奎斯特診斷 (DGX) 2025 Q2 法說會逐字稿

Welcome to the Quest Diagnostics second-quarter 2025 conference call. At the request of the company, this call is being recorded. The entire contents of this 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 2025 年第二季電話會議。應本公司要求，本次通話正在錄音。本次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、重新傳輸或重新廣播此通話。

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

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

Thank you, and good morning. I'm joined by Jim Davis, our Chairman, Chief Executive Officer, and President; and Sam Samad, our Chief Financial Officer. During this call, we may make forward-looking statements and will discuss non-GAAP measures. We provide a reconciliation of non-GAAP measures to comparable GAAP measures in the tables to our earnings press release. Actual results may differ materially from those projected.

謝謝，早安。與我一起出席的還有我們的董事長、執行長兼總裁 Jim Davis 和財務長 Sam Samad。在本次電話會議中，我們可能會做出前瞻性陳述，並將討論非公認會計準則指標。我們在收益新聞稿的表格中提供了非 GAAP 指標與可比較 GAAP 指標的對帳表。實際結果可能與預測結果有重大差異。

The 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. For this call, references to reported EPS refer to reported diluted EPS, and references to adjusted EPS refer to adjusted diluted EPS.

可能影響 Quest Diagnostics 未來業績的風險和不確定因素包括但不限於我們最近的 10-K 表年度報告以及隨後提交的 10-Q 表季度報告和 8-K 表當前報告中所述。對於本次電話會議，報告每股盈餘的引用是指報告稀釋每股盈餘，調整後每股盈餘的引用是指調整後稀釋每股盈餘。

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.

與我們的長期展望預測相關的成長率，包括合併收入成長、收購收入成長、有機收入成長和調整後收益成長都是複合年增長率。

Now here is Jim Davis.

現在請吉姆戴維斯發言。

Thanks, Shawn, and good morning, everyone. At our Investor Day in March, we communicated our strategy to drive growth through innovative solutions that meet the evolving needs of our customers. Our strong second-quarter results reinforce this strategic direction. Given our performance in the quarter and continued utilization trends, we're raising our full-year 2025 guidance.

謝謝，肖恩，大家早安。在三月的投資者日上，我們傳達了透過滿足客戶不斷變化的需求的創新解決方案來推動成長的策略。我們強勁的第二季業績強化了這個策略方向。鑑於我們本季的表現和持續的利用趨勢，我們提高了 2025 年全年的預期。

During the quarter, we saw strong top-line growth of 15.2%, including 5.2% organic revenue growth as increased demand for our innovative clinical solutions and expanded business from enterprise accounts complemented growth from acquisitions. Our adjusted earnings per share grew 11.5% as a result of strong top-line growth, combined with productivity gains from our deployment of automation, digitization, and other advanced technologies.

本季度，我們的營業收入強勁成長 15.2%，其中有機收入成長 5.2%，這得益於對我們創新臨床解決方案的需求增加以及企業帳戶業務的擴大，以及收購帶來的成長。由於強勁的營收成長，加上我們部署自動化、數位化和其他先進技術帶來的生產力提高，我們的調整後每股盈餘成長了 11.5%。

Before Sam provides more detail on our results, I'll highlight a few ways our strategy is enabling growth. We are focused on delivering solutions that meet the evolving needs of our core clinical customers, physicians, and hospitals as well as customers in the higher growth areas of consumer, life sciences and data analytics.

在 Sam 提供更多有關我們業績的細節之前，我將先重點介紹我們的策略促進成長的幾種方式。我們專注於提供滿足核心臨床客戶、醫生和醫院以及消費者、生命科學和數據分析等高成長領域的客戶不斷變化的需求的解決方案。

We enable growth across our customer channels through faster-growing advanced diagnostics in five key clinical areas, which are advanced cardio-metabolic, autoimmune, brain health, oncology and women's and reproductive health. In addition, acquisitions are a key growth driver, and our strategy emphasizes accretive outreach purchases and independent labs.

我們透過在五個關鍵臨床領域（高階心臟代謝、自體免疫、腦部健康、腫瘤學以及婦女和生殖健康）快速發展的先進診斷技術，推動客戶通路的成長。此外，收購是關鍵的成長動力，我們的策略強調增值外展購買和獨立實驗室。

Finally, we are focused on driving operational improvements across the business with the deployment of automation, AI and other advanced technologies for improved quality, productivity and customer and employee experiences.

最後，我們專注於透過部署自動化、人工智慧和其他先進技術來推動整個業務的營運改進，以提高品質、生產力以及客戶和員工體驗。

Here are some of the updates on the progress we have made in these areas in the second quarter. In the physician channel, we delivered approximately 20% revenue growth driven primarily by acquisitions complemented by organic revenue growth in the high single digits. Demand for our innovative clinical solutions contributed significantly to organic revenue growth as physicians ordered more tests per requisition across our portfolio, supported by strong commercial execution.

