奎斯特診斷 (DGX) 2024 Q3 法說會逐字稿

Welcome to the Quest Diagnostics third 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 the 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 年第三季電話會議。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。

I'd now like to turn the call over to Shawn Bevec, Vice President of Investor Relations for Quest Diagnostics. Sir, please go ahead.

我現在想將電話轉給 Quest Diagnostics 投資者關係副總裁 Shawn Bevec。先生，請繼續。

Thank you, and good morning. I'm joined by Jim Davis, our Chairman, Chief Executive Officer and President; and Sam Samad, our Chief Financial Officer.

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 to 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.

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。實際結果可能與預測結果有重大差異。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新的 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. 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 rates.

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。與我們的長期前景預測相關的成長率，包括合併收入成長、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。

Now here is Jim Davis.

現在請聽吉姆戴維斯的演講。

Thanks, Shawn, and good morning, everyone. Before we get into the details from the third quarter, I want to recognize the Quest employees who are working hard to serve our patients and customers impacted by hurricanes Helene and Milton while also contending with the effects on their personal lives. I'm inspired by their commitment to our values, especially customer focus, collaboration and care during this very difficult time. They bring to life our purpose, working together to create a healthier world, one life at a time. Now turning to our results.

謝謝肖恩，大家早安。在我們詳細介紹第三季的情況之前，我想對 Quest 員工表示感謝，他們努力為受海倫和米爾頓颶風影響的患者和客戶提供服務，同時也應對個人生活受到的影響。他們對我們價值觀的承諾，特別是在這個非常困難的時期對客戶的關注、協作和關懷，讓我深受鼓舞。他們實現了我們的目標，共同努力創造一個更健康的世界，一次一個生命。現在轉向我們的結果。

We delivered a strong third quarter with total revenue growth of 8.5% including 4.2% organic growth, driven by new customer wins and expanded business with physicians and hospitals as well as acquisitions. During the third quarter, we completed three acquisitions. We finalized our acquisition of LifeLabs, a trusted lab leader serving millions of Canadians. Life Labs provides a strong foundation for us to expand in Canada, and we are excited about the growth opportunity serving a population that is growing and with more favorable demographics than in the US. We also completed our transaction with Alina Health, a leading nonprofit health system serving in Minnesota in Western Wisconsin. And at the end of the quarter, we acquired the laboratory business of three physician groups in New York.

在贏得新客戶、擴大與醫生和醫院的業務以及收購的推動下，我們第三季的總收入成長了 8.5%，其中有機成長 4.2%。第三季度，我們完成了三項收購。我們完成了對 LifeLabs 的收購，LifeLabs 是值得信賴的實驗室領導者，為數百萬加拿大人提供服務。Life Labs 為我們在加拿大的擴張奠定了堅實的基礎，我們對為加拿大不斷增長的人口提供服務且人口結構比美國更有利的增長機會感到興奮。我們也完成了與 Alina Health 的交易，Alina Health 是一家領先的非營利醫療系統，在威斯康辛州西部的明尼蘇達州提供服務。在季度末，我們收購了紐約三個醫師集團的實驗室業務。

During the quarter, we also announced the plans to acquire select outreach lab assets from Ohio Health and university hospitals, two leading nonprofit health systems in Ohio. We completed the transaction with Ohio Health just last week and expect to complete the acquisition with University Hospitals later this quarter. Our recent outreach acquisitions highlight our ability to attract top health systems seeking to evolve their lab strategies to improve access and affordability.

在本季度，我們也宣布了從俄亥俄州健康中心和大學醫院（俄亥俄州兩個領先的非營利醫療系統）收購精選外展實驗室資產的計畫。我們上週剛完成了與俄亥俄州健康中心的交易，預計將在本季稍後完成與大學醫院的收購。我們最近的外展收購凸顯了我們吸引頂級衛生系統的能力，這些系統尋求發展其實驗室策略以提高可近性和可負擔性。

They also position us to expand in geographic areas of the US where the influence of health systems had previously limited our reach. We are now on track to complete eight acquisitions this year that meet our criteria for growth, profitability and returns. Now I'll recap our strategy and discuss highlights from the third quarter, and then Sam will provide detail on our financial results and talk about our updated financial guidance for 2024.

它們還使我們能夠在美國的地理區域進行擴張，而這些區域之前因衛生系統的影響而限制了我們的覆蓋範圍。我們今年預計將完成八項符合我們成長、獲利和回報標準的收購。現在，我將回顧我們的策略並討論第三季度的亮點，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。

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 brain health and molecular genomics and oncology.

我們推動成長的策略重點是提供滿足核心客戶、醫生、醫院和消費者不斷變化的需求的解決方案。我們透過先進的診斷技術實現客戶管道的成長，重點關注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 the progress we have made in each of these areas. In Physician lab services, we delivered another quarter of high single-digit revenue growth.

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。在醫師實驗室服務方面，我們又實現了一個季度高個位數的營收成長。

Our performance was driven by new customer wins and expanded business, largely due to increased utilization of our advanced diagnostics. Our acquisitions also contributed to growth within this core customer channel. And as a reminder, volumes from both hospital outreach and independent lab acquisitions originate in physician offices.

我們的業績是由新客戶贏得和業務擴展推動的，這主要是由於我們先進診斷技術的利用率提高。我們的收購也促進了這個核心客戶管道的成長。需要提醒的是，醫院外展和獨立實驗室採購的數量均來自醫生辦公室。

We also continue to see strong volume and revenue growth within Medicare Advantage plans where narrow network strategies direct testing to high-quality, cost-efficient options like Quest. During the quarter, we also made progress to expand into new geographies through our health plan partnerships. We renewed a large national health plan agreement with Elevance Health that will extend our reach in Virginia, Georgia, Colorado and Nevada, markets which we had previously limited access. We also broadened our access in Virginia and Florida with our recently announced arrangements with Centerra Health plans.

我們也繼續看到 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。本季度，我們也透過健康計畫合作夥伴關係在新地區擴張方面取得了進展。我們與 Elevance Health 續簽了一項大型國家健康計畫協議，該協議將擴大我們在維吉尼亞州、喬治亞州、科羅拉多州和內華達州的覆蓋範圍，這些市場是我們之前限制進入的市場。透過最近宣布的與 Centerra Health 計劃的安排，我們還擴大了在維吉尼亞州和佛羅裡達州的服務範圍。

In hospital lab services, we grew revenues mid-single digits, which is above historical levels. Hospitals continue to struggle to fill specialized lab positions, including histology cytotechnology and microbiology. In addition, the rain and scope of testing being ordered is increasing as hospitals take advantage of our expanding advanced diagnostics portfolio rather than building their own in-house capability. These dynamics contributed to strong continued demand for reference testing.

在醫院實驗室服務方面，我們的收入成長了中個位數，高於歷史水準。醫院繼續努力填補專業實驗室職位，包括組織學、細胞技術和微生物學。此外，隨著醫院利用我們不斷擴大的先進診斷產品組合而不是建立自己的內部能力，訂購的測試數量和範圍都在增加。這些動態推動了對參考測試的強勁持續需求。

Our expertise managing laboratories can help hospitals improve quality and efficiency in their core lab operations. During the quarter, we formed a professional lab services collaboration with a leading health system in New Jersey that includes reference testing as well as laboratory and supply chain management. us specializes in scaling diagnostic innovations to improve access, quality and affordability.

我們管理實驗室的專業知識可以幫助醫院提高核心實驗室運作的品質和效率。本季度，我們與新澤西州領先的衛生系統建立了專業的實驗室服務合作關係，包括參考測試以及實驗室和供應鏈管理。我們專注於擴大診斷創新，以提高可及性、品質和負擔能力。

This ability enables us to help hospitals address the many challenges that they face. -- from workforce shortages to capital constraints to the demand for more affordable care from patients, health plans and employers. That's why premier health systems continue to seek us out for a range of collaborations ranging from reference testing to professional lab management to outreach acquisitions.

這種能力使我們能夠幫助醫院應對他們面臨的許多挑戰。 ——從勞動力短缺到資本限制，再到病患、健康計畫和雇主對更負擔得起的照護的需求。這就是為什麼主要衛生系統繼續尋求我們進行一系列合作，從參考測試到專業實驗室管理再到外展收購。

In consumer-initiated testing, our consumer-facing platform, questhealth.com, grew total revenues more than 40%. Our repeat customer rate has grown to 30% from less than 10% two years ago, driven by demand for comprehensive health, chronic disease and STI testing.

在消費者發起的測試中，我們面向消費者的平台 questhealth.com 的總收入成長了 40% 以上。在全面健康、慢性病和性傳染感染檢測需求的推動下，我們的回頭客率已從兩年前的不到 10% 成長到 30%。

During the quarter, we also introduced micronutrient blood tests to help identify vitamin and mineral deficiencies. In addition, we continue to expand our partner network with resellers and e-commerce providers.

