易。我們最近宣布收購領先的非營利醫療系統 Alina Health 的精選實驗室資產，這將使我們能夠擴大我們在明尼阿波利斯以及整個明尼蘇達州和威斯康辛州的業務範圍。

We also announced our plans to acquire the outreach lab assets of Ohio Health a nationally recognized charitable health system in Ohio. Both transactions will broaden our presence in geographic areas of the United States where we've had limited access to providers due to the predominance of health system. These acquisitions show our ability to attract and partner with top growing health systems that share our commitment to expanding patient access to innovative and more affordable testing. We expect to complete both transactions in the third quarter. We also completed our acquisition of Path AI Diagnostics, which provides a ready-made platform on which to scale digital pathology and AI to help health systems and other providers improve quality, speed and efficiency in cancer diagnosis. These acquisitions take time and involve teams of dedicated individuals.

我們也宣布計劃收購俄亥俄州健康中心（俄亥俄州全國認可的慈善醫療系統）的外展實驗室資產。這兩筆交易將擴大我們在美國地理區域的影響力，由於衛生系統的主導地位，我們在這些地區獲得醫療服務的機會有限。這些收購表明我們有能力吸引發展最快的衛生系統並與其合作，這些系統與我們共同致力於擴大患者獲得創新且更實惠的檢測的機會。我們預計這兩項交易將在第三季完成。我們還完成了對 Path AI Diagnostics 的收購，該公司提供了一個現成的平台，可在其上擴展數位病理學和人工智慧，以幫助衛生系統和其他提供者提高癌症診斷的品質、速度和效率。這些收購需要時間並且需要由敬業的個人組成的團隊。

I want to personally thank my Quest colleagues for delivering on our M&A strategy and we will now turn our attention to the hard work of integrating these deals. Now I'll recap our strategy and discuss highlights from the second quarter. Then Sam will provide detail on our financial results and talk about our updated financial guidance for 2024. Our strategy to drive growth is focused on delivering solutions that meet the evolving needs of our core customers. physicians, hospitals and consumers. We enable growth across our customer channels through advanced diagnostics with an intense focus on faster-growing clinical areas, including within brain health and molecular genomics and oncology.

我想親自感謝我的 Quest 同事實施了我們的併購策略，現在我們將把注意力轉向整合這些交易的努力。現在我將回顧我們的策略並討論第二季的亮點。然後 Sam 將提供有關我們財務業績的詳細信息，並討論我們更新的 2024 年財務指引。醫生、醫院和消費者。我們透過先進的診斷技術實現整個客戶管道的成長，並專注於快速成長的臨床領域，包括大腦健康、分子基因組學和腫瘤學。

In addition, acquisitions are a key growth driver with an emphasis on accretive outreach purchases as well as other independent labs. Our strategy also includes driving operational improvements across the business with the strategic deployment of automation and AI to improve quality, service, efficiency and the workforce experience. Here are some updates on progress we have made in each of these areas. While we grew total volumes from Diagnostic Information Services 1.1%, with base business volume growth of 1.7% and Volumes from our base clinical business grew 3.2% in the second quarter due to the strength among physicians and hospitals. In Physician Lab Services, we delivered another quarter of high single-digit base business revenue growth. This growth was driven by continued strength in health care utilization as well as overall market growth and share gains due to new customer wins. We drove favorable test mix as well as growth in test per requisition, which we attribute to greater utilization of our expanding portfolio of advanced diagnostics.

此外，收購是一個關鍵的成長動力，重點是增加外展採購以及其他獨立實驗室。我們的策略還包括透過自動化和人工智慧的策略部署來推動整個企業的營運改進，以提高品質、服務、效率和員工體驗。以下是我們在每個領域取得的進展的一些最新情況。由於醫生和醫院的實力，第二季我們的診斷資訊服務總銷量成長了 1.1%，基礎業務量成長了 1.7%，基礎臨床業務量成長了 3.2%。在醫師實驗室服務方面，我們的基礎業務收入又實現了一個季度的高個位數成長。這一成長是由醫療保健利用的持續強勁以及新客戶贏得帶來的整體市場成長和份額成長所推動的。我們推動了有利的測試組合以及每個請求測試的成長，我們將其歸因於我們不斷擴大的先進診斷產品組合的更大利用率。

Finally, we also saw strong volume and revenue growth within Medicare Advantage plans, where narrow network strategies direct testing to high-quality, cost-efficient options like Quest. Our broad health plan access, which extends to approximately 90% of covered lives in the US enabled us to take advantage of high demand for lab services consistent with recent quarters. Health plans value our ability to improve access, scale innovation and drive costs out of health care.

最後，我們也看到 Medicare Advantage 計劃的銷售和收入強勁增長，其中狹窄的網路策略直接測試高品質、具有成本效益的選項，例如 Quest。我們廣泛的健康計劃涵蓋了美國約 90% 的受保人，這使我們能夠利用近幾個季度對實驗室服務的高需求。健康計畫重視我們改善醫療服務取得、擴大創新和降低醫療成本的能力。

We are also working to develop opportunities to serve new geographies with our health plan partners. In hospital lab services, we grew base business revenues by nearly 4%. The growth of reference testing remains higher than historical levels as hospitals struggle to fill open positions, especially in technical fields such as histotechnology, microbiology and cytotechnology. Our advanced diagnostics portfolio provides a compelling alternative for hospitals to send us more reference work. Hospitals faced several challenges, including high supply costs, high wages and decisions about how and where to deploy their capital. Patients want better value from lab services as well as easier access. Plus, diagnostic innovation is evolving at a fast pace. These dynamics are contributing to an accelerating trend of outreach acquisitions and professional lab service arrangements with the national labs.

我們也致力於與我們的健康計劃合作夥伴一起尋找為新地區提供服務的機會。在醫院實驗室服務方面，我們的基礎業務收入成長了近 4%。由於醫院難以填補空缺職位，尤其是在組織技術、微生物學和細胞技術等技術領域，參考檢測的成長仍高於歷史水準。我們先進的診斷產品組合為醫院提供了一個令人信服的替代方案，可以向我們發送更多參考資料。醫院面臨多項挑戰，包括高供應成本、高薪以及如何以及在何處部署資金的決策。患者希望從實驗室服務中獲得更好的價值以及更方便的服務。此外，診斷創新正在快速發展。這些動態促進了與國家實驗室的外展收購和專業實驗室服務安排的加速趨勢。

Our specialization and scale empower us to deliver a breadth of quality innovative and accessible services that are often far more affordable for the patient. That's why top hospitals are choosing Quest for reference testing, professional lab services and outreach asset sales that deliver quality and efficiency in consumer-initiated testing.

我們的專業化和規模使我們能夠提供廣泛的優質創新且方便的服務，這些服務通常對患者來說更實惠。這就是為什麼頂級醫院選擇 Quest 進行參考測試、專業實驗室服務和外展資產銷售，以提高消費者發起的測試的品質和效率。

Our consumer facing platform plus [telus.com] grew total revenues nearly 40%, while base business revenues grew more than 50% versus the prior year as we learn more about our customers as our portfolio expands, we are improving growth marketing productivity today, about 25% of our revenues are from existing customers, and 20% of our revenues are from test we introduced in the past year.

我們面向消費者的平台加上[telus.com] 總收入成長了近40%，而基礎業務收入與前一年相比增長了50% 以上，因為隨著我們的產品組合擴展，我們對客戶的了解越來越多，我們今天正在提高成長行銷生產力，我們大約 25% 的收入來自現有客戶，20% 的收入來自我們去年推出的測試。

In Advanced Diagnostics, several key clinical areas drove double-digit revenue growth, continuing the trend in recent quarters. This growth was particularly strong in brain health, women's health particularly prenatal and hereditary genetics and advanced cardio metabolic health. Our Alzheimer's disease portfolio was the primary driver of growth for our brain health offering. Demand was strong for our AV detect blood test, which assessed risk based on amyloid, (inaudible), and ApoE biomarkers. Demand was also strong for our CSF test options for aiding treatment decisions. Yesterday, we introduced our neurofilament light chain test, which helps assess neuronal damage that may signify Alzheimer's disease as well as multiple sclerosis and other neurodegenerative conditions. In molecular genomics and oncology, we are encouraged by early results of our Haystack MRD early experience program prior to the broad national launch later this year. Physicians from leading cancer institutions are using a Haystack MRD blood test to assess cancer recurrence and treatment response for a range of cancers, including colorectal, lung and breath.

在高階診斷領域，幾個關鍵臨床領域推動了兩位數的收入成長，延續了最近幾季的趨勢。這種增長在大腦健康、女性健康（尤其是產前和遺傳遺傳學以及高級心臟代謝健康）方面尤其強勁。我們的阿茲海默症產品組合是我們大腦健康產品成長的主要驅動力。我們的 AV 檢測血液檢查需求強勁，該測試根據澱粉樣蛋白（聽不清楚）和 ApoE 生物標記評估風險。對我們用於幫助治療決策的腦脊髓液測試選項的需求也很強勁。昨天，我們介紹了神經絲輕鏈測試，該測試有助於評估可能預示阿茲海默症以及多發性硬化症和其他神經退化性疾病的神經元損傷。在分子基因組學和腫瘤學領域，我們對 Haystack MRD 早期體驗計畫的早期結果感到鼓舞，該計畫將於今年稍後在全國廣泛推出。來自領先癌症機構的醫生正在使用 Haystack MRD 血液檢測來評估癌症復發和一系列癌症的治療反應，包括大腸癌、肺癌和呼吸癌。

We also grew the body of evidence on clinical and economic value of CTDNA blood testing in cancer care. A study published in JAMA Health Forum in June found that MRD testing could reduce costs for health plans, particularly commercial payers by identifying patients that would benefit from chemotherapy after Stage II colon cancer surgery. In addition, research presented at the June ASCO conference showed that the Haystack MRD testing identified complete clinical response to immunotherapy for patients with colorectal cancer earlier than standard assessments such as pet MRI and endoscopy scans.