以下是我們在第二季度在這些領域取得的一些進展的最新消息。在醫生管道，我們實現了約 20% 的收入成長，這主要得益於收購，以及高個位數的有機收入成長。由於醫生在我們的產品組合中每次請求中訂購了更多測試，並得到了強大的商業執行力的支持，對我們創新臨床解決方案的需求對有機收入增長做出了重大貢獻。

We also saw robust growth from large enterprise accounts, particularly in functional medicine, a growing area of preventative health care in which providers often order a range of lab tests to identify and act on multiple health risks. Large enterprises value our ability to scale diagnostic innovation to improve access, quality, and affordability.

我們也看到大型企業帳戶的強勁成長，特別是在功能醫學領域，這是預防性醫療保健的一個不斷發展的領域，其中服務提供者通常會訂購一系列實驗室測試來識別多種健康風險並採取行動。大型企業重視我們擴大診斷創新的能力，以提高可近性、品質和可負擔性。

Later this summer, we expect to begin providing laboratory testing under our previously announced relationship with Fresenius Medical Care to support over time more than 200,000 kidney dialysis patients in the US.

今年夏天晚些時候，我們預計將根據先前宣布的與費森尤斯醫療保健的合作關係開始提供實驗室測試，以便為美國超過 20 萬名腎臟透析患者提供支援。

In the hospital channel, revenues grew low single digits with collaborative lab solutions driving our growth in the quarter. As hospitals grapple with financial pressures and shortages of skilled lab technologists, they are choosing Quest to access our best-in-class expertise, innovation, and efficiency instead of running their own lab. Our acquisition of Outreach Labs also provides hospitals with capital for investment in their core care missions. Our pipelines for hospital outreach M&A and collaborative lab solutions remains strong.

在醫院管道，收入成長了個位數，協作實驗室解決方案推動了本季的成長。由於醫院面臨財務壓力和熟練實驗室技術人員短缺的問題，他們選擇 Quest 來獲得我們一流的專業知識、創新和效率，而不是營運自己的實驗室。我們對 Outreach Labs 的收購也為醫院提供了投資其核心護理任務的資金。我們在醫院外展併購和協作實驗室解決方案的管道依然強勁。

In addition to our physician and hospital channels, we are highly focused on expanding access for our consumer channel. During the quarter, we continued to see strong growth across our expanding array of offerings, including a new women's hormone panel on questhealth.com.

除了我們的醫生和醫院管道外，我們還高度專注於擴大消費者管道的訪問管道。在本季度，我們繼續看到不斷擴大的產品系列呈現強勁增長，其中包括 questhealth.com 上新的女性荷爾蒙面板。

We recently fulfilled our 1 millionth customer order since launching this enhanced online platform in the fall of 2022, demonstrating ongoing consumer demand for greater health information. Complementing our consumer-initiated channel, we continue to expand our partnerships with top consumer and wellness brands who value our high-quality lab testing, broad access and flexible technology integrations as the lab engine inside of their offerings.

自 2022 年秋季推出這個增強型線上平台以來，我們最近完成了第 100 萬份客戶訂單，這表明消費者對更多健康資訊的需求持續存在。作為我們消費者發起管道的補充，我們繼續擴大與頂級消費者和健康品牌的合作夥伴關係，這些品牌重視我們高品質的實驗室測試、廣泛的訪問和靈活的技術集成，將其作為其產品中的實驗室引擎。

In advanced diagnostics, we delivered double-digit revenue growth in several areas, including advanced cardiometabolic, especially testing for metabolic and endocrine disorders and chronic kidney disease as well as for our analyzer autoimmune solution. In brain health, we drove robust growth for our AD-Detect blood test for Alzheimer's disease.

在先進診斷領域，我們在多個領域實現了兩位數的收入成長，包括先進的心臟代謝，特別是代謝和內分泌疾病和慢性腎臟病的檢測，以及我們的分析儀自體免疫解決方案。在大腦健康方面，我們推動了阿茲海默症的 AD-Detect 血液檢查的強勁成長。

During the quarter, we launched our new AB 42/40 and p-tau 217 AD-Detect panel which is designed to help physicians confirm amyloid brain pathology in symptomatic patients. In oncology, we are ramping up our commercial outreach to drive Haystack MRD market adoption while we also continue to convert participants from our early experience program. A recent study in the New England Journal of Medicine affirmed the high sensitivity and specificity of our Haystack MRD test, finding it identified complete response to an immunotherapy in Phase II trials several months before standard imaging tests.