在本季度，我們還引入了微量營養素血液測試，以幫助識別維生素和礦物質缺乏症。此外，我們繼續擴大與經銷商和電子商務提供者的合作夥伴網路。

In advanced diagnostics, we drove double-digit revenue growth across several clinical areas. The growth was particularly strong in areas of brain health especially for our AD detect blood-based Alzheimer's disease testing as well as in women's health, cardiometabolic health and autoimmune disorders. Our investments in advanced diagnostics enable us to deliver and scale innovative services that improve patient care and drive growth.

在先進診斷領域，我們在多個臨床領域推動了兩位數的收入成長。大腦健康領域的成長尤其強勁，特別是我們的 AD 檢測血液阿茲海默症檢測以及女性健康、心臟代謝健康和自體免疫疾病領域。我們對先進診斷的投資使我們能夠提供和擴展創新服務，從而改善患者護理並推動成長。

In molecular genomics and oncology, we are pleased with the results to date from our Haystack MRD early experience program. through which providers from many leading academic and community oncology centers have used our Haystack MRD blood test to assess cancer recurrence and treatment response for solid tumor cancers. We're on track to make Haystack MRD available nationally to providers in the fourth quarter.

在分子基因組學和腫瘤學領域，我們對 Haystack MRD 早期體驗計劃迄今為止的結果感到滿意。來自許多領先學術和社區腫瘤中心的提供者使用我們的 Haystack MRD 血液檢測來評估癌症復發和實體瘤癌症的治療反應。我們預計在第四季度向全國各地的提供者提供 Haystack MRD。

Our growth in women's health was largely driven by prenatal and hereditary genetic testing, consistent with recent quarters. We also saw continued robust testing demand in genital tract infections, which includes several STIs. This month, we introduced a specimen self-collection option at our 2,000 patient service centers that give women a fast, convenient and discrete way to access GTI testing. In the area of autoimmune disorders, we saw strong demand for our testing solutions, which help primary care physicians comprehensively screen for autoimmune disorders in order to speed diagnosis and care by specialists.

我們女性健康的成長主要是由產前和遺傳基因檢測推動的，與最近幾季的情況一致。我們也看到生殖道感染（包括多種性傳染感染）的檢測需求持續強勁。本月，我們在 2,000 個患者服務中心推出了樣本自助採集選項，為女性提供了一種快速、方便且獨立的方式來進行 GTI 檢測。在自體免疫疾病領域，我們看到對我們的測試解決方案的強勁需求，該解決方案可幫助初級保健醫生全面篩檢自體免疫疾病，以加快專家的診斷和護理速度。

Finally, we are pleased to be selected by the CC to be one of a handful of diagnostic service providers to support the development of laboratory tests for H5N1 avian flu and oropouche viruses. We plan to introduce an H5N1 Avian flu test later this month. Now turning to operational excellence.

最後，我們很高興被 CC 選為少數支援 H5N1 禽流感和奧羅普切病毒實驗室檢測開發的診斷服務提供者之一。我們計劃在本月稍後推出 H5N1 禽流感檢測。現在轉向卓越營運。

Our Invigorate program aims to deliver [3%] annual cost savings and productivity improvements, driven largely through the use of automation and AI and to improve productivity as well as service levels and quality. During the quarter, we completed the build-out of full end-to-end automation for our core routine tests at our Lenexa, Kansas laboratory making it the third fully automated lab in our national network. We are now piloting automated specimen accessioning in our Clifton lab, which will help increase productivity in specimen processing and improved quality.

我們的 Invigorate 計劃旨在每年節省 [3%] 成本並提高生產力，這主要是透過使用自動化和人工智慧來推動的，並提高生產力以及服務水準和品質。本季度，我們在堪薩斯州萊內克薩實驗室完成了核心例行測試的完全端到端自動化建設，使其成為我們國家網路中的第三個全自動實驗室。我們現在正在克利夫頓實驗室試行自動樣本加入，這將有助於提高樣本處理的生產力並提高品質。

Finally, we are pleased to extend our collaboration with Hologic to include their automated cytology solution, the Hologic Genius digital diagnostic system which utilizes AI to help analyze cervical cell samples. We expect the solution will help us improve quality and efficiency in cervical cancer screening.

最後，我們很高興擴大與 Hologic 的合作，納入他們的自動化細胞學解決方案，即 Hologic Genius 數位診斷系統，該系統利用人工智慧來幫助分析子宮頸細胞樣本。我們期望該解決方案將幫助我們提高子宮頸癌篩檢的品質和效率。

Now before I turn it over to Sam, I want to take a moment to recognize the decision by Congress to delay Medicare reimbursement cuts and data collection scheduled under PAMA for 2025. While we are pleased with the delay, we continue to collaborate with our trade association, ACLA, to encourage Congress to secure a permanent legislative solution that provides fair reimbursement.

現在，在我將其交給 Sam 之前，我想花一點時間來認可國會推遲 2025 年 PAMA 計劃下的醫療保險報銷削減和數據收集的決定。雖然我們對延遲感到高興，但我們將繼續與我們的行業協會 ACLA 合作，鼓勵國會確保提供公平報銷的永久性立法解決方案。

Now Sam will give more details on our third quarter performance and our updated guidance for 2024. Sam?

現在，Sam 將提供有關我們第三季業績和 2024 年更新指導的更多詳細資訊。薩姆？

Thanks, Jim. In the third quarter, consolidated revenues were $2.49 billion, up 8.5% versus the prior year. Consolidated organic revenues grew by 4.2%. Revenues for Diagnostic Information Services were up 9% compared to the prior year, reflecting strong growth in our key physician and hospital channels as well as the contribution from recently closed acquisitions. As a reminder, our acquisition of LifeLabs closed towards the end of August and our outreach acquisition from Alina Health closed in September.

謝謝，吉姆。第三季綜合營收為 24.9 億美元，較上年成長 8.5%。綜合有機收入成長 4.2%。診斷資訊服務收入比上年增長 9%，反映出我們主要醫生和醫院管道的強勁增長以及最近完成的收購的貢獻。提醒一下，我們對 LifeLabs 的收購於 8 月底完成，對 Alina Health 的外展收購已於 9 月完成。

Total volume measured by the number of requisitions, increased 5.5% versus the third quarter of 2023, with acquisitions contributing 5% to total volume. The impact of weather and the CrowdStrike global IT outage in July negatively impacted volume by approximately 40 basis points in the quarter. Total revenue per requisition was up 3.3% versus the prior year. driven primarily by an increase in the number of tests per rec and favorable test mix driven by advanced diagnostics demand, partially offset by the impact of the recent LifeLabs acquisition, which carries a lower revenue per requisition than our typical average.

以請購數量衡量的總銷售量較 2023 年第三季增加了 5.5%，其中採購佔總銷售量的 5%。7 月天氣和 CrowdStrike 全球 IT 中斷的影響對該季度的銷售產生了約 40 個基點的負面影響。每份申請的總收入比上年增加 3.3%。主要是由於每個建議的測試數量增加以及先進診斷需求推動的有利測試組合的增加，部分被最近收購 LifeLabs 的影響所抵消，該收購帶來的每個請求的收入低於我們的典型平均水平。

Unit price reimbursement was stable, consistent with our expectations. Reported operating income in the third quarter was $330 million or 13.3% of revenues compared to $342 million or 14.9% of revenues last year. On an adjusted basis, operating income was $385 million or 15.5% of revenues compared to $380 million or 16.6% of revenues last year. The increase in adjusted operating income was due to strong organic revenue growth, and the impact of recent acquisitions, partially offset by the impact of weather and the CrowdStrike outage as well as wage increases and higher performance-based compensation.

報銷單價穩定，符合我們的預期。第三季報告的營業收入為 3.3 億美元，佔營收的 13.3%，而去年為 3.42 億美元，佔營收的 14.9%。調整後的營業收入為 3.85 億美元，佔營收的 15.5%，而去年為 3.8 億美元，佔營收的 16.6%。調整後營業收入的成長是由於強勁的有機收入成長以及近期收購的影響，但部分被天氣和 CrowdStrike 中斷的影響以及薪資上漲和更高的基於績效的薪酬所抵消。

We estimate the impact of weather and the IT outage on operating margin to be approximately 50 basis points. LifeLabs had a negligible impact on operating margin rate in the quarter. Reported EPS was $1.99 in the quarter compared to $1.96 a year ago. Adjusted EPS was $2.30 versus $2.22 the prior year. We estimate the EPS impact of weather and the IT outage to be approximately $0.08 in the quarter. Cash from operations was $870 million year-to-date through the third quarter versus $745 million in the prior year. In the third quarter, we issued $1.85 billion of senior notes with an average coupon of approximately 4.8%. Turning now to our updated full year 2024 guidance.