我們也增加了 CTDNA 血液檢測在癌症護理中的臨床和經濟價值的證據。 6 月發表在《美國醫學會雜誌健康論壇》上的一項研究發現，MRD 檢測可以透過識別II 期結腸癌手術後可從化療中受益的患者來降低健康計劃的成本，特別是商業付款人的成本。此外，在 6 月 ASCO 會議上發表的研究表明，Haystack MRD 測試比寵物 MRI 和內視鏡掃描等標準評估更早確定了結直腸癌患者對免疫療法的完全臨床反應。

Finally, we recently expanded our Haystack research collaborations to include (inaudible) Therapeutics, which will use Haystack MRD to study an investigational treatment for advanced pancreatic cancer. Turning to advanced cardiometabolic testing. We are seeing interest in several biomarkers that improve early detection of cardiovascular and metabolic diseases like diabetes and kidney disease. These include insulin resistance, which can identify prediabetes risk before A1C test and (inaudible), a more precise marker of heart attack risk than traditional lipid panels. They also include Lp(a), which is an inherited marker of heart disease risk found in up to 20% of the population and for which several therapies are now in development.

最後，我們最近擴大了 Haystack 研究合作範圍，納入了（聽不清楚）Therapeutics，該計畫將使用 Haystack MRD 來研究晚期胰腺癌的研究性治療方法。轉向高階心臟代謝測試。我們看到了人們對幾種生物標記的興趣，這些生物標記可以改善心血管和代謝疾病（如糖尿病和腎臟疾病）的早期檢測。其中包括胰島素阻抗，它可以在 A1C 測試之前識別糖尿病前期風險，並且（聽不清楚），它是比傳統血脂檢測更精確的心臟病風險標記。它們還包括 Lp(a)，這是一種心臟病風險的遺傳標記，在高達 20% 的人群中被發現，目前正在開發幾種針對該疾病的治療方法。

Turning to operational excellence. Our Invigorate program aims to deliver a targeted 3% annual cost savings and productivity improvements. During the quarter, we expanded our use of automation and AI in order to improve productivity as well as service levels and quality. For instance, we advanced our use of automation in front-end specimen processing to now include five of our labs, bringing more of our processors to focus on value-added work.

轉向卓越營運。我們的 Invigorate 計劃旨在實現每年 3% 的成本節約和生產力提高的目標。本季度，我們擴大了自動化和人工智慧的使用，以提高生產力以及服務水準和品質。例如，我們在前端樣本處理中推進了自動化的使用，現在包括我們的五個實驗室，使更多的處理者能夠專注於增值工作。

We also expanded our AI capabilities in microbiology to include the ability to segregate out specimens with no evidence of microbial growth so our medical scientists can concentrate on reviewing those with the greatest likelihood of disease. In addition, we broadened our use of AI in customer service to help our representatives access answers more quickly, improving their efficiency and service quality.

我們也擴展了人工智慧在微生物學方面的能力，包括分離出沒有微生物生長證據的樣本的能力，以便我們的醫學科學家可以專注於審查那些最有可能生病的樣本。此外，我們擴大了人工智慧在客戶服務中的應用，幫助我們的代表更快獲得答案，並提高了他們的效率和服務品質。

Now I'll turn it over to Sam to provide more details on our performance and our 2024 guidance. Sam?

現在我將把它交給 Sam，以提供有關我們的表現和 2024 年指導的更多詳細資訊。薩姆？

Thanks, Jim. In the second quarter, consolidated revenues were $2.4 billion, up 2.5% versus the prior year, while base business revenues grew 3.8%. Organic base business revenues grew by 3.1%. Revenues for Diagnostic Information Services were up 2.8% compared to the prior year, reflecting strong growth in our base testing revenues, partially offset by lower revenues from COVID-19 testing services.

謝謝，吉姆。第二季度，綜合營收為 24 億美元，比上年成長 2.5%，基礎業務收入成長 3.8%。有機基礎業務收入成長 3.1%。診斷資訊服務的收入比前一年增長了 2.8%，反映出我們的基礎測試收入的強勁增長，但部分被 COVID-19 測試服務收入的下降所抵消。

Total volume, measured by the number of requisitions, increased 1.1% versus the second quarter of 2023, with acquisitions contributing 40 basis points of the total volume. Total base testing volumes grew 1.7% versus the prior year. Total revenue per requisition was up 1.6% versus the prior year, driven primarily by an increase in the number of tests per rec and favorable test mix partially offset by the timing of certain value-based arrangements in the second quarter of 2023 that did not repeat this year and lower COVID-19 testing.

以請購數量衡量的總交易量較 2023 年第二季增加了 1.1%，其中收購佔總交易量的 40 個基點。基礎測試總量較上年增加 1.7%。每份申請的總收入較上年增長1.6%，這主要是由於每份申請的測試數量和有利的測試組合的增加，部分被2023 年第二季度某些基於價值的安排的時間所抵消，這些安排不會重複今年並降低了 COVID-19 檢測水平。

Base business revenue per req was up 2.4%. Unit price reimbursement was flat. Clinical base business revenues were up 5.1%, while volumes grew 3.2%. This primarily reflects growth through our physician and hospital channels, which comprise approximately 90% of our total revenues and excludes the impact of lower volumes, primarily in our employer businesses, providing workforce drug testing and employee population health services. Reported operating income in the second quarter was $355 million or 14.8% of revenues compared to $348 million or 14.9% of revenues last year. On an adjusted basis, operating income was $398 million or 16.6% of revenues compared to $389 million or 16.7% of revenues last year.

每項要求的基本業務收入成長了 2.4%。單價報銷持平。臨床基礎業務收入成長 5.1%，銷售成長 3.2%。這主要反映了我們的醫生和醫院管道的成長，這些管道約占我們總收入的 90%，不包括銷售下降的影響，主要是在我們的雇主業務中，提供勞動力藥物測試和員工群體健康服務。第二季報告的營業收入為 3.55 億美元，佔營收的 14.8%，而去年為 3.48 億美元，佔營收的 14.9%。調整後的營業收入為 3.98 億美元，佔營收的 16.6%，而去年為 3.89 億美元，佔營收的 16.7%。

The increase in adjusted operating income was due to strong growth in the base business, partially offset by lower COVID-19 testing revenues and wage increases. Reported EPS was $2.03 in the quarter compared to $2.05 a year ago. Adjusted EPS was $2.35 versus $2.30 the prior year. Cash from operations was $514 million year-to-date through the second quarter versus $538 million in the prior year.

調整後營業收入的成長是由於基礎業務的強勁成長，但部分被 COVID-19 測試收入下降和薪資上漲所抵消。本季報告的每股收益為 2.03 美元，而去年同期為 2.05 美元。調整後每股收益為 2.35 美元，上年度為 2.30 美元。截至今年第二季度，營運現金為 5.14 億美元，而去年同期為 5.38 億美元。

Turning now to our updated full year 2021 guidance. Revenues are expected to be between $9.5 billion and $9.58 billion. Reported EPS is expected to be in a range of $7.57 to $7.77 and adjusted EPS to be in a range of $8.80 to $9. Cash from operations is expected to be approximately $1.3 billion and capital expenditures are expected to be approximately $420 million. Given the uncertainty around when the LifeLabs acquisition will close, we are not including this transaction in our updated 2024 guidance. However, in the first 12 months after closing the acquisition, we expect the transaction to generate approximately $710 million in annual revenues and to be slightly dilutive to GAAP EPS, due primarily to amortization of intangibles and other items but approximately $0.10 to $0.15 accretive to adjusted EPS. These assumptions include the impact of expected debt financing to close the acquisition.

現在轉向我們更新的 2021 年全年指引。收入預計在 95 億美元至 95.8 億美元之間。預計報告每股收益為 7.57 美元至 7.77 美元，調整後每股收益為 8.80 美元至 9 美元。營運現金預計約 13 億美元，資本支出預計約 4.2 億美元。鑑於 LifeLabs 收購何時完成的不確定性，我們不會將此交易納入更新的 2024 年指南中。然而，在收購完成後的前12 個月內，我們預計該交易將產生約7.1 億美元的年收入，並略微稀釋GAAP 每股收益，這主要是由於無形資產和其他項目的攤銷，但調整後約增加0.10 至0.15 美元每股收益。這些假設包括預期債務融資對完成收購的影響。

With that said, the following are some key assumptions underlying our updated guidance for you to consider. The increase in our revenue guidance reflects the recently announced acquisitions of Path AI Diagnostics, Alina Health and Ohio Health as well as the strength of our base business. The Path AI Diagnostics acquisition closed in June, while Alina Health and Ohio Health are expected to close in Q3. The revenue contribution from these acquisitions represents the majority of the increase in our updated revenue guidance. As a reminder, new acquisitions are typically breakeven to slightly profitable initially with profitability expanding over several quarters. Therefore, we are not expecting a material contribution to earnings from these acquisitions in 2024, but do expect increasing profitability next year.