我們估計天氣和 IT 中斷對營運利潤率的影響約為 50 個基點。LifeLabs 對本季營業利潤率的影響可以忽略不計。本季報告的每股收益為 1.99 美元，而去年同期為 1.96 美元。調整後每股收益為 2.30 美元，上年度為 2.22 美元。我們估計天氣和 IT 中斷對本季 EPS 的影響約為 0.08 美元。截至今年第三季度，營運現金為 8.7 億美元，而去年同期為 7.45 億美元。第三季度，我們發行了18.5億美元的優先票據，平均票面利率約為4.8%。現在轉向我們更新的 2024 年全年指引。

Revenues are expected to be between $9.8 billion and $9.85 billion. Reported EPS is expected to be in a range of $7.55 and to $7.65 and adjusted EPS to be in a range of $8.85 to $8.95. Cash from operations is expected to be approximately $1.3 billion and capital expenditures are expected to be approximately $420 million. The following are key assumptions underlying our updated guidance for you to consider. The increase in our updated revenue guidance is related to recently announced and closed acquisitions with the majority being from LifeLabs.

收入預計在 98 億美元至 98.5 億美元之間。預計報告每股收益將在 7.55 美元至 7.65 美元之間，調整後每股收益將在 8.85 美元至 8.95 美元之間。營運現金預計約 13 億美元，資本支出預計約 4.2 億美元。以下是我們更新指南的關鍵假設，供您考慮。我們更新的收入指引的增加與最近宣布和完成的收購有關，其中大部分來自 LifeLabs。

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. We are projecting the disruption from Hurricane Milton to negatively impact revenues by approximately $15 million and EPS by approximately $0.08 in the fourth quarter.

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。我們預計颶風米爾頓造成的破壞將對第四季的收入產生約 1500 萬美元的負面影響，對每股收益產生約 0.08 美元的負面影響。

Operating margin expected to be down versus the prior year due to the integration of LifeLabs and the combined impact of weather and crowd strike headwinds. Excluding the impact of these items, full year operating margin is expected to be Net interest expense is expected to be approximately $200 million. Weighted average share count to be flat compared to the end of 2023. We have narrowed our adjusted EPS guidance and maintained the midpoint at $8.90 despite the impact of Hurricane Milton in the fourth quarter. While we aren't prepared to provide 2025 guidance today, I'd like to share some initial considerations as you think about next year.

由於 LifeLabs 的整合以及天氣和人群罷工逆風的綜合影響，預計營業利潤率將比去年有所下降。排除這些項目的影響，預計全年營業利潤率淨利息支出預計約為2億美元。與 2023 年底相比，加權平均股數持平。儘管第四季受到颶風米爾頓的影響，我們還是縮小了調整後每股盈餘指引，並將中點維持在 8.90 美元。雖然我們今天不准備提供 2025 年指導，但我想與您分享一些關於明年的初步考慮。

We are reaffirming our long-term outlook from 2023 through 2026 and which assumes a mid-single-digit revenue CAGR with at least 1% to [2%] growth from acquisitions and a high single-digit earnings CAGR with approximately 75 to 150 basis points of margin expansion over the three-year period. Given the 8 acquisitions we expect to complete in 2024, we will exceed our 1% to [2%] revenue growth target from acquisitions next year.

我們重申2023 年至2026 年的長期前景，並假設收入複合年增長率為中等個位數，收購增長至少為1% 至[2%]，收益複合年增長率為高個位數，約為75至150三年期間利潤率擴張的點。鑑於我們預計在 2024 年完成 8 項收購，我們明年將超過收購帶來的 1% 至 [2%] 營收成長目標。

Excluding LifeLabs, we already expect to be towards the high end of this range due to the carryover contribution from the other acquisitions that will be completed this year. Interest expense is expected to increase next year as a result of our recent debt issuance. As I noted previously, we raised $1.85 billion of senior notes with an average coupon of approximately 4.8% in August.

除 LifeLabs 外，由於今年將完成的其他收購的結轉貢獻，我們已經預計將達到該範圍的高端。由於我們最近發行了債務，預計明年的利息支出將會增加。正如我之前指出的，我們 8 月籌集了 18.5 億美元的優先票據，平均票面利率約為 4.8%。

And in March of 2025, we plan to retire $600 million of senior notes with a coupon of 3.5%. Finally, as we consider all the moving pieces hang into 2025. We expect to deliver earnings growth consistent with our long-term outlook in the high single digits.

我們計劃在 2025 年 3 月償還 6 億美元的優先票據，票息率為 3.5%。最後，我們認為所有的變化都將持續到 2025 年。我們預計獲利成長將達到高個位數，與我們的長期前景一致。

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 organic revenue growth driven by new customer wins and expanded business with physicians and hospitals as well as acquisitions. We are now on track to complete 8 acquisitions by year's end that meet our criteria for profitability, growth and returns. Our growing advanced diagnostics offering and increasing health plan access position us to drive new customer business next year. Given the strength of our business and revenue from acquisitions, we are well positioned to drive accelerated revenue growth and earnings growth in 2025.

謝謝，山姆。總而言之，在贏得新客戶、擴大與醫生和醫院的業務以及收購的推動下，我們的業務實現了強勁的總收入和有機收入成長。目前，我們預計在年底前完成 8 項符合我們獲利能力、成長和回報標準的收購。我們不斷增長的先進診斷產品和不斷增加的健康計劃訪問權限使我們能夠在明年推動新客戶業務。鑑於我們的業務實力和收購帶來的收入，我們有能力在 2025 年推動營收和獲利的加速成長。

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)

（操作員說明）

Ann Hynes, Mizuho Securities.

安·海因斯，瑞穗證券。

Thanks for all the detail in 2025. When you think about next year, how do you think the organic growth profile of the business will do? And within that, can you remind us with Haystack, is there any change in your assumptions now that you've had the assets for over a year and how you think you will do 2025?

感謝 2025 年提供的所有詳細資訊。當您考慮明年時，您認為該業務的有機成長狀況會如何？其中，您能否透過 Haystack 提醒我們，既然您已經擁有這些資產一年多了，您的假設是否有任何變化以及您認為 2025 年會如何？

Yes. So. So we just came off a very strong quarter of organic growth of 4.2%, driven by good volume growth and really nice improvements in rev per req. Those improvements in report coming with basically price (inaudible) about flat price per test but really nice increases in test per rec and test mix. So as we enter into 2025, we would put out there at this point approximately 3%. I mean it's hard to judge. It's going to go on with utilization. But by all means, and based on some of the payer report out earlier in the week and last week, it appears that utilization remains strong.

是的。所以。因此，我們剛剛經歷了一個非常強勁的季度有機成長 4.2%，這得益於良好的銷售成長和每需求轉速的巨大改善。報告中的這些改進基本上是關於每次測試的固定價格（聽不清楚）的，但每次測試和測試組合的測試確實有很好的增加。因此，當我們進入 2025 年時，我們將在此時投入約 3%。我的意思是很難判斷。它將繼續使用。但無論如何，根據本週稍早和上週發布的一些付款人報告，利用率似乎仍然強勁。

So I think an assumption of roughly 3% is solid. In terms of Haystack, we've said the dilution this year is approximately $0.20. We said the dilution going into next year would be less, and we're still on track to achieve that.

所以我認為大約 3% 的假設是可靠的。就 Haystack 而言，我們說過今年的稀釋度約為 0.20 美元。我們說過明年的稀釋度會更少，而且我們仍然有望實現這一目標。

Yes. With regards to Haystack and the incremental dilution this year is $0.20. So it's a total of $0.35 to $0.40 dilution. And it will improve next year. And we are preparing to launch the assay in the next few months here and expect to get reimbursement as we go forward as well.

是的。至於 Haystack，今年的增量稀釋為 0.20 美元。所以總共稀釋了 0.35 美元到 0.40 美元。明年情況將會有所改善。我們正準備在接下來的幾個月內在這裡啟動該檢測，並期望在我們前進的過程中獲得報銷。

Michael Cherny of Leerink Partners.

Leerink Partners 的邁克爾切爾尼。

Maybe if I can go back to just some of your commentary about the marketplace and your positioning. If I heard correctly, I think you had some incremental share gains from Elevance, Obviously, you have a combination of inorganic growth. As you think about building on Ann's question a bit relative to the organic side, how much do you feel like the growth profile is within your control relative to the share pickup relative to what you're doing on the pricing side versus market-driven. If there's any way we can break that down, that would be great.

也許我可以回顧一下您對市場和定位的一些評論。如果我沒聽錯的話，我認為您從 Elevance 中獲得了一些增量份額收益，顯然，您擁有無機增長的組合。當你考慮以安的問題為基礎，與有機方面相關時，你覺得相對於股價上漲，相對於你在定價方面所做的事情與市場驅動方面的增長情況在你的控制範圍內有多少。如果有什麼辦法可以打破這個局面，那就太好了。

Yes. So first, thanks for the question, Mike. With respect to Elevance, none of those changes take effect until the first of the year in 2025. And those changes which are allowing us to be in network in the states of Colorado and in the states of Nevada, with expanded access in Georgia and Virginia. But again, none of those changes had any impact on our third quarter results, but we expect those to help fuel organic growth going into next year.