話雖如此，以下是我們更新指南的一些關鍵假設，供您考慮。我們營收指引的成長反映了最近宣布的對 Path AI Diagnostics、Alina Health 和 Ohio Health 的收購以及我們基礎業務的實力。 Path AI Diagnostics 的收購已於 6 月完成，而 Alina Health 和 Ohio Health 預計將在第三季完成收購。這些收購帶來的營收貢獻占我們更新的營收指引中成長的大部分。需要提醒的是，新收購通常在最初會實現盈虧平衡或微利盈利，並且盈利能力會在幾個季度內不斷擴大。因此，我們預計這些收購不會對 2024 年的獲利產生重大貢獻，但預計明年的獲利能力將會增加。

No change to our expectation for dilution from Haystack oncology of an incremental $0.20 to adjusted EPS for the full year. Operating margin to expand for the full year, driven by volume growth and improved productivity. Net interest expense expected to be approximately $190 million. This does not include interest expense related to debt financing for the LifeLabs acquisition. Weighted average share count to be flat compared to the end of 2023.

我們對 Haystack 腫瘤學的稀釋預期不變，全年調整後每股盈餘將增加 0.20 美元。在產量成長和生產力提高的推動下，全年營業利潤率將擴大。淨利息支出預計約 1.9 億美元。這不包括與收購 LifeLabs 的債務融資相關的利息費用。與 2023 年底相比，加權平均股數持平。

Finally, our operations were affected by the worldwide IT outage last week, which limited our ability to collect and process specimens on Friday and through the weekend. Our labs were processing specimens by Friday afternoon, and the rest of our operations, including patient service centers were largely restored to normal by yesterday morning. At this point, we estimate the IT outage and the minor impact from Hurricane Beryl in Texas earlier this month, could amount to a roughly $0.06 to $0.08 headwind on our Q3 earnings. This is currently reflected in our updated full year guidance.

最後，我們的營運受到上周全球 IT 中斷的影響，這限制了我們在周五和整個週末收集和處理樣本的能力。到週五下午，我們的實驗室已開始處理樣本，到昨天上午，我們的其餘業務（包括患者服務中心）已基本恢復正常。目前，我們估計本月稍早德州的 IT 中斷和颶風 Beryl 的輕微影響可能會對我們第三季的收益造成約 0.06 至 0.08 美元的阻力。目前這已反映在我們更新的全年指導中。

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, our business delivered strong total and base revenue growth across our core customer channels due to strong commercial execution, innovative offerings and ongoing strength in our health care utilization. We announced four acquisitions that meet our criteria for growth profitability and returns and position us for growth in new geographic and service areas. We improved productivity as well as service levels and quality through greater use of automation and AI.

謝謝，山姆。總而言之，由於強大的商業執行力、創新產品和醫療保健利用方面的持續優勢，我們的業務在核心客戶管道中實現了強勁的總收入和基礎收入成長。我們宣布了四項收購，這些收購符合我們的成長獲利能力和回報標準，並使我們能夠在新的地理和服務領域實現成長。透過更多地使用自動化和人工智慧，我們提高了生產力以及服務水準和品質。

Finally, I'd like to personally thank my nearly 50,000 Quest colleagues for our strong performance this quarter, which is largely the result of the dedication, care and collaboration that they show patients, customers each and every single day. This commitment was exemplified by the tireless efforts of our teams to restore outstanding service for our patients and customers this past weekend following the global IT outage. I'm proud to work with so many talented people committed to living our purpose, working together to create a healthier world, one life at a time.

最後，我要親自感謝我的近 50,000 名 Quest 同事，讓我們在本季度取得了強勁的業績，這很大程度上歸功於他們每天為患者、客戶提供的奉獻、關懷和協作。在全球 IT 中斷後的上週末，我們的團隊不懈地努力，為患者和客戶恢復出色的服務，體現了這項承諾。我很自豪能與這麼多致力於實現我們目標的才華橫溢的人一起工作，共同創造一個更健康的世界，一次一個人的生活。

And with that, we'd be happy to take your questions. Operator?

因此，我們很樂意回答您的問題。操作員？

(Operator Instructions) Ann Hynes, Mizuho Securities.

（操作員指示）Ann Hynes，瑞穗證券。

I just had a follow-up question on volumes. I believe you said the total base volume was up 1.7%. But if you exclude employer base, it's up 3.2%. Can you just give us more detail what's happening in that business? Is it just the overall job market? And maybe if you can provide some like profitability versus that physician-based business versus the employer-based business and whether or not it was in line with your estimate? And then my second question just has to do around the Canadian acquisition. Can you just give us more details on that market? How is it different in the US, why you view it as attractive? And maybe some long-term growth revenue algorithms versus the US business? Is it growing in line with the business or is it a higher growth, that would be great?

我剛剛有一個關於數量的後續問題。我相信你說總基數增加了 1.7%。但如果排除雇主基礎，則成長 3.2%。您能否向我們詳細介紹一下該業務的進展？這只是整個就業市場嗎？也許您可以提供一些類似於基於醫生的業務與基於雇主的業務的盈利能力以及它是否符合您的估計？我的第二個問題與加拿大的收購有關。您能給我們提供更多有關該市場的詳細資訊嗎？美國的情況有何不同，為什麼您認為它有吸引力？也許還有一些與美國業務相比的長期成長收入演算法？是與業務同步成長還是更高的成長，那就太好了？

Yes. So let me start here. So on the employer side, we have two principal businesses that serve employers. One is our employee drug testing business; second, our employee population health business. There is a third business, as you know, called exam one that does health risk assessments for life insurance companies. Taken together, all three of those businesses showed meaningful declines in the quarter and really largely represent the difference in the 3.2% that Sam referred to in the 1.7%. In the drug testing market, there's a couple of shifts going on. Number one, a lot of the job growth still coming in the services industry, hotel workers, restaurant workers, and a lot of those industries just have given up on drug testing. And other companies that still do drug testing, as you probably know, many have eliminated marijuana off the panel.

是的。那麼讓我從這裡開始。所以在雇主方面，我們有兩個主要業務是為雇主服務的。一是我們的員工藥檢業務；第二，我們的員工群體健康業務。如您所知，還有第三種業務，稱為考試一，為人壽保險公司進行健康風險評估。總而言之，這三項業務在本季度都出現了顯著下降，並且在很大程度上體現了 Sam 提到的 3.2% 與 1.7% 之間的差異。在藥物測試市場中，正在發生一些轉變。第一，大量就業成長仍來自服務業、飯店員工、餐廳員工，其中許多產業剛剛放棄了藥物檢測。正如您可能知道的那樣，其他仍在進行藥物測試的公司許多已經將大麻從測試中剔除。

So that has created some pressure. And then the final thing I'd tell you is there's a shift going on in employee drug testing, where more companies are doing what we call on-site or oral testing and if that test is positive, it eventually reflexes back to a central lab. But if it's a negative test, it's just an on-site screen and the employee passes and we don't get that work. On employee population health, we're just seeing companies not spend as much money on these wellness events that they've typically done in the past. Finally, again, ExamOne, our life insurance business that does risk assessments for life insurance just the life insurance policies, we saw a spike during COVID. People started to get life insurance again post-COVID, that negative trend has continued, which we were seeing actually pre-COVID.

所以這造成了一些壓力。我要告訴你的最後一件事是，員工藥物測試正在轉變，越來越多的公司正在進行我們所說的現場或口頭測試，如果測試結果呈陽性，它最終會反射回中央實驗室。但如果測試結果呈現陰性，那隻是現場篩選，員工通過了，我們就不會得到這項工作。在員工群體健康方面，我們只是看到公司在這些健康活動上投入的資金不像過去那麼多。最後，我們的人壽保險業務 ExamOne 只對人壽保險保單進行風險評估，在新冠疫情期間我們看到了激增。在新冠疫情之後，人們開始再次購買人壽保險，這種負面趨勢仍在繼續，我們在新冠疫情之前就已經看到了這種情況。

Now let me turn to the Canada market for just a minute here. So look, there's a lot to like about the Canadian market. First of all, a population of roughly 41 million people the population growth rate is actually faster than the US, the population growth there at about 1.1%. Here in the US, population growing less than 50 basis points. The aging of the population there as well is a good trend that we like. And Lifelabs is really centered in two key markets: British Columbia and Ontario. Ontario being the biggest province in Canada, British Columbia being the second largest proppants. Collectively, those two provinces are over 50% or close to 50% of the Canadian population. We like the reimbursement model in Canada. It's steady. It's consistent we think it will fill growth over the coming years.

現在讓我談談加拿大市場。所以看，加拿大市場有很多值得喜歡的地方。首先，人口大約為4,100萬，人口成長速度實際上比美國更快，那裡的人口成長在1.1%左右。在美國，人口成長不到 50 個基點。那裡的人口老化也是我們喜歡的好趨勢。 Lifelabs 實際上集中在兩個主要市場：不列顛哥倫比亞省和安大略省。安大略省是加拿大最大的省份，不列顛哥倫比亞省是第二大支撐劑省。總的來說，這兩個省份的人口占加拿大人口的 50% 以上或接近 50%。我們喜歡加拿大的報銷模式。很穩定。我們一致認為它將在未來幾年內實現成長。

And when we look at things like test per req when we look at the types of testing done here in the US versus Canada, we think there's opportunity to grow the types of testing that we bring into that market from an esoteric standpoint, from an advanced testing standpoint. So we feel great about entering the Canadian market. And by the way, it's a market we know. We've served that market for many, many years as a reference provider. We've served LifeLabs, we've served other independent labs and hospital labs up in Canada. So we know the market. We're familiar with it, and we think it's a great opportunity for Quest Diagnostics.

當我們考慮諸如按要求進行測試之類的事情時，當我們考慮在美國與加拿大進行的測試類型時，我們認為有機會從深奧的角度、從先進的角度來發展我們引入該市場的測試類型。測試的立場。因此，我們對進入加拿大市場感到非常高興。順便說一句，這是一個我們熟悉的市場。作為參考提供者，我們已經服務該市場很多年了。我們為 LifeLabs 提供服務，也為加拿大的其他獨立實驗室和醫院實驗室提供服務。所以我們了解市場。我們對此很熟悉，我們認為這對 Quest Diagnostics 來說是一個很好的機會。

Maybe a couple of comments to add on the services businesses. And just to give you some financials behind them or at least some percentages. I mean the workforce health solutions businesses, employer population health and the employer solutions are less than 5% of our overall revenue. So just to give you a sense of bucketing of how much those businesses are. So they're not that material or not material to our overall revenues.

也許可以對服務業務添加一些評論。只是為了給你一些背後的財務數據或至少一些百分比。我的意思是勞動力健康解決方案業務、雇主人口健康和雇主解決方案不到我們總收入的 5%。只是為了讓您了解這些業務的規模。所以它們對我們的整體收入來說並不重要或不重要。

But as Jim said, they have been impacted post COVID somewhat significantly and with some of the market dynamics in the drug testing business. So they are impacting our growth rates. And then ExamOne is on top of that, but it's also impacted by some of the dynamics that Jim said coming out of COVID. So these businesses are down significantly year-over-year, but we don't expect further deterioration as we look forward. So there is a year-over-year impact, but we don't expect that to further amplify as we go forward.

但正如吉姆所說，他們在新冠疫情之後受到了一定程度的影響，並且受到了藥物測試業務的一些市場動態的影響。所以它們正在影響我們的成長率。 ExamOne 是最重要的，但它也受到吉姆所說的新冠疫情帶來的一些動態的影響。因此，這些業務將年比大幅下降，但我們預計未來不會進一步惡化。因此，存在逐年影響，但我們預計這種影響不會隨著我們的前進而進一步放大。

Kevin Caliendo, UBS.

凱文‧卡里恩多，瑞銀集團。

It's not usually you want to raise guidance by more than a beat in any particular quarter, yet you did. And now we find out there was actually from a -- what appears to be a core even a greater upside in the second half than what you had originally had if you back out the impact of the strike in the hurricanes and the like, the IT issues, I mean. So is that mostly driven just by core? Are you expecting margins to expand a little bit on a year-over-year basis more than what we saw in the second quarter. I guess I just want to understand what's driving the enthusiasm for the second half improvements. You had the M&A stuff that you mentioned, but you said there wasn't a lot of contribution. So I'm guessing it's core, but I'm wondering, is it expected volume is expected mix? Is it expected cost to come in better, wage, labor, churn, that kind of thing?

通常你不會想在任何特定季度將指引提高超過一個節拍，但你卻這麼做了。現在我們發現，如果你排除颶風等罷工的影響，下半場的核心似乎比原來有更大的上升空間，IT問題，我的意思是。那麼這主要是由核心驅動的嗎？您是否預計利潤率將比我們在第二季度看到的同比有所擴大？我想我只是想了解是什麼推動了下半年改進的熱情。你有你提到的併購的東西，但你說沒有太多貢獻。所以我猜它是核心，但我想知道，預期的數量是預期的混合嗎？預期成本會變得更好，例如薪資、勞動力、員工流失等？

Yes. So maybe I'll start, Kevin and Jim can add comments. First, let's kind of talk about the details in terms of what we shared. We said we're going to take up revenues by $100 million, we said we're going to take up EPS, and this is at the midpoint. We're going to take up EPS by $0.05 to $8.80 to $9. Within the $100 million that we talked about, the majority of that is really new M&A. So essentially M&A that we have signed that we expect to close sometime between mid-Q3 and the end of the year. And those reflect the M&A related or the transactions which are Alina, Health, Ohio Health.

是的。那麼也許我會開始，凱文和吉姆可以添加評論。首先，讓我們來談談我們分享的細節。我們說過我們將計入 1 億美元的收入，我們說過我們將計入每股收益，這是中點。我們將使 EPS 上漲 0.05 美元至 8.80 美元至 9 美元。在我們談到的 1 億美元中，其中大部分是真正的新併購。因此，基本上我們已經簽署的併購預計將在第三季中期到年底之間的某個時間完成。這些反映了與 Alina、Health、Ohio Health 相關的併購或交易。

We have some upside from past AI as well, which we closed in Q2, but wasn't in our original guidance. So the revenue has a majority -- the majority of the revenue is really driven by the M&A that we expect to close. The EPS increase is related to contribution from this M&A, although as we talked about in the prepared remarks, M&A ramps up in terms of profitability. So 2024 in the second half, very little contribution in terms of profitability from M&A. The remainder, I would say, is contribution from the base business and some M&A, but little.

我們也從過去的人工智慧中得到了一些好處，我們在第二季關閉了這些好處，但不在我們最初的指導中。因此，收入佔了大部分——大部分收入實際上是由我們預計完成的併購所驅動的。每股盈餘的成長與此次併購的貢獻有關，儘管正如我們在準備好的發言中談到的，併購在獲利能力方面有所提升。所以2024年下半年，併購對獲利的貢獻很小。我想說，剩下的部分是基礎業務和一些併購的貢獻，但很少。

And we are absorbing, as you said, the impact of the IT outage, which is $0.06 to $0.08 in Q3 that we expect to -- that we have now sized. This is preliminary. We'll get better detail as we go, but we are absorbing that impact. So in terms of what's driving this improvement or the raise of EPS we're basically continuing with a lot of the productivity work and the cost reductions that we had talked about. We have a lot of the AI and productivity improvements that Jim mentioned, a lot of the focus on improving margins Importantly, base volumes continue to be very strong. And that's the biggest I would say, driver in terms of improved margins in the business.

正如您所說，我們正在吸收 IT 中斷的影響，我們預計第三季的影響為 0.06 至 0.08 美元，我們現在已經確定了規模。這是初步的。隨著我們的進展，我們會獲得更好的細節，但我們正在吸收這種影響。因此，就推動這種改善或每股盈餘提高的因素而言，我們基本上仍在繼續進行我們之前討論過的大量生產力工作和成本削減。吉姆提到，我們在人工智慧和生產力方面進行了許多改進，重點放在提高利潤率上，重要的是，基本銷售仍然非常強勁。我想說，這是提高業務利潤率的最大動力。

We continue to see base volumes be strong, utilization will be strong. So really, that's the key driver, strength of volumes it's continued productivity and cost improvements. It's also the fact that we have, as we've talked about many times over previous calls, a positive pricing and reimbursement environment, which is now stabilized, which is now flat to improving as opposed to a negative price impact that we used to see in prior years.

我們持續看到基數強勁，利用率也將強勁。事實上，這是關鍵的驅動因素，銷售的成長是持續的生產力和成本的提高。還有一個事實是，正如我們在之前的電話會議中多次談到的那樣，我們擁有積極的定價和報銷環境，現在已經穩定下來，與我們過去看到的負面價格影響相比，現在的情況趨於改善在前幾年。

Yes. Kevin, you probably saw a meaningful improvement in rev per req in the quarter. And as Sam mentioned, within that recorrect calculation, price per test flat to last year. So the improvement is really coming in three areas. One, test for rec continue to be very strong, north of 4, pre-COVID, that was a number that was south of it was in the 3s. So that's a nice uptick, and that's coming from some of our advanced testing around allergy, tick testing, cardio metabolic testing, the neurology testing.

是的。凱文，您可能會看到本季每需求轉速有了顯著的改善。正如薩姆所說，在重新正確的計算中，每次測試的價格與去年持平。因此，改進實際上體現在三個方面。第一，rec 的測試仍然非常強勁，在新冠疫情之前，在 4 的北部，這個數字在 3 的南部。所以這是一個很好的上升，這來自於我們圍繞過敏、蜱蟲測試、心臟代謝測試、神經學測試進行的一些高級測試。

And in that also is a mix improvement that comes from some of those advanced tests. The final thing I'd say is we saw, again, strength in our overall Medicare Advantage and Medicare book of business. That that pricing, as you know, tends to be better than the average. And we also see more advanced tasks coming on those requisitions versus our normal general health and wellness requisition. So we expect those trends to continue into the back half of the year. and that's contributing to the improvements that we're laying out there.

其中還有一些高級測試的混合改進。我要說的最後一件事是，我們再次看到了我們整體醫療保險優勢和醫療保險業務的實力。如您所知，該定價往往優於平均水平。與我們正常的一般健康和保健申請相比，我們也看到這些申請中出現了更高級的任務。因此，我們預計這些趨勢將持續到今年下半年。這有助於我們在那裡進行的改進。

Michael Cherny, Leerink.

麥可·切爾尼，萊林克。

Maybe if I can just dive a little bit into the market. I know there's still some small moving pieces. I appreciate the color you've given so far on some of the employer testing. If I sort through all of the data points you have, the $3.2 billion base business volumes, I just want to make sure I got that number correctly. And then, b, as you think about that number, how do you think about that in terms of translating where you see the health of broad-based market utilization versus where your competitive position is allowing you to take share? I guess just trying to understand fully where you see utilization baked into the implied second half guidance versus what we've seen over the last 6, 12 months on a baseline business?