是的。首先，謝謝你的提問，麥克。對於 Elevance，這些變更要到 2025 年初才會生效。這些變化使我們能夠進入科羅拉多州和內華達州的網絡，並擴大了喬治亞州和維吉尼亞州的訪問範圍。但同樣，這些變化都沒有對我們第三季的業績產生任何影響，但我們預計這些變化將有助於推動明年的有機成長。

Maybe if I add also with regards to pricing and share gains. I think in terms of pricing, we still expect flattish to slightly improving reimbursement dynamics within our business. I think that's the expectation going forward as it is this year. So we're seeing a positive improving reimbursement dynamic. And in addition to the increased access that Jim just talked about, we're also seeing share gains as a result of the hospital outreach acquisitions that we've made, where we've gained some -- we've shifted share and we've gained some good market share recently as a result of these acquisitions.

也許我還可以補充一下定價和股票收益方面的內容。我認為在定價方面，我們仍然預計我們業務中的報銷動態將持平或略有改善。我認為這就是今年的預期。因此，我們看到了報銷動態的正面改善。除了吉姆剛才談到的增加訪問量之外，我們還看到由於我們進行的醫院外展收購而獲得了份額增長，我們已經獲得了一些——我們已經轉移了份額，並且我們”由於這些收購，最近獲得了一些良好的市場份額。

Patrick Donnelly of Citi.

花旗銀行的派崔克唐納利。

Sam, maybe one on LifeLabs, Nice to see that close early. Can you just talk a little bit about both the margin impact, at least in near term there? I know obviously accretive to earnings, but just the margin impact. And then the progression on the earnings accretion as we get into next year. I know there's some accounting of that maybe hold it back a little bit and then it should step up.

Sam，也許是 LifeLabs 的一員，很高興看到它早點結束。能否簡單談談對利潤率的影響，至少在短期內是如此？我知道顯然會增加收益，但只是對利潤率的影響。然後，隨著我們進入明年，收入成長的進展。我知道有一些考慮可能會阻礙它一點點，然後它應該會加快。

But it would be helpful just to talk through that profile. And then lastly, just, Jim, on the M&A side because we're on the topic what the pipeline looks like? Should we expect continued smaller deals versus obviously what we saw at LifeLabs being a much larger one and what we see in there.

但僅僅討論一下該簡介就會有所幫助。最後，吉姆，在併購方面，因為我們的主題是管道是什麼樣的？我們是否應該期待繼續較小的交易，而不是我們在 LifeLabs 看到的規模大得多的交易以及我們在那裡看到的交易。

Yes. Patrick, so with regards to -- I'll talk maybe briefly about operating margins first, and then I'll talk about how LifeLabs impacted it in Q3 and what trajectories going forward. Just at a high level, we will go into too much details in terms of the actual specifics around the deal. But in Q3, operating margins were 15.5%. I would say, adjusted for weather that was closer to 16%. We had both weather and CloudStrike impacted us by about 50 basis points. There was a slight negative impact from LifeLabs as well in the quarter.

是的。派崔克，關於——我可能會先簡短地談談營業利潤率，然後我會談談 LifeLabs 在第三季如何影響它以及未來的發展軌跡。就交易的實際細節而言，我們將在較高的層面上討論太多細節。但第三季的營業利益率為 15.5%。我想說的是，根據天氣進行調整後，這一比例接近 16%。天氣和 CloudStrike 都對我們造成了約 50 個基點的影響。LifeLabs 在本季也產生了輕微的負面影響。

As you know, we had about five weeks' worth of LifeLabs revenues in there. The deal is scaling up in terms of profitability. There are some adjustments at the beginning as well in terms of some accounting adjustments, as you mentioned. But really, the margin profile of the deal is expected to increase as we go forward. Now we talked about potential $0.10 to $0.15 EPS accretion from the deal in year one, and that was assuming that the year would -- that the deal would close basically at the end of the year, so we'd have a full year in 2025.

如您所知，我們的 LifeLabs 收入大約相當於五週的收入。該交易正在擴大盈利能力。正如您所提到的，一開始也有一些調整以及一些會計調整。但實際上，隨著我們的推進，交易的利潤率預計會增加。現在我們討論了第一年該交易可能帶來 0.10 美元至 0.15 美元的每股收益增長，這是假設這一年交易將基本上在年底完成，因此我們將在 2025 年度過一整年。

So the deal closed a bit early, so we still -- we'll give more color on the Q4 call in terms of what the expectation is for 2025 specifically. But listen, at a high level, Patrick, I would just say that the operating margin to start will be below our overall operating margin as an enterprise. So it's going to be a bit dilutive in terms of operating margin rates, but accretive in terms of operating margin dollars and EPS. And it's going to ramp up over the next two to three years to eventually be at the level of Quest operating margins, but that's going to take some time. So I'd say focus more on operating margin dollars and EPS accretion that we get from the deal as opposed to the operating margin rate in the short term.

因此，交易結束得有點早，所以我們仍然會在第四季度的電話會議上就 2025 年的具體預期提供更多資訊。但是聽著，派崔克，從高水準來看，我只想說，開始的營業利潤率將低於我們作為一個企業的整體營業利潤率。因此，就營業利潤率而言，它會有點稀釋，但就營業利潤率和每股盈餘而言，會增加。未來兩到三年內，該業務的營運利潤率將持續提升，最終達到 Quest 的營運利潤率水平，但這需要一些時間。因此，我想說，更多地關注我們從交易中獲得的營業利潤率和每股收益的增加，而不是短期的營業利潤率。

Yes. Patrick, in terms of your question on the last part of your question on the funnel and M&A pipeline. So it does remain strong and lots of discussions going on with various health systems around the country. But what I would say now is we're in this phase of integration and digestion of the deals that we've just needed, including the lab assets of Path AI, Alina Health System, Ohio Health University Hospitals the three physician office labs here in New York and then obviously, lifeless. So we are hard at work at integrating these and getting the margin accretion that we've talked about. Our appetite will continue for all outreach deals, and we're always on the look for those.

是的。派崔克，關於你關於漏斗和併購管道問題的最後一部分的問題。因此，它確實仍然很強大，並且與全國各地的各個衛生系統正在進行大量討論。但我現在要說的是，我們正處於整合和消化我們剛剛需要的交易的階段，包括 Path AI、Alina Health System、俄亥俄健康大學醫院的實驗室資產，這三個醫生辦公室實驗室位於紐約顯然毫無生氣。因此，我們正在努力整合這些並獲得我們所討論的利潤成長。我們對所有外展交易的興趣將繼續存在，我們一直在尋找這些交易。

Pito Chickering of Deutsche Bank.

德意志銀行的皮托·奇克林。

Can I go back to the questions on Elevance and Centura Health on these contracts. You talked about earlier I guess, why weren't you in those contracts previously? Did you have to give any pricing concessions in other states in order to go in those markets? Or do you get pricing concessions to enter the state. I guess who is previously servicing those patients. It's just been a long time since we've seen sort of large managed care contract wins for you guys. So just curious where the central labs servicing these guys? Or is it simply payers pushing large labs to take share from hospital-based labs?

我可以回到關於 Elevance 和 Centura Health 的這些合約的問題嗎？我想你之前談過，為什麼你之前沒有簽訂這些合約？您是否必須在其他州給予任何價格優惠才能進入這些市場？或者您是否可以獲得進入該州的價格優惠。我猜是誰以前為這些病人提供服務的。我們已經很長一段時間沒有看到你們贏得大型管理式醫療合約了。所以只是好奇為這些人提供服務的中心實驗室在哪裡？還是只是付款人推動大型實驗室從醫院實驗室手中奪取份額？

Yes. So with respect to Elevance, we've been in their network broadly on a national basis. except for the markets that I indicated. Colorado and Nevada, we were completely out of their network, Georgia. We had limited access to some products, but not all in the same with Virginia. So this is just an opening up like many of the other large national labs that provide access to all the independent labs. So we feel great on that.

是的。因此，就 Elevance 而言，我們在全國範圍內廣泛參與了他們的網絡。除了我指出的市場。科羅拉多州和內華達州，我們完全脫離了他們的網絡，喬治亞州。我們對某些產品的存取受到限制，但與維吉尼亞州的情況並不相同。因此，這只是一個開放，就像許多其他大型國家實驗室一樣，可以訪問所有獨立實驗室。所以我們對此感覺很好。

Centura, we were previously not serving. It was being served by other laboratories. And -- they made the decision to put us in their network. It's a great health plan, a great health system that was in the Virginia, but the health plan actually goes down well below Virginia into the Carolinas and Florida. So we feel really, really good about that. Look, I think it represents just a commitment on behalf of these health plans to include independent labs that offer great quality, (inaudible) with great quality, great service and really competitive pricing.

Centura，我們之前沒有提供服務。它由其他實驗室提供服務。而且──他們決定將我們納入他們的網路。這是一項很棒的健康計劃，維吉尼亞州有一個很棒的醫療系統，但該健康計劃實際上遠低於維吉尼亞州，一直延伸到卡羅來納州和佛羅裡達州。所以我們對此感覺非常非常好。聽著，我認為這只是代表這些健康計劃的一個承諾，包括提供高品質（聽不清楚）的獨立實驗室，優質的服務和真正有競爭力的價格。

Brian Tanquilut of Jefferies.

傑富瑞 (Jefferies) 的布萊恩坦奎魯特 (Brian Tanquilut)。

This is [Megan Hold] on for Brian. Just going back to guidance, ex hurricane, Milton, core EPS guidance is up slightly, right, if I just check my math, the midpoint stayed at [890], but you have to add back that $0.08 per [Milton] while LifeLabs should be a little less. So can you just kind of break down that EPS guidance?

這是布萊恩的[梅根·霍爾德]。回到指導，前颶風，米爾頓，核心EPS 指導略有上升，對吧，如果我檢查一下我的數學，中點保持在[890]，但你必須加上每[Milton] 0.08 美元，而LifeLabs應該少一點。那可以分解一下 EPS 指導嗎？

Yes, sure. And to talk about EPS guidance, let me talk a little bit about revenue as well because we took up revenue, as you know, by $285 million at the midpoint, the majority of that is really M&A and the majority of the M&A was really LifeLabs. So in terms of the $285 million at the midpoint, I would say the majority really is driven by M&A, which, as we said, scales up in profitability. So little to no profitability in the initial term. To your point around EPS, we tightened the range by $0.05 on each side.

是的，當然。在談論 EPS 指導時，讓我也談談收入，因為如你所知，我們的收入中點增加了 2.85 億美元，其中大部分實際上是併購，而大部分併購實際上是 LifeLabs 。因此，就中點的 2.85 億美元而言，我想說大部分確實是由併購驅動的，正如我們所說，併購擴大了獲利能力。初期的獲利能力幾乎是零。對於您關於 EPS 的觀點，我們將範圍每邊收緊了 0.05 美元。

The midpoint remains unchanged to at $8.90. We are absorbing an $0.08 headwind from Milton in Q4. So yes, you are correct in the sense that EPS, excluding the impact of Milton, would have gone up, and that's driven by the strength of the organic business. We're seeing some -- as you saw in Q3, great rev per req at 3.3%. Organic rev per req was even higher than that. We're seeing good utilization. So some of that strength is offsetting the impact of Milton, but largely kept the EPS unchanged at the midpoint.

中點保持不變，為 8.90 美元。我們在第四季度吸收了來自 Milton 的 0.08 美元的阻力。所以，是的，你是對的，排除米爾頓的影響，每股收益將會上升，這是由有機業務的實力推動的。我們看到了一些——正如您在第三季度看到的那樣，每個需求的轉速很高，達到 3.3%。每個請求的有機轉速甚至更高。我們看到了良好的利用率。因此，部分實力抵消了米爾頓的影響，但在很大程度上使每股收益保持在中點不變。

David Westenberg of Piper Sandler

派珀·桑德勒 (Piper Sandler) 的大衛·韋斯特伯格 (David Westenberg)

Congrats on a good quarter. So I believe (inaudible) reduced pretty meaningfully. I think you're still seeing wage inflation here above historical norms. So can you just talk about some of the pushes and pulls in terms of historically low unemployment rate. Are there actually maybe some tailwinds you're seeing with insurance and other things, maybe even price increases that could help offset that?

恭喜季度表現良好。所以我相信（聽不清楚）減少非常有意義。我認為你仍然看到這裡的薪資通膨高於歷史正常。那麼您能否談談歷史低失業率方面的一些推動和拉動？您實際上是否在保險和其他方面看到了一些順風車，甚至可能有助於抵消價格上漲？

And can you talk about maybe some of the headwinds in terms of waiting wage pressures, how long they expect to continue. And if we do continue to see some of those wage pressure, are there any ways otherwise you can get operating leverage, say, AI, automation, et cetera?

您能否談談等待薪資壓力方面的一些不利因素，以及他們預計會持續多久。如果我們確實繼續看到一些薪資壓力，是否還有其他方法可以獲得營運槓桿，例如人工智慧、自動化等？

Dave, just real quick, you broke up there in the very beginning. What did you start with?

戴夫，快點，你們一開始就在那裡分手了。你是從什麼開始的？

I started there with turnover rates being reduced. However, I still believe wage inflation is above historical norms. Can you just talk about the pushes and pulls with that? And then I think you got the rest of the (inaudible) rate.

我從降低流動率開始。然而，我仍然認為薪資通膨高於歷史正常水平。能簡單談談推力和拉力嗎？然後我想你得到了剩下的（聽不清楚）費率。

Yes, we got it.

是的，我們明白了。

Yes. So as we indicated in the script, our turnover rates have come down here in 2024. So last year, they were in the low 20s, and we're now below 20% in the 18% to 19% range. Some of this still depends on job category. But overall, we've seen a really nice improvement. Now the wage inflation of 3% to 4%, I'd say it's slightly less than last year. But in terms of historical norms, if you want to go back to 2012 to 2019 kind of pre-COVID, I would tell you it was in the 2% to 3% range. So it's 100 basis points higher than it historically was.

是的。正如我們在劇本中指出的，我們的人員流動率在 2024 年已經下降。去年，他們的比例在 20% 左右，而我們現在低於 20%，在 18% 到 19% 的範圍內。其中一些仍然取決於工作類別。但總的來說，我們看到了非常好的改進。現在薪資通膨3%到4%，我想說比去年略少。但就歷史標準而言，如果你想回到 2012 年至 2019 年新冠疫情之前的情況，我會告訴你它在 2% 到 3% 的範圍內。因此，它比歷史水準高出 100 個基點。

As we walk into next year, it might be a bit early to tell, but I would still think it's going to hang closer to 3% in that range. And I think you're reading the same articles we are. The quick rate in America has certainly come down. I think unemployment is relatively stable. So I think there'll be continued tightness in the labor markets, particularly in our frontline employees.

當我們步入明年時，現在下結論可能有點早，但我仍然認為它會在這個範圍內接近 3%。我認為您正在閱讀與我們相同的文章。美國的速動利率肯定已經下降了。我認為失業率相對穩定。因此，我認為勞動市場將持續緊張，尤其是我們的第一線員工。

And by those employees, we mean our phlebotomists, our logistics, our assessment processors it's actually those positions where we see a more competitive labor environment, primarily because those three types of roles, they can move from industry to industry. They don't need to stay in the lab industry.

這些員工是指我們的抽血醫生、我們的後勤人員、我們的評估處理人員，實際上，我們看到這些職位的勞動力環境更具競爭力，主要是因為這三種類型的角色，他們可以從一個行業轉移到另一個行業。他們不需要留在實驗室行業。

Now there's lots of things we're doing to continue to offset that wage inflation. We've talked a lot about use of automation in AI in our laboratories. As we indicated in the script, we just went live with our third highly automated laboratory full automation in our Lenexa, Kansas operation. We've installed what we call some front-end specimen automation sorting types of equipment in several of our laboratories, and we're getting nice use out of that. And then we continue to expand some of our automated and AI-driven platforms like the [copan] microbiology platform, which continues to give us a ton of productivity across our laboratories.

現在我們正在做很多事情來繼續抵消薪資上漲。我們已經討論了很多關於實驗室中人工智慧自動化的使用。正如我們在腳本中指出的那樣，我們剛剛在堪薩斯州萊內克薩運營的第三個高度自動化的全自動化實驗室投入使用。我們在幾個實驗室中安裝了一些所謂的前端樣本自動化分選類型的設備，並且我們正在充分利用它。然後，我們繼續擴展一些自動化和人工智慧驅動的平台，例如 [copan] 微生物學平台，該平台繼續為我們的實驗室提供大量生產力。

Yes. And if I just add a couple of things, David, with regards to just overall productivity and leverage in the P&L, as both we look in 2024 and going forward. We are seeing a couple of positive dynamics there as well that I'm sure you're aware of. In terms of rev per req, pricing is a modest favorable. I don't mean to say that there -- it still isn't a challenging pricing environment in the health system space. But overall, we're getting flat to positive reimbursement.

是的。David，如果我補充幾件事，關於損益表中的整體生產力和槓桿率，正如我們對 2024 年和未來的展望一樣。我們也看到了一些正面的動態，我相信您也知道這一點。就每需求轉速而言，定價是適度優惠的。我並不是說這一點——衛生系統領域的定價環境仍然不具挑戰性。但總體而言，我們的補償正持平。

We're seeing test per rec continue to go up versus historically, we're seeing a nice step-up in terms of test per req as well as test mix, which are both giving us a positive in terms of overall rev per req. Utilization, we've talked about continues to be positive and also aided by the fact that we've gained share with some of the acquisitions that we've done. So overall, all of these would drive us to additional productivity and improved leverage as we look forward and this year in 2024.