也許如果我能稍微深入市場的話。我知道還有一些小的移動部分。我很欣賞您迄今為止在一些雇主測試中給出的顏色。如果我對您擁有的所有數據點（32 億美元的基本業務量）進行排序，我只想確保我得到的數字是正確的。然後，b，當你考慮這個數字時，你如何看待這個數字，將你所看到的廣泛市場利用的健康狀況與你的競爭地位允許你佔領的份額進行比較？我想只是想完全理解您認為下半年指導中的利用率與我們在過去 6、12 個月的基準業務中看到的利用率有何不同？

Yes. Again, the 3.2% represents the volume growth that we see through what we call our core base business. And that means our physician business, our hospital reference business our hospital PLS business and embedded in that is both clinical as well as anatomical pathology. So that entire book of business, which is about 90% of the company, the volumes grew 3.2%. Down from Q1, but the compare in Q2 was higher. But again, the 3.2%, we feel really good about that.

是的。同樣，3.2% 代表了我們透過所謂的核心基礎業務所看到的銷售成長。這意味著我們的醫生業務、我們的醫院參考業務、我們的醫院 PLS 業務，以及其中的臨床和解剖病理學業務。因此，占公司總業務量約 90% 的業務量成長了 3.2%。較第一季有所下降，但第二季的比較較高。但同樣，對於 3.2%，我們對此感覺非常好。

Now that 3.2% volume growth again translated into 5.1% revenue growth, and that was coming again on the strength of test mix plus the test per req increase that we've been seeing year-over-year. So we feel good about that again going into the second half of the year. In terms of the implied growth in the second half of the year, it's in the 3.7% revenue range. So again -- and that's just the base organic that's without acquisition. The timing of the close of these acquisitions, we've said in Q3 with Alina in Ohio Health, we just don't know when in Q3, okay? So there's still some uncertainty about when these deals will officially close.

現在，3.2% 的銷售成長再次轉化為 5.1% 的收入成長，而這又是由於測試組合的強度以及我們逐年看到的按要求測試的成長而再次實現的。因此，我們對今年下半年的情況再次感到滿意。就下半年的隱含成長而言，營收成長在3.7%範圍內。再說一次——這只是沒有收購的基礎有機物。這些收購的完成時間，我們在第三季與俄亥俄州健康中心的阿麗娜說過，我們只是不知道第三季的時間，好嗎？因此，這些交易何時正式完成仍存在一些不確定性。

And Mike, maybe I'll add a couple of comments just in terms of utilization. I mean, as we have been mentioning, utilization continues to be strong. We've seen it strong in Q1. We've seen it strong in Q2. The year-over-year compare in Q2 was maybe a little bit tougher versus Q2 of 2023, we had some lapping of some wins. And just overall, we saw more of a resurgence in the base business in Q2 of last year.

麥克，也許我會在利用率方面添加一些評論。我的意思是，正如我們一直提到的，利用率仍然強勁。我們在第一季看到它的強勁表現。我們在第二季度看到了它的強勁表現。第二季的年比比較可能比 2023 年第二季的情況要艱難一些，我們取得了一些勝利。總體而言，我們在去年第二季度看到了基礎業務的更多復甦。

But in terms of the dynamics there, we do believe that both in terms of -- there's strong utilization out there. We think some of it is returned to care, but also just general strength of utilization by just additional testing, and that's reflected in the higher number of test per req that we're seeing. But also, we are gaining share. We do believe that we are gaining share, and we're gaining share through some of these also outreach acquisitions that we're doing that help us direct more testing to Quest.

但就那裡的動態而言，我們確實相信，那裡的利用率很高。我們認為其中一些已返回護理，但也只是透過額外的測試來提高利用率，這反映在我們看到的每個請求的測試數量較高。而且，我們正在獲得份額。我們確實相信我們正在獲得份額，並且我們正在透過我們正在進行的一些外展收購來獲得份額，這些收購有助於我們對 Quest 進行更多測試。

Patrick Donnelly, Citi.

派崔克唐納利，花旗銀行。

Sam, maybe just expand on the utilization piece. Obviously, you guys have seen pretty nice elevated levels there in the past couple of quarters. Can you just talk about what you're seeing and then what the guide implies in terms of how you're feeling about it? I know previously, it was the guidance assume normal utilization, obviously stayed a little bit elevated here. And just how you're thinking about the trend? Does it gradually come down to normal? Would like to just discuss that a bit.

薩姆，也許只是擴展一下使用部分。顯然，在過去的幾個季度裡，你們已經看到了相當不錯的水平提升。您能談談您所看到的情況，然後根據您的感受來談談指南的暗示嗎？我之前知道，這是假設正常利用率的指導，顯然在這裡保持了一點高位。您如何看待這股趨勢？會逐漸恢復正常嗎？我想稍微討論一下。

Yes. I mean, as we've talked about before, Patrick, we do expect eventually utilization to level off to essentially what we've talked about in terms of our long-term growth algorithm, which is roughly around 3%-ish in terms of organic growth. And then as we said before, in terms of long-term growth, we expect 1% to 2% contribution from acquisitions.

是的。我的意思是，正如我們之前討論過的那樣，帕特里克，我們確實預計利用率最終會趨於穩定，基本上達到我們在長期增長算法方面所討論的水平，就長期增長算法而言，利用率大約約為3% 左右。正如我們之前所說，就長期成長而言，我們預計收購將帶來 1% 至 2% 的貢獻。

So we still think, longer term, if you're thinking over the next, let's say, longer period, I'm not going to necessarily bracket it with a time period, but I think that's the right algorithm to be thinking about. In terms of for us, our current guide right now at the midpoint, we're saying total growth is close to 3%, 3.1%. Our base revenue guide is somewhere around 5% for the full year. Our second half, if you think about second half, that's essentially on the base revenue growth, it's about a 5.3% second half growth.

所以我們仍然認為，從長遠來看，如果你正在考慮下一個，比如說更長的時期，我不一定會把它與一個時間段放在一起，但我認為這是值得考慮的正確演算法。就我們而言，我們目前的指南目前處於中點，我們說總成長率接近 3%、3.1%。我們全年的基本收入指引約為 5% 左右。我們的下半年，如果你考慮下半年，基本上是基於基本收入成長，下半年成長約為 5.3%。

Now recall, the 5.3% in the second half, and this is revenue includes, as we said, the majority of the $100 million take up of the guide is acquisitions. So in that 5.3% second half, there is a significant portion, which is acquisitions. So in effect, if you look at just organic, as Jim just alluded to, it's actually a slightly slower second half than what we saw in the first half. So embedded in that is the expectation, Patrick, that this utilization doesn't continue at the same level, but starts to slow down a bit. So again, total growth, first half base -- or sorry, full year base is 5% and second half base is 5.3%. But within that, there's some acquisitions. So the second half is closer to something between 3.5% to 4% in terms of base.

現在回想一下，下半年的 5.3%，這是收入，正如我們所說，該指南所佔的 1 億美元中大部分是收購。因此，在下半年的 5.3% 中，有很大一部分是收購。所以實際上，如果你只看有機的，正如吉姆剛才提到的那樣，下半場實際上比我們在上半場看到的要慢一些。因此，Patrick 的預期是，這種利用率不會繼續保持在同一水平，而是開始放緩一點。再說一次，總增長，上半年基數——或者抱歉，全年基數是 5%，下半年基數是 5.3%。但其中也有一些收購。因此，下半年的基數更接近 3.5% 至 4%。

David Westenberg, Piper Sandler.

大衛‧韋斯特伯格，派珀‧桑德勒。

I just want to take a little bit more of a long-term look at the business here. How should we think about digital pathology in light of the acquisition with a PathAI. Can we see a more immediate path to incorporate it more broadly? If so, would there be cost savings in the intermediate term?

我只是想更長遠地審視這裡的業務。鑑於收購 PathAI，我們應該如何思考數位病理學。我們能否找到一條更直接的途徑將其更廣泛地納入其中？如果是這樣，中期會節省成本嗎？

And then is there any maybe potential for pricing benefits given that human plus AI kind of reading probably is a better outcome. And so maybe would justify kind of a higher price? And just as a background, can you talk about maybe a broader framework for how much revenue of your business is pathology overall just anything you feel comfortable with?

鑑於人類加人工智慧的閱讀可能是一個更好的結果，那麼是否存在定價優勢的潛力呢？那麼也許可以證明更高的價格是合理的？作為背景，您能否談談一個更廣泛的框架，即您的業務收入有多少是病態的，只是您覺得舒服的任何事情？

Yes. We've said in the past, just on our revenue from anatomical pathology that it was -- and this was pre-half AI diagnostics that it was roughly a $500 million book of business. But we're excited about the digital pathology opportunity on numerous fronts. On the surface, unlike radiology, digital pathology just does not naturally lower your cost because you're actually -- you still need to create the slide. Once you've created the slide, then you digitize the slide, okay? So there's actually an extra step in the process. Now here's where it creates productivity.

是的。我們過去曾說過，僅就我們來自解剖病理學的收入而言，這是一項大約 5 億美元的業務，這是半年前的人工智慧診斷業務。但我們對眾多領域的數位病理機會感到興奮。從表面上看，與放射學不同，數位病理學並不會自然地降低您的成本，因為您實際上 - 您仍然需要創建幻燈片。創建幻燈片後，就可以將幻燈片數位化，好嗎？所以這個過程其實還有一個額外的步驟。現在這就是它創造生產力的地方。

And as you said, we think better quality. Number one, we do anatomical pathology in over 20 locations across the country because you want the pathologist to sit right near where you're preparing the slide so that you don't have to move slides and vehicles and things like that. So we believe that it's going to digital pathology will allow us to collapse the network of sites that actually do what we call the histology work or the preparation of the slides. So there will be cost savings when we collapse that network.