我們看到每個req的測試量與歷史上相比繼續上升，我們看到每個req的測試量以及測試組合都取得了不錯的進步，這都給我們帶來了積極的每個req的整體rev。我們談到的利用率仍然是積極的，而且我們透過我們所做的一些收購獲得了份額這一事實也有所幫助。因此，總體而言，所有這些都將推動我們在展望 2024 年時提高生產力並提高槓桿率。

Jack Meehan of Nephron Research.

Nephron Research 的 Jack Meehan。

Wanted to follow up for Sam. I had a couple of follow-ups. Just trying to dig into the quarterly revenue a little bit. The first was, could you just tell me what the COVID sales were trying to gauge what the base was doing within the 4% organic growth? And then second is, looks like M&A added about $100 million of sales in the quarter. How much was the initial five weeks from LifeLabs versus everything else could have been like [50-50]?

想跟進山姆。我進行了幾次後續行動。只是想稍微深入了解一下季度營收。第一個問題是，您能否告訴我，新冠肺炎 (COVID-19) 銷售情況是如何衡量基地在 4% 有機成長範圍內的表現？其次，看起來併購在本季增加了約 1 億美元的銷售額。LifeLabs 的最初五週與其他一切可能的情況相比是多少[50-50]？

Sure, Jack. Yes. So with regards to COVID, I mean, as you have noted, we've stopped really reporting COVID and we stopped reporting base versus total because it's really become somewhat insignificant. All I would say is it was largely within our expectations in Q3. It impacted from a year -- on a year-to-year basis, it impacted growth by about 50 basis points. That was the impact of COVID in terms of total impact on revenue growth.

當然，傑克。是的。因此，關於新冠病毒，我的意思是，正如您所指出的，我們已經停止真正報告新冠病毒，我們也停止報告基數與總數，因為它確實變得有些微不足道。我想說的是，第三季的情況很大程度上符合我們的預期。它的影響從一年開始——按年計算，它對經濟成長產生了約 50 個基點的影響。這就是新冠疫情對營收成長的整體影響。

Now with regards to M&A, I think your other question, so we grew by 8.5% in total revenues for the quarter. Organic growth was about 4.2%. So we had about a 4% contribution from M&A. LifeLabs over 5 weeks or so was about $70 million roughly in terms of revenues in the quarter. So that should give you a sense as to the contribution of LifeLabs. Obviously, it's a significant portion of the M&A growth.

現在關於併購，我想你的另一個問題，所以我們本季的總收入成長了 8.5%。有機成長約4.2%。因此，併購對我們的貢獻約為 4%。LifeLabs 在 5 週左右的時間裡，該季度的收入約為 7000 萬美元。這應該讓您對 LifeLabs 的貢獻有所了解。顯然，這是併購成長的重要組成部分。

Elizabeth Anderson of Evercore.

Evercore 的伊麗莎白·安德森。

So long-term question. One, can you just confirm the DCP impact in the quarter? I know that creates some unnecessary volatility that is neutral to EPS? And then longer term, I think what you guys were saying it sounds like you're saying, in general, the unit pricing, we should think of sort of a stable to slightly positive for 2025 as well. I think that's what you're saying. I just -- if you could confirm that, that would be great.

那麼長期的問題。第一，您能否確認本季 DCP 的影響？我知道這會造成一些不必要的波動，但對每股盈餘來說是中性的？然後從長遠來看，我認為你們所說的聽起來就像你們所說的，一般來說，我們應該考慮到 2025 年的單位定價將保持穩定至略為積極。我想這就是你所說的。我只是——如果你能證實這一點，那就太好了。

Yes. With regards to DCP, abet first, thanks for the question. So on a year-to-year basis, it was up I would say, close to $10 million in the quarter itself. So it was a negative impact on operating margin in the quarter. So that should be the detail that you want. We -- it's going to it's going to ebb and flow depending on the markets, but this quarter was a negative impact year-over-year.

是的。關於DCP，首先支持一下，謝謝你的提問。因此，我想說，與去年同期相比，本季的營收成長了近 1,000 萬美元。因此，這對該季度的營業利潤率產生了負面影響。所以這應該是您想要的細節。我們——它會根據市場的情況而波動，但本季同比受到了負面影響。

And then with regards to pricing, I think the current view and what we've been seeing in 2024 is that if I kind of bifurcate that, health systems is definitely a net negative in terms of a challenging health systems environment in terms of the reimbursement and pricing dynamics. Health plans, I would say, modestly positive, flat to modestly positive.

然後就定價而言，我認為當前的觀點以及我們在2024 年所看到的情況是，如果我將這一點分開，那麼就報銷而言，衛生系統在充滿挑戰的衛生系統環境中絕對是淨負面因素和定價動態。我想說，健康計劃是適度積極的、持平到適度積極的。

So overall, when you put the pieces together and we've got the government business right now, we expect to be flat pricing as well since the PAMA cuts were deferred. So overall, I'd say the expectation is flat to slightly positive is the current view. But we'll give you more information when we give specific 2025 guidance on the Q4 call.

因此，總的來說，當你把各個部分放在一起時，我們現在已經有了政府業務，我們預計價格也會保持不變，因為 PAMA 削減被推遲。因此，總體而言，我認為目前的預期是持平或略有積極。但當我們就第四季度電話會議提供具體的 2025 年指導時，我們會向您提供更多資訊。

Erin Wright of Morgan Stanley.

摩根士丹利的艾琳·賴特。

Great. So with the hospital outreach deals and the market share gains you've been talking about that a little bit more recently. And are there specific geographies where you're seeing that sort of halo effect around these deals? Has anything changed in terms of your strategy around kind of what you target or how you're approaching these hospital outreach deals. I guess any way to quantify as well how much in terms of market share gains, this is contributing at the moment just from a either volume or revenue perspective?

偉大的。因此，隨著醫院外展交易和市場份額的增加，您最近一直在談論這一點。您是否在特定地區看到這些交易帶來的光環效應？您的目標或如何處理這些醫院外展交易的策略是否改變了？我想有什麼方法可以量化市佔率收益的多少，目前僅從銷售量或收入的角度來看？

Yes. So the 3 deals we announced, Alina in the Minneapolis market and closed OhioHealth in Columbus, Ohio and university hospitals, which we expect to close later in the quarter in Cleveland, Ohio. All three of those markets had the characteristics of the majority of independent physicians were owned by health systems lab, health systems and therefore, using the labs of those health systems. So it puts us into those three marketplace. Our share in those markets was de minimis before these acquisitions.

是的。因此，我們宣布的 3 項交易是，Alina 進入明尼阿波利斯市場，並關閉了俄亥俄州哥倫布市的 OhioHealth 和大學醫院，我們預計將在本季稍後關閉俄亥俄州克利夫蘭的大學醫院。這三個市場都具有以下特點：大多數獨立醫生屬於衛生系統實驗室、衛生系統，因此使用這些衛生系統的實驗室。因此，它將我們帶入這三個市場。在這些收購之前，我們在這些市場的市佔率微乎其微。

And so now we have a strong presence in those three markets, all of which are big markets, growing markets. And we will continue to look for other markets in the US where we have strong payer access in all of those markets, we were in network with, obviously, all the nationals and all the [Blues] plans that play in those markets. So we had strong access.

因此，現在我們在這三個市場擁有強大的影響力，所有這些都是大市場，不斷成長的市場。我們將繼續尋找美國的其他市場，在這些市場中，我們擁有強大的支付管道，顯然，我們與所有國民以及在這些市場中發揮作用的所有[Blues]計劃建立了網絡。所以我們有很強的存取權限。

But our ability to sell, given that physicians who are largely owned by the health systems was very limited. So those are the characteristics of the markets that we look for in terms of the outreach acquisitions. We look for markets where we have long access, which we do nationally. And we look for markets where health systems have dominated in that space, and they may be willing to get out of that market.

但考慮到醫生主要由衛生系統擁有，我們的銷售能力非常有限。這些就是我們在外展收購方面所尋找的市場的特徵。我們尋找能夠長期進入的市場，我們在全國範圍內這樣做。我們尋找衛生系統在該領域占主導地位的市場，並且他們可能願意退出該市場。

Stephanie Davis of Barclays.

巴克萊銀行的史蒂芬妮戴維斯。

You had in the prepared remarks comments about volume and revenue benefits from narrower networks at the MA plans. So I was curious given some of the challenges those clients are facing, could you see a potential for an accelerated pace of adoption for the strategy and forward benefits in the coming few years?

您在準備好的評論中評論了 MA 計劃中較小網絡帶來的數量和收入收益。因此，我很好奇，考慮到這些客戶面臨的一些挑戰，您是否認為未來幾年該策略的採用速度和未來效益有可能加快？

Well, I think all of the Medicare Advantage plans versus Medicare are going to have, by definition, more narrow networks. Medicare, as you know, is any willing provider. And if you look at the Medicare work spread across the country that health systems generally do fairly well in that space. Again, by definition, when a life moves from a Medicare plan to a Medicare Advantage plan, most of the Medicare Advantage plans have networks that are more defined and more narrow. So there's generally good things that come from that.

嗯，我認為所有 Medicare Advantage 計劃與 Medicare 相比，根據定義，都將擁有更狹窄的網絡。如您所知，醫療保險是任何自願的提供者。如果你看看全國範圍內的醫療保險工作，你會發現衛生系統在該領域總體上做得相當好。同樣，根據定義，當生命從 Medicare 計劃轉向 Medicare Advantage 計劃時，大多數 Medicare Advantage 計劃的網絡更加明確且更狹窄。因此，通常會帶來一些好處。

And now -- going forward, the Medicare Advantage plans, yes, they seem to be under some -- they're experiencing higher utilization. That's generally good for us. But they're experiencing profit pressures on that book of business as well.

現在 - 展望未來，醫療保險優勢計劃，是的，他們似乎在一些 - 他們正在經歷更高的利用率。一般來說，這對我們來說是好事。但他們的業務也面臨利潤壓力。

So to the extent more of that work comes to independent labs like Quest Diagnostics, it means good quality, great service and generally lower cost. So we welcome the opportunity to work the Medicare Advantage plans to continue to move work from high-priced out-of-network labs to labs like Quest Diagnostics.

因此，如果更多的工作交給像 Quest Diagnostics 這樣的獨立實驗室，這意味著良好的品質、優質的服務和整體上較低的成本。因此，我們歡迎有機會參與 Medicare Advantage 計劃，繼續將工作從高價的網外實驗室轉移到 Quest Diagnostics 等實驗室。

Lisa Gill of JPMorgan.

摩根大通的麗莎吉爾。

I just had a couple of follow-up questions on LifeLabs. So Jim, I think in your prepared remarks, you made a comment that the demographics are more favorable in Canada. Can you maybe just help us to understand what market growth looks like in Canada? And then secondly, you talked about the margins being below the corporate average at Quest today and that over two to three years, you'll get there. Can you give us an idea of what the margins look like today for LifeLabs.

我剛剛有幾個關於 LifeLabs 的後續問題。吉姆，我認為在您準備好的發言中，您評論說加拿大的人口結構更為有利。您能否幫助我們了解加拿大的市場成長？其次，您談到今天 Quest 的利潤率低於公司平均水平，並且在兩到三年內，您將達到這一目標。可以為我們介紹一下 LifeLabs 目前的利潤狀況嗎？

Yes. So first on the demographics of Canada. So the population growth of Canada is actually significantly higher than the US. So it's been north of 1% for the last several years. And so that's good news for us and for all those that participate. Second is the aging of the Canadian population is also -- the average age of the population there is north of what it is in the US. And the demographics of older people what we see in the US, obviously, Medicare and Medicare Advantage, they -- there's more recs per life. They visit physicians more frequently, generally higher acuity levels.

是的。首先是加拿大的人口統計。所以加拿大的人口成長其實明顯高於美國。所以過去幾年這個數字一直在 1% 以上。這對我們和所有參與者來說都是個好消息。其次，加拿大人口的老化也加劇──那裡的人口平均年齡高於美國。我們在美國看到的老年人的人口統計數據，顯然，醫療保險和醫療保險優勢，他們 - 每個生命都有更多的建議。他們看醫生的頻率更高，通常病情的嚴重程度也更高。

And so serving an older population is also beneficial to the industry, to us. So that's why we like the demographics of Canada. There's some variation between that in Ontario and British Columbia, the two major provinces that we serve. But in total, we think it's a great place to operate. Now in terms of the margin, yes, the operating margin rate is lower than our company average. And we expect over the next couple of years through the synergies that we expect to get and through sharing of ideas, best practices from us at them and then to us, we expect to get the margin rate back to close to Quest company average.

因此，為老年人口提供服務對這個行業、對我們來說也是有利的。這就是我們喜歡加拿大人口統計的原因。我們服務的兩個主要省份安大略省和不列顛哥倫比亞省之間存在一些差異。但總的來說，我們認為這是一個很好的營運場所。現在就利潤率而言，是的，營業利潤率低於我們公司的平均水平。我們預計，在接下來的幾年裡，透過我們期望獲得的協同效應，以及透過我們與他們和我們分享想法、最佳實踐，我們預計將使利潤率恢復到接近 Quest 公司的平均水平。

Andrew Brackmann of William Blair.

威廉布萊爾的安德魯布拉克曼。

Jim, I wanted to go back to your comment on integration and net digestion. Can you maybe just sort of talk about how your integration efforts or tactics have evolved over the last few years? Just anything you can share, which maybe gives a little bit more comfort on keeping up this accelerated pace of deals going forward?

吉姆，我想回到你對整合和網路消化的評論。您能否談談您的整合工作或策略在過去幾年中是如何演變的？您可以分享的任何內容，也許能讓您在繼續加快交易步伐方面感到更多安慰？

Yes. So it very much depends on the deal. I mean let's start with Life Labs. LifeLabs, it operates in Canada. Obviously, we're here in the US. So there's not what I would call big synergies across -- and there's no -- we're not shutting down any laboratories. We're not changing the phlebotomy network or the logistics network at all. What we do look for in opportunities like that is we look for procurement synergies, right? What are we buying things at? What are they buying things at -- and then we're going to take the best of the best price.

是的。所以這很大程度取決於交易。我的意思是讓我們從生命實驗室開始。LifeLabs，在加拿大營運。顯然，我們在美國。因此，我們不會關閉任何實驗室，也不存在我所說的巨大協同效應。我們根本不會改變放血網絡或物流網絡。我們在這樣的機會中尋找的就是採購綜效，對嗎？我們買東西的目的是什麼？他們以什麼價格購買東西——然後我們將採取最好的價格。

And in general, that is on the Quest Diagnostics side. Second is we benchmark their operations versus our operations in phlebotomy, the draws per FTE, logistics, how many stops per person in the laboratory. We benchmark not just the overall laboratory, but the departments within the laboratory, microbiology, auto chemistry. And really what it is, it's a series of best practices shared from each side.

一般來說，這是 Quest Diagnostics 方面的事情。其次，我們將他們的操作與我們在放血、每個 FTE 的抽籤、物流、每人在實驗室的停留次數等方面的操作進行基準比較。我們不僅對整個實驗室進行基準測試，還對實驗室、微生物學、汽車化學等部門進行基準測試。事實上，它是各方分享的一系列最佳實踐。

And in some cases, we learned we obviously learn things from them that we bring back into our operations. So that's the nature of Life labs. Now with the health system deals, in general, what we're acquiring is a book of business. We're not acquiring laboratories. We're not acquiring logistics, in many cases, we take on the phlebotomist that we're serving that network. So really, the integration is about number one, IT integration, integrating with all of their physicians, whether they're on [Epic] or [Cerner] or whatever EMR they're on.

在某些情況下，我們了解到我們顯然從他們身上學到了一些東西，然後將其帶回我們的營運中。這就是生命實驗室的本質。現在，在醫療系統交易中，總的來說，我們獲得的是一本商業書。我們不會收購實驗室。我們不會收購物流，在許多情況下，我們會聘請為該網路提供服務的抽血醫生。因此，實際上，集成的首要任務是 IT 集成，與所有醫生集成，無論他們使用的是 [Epic] 還是 [Cerner] 或任何 EMR。

And then second is about the movement of that work from the hospital lab into Quest Diagnostics. So we look for opportunities in logistics and again, phlebotomy to get synergies and productivity out of that. Generally, what we bring to these integrations are dedicated full-time groups of people. They hit within the regional structure of Quest so depending on the region. We come in with a dedicated team that works the IT side, the phlebotomy side, logistics side and the laboratory side.

其次是關於將這項工作從醫院實驗室轉移到 Quest Diagnostics。因此，我們在物流和放血方面尋找機會，以從中獲得協同效應和生產力。一般來說，我們為這些整合帶來的是專門的全職人員。他們在 Quest 的區域結構內進行攻擊，因此取決於區域。我們擁有一支專門的團隊，負責 IT 方面、放血方面、物流方面和實驗室方面的工作。

And as Sam said in his remarks, it will take several quarters to get these books of business up to the profitability rate that we expect. But it's a lot of hard work, and the team has some deep experience in doing this.

正如薩姆在演講中所說，這些業務帳簿需要幾個季度才能達到我們預期的獲利率。但這是一項艱鉅的工作，團隊在這方面有一些深厚的經驗。

Kevin Caliendo of UBS.

瑞銀集團 (UBS) 的凱文·卡里恩多 (Kevin Caliendo)。

I appreciate it. I just want to go through some of these moving pieces. I appreciated the color that you gave on 2025. But if we just kind of think of -- tell me I'm not thinking about this incorrectly. Revenue growth should probably be better given all the M&A that's maturing into next year. You talked about the organic growth still estimated to be up 3% roughly.