正如您所說，我們認為品質更好。第一，我們在全國 20 多個地點進行解剖病理學，因為您希望病理學家坐在您準備載玻片的位置附近，這樣您就不必移動載玻片和車輛之類的東西。因此，我們相信數位病理學將使我們能夠瓦解實際上進行我們所謂的組織學工作或幻燈片準備的站點網絡。因此，當我們關閉該網路時，將會節省成本。

Second is it allows us to route the route the image to expert pathologists wherever they sit in the country. So if our guru for breast pathology sits on the West Coast, you move those slides out there. If the prostate guru sits on the East Coast, you move those slides there. And yes, we believe once you've digitized that slide, there's many companies out there that are working on algorithms. There's one or two that have been FDA approved, that allow you to apply algorithmic analysis to the digital image in order to improve the quality of the REIT.

其次，它允許我們將圖像路由給專家病理學家，無論他們位於該國的哪個地方。因此，如果我們的乳房病理學專家位於西海岸，您就可以將這些幻燈片移到那裡。如果攝護腺專家位於東岸，你就把這些投影片移到那裡。是的，我們相信一旦你將這張投影片數位化，就會有許多公司正在研究演算法。一兩個已獲得 FDA 批准，可讓您對數位影像應用演算法分析，以提高房地產投資信託基金的品質。

In terms of reimbursement, we absolutely believe there's a strong case to be made for higher reimbursement using these algorithms. The final thing I would tell you is that with digital pathology, it opens up a realm of new just histology-only types of operations, meaning we will take on the histology work for a health system. They'll still keep the pathologist, but they'll shut down their histology operations. We'll do the slide preparation, digitize it and send that back to the hospital pathologists for them still to do the reading. We call this a technical-only solution and it's a solution that's starting to take off and the margins on the technical component of histology are quite good. So we're bullish on the overall market opportunity here.

在報銷方面，我們絕對相信使用這些演算法有充分的理由獲得更高的報銷。我要告訴你的最後一件事是，透過數位病理學，它開闢了一個僅組織學類型的新操作領域，這意味著我們將為衛生系統承擔組織學工作。他們仍然會保留病理學家，但他們會停止組織學操作。我們將準備載玻片，將其數位化，然後將其發送回醫院病理學家，以便他們繼續進行讀數。我們稱之為純技術解決方案，這是一個正在開始起飛的解決方案，組織學技術部分的利潤非常好。因此，我們看好這裡的整體市場機會。

Erin Wright, Morgan Stanley.

艾琳·賴特，摩根士丹利。

I have two questions here. But on value-based care contracts, you mentioned that you lapped some of the payments that were made through those contracts or relationships last year. I guess, how much did that benefit you last year? And how should we be thinking about modeling that on a quarter-to-quarter basis? Will will those incentive payments or contributions? Are they relatively onetime in nature? Is that something you'll be breaking out for us going forward? And how material have those payments been, I guess, year-to-date? And then a second part of my question would just be more on the regulatory environment, just what you're thinking in terms of PAMA and Salsa and your expectations into 2025 on that front?

我在這裡有兩個問題。但在基於價值的護理合約中，您提到您去年透過這些合約或關係支付了一些款項。我想，去年這對你有多少好處？我們應該如何考慮按季度進行建模？會有那些獎勵金或捐款嗎？它們本質上是相對一次性的嗎？這是你接下來要為我們透露的事情嗎？我想，今年迄今為止，這些付款有多重要？我的問題的第二部分更多地涉及監管環境，您對 PAMA 和 Salsa 有何看法，以及您對 2025 年這方面的期望？

All right. So let me start with your value-based care comment. I'll ask Sam to add some color, and then I'll come back and address PAMA and Salsa. So on the value-based care, it made positive contributions in the second quarter of this year. they just weren't bigger than the second quarter of last year. Last year, we had a meaningful gain. We acknowledged that last second quarter. Again, this year, it was positive, but the delta between last year and this year was a headwind for us. It is very difficult for us to give you guidance on how to model these things.

好的。讓我從您基於價值的護理評論開始。我會請 Sam 添加一些顏色，然後我會回來向 PAMA 和 Salsa 發表講話。所以在價值關懷上，今年第二季做出了正面的貢獻。它們只是沒有比去年第二季更大。去年，我們取得了有意義的收穫。我們在上第二季承認了這一點。今年同樣是積極的，但去年和今年之間的增量對我們來說是一個逆風。我們很難為您提供有關如何建模這些事物的指導。

The really two principal components to these value-based payments. One is from shared savings from acquisitions and those are lumpy. They're based on the acquisitions they do. And in some cases, payments can be six months post-deal closure. Some cases, it could be a year post deal closure, it just depends on the contract. The other type of value-based incentive payment that we have with some of our payers is around the movement of requisitions from high-priced either out-of-network laboratories or high-priced health system laboratories and again, that could be a once a year true-up and depending on when we signed that contract, would it be in June, it could be in January, it could be equal. So very, very hard to model these things.

這些基於價值的支付的真正兩個主要組成部分。一是來自收購的共享節省，而且這些節省是不穩定的。它們是基於他們所做的收購。在某些情況下，付款可能會在交易結束後六個月內進行。在某些情況下，可能是交易結束後一年，這僅取決於合約。我們與一些付款人進行的另一種基於價值的激勵付款是圍繞高價網絡外實驗室或高價衛生系統實驗室的請購單的流動，這可能是一次年度調整，取決於我們簽署合約的時間，是在六月，可能是一月，也可能是相等的。對這些東西進行建模非常非常困難。

So Sam, any other color on that?

那麼 Sam，還有其他顏色嗎？

I think you've really captured it, Jim. The key thing there, Aaron, is it's difficult to give you a sense as to how the pacing is going to be. We always said these are lumpy. And sometimes, there's also accounting nuances on these where if it's a shared service share savings commitment for instance, we might accrue for that shared savings as if we're not going to achieve it, but then when we do achieve it, we have to release that accrual, so to speak, and get a benefit in that quarter. The suffice it to say that these continue to be a positive for us in terms of our overall pricing in Q2 of 2024, it was a pricing or a positive benefit for us in the quarter, but on a year-over-year basis, we had a significant benefit in Q2 2023. So it impacted us negatively in terms of total revenues on a year-over-year basis. So I think everything that Jim said stands in terms of the difficulty of giving you a modeling algorithm for these.

我想你已經真正抓住了它，吉姆。亞倫，關鍵是很難讓你了解節奏將如何。我們總是說這些是塊狀的。有時，這些方面還存在會計上的細微差別，例如，如果這是共享服務份額節省承諾，我們可能會累積共享節省，就好像我們不會實現它一樣，但當我們確實實現它時，我們必須可以這麼說，釋放該應計費用，並在該季度獲得收益。可以說，就 2024 年第二季的整體定價而言，這些對我們來說仍然是正面的，這對我們本季來說是定價或正面的好處，但與去年同期相比，我們在2023 年第二季取得了顯著的效益。所以我認為吉姆所說的一切都代表著為這些問題提供建模演算法的難度。

And then PAMA, James, did you want to comment on?

然後PAMA、詹姆斯，你想發表評論嗎？

Yes. In terms of PAMA and Salsa, while we and our trade association and other independent labs continue to push the case for Salsa we acknowledge it's going to be difficult to get that through in a year with an election year and especially now given many of the changes that have occurred in the last week. Having said that, we will continue to push very hard for another 1-year delay in PAMA. The recent CBO scoring on this was actually bigger than it was last year. They projected it would save the government over $3 billion.

是的。就PAMA 和Salsa 而言，雖然我們和我們的行業協會以及其他獨立實驗室繼續推動Salsa 的發展，但我們承認，在選舉年的一年內很難實現這一目標，尤其是考慮到現在發生的許多變化上週發生的事情。話雖如此，我們將繼續努力推動 PAMA 再次推遲一年。最近國會預算辦公室對此的評分實際上比去年更高。他們預計這將為政府節省超過 30 億美元。

And in addition, the committee in the House that overlooks this is looking for a pay-for program to pay for continued telehealth benefits. So this becomes a really nice pay for program that can satisfy the requirement to fund the telehealth. So we're confident that at a minimum, there would be a 1-year delay in PAMA and hopefully, we can get this done and figured out in the October, November time frame as opposed to waiting for the December time frame like we've seen in the past.

此外，眾議院的委員會正在尋找一項付費計劃來支付持續的遠距醫療福利。因此，這成為一個非常好的專案報酬，可以滿足資助遠距醫療的要求。因此，我們有信心，PAMA 至少會延遲 1 年，希望我們能夠在 10 月、11 月的時間範圍內完成並解決這一問題，而不是像我們一樣等待 12 月的時間範圍。

Brian Tanquilut, Jefferies.

布萊恩·坦奎魯特，傑弗里斯。

Congrats on the quarter. Maybe, Sam, as I think about your comments on Haystack, I understand maintaining the drag guidance for this year. But how are you thinking about the ramp on that as we think about 2025 and given some of the announcements you've made on new partnerships there. So just curious how we should be thinking about the development and the ramp of Haystack going forward?

恭喜本季。也許，薩姆，當我想到你對 Haystack 的評論時，我理解維持今年的阻力指導。但是，當我們考慮 2025 年並考慮到您在那裡發布的一些關於新合作夥伴關係的公告時，您如何看待這一進展。所以只是好奇我們該如何考慮 Haystack 的未來發展和升級？

Yes, sure. Brian. So as we said in the prepared remarks, Haystack dilution this year will be somewhere in the $0.35 to $0.40 range, which is about a $0.20 increase in terms of dilution from prior year. For 2025, Brian, the way we see it is it's still going to be dilutive but it's going to be less dilutive than we see in 2024 because we will start to recognize revenues on the assay as we launch later this year.

是的，當然。布萊恩.因此，正如我們在準備好的評論中所說，Haystack 今年的稀釋度將在 0.35 美元至 0.40 美元之間，比去年的稀釋度增加約 0.20 美元。 Brian，我們認為 2025 年它仍然會被稀釋，但稀釋程度將低於我們在 2024 年看到的情況，因為我們將在今年稍後推出檢測時開始確認收入。

In 2026, we expect Haystack to be slightly accretive. And we expect by the end of 2025 also to get to a positive return on invested capital from this acquisition. In terms of all the things that we've seen, the early launch has been really successful. We've had a very, very high interest in terms of number of key thought leaders and cancer centers that have signed up for this. So everything that we see today is really encouraging. And you touched on the partnerships that we've made as well.

到 2026 年，我們預計 Haystack 將略有成長。我們預計到 2025 年底，此次收購也能獲得正的投資報酬。就我們所看到的所有事情而言，早期的發布確實非常成功。我們對已簽約的關鍵思想領袖和癌症中心的數量非常非常感興趣。所以我們今天看到的一切確實令人鼓舞。您也談到了我們建立的合作關係。

We continue to sign new partnerships in terms of cancer centers that are -- or companies that are partnering with us to evaluate the use of the assay and MRD in a specific type of cancer. So really excited about the upcoming launch. I think the early launch has been very positive. And hopefully, this gives you a sense as to the financial impact in terms of accretion dilution.

我們繼續與癌症中心或與我們合作的公司簽署新的合作夥伴關係，以評估該檢測和 MRD 在特定類型癌症中的使用。對即將推出的產品感到非常興奮。我認為早期的推出非常積極。希望這能讓您了解吸積稀釋的財務影響。

Lisa Gill, JPMorgan.

麗莎·吉爾，摩根大通。

Since your last (inaudible) rule came out, can you maybe just talk about what the impact is there? I heard your comments on PAMA and SALSA, but anything else on the regulatory front that we should be aware of?

自從您的最後一條（聽不清楚）規則出台以來，您能否談談有什麼影響？我聽到了您對 PAMA 和 SALSA 的評論，但是在監管方面我們還有什麼需要注意的嗎？

Yes. Thanks, Lisa. So as you know, our trade association filed a lawsuit in the Federal Court of Texas, District Court of Texas, and work by outside counsel that the trade association has retained continues. We expect movement in the case in the latter part of this year. November, December and probably into January of next year.

是的。謝謝，麗莎。如您所知，我們的行業協會向德克薩斯州聯邦法院和德克薩斯州地方法院提起了訴訟，行業協會聘請的外部律師的工作仍在繼續。我們預計案件將在今年下半年取得進展。十一月、十二月，可能到明年一月。

Having said that, the rule is in place. We are running the company and operating the company with the rule in place. There's certain requirements that we need to have in place by May of next year, including a complaint handling unit up and running as well as the ability to report adverse events. And these capabilities, some of which we had in the company, some of which we have to add are ongoing as we speak.

話雖如此，規則已經到位。我們正在經營公司，並按照既定的規則來經營公司。我們需要在明年 5 月之前落實某些要求，包括建立並運行投訴處理單位以及報告不良事件的能力。這些能力，其中一些是我們在公司擁有的，其中一些是我們必須添加的，就在我們說話的時候，這些能力仍在持續進行。

We've launched training for the organization, in particular, our R&D teams, our product marketing teams around design controls, and again, we're living with the rule and implementing things for the directive of the FDA. We've said this year, it's not going to add a material cost into the business. But we continue to evaluate what we need to be fully compliant, especially if the law suit is not successful.

我們已經為該組織，特別是我們的研發團隊、我們的產品行銷團隊圍繞設計控制開展了培訓，並且我們再次遵守規則並按照 FDA 的指示實施。我們今年已經說過，這不會增加業務的材料成本。但我們會繼續評估我們需要完全合規的內容，特別是在訴訟不成功的情況下。

Michael Ryskin, Bank of America.

麥可‧萊斯金，美國銀行。

I'm going to stay on the regulatory side. It's still fairly recent, but we had a couple of questions coming from investors on Chevron defer. The Supreme Court ruling to overtime the Chevron option, what could mean for deregulation is still kind of a hypothetical, I think. But just curious what your take on that is doing your place in the industry.

我將留在監管方面。這仍然是最近的事，但投資者對雪佛龍延期提出了幾個問題。我認為，最高法院裁定雪佛龍選擇加班，這對放鬆管制意味著什麼仍然是一種假設。但只是好奇你對此的看法如何影響你在業界的地位。

Well, it certainly doesn't hurt that we believe is in front again, the Federal District Court in Texas. I'm not a legal expert by any means. But as you know, look, Congress is the one that sets the operating parameters for various departments that exist like the FDA. We believe what Congress authorized the FDA to do is to regulate medical devices. And congress also authorized the CLIA Act of 1988 that talked about the regulation of clinical laboratories. So we believe it's very clear what Congress intended. Obviously, others don't see it that way. But we do believe that, yes, what has come out of the Supreme Court recently is favorable, and it clearly dictates what should occur within the four walls of regulatory bodies.

好吧，我們相信德州聯邦地方法院再次出現在面前，這當然不會有什麼壞處。無論如何，我不是法律專家。但如你所知，國會是為 FDA 等現有各部門設定操作參數的人。我們認為國會授權 FDA 的職責是監管醫療器材。國會也批准了 1988 年 CLIA 法案，其中涉及臨床實驗室的監管。所以我們相信國會的意圖非常明確。顯然，其他人不這麼看。但我們確實相信，最高法院最近的裁決是有利的，它明確規定了監管機構的四面牆應該發生什麼。

Jack Meehan, Nephron Research.

傑克·米漢，腎單位研究。

Either for Sam or for Jim, I was wondering if you could give an update on what you're seeing in terms of cost trends, how are wage costs trending, an update on turnover, and sorry if I missed this, Sam, what's the full year margin target?

無論是山姆還是吉姆，我想知道您是否可以提供您在成本趨勢方面所看到的最新情況，工資成本趨勢如何，營業額的最新情況，抱歉，如果我錯過了這一點，山姆，什麼是全年利潤率目標？

Yes. So from a wage standpoint, we said at the beginning of the year that we expected wage increases to be in that 3% to 4% range. We're still operating within that 3% to 4%. So we're comfortable with that estimate for the back half of the year that it will play out in that range.

是的。因此，從薪資的角度來看，我們在年初表示，預計薪資增幅將在 3% 至 4% 的範圍內。我們仍然在 3% 到 4% 的範圍內運作。因此，我們對今年下半年的預測感到滿意，因為它將在這個範圍內發揮作用。

In terms of turnover, last year, all in for our frontline positions, patient services, logistics, specimen processing, our laboratory workers, we were north of 20%. In the first quarter, we came down below 20% into the mid-18s. And we've kind of hung there in the second quarter.

就營業額而言，去年，我們的第一線職位、病患服務、物流、標本處理、實驗室工作人員的營業額都超過了 20%。第一季度，我們的成長率下降到了 18 年代中期的 20% 以下。我們在第二季度有點停滯不前。

So we feel good that generally, you can see an uptick sometimes after your first quarter, after bonus payments and things like that. But we've maintained a relatively flat position. We obviously have some hotspots around the country in certain job categories that tend to be competitive related, either with health systems or with other industries. And so we address those hotspots, and we expect to make meaningful improvements in the back half of this year.

所以我們感覺很好，一般來說，在第一季之後、獎金支付等之後，有時你會看到上升。但我們一直保持相對平穩的立場。顯然，我們在全國各地的某些工作類別中存在一些熱點，這些工作類別往往與衛生系統或其他行業的競爭有關。因此，我們解決了這些熱門議題，並期望在今年下半年做出有意義的改進。

Yes. And for a margin target, Jack, we didn't give one, so you didn't miss it. But we did say that operating margins are expected to be up year-over-year, which is what we had shared also on the Q1 call.

是的。對於利潤目標，傑克，我們沒有給出目標，所以你不會錯過它。但我們確實說過，營業利潤率預計將比去年同期上升，這也是我們在第一季電話會議上分享的內容。

Andrew Brackmann, William Blair.

安德魯·布拉克曼，威廉·布萊爾。

Sam, maybe one for you just on the balance sheet and the upcoming debt maturities. Anything that you can sort of share in terms of your expectations for timing or interest costs associated with those refinancings? And I guess just related to that, any color that you can provide on the debt assumptions for the LifeLabs acquisition?

薩姆，也許您只需要了解資產負債表和即將到期的債務。對於與這些再融資相關的時間安排或利息成本的期望，您有什麼可以分享的嗎？我想與此相關的是，您可以為 LifeLabs 收購的債務假設提供任何顏色嗎？

Sure, Andrew. So let's start with the LifeLabs. What we are assuming, I mean, I shared in the prepared remarks that we expect the acquisition -- first of all, we're not expecting LifeLabs to close this year, at least in our guidance assumptions. It could, but we're not assuming it's in guidance.

當然，安德魯。讓我們從 LifeLabs 開始。我的意思是，我在準備好的發言中分享了我們的假設，即我們預計此次收購——首先，我們預計 LifeLabs 不會在今年關閉，至少在我們的指導假設中是如此。它可以，但我們並不假設它在指導中。

But for 2025, it's $0.10 to $0.15 EPS accretion or at least in its first year, let's call it that. It's $0.10 to $0.15. We're assuming that it's funded by a combination of debt and cash. But within that assumption of $0.10 to $0.15 is that 75% of that purchase price is funded with debt. So the roughly $1 billion purchase price, 75% of it is debt funded, which is what drives the $0.10 to $0.15 accretion in the first year.