我很感激。我只想回顧一下其中一些感人的片段。我很欣賞你為 2025 年所賦予的色彩。但如果我們想一想——告訴我我沒有錯誤地思考這個問題。考慮到所有併購活動將於明年到期，收入成長可能會更好。您談到有機成長預計仍將成長 3% 左右。

The cost trends wages and the like 3% to 4%, 3%, hopefully, Invigorate is there to offset that, plus you add in the benefit of the maturation of LifeLabs, which $0.10 to $0.15 is probably going to be more than that as you're getting an extra quarter than you anticipated. And you have Haystack dilution coming down. Isn't it I mean, unless I'm not thinking about the impact or there is a negative impact to core margins, shouldn't EPS grow faster next year than your traditional CAGR, just thinking about all those moving pieces?

成本趨勢工資等 3% 到 4%，3%，希望 Invigorate 可以抵消這一點，再加上 LifeLabs 成熟的好處，這 0.10 到 0.15 美元可能會更多，因為你得到的比你預期的多了四分之一。Haystack 的稀釋度正在下降。我的意思是不是，除非我不考慮影響或對核心利潤率產生負面影響，否則明年每股收益的增長不應該比傳統的複合年增長率更快，只考慮所有這些移動因素嗎？

Yes. So I think you've got the moving pieces right, Kevin. As you said, we've got -- and as we talked about in the prepared remarks, we've got M&A excluding LifeLabs growing at the high end of the range that we've given, about 2%. We've got LifeLabs adding a full year worth of revenues in there. So that will help revenues as well.

是的。所以我認為你已經做好了準備，凱文。正如您所說，正如我們在準備好的演講中談到的那樣，我們的併購（不包括 LifeLabs）在我們給出的範圍的高端增長，約為 2%。我們已經讓 LifeLabs 增加了全年的收入。因此這也將有助於收入。

So yes, revenue growth will be faster. We've got the -- also the carryover from some of the M&A that we've done this year. You've I mean in terms of the cost headwinds right now, it's, I'd say, early to say that we're going to face lesser headwinds in general, like in terms of inflation, for instance, we're still assuming in general, that 3% to 4%. I wouldn't say that we're assuming that that's going to moderate significantly this year.

所以，是的，收入成長將會更快。我們也得到了今年進行的一些併購的結轉成果。我的意思是，就目前的成本不利因素而言，我想說的是，我們總體上將面臨較小的不利因素，例如在通貨膨脹方面，我們仍然假設一般來說，即3%至4% 。我不會說我們假設今年這種情況會顯著放緩。

So what we're seeing today is in that 3% to 4% range. I think we're expecting that to be the same. I think the pricing dynamics will give more detail on that on the Q4 call. But in general, fairly in line with what we're seeing right now, which is flat to slightly positive. Although, as I said before, we are seeing competitive dynamics in the health system space. And for now, we're saying EPS is going up in the high single digits.

所以我們今天看到的就是 3% 到 4% 的範圍。我想我們期待的是同樣的情況。我認為定價動態將在第四季的電話會議上提供更多細節。但總的來說，與我們現在所看到的情況相當一致，即持平或略有積極。儘管如此，正如我之前所說，我們看到衛生系統領域的競爭動態。目前，我們說每股收益正在以高個位數成長。

So to the extent that we provide more information on the Q4 call that's different than that, we will. But at this point, with the visibility that we have with all the moving pieces, we feel comfortable just reaffirming that growth rate for EPS. So there isn't anything here that's a negative that we're -- that you're teasing out that's not something that we're not disclosing. It's basically we feel comfortable that with all the moving parts that we're at the high end of the guidance range that we had before.

因此，只要我們提供有關第四季度電話會議的更多信息，與此不同，我們就會這樣做。但在這一點上，鑑於我們對所有活動的了解，我們對重申每股收益的成長率感到放心。因此，這裡沒有任何對我們不利的事情——你正在梳理的事情不是我們沒有披露的。基本上，我們對所有移動部件感到滿意，因為我們處於先前指導範圍的高端。

Michael Ryskin of Bank of America.

美國銀行的麥可‧萊斯金。

I'll just -- I'll close with an sort of been covered. I want to ask a little bit on PAMA. Obviously, it's been delayed. You made some comments about potentially working on a permanent legislative solution. Just could you expand on that a little bit, like what that could look like and obviously, PAMA has been delayed for a number of years now. So we're kind of used to this, but any sense of what the future could look like there, just so we're not in a constant delay cycle again?

我將以一種被覆蓋的方式結束。我想問一些關於 PAMA 的問題。顯然，它被推遲了。您對可能製定永久性立法解決方案發表了一些評論。您能否詳細說明一下，就像它可能會是什麼樣子一樣，顯然，PAMA 已經推遲了好幾年了。所以我們已經習慣了這一點，但是對未來會是什麼樣子有什麼感覺，只是為了讓我們不再陷入持續的延遲週期？

Yes. So you're right. PAMA has now been delayed five straight years, and it is certainly a welcome relief to us and to our entire industry. Now having said that, look, Salsa has continued to be on the legislative agenda it's a complex task to get these things approved. There's one senate committee, two house committees that you have to work through. And as you know, with the election coming up, a lot of these committees can potentially change. The leadership can change, members can change. And so our trade association and the members of it will be hard at work once the election is over.

是的。所以你是對的。PAMA 現在已連續推遲五年，這對我們和整個行業來說無疑是一種令人欣慰的解脫。話雖如此，薩爾薩舞仍然在立法議程上，讓這些事情獲得批准是一項複雜的任務。你必須通過一個參議院委員會和兩個眾議院委員會的工作。如您所知，隨著選舉的臨近，許多委員會可能會發生變化。領導階層可以變，成員也可以變。因此，一旦選舉結束，我們的行業協會及其成員將努力工作。

And once the committee memberships are defined, we'll be hard at work to figure out who on these committees are going to support us and to put forth a fix to this constant year-over-year, I would say, battle that we have to defer these cuts. We were happy with the Solsys solution, which called for if enacted called for another year of a delay, followed by a new data collection process. There were agreed to reductions.

一旦確定了委員會的成員資格，我們將努力找出這些委員會中的哪些人將支持我們，並提出解決辦法，以解決我們每年持續不斷的戰鬥。我們對 Solsys 解決方案感到滿意，解決方案要求如果頒布則需要再推遲一年，然後再進行新的資料收集流程。各方同意削減。

But I'm not sure that's the solution we're going to put forth on the table. We've had 5 straight years of delayed cuts -- and while that sounds good, in fact, it's not good because we've had five really heavy years of wage inflation and other inflation, and we're going to press the case that, in fact, the Medicare rate should go up. We've gotten rates up through our commercial plans. Yes, as Sam said, there's been pressure on our hospital reference pricing. But we believe, given the inflationary environment that we've lived in from 2019 to 2024, that the rates need to go up.

但我不確定這就是我們要提出的解決方案。我們已經連續五年推遲削減開支——雖然這聽起來不錯，但事實上，這並不好，因為我們已經經歷了五年嚴重的工資通膨和其他通膨，我們將堅持以下觀點：事實上，醫療保險費率應該提高。我們已經透過商業計劃提高了費率。是的，正如薩姆所說，我們醫院的參考定價面臨壓力。但我們認為，考慮到 2019 年至 2024 年我們所居住的通膨環境，利率需要上升。

And so that's the fix that we're going to propose. We believe a new data collection process. We'll indicate that when they benchmark our pricing in -- across all the commercial plans, including what the commercial plans are paying hospital labs. I think we'll find that -- the combination of those prices would lead one to believe that Medicare pricing should go up. So that's what we're going to push for going forward.

這就是我們要提出的解決方案。我們相信新的資料收集流程。當他們對所有商業計劃的定價進行基準測試時，我們會指出這一點，包括商業計劃向醫院實驗室支付的費用。我認為我們會發現——這些價格的結合將使人們相信醫療保險定價應該會上漲。這就是我們接下來要推動的事情。

Okay. So thank you very much for joining the call today. We appreciate your support. Have a good day, everyone.

好的。非常感謝您今天參加電話會議。我們感謝您的支持。祝大家有美好的一天。

Thank you for participating in the Quest Diagnostics Third 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. A replay of the call may be accessed online at www.questdiagnostics.com/investor or by phone at (800) 839-5154 for domestic callers or (203) 369-3358 for international callers. Telephone replays will be available from approximately 10:30 AM. Eastern Time on October 22, 2024, until midnight Eastern Time November 5, 2024. Thank you for your participation, and goodbye.

感謝您參加 Quest Diagnostics 2024 年第三季電話會議。本次電話會議的準備演講稿將於今天稍晚發佈在 Quest Diagnostics 網站 www.questdiagnostics.com 上。您可以透過 www.questdiagnostics.com/investor 線上查看通話重播，也可以透過電話 (800) 839-5154（國內來電者）或 (203) 369-3358（國際來電者）查看通話重播。電話重播將於上午 10:30 左右開始提供。東部時間2024年10月22日至東部時間2024年11月5日午夜。感謝您的參與，再見。