但到 2025 年，每股盈餘將增加 0.10 至 0.15 美元，或至少在第一年如此，我們就這樣稱呼它吧。價格為 0.10 美元至 0.15 美元。我們假設它的資金來源是債務和現金。但在 0.10 至 0.15 美元的假設範圍內，購買價格的 75% 是透過債務融資的。因此，大約 10 億美元的購買價格中，75% 是債務融資的，這推動了第一年 0.10 至 0.15 美元的增值。

In terms of just broadly on debt assumptions and liquidity, et cetera, I think you talked about balance sheet assumptions. Listen, a lot of that is going to depend on market conditions and depend on the timing of the flows of some of these acquisitions, not just LifeLabs, primarily LifeLabs. But also, we have OhioHealth, Allina Health. We also closed PathAI in June. So as we've been talking about, we've had a busy M&A pipeline and starting to come to fruition.

就債務假設和流動性等問題而言，我認為您談到了資產負債表假設。聽著，其中很大一部分將取決於市場狀況，並取決於其中一些收購的流程時間，而不僅僅是 LifeLabs，主要是 LifeLabs。而且，我們還有 OhioHealth、Allina Health。我們還在 6 月關閉了 PathAI。因此，正如我們一直在談論的，我們的併購管道很繁忙，並開始取得成果。

So we're going to evaluate market conditions. We've got the flexibility to access the capital markets. We've got very strong short-term liquidity through the access to our facilities. But our goal continues to be to target a 2.5 to 3 times leverage ratio. That's our goal. There could be some slight tip above that higher end of 3, but then we expect to delever back to somewhere within that 2.5% to 3% in short time, given the growth and the accretion from these acquisitions. So again, no specific debt number right now, but we'll keep you posted as we get more timing on the closes of these acquisitions.

因此，我們將評估市場狀況。我們可以靈活地進入資本市場。透過使用我們的設施，我們擁有非常強大的短期流動性。但我們的目標仍然是 2.5 至 3 倍的槓桿率。這就是我們的目標。可能會在 3 的上限之上出現一些小幅波動，但考慮到這些收購帶來的成長和增值，我們預計會在短時間內將槓桿率回落至 2.5% 至 3% 之內。再說一次，目前還沒有具體的債務數字，但當我們獲得更多有關這些收購完成的時間時，我們會及時通知您。

Pito Chickering, Deutsche Bank.

皮托·奇克林，德意志銀行。

A multipart question here. How are volumes looking at from your preferred network customers versus everyone else? And looking at both the physician market and the hospital market, are you losing gaining or maintaining share? Any quantification of any of those would be helpful.

這裡有一個多部分的問題。與其他客戶相比，您的首選網路客戶的銷售量如何？看看醫生市場和醫院市場，您是失去了獲得的份額還是維持了份額？對其中任何一個進行量化都會有所幫助。

Okay. So on volume from our payers with preferred arrangements, the volume with several of them, Pito, is higher. Now some of that can be also driven by Medicare Advantage, the various size of the Medicare Advantage books of business. But in general, when we operate within these preferred networks, where we have incentives in place to move share from out-of-network labs, high-priced health systems, we definitely see benefits.

好的。因此，就我們的首選安排付款人的交易量而言，其中幾個（Pito）的交易量更高。現在，其中一些也可以由醫療保險優勢（醫療保險優勢業務的各種規模）推動。但總的來說，當我們在這些首選網路內運作時，我們有激勵措施從網路外實驗室、高價醫療系統轉移份額，我們肯定會看到好處。

In terms of market share statistics around our physician book of business and our health system book of business, it's hard to tell, right? There's just not great industry reports that talk about that. But I can tell you, when we said that, that book of business was up 5.1% from a revenue standpoint, our physician growing faster than that, health system growing slightly lower than that. But still, they're growing in ranges that are significantly above what we saw from a pre-COVID standpoint.

就我們的醫生業務手冊和健康系統業務手冊的市場份額統計數據而言，很難說，對吧？只是沒有很好的行業報告談論這一點。但我可以告訴你，當我們這麼說時，從收入的角度來看，該業務增長了 5.1%，我們的醫生增長速度比這更快，醫療系統的增長略低於此。但儘管如此，它們的增長幅度仍大大高於我們從新冠疫情爆發前的角度看到的水平。

So that leads us to believe -- and also just based on the number of new wins with large physician groups, the number of new wins in our reference book of business, it leads us to believe that, yes, we are picking up share in this industry. And much of that share, we believe, is coming from health systems that potentially aren't as aggressive on some of that outreach book of business, from specialty labs and also from very small little regional labs.

因此，這讓我們相信——而且僅僅基於大型醫生團體的新勝利數量，我們的商業參考書中的新勝利數量，它讓我們相信，是的，我們正在獲得市場份額這個行業。我們相信，其中大部分份額來自於專業實驗室和非常小的區域實驗室，這些系統可能在某些外展業務方面不那麼積極。

Stephanie Davis, Barclays.

史蒂芬妮戴維斯，巴克萊銀行。

Congrats on the quarter. I was just curious if there's anything that changed either in the environment or maybe in strategy that had this pickup in M&A so much this year? And how sustainable is this? Or how much of this is kind of strike while the iron is hot?

恭喜本季。我只是很好奇，環境或策略是否發生了任何變化，導致今年併購活動如此大的成長？這有多可持續？或者說，這其中有多少是趁熱打鐵？

Yes. No change in the strategy at all, Stephanie. And as we've been saying for many quarters in a row, the M&A funnel is full. Now we don't go into a year of planning on getting four deals announced in one quarter. In fact, you would prefer to space these out a little bit. But there's always somebody on the other end that you're negotiating with, and these things sometimes take time.

是的。策略根本沒有改變，史蒂芬妮。正如我們連續多個季度所說，併購漏斗已滿。現在，我們不會在一年內計劃在一個季度內宣布四筆交易。事實上，您更願意將它們分開一點。但總有一些人在跟你談判，而這些事情有時需要時間。

So look, we're really excited about all of these. Allina Health in Minneapolis, it represents a market where the independent labs basically have really, really low share in that market space. So really excited about the Minneapolis marketplace. We're also very excited about Columbus, Ohio. Dominated by two health systems, very difficult for independent labs to operate there. And so this gives us a substantial foothold within that Columbus marketplace.

所以看，我們對所有這些感到非常興奮。明尼阿波利斯的 Allina Health 代表了一個市場，其中獨立實驗室基本上在該市場空間中所佔的份額非常非常低。對明尼阿波利斯市場非常興奮。我們對俄亥俄州哥倫布市也感到非常興奮。由兩個衛生系統主導，獨立實驗室很難在那裡運作。因此，這使我們在哥倫布市場中擁有了堅實的立足點。

Obviously, excited about the Canadian marketplace as we talked. And again, PathAI represents both a nice opportunity in the Memphis marketplace itself, where we believe we can grow our book of business there. And as well, it doesn't really matter where that lab is located because a lot of the work is done digitally. So it accepts specimens from all over the country.

顯然，正如我們所說，我們對加拿大市場感到興奮。再說一次，PathAI 代表了孟菲斯市場本身的一個很好的機會，我們相信我們可以在那裡發展我們的業務。而且，實驗室位於哪裡並不重要，因為許多工作都是數位化完成的。因此它接受來自全國各地的標本。

I would tell you that there's still opportunities within the funnel. The emphasis continues to be on these outreach tuck-in deals. It continues to focus in markets where our share position or access to independent labs is waning. And that's where our focus will be in the second half of this year.

我想告訴你，漏斗中仍然有機會。重點仍然是這些外展內含交易。它繼續專注於我們的份額地位或進入獨立實驗室的機會正在減弱的市場。這就是我們今年下半年的重點。

One other thing I'd add, Stephanie, is all of these acquisitions that we announced meet our criteria. They basically hit the mark on all of the criteria that we have accretive in the first year. They meet our return on invested capital threshold, they meet our NPV criteria. So again, the activity would depend also if these acquisitions are going to hit our profitability criteria in our ROIC hurdle rate, and they do.

史蒂芬妮，我要補充的另一件事是，我們宣布的所有這些收購都符合我們的標準。他們基本上達到了我們在第一年增加的所有標準。他們符合我們的投資資本報酬率門檻，他們符合我們的淨現值標準。因此，活動也取決於這些收購是否會達到我們的投資資本回報率中的獲利標準，而事實確實如此。

Okay. So that concludes our call today. We really appreciate everybody joining. Thanks for your support and have a great week ahead.

好的。我們今天的電話會議到此結束。我們非常感謝大家的加入。感謝您的支持，祝您有個愉快的一週。

Thank you for participating in the Quest Diagnostics Second Quarter 2024 Conference Call. A transcript of prepared remarks on this call will be posted later today on Quest Diagnostics' website at www.questdiagnostics.com.

感謝您參加 Quest Diagnostics 2024 年第二季電話會議。本次電話會議的準備演講稿將於今天稍晚發佈在 Quest Diagnostics 的網站 www.questdiagnostics.com 上。

A replay of the call may be accessed online at www.questdiagnostics.com/investor or by phone at (866) 363-1805 for domestic callers or (203) 369-0193 for international callers. Telephone replays will be available from approximately 10:30 AM Eastern Time on July 23, 2024, until midnight Eastern Time, August 6, 2024. Thank you for your participation, and you may disconnect.

您可以透過 www.questdiagnostics.com/investor 在線查看通話重播，也可以致電 (866) 363-1805（國內來電者）或 (203) 369-0193（國際來電者）查看通話重播。電話重播將於 2024 年 7 月 23 日東部時間上午 10:30 左右至 2024 年 8 月 6 日東部時間午夜進行。