在本季度，我們推出了新的 AB 42/40 和 p-tau 217 AD-Detect 面板，旨在幫助醫生確認有症狀患者的澱粉樣蛋白腦病理。在腫瘤學領域，我們正在加強商業推廣力度，以推動 Haystack MRD 的市場應用，同時我們也持續轉化早期體驗計畫的參與者。 《新英格蘭醫學雜誌》最近的一項研究證實了 Haystack MRD 檢測的高靈敏度和特異性，發現該檢測在 II 期臨床試驗中比標準影像學檢查提前數月就確定了免疫療法的完全緩解。

Finally, Quest continues to be at the forefront of serving public health needs. Earlier this month, we announced the launch of a molecular test for diagnosing Oropouche Virus, which we developed under a CDC contract to enhance the nation's preparedness for emerging infectious diseases.

最後，Quest 繼續站在滿足公共衛生需求的最前線。本月初，我們宣布推出一種用於診斷奧羅普切病毒的分子檢測，該檢測是我們與疾病預防控制中心簽訂合約後開發的，旨在增強國家對新興傳染病的防範能力。

Turning now to operational excellence. We continue to target 3% annual cost savings and productivity improvements through our Invigorate program. We are deploying innovative automation and AI technologies, including digitizing processes to improve quality, productivity and customer and employee experiences. We have now installed our front-end automation solution, which speeds specimen aliquoting and labeling at half a dozen sites.

現在來談談卓越營運。我們將繼續透過 Invigorate 計劃實現每年 3% 的成本節約和生產力提高的目標。我們正在部署創新的自動化和人工智慧技術，包括數位化流程，以提高品質、生產力以及客戶和員工體驗。我們現在已經安裝了前端自動化解決方案，可以加快六個站點的標本分裝和標記速度。

We also recently completed a successful pilot of our automated accessioning platform at our Clifton lab. We plan to roll out both solutions across our lab network through the rest of the year and into 2026. Along with automation enhancements, strong employee retention improves productivity across our operations and service lines.

我們最近也在克利夫頓實驗室成功完成了自動接收平台的試點。我們計劃在今年剩餘時間和 2026 年在我們的實驗室網路中推廣這兩種解決方案。隨著自動化程度的提高，強大的員工留任率提高了我們整個營運和服務線的生產力。

During the quarter, employee retention further improved, building on trends in recent quarters. Overall, we are pleased with our progress in the quarter, executing on our strategy to serve customers and drive gains in revenue and productivity.

本季度，員工留任率進一步提高，延續了最近幾季的趨勢。總體而言，我們對本季的進展感到滿意，我們執行了服務客戶、提高收入和生產力的策略。

And now Sam will provide more details on our performance and 2025 guidance. Sam?

現在，Sam 將提供有關我們的業績和 2025 年指導的更多詳細資訊。山姆？

Thanks, Jim. In the second quarter, consolidated revenues were $2.76 billion, up 15.2% versus the prior year. Consolidated organic revenues grew by 5.2%. Revenues for Diagnostic Information Services were up 15.7% compared to the prior year, reflecting recent acquisitions as well as organic growth in our physician and hospital channels.

謝謝，吉姆。第二季度，綜合營收為27.6億美元，較上年成長15.2%。綜合有機收入成長5.2%。診斷資訊服務收入較上年增長 15.7%，反映了最近的收購以及我們醫生和醫院管道的有機增長。

Total volume, measured by the number of requisitions, increased 16.3% versus the second quarter of 2024, with organic volume up 2.1%. Total revenue per requisition was down 0.4% versus the prior year, driven primarily by the impact of the LifeLabs acquisition, which carries a lower revenue per req. On an organic basis, revenue per requisition was up 3.3% in the quarter versus last year, driven primarily by an increase in the number of tests per requisitions and test mix.

以申請數量衡量的總量與 2024 年第二季相比增加了 16.3%，其中有機量增加了 2.1%。每項請求的總收入與前一年相比下降了 0.4%，主要原因是受到 LifeLabs 收購的影響，導致每項請求的收入較低。從有機成長來看，本季每份申請的收入比去年同期增加了 3.3%，主要原因是每份申請的測試數量和測試組合有所增加。

Unit price reimbursement remained consistent with our expectations. Reported operating income in the second quarter was $438 million or 15.9% of revenues compared to $355 million or 14.8% of revenues last year. On an adjusted basis, operating income was $466 million or 16.9% of revenues compared to $398 million or 16.6% of revenues last year. The increase in adjusted operating income was due to recent acquisitions and organic revenue growth, partially offset by wage increases.

單價補償與我們的預期一致。第二季報告的營業收入為 4.38 億美元，佔營收的 15.9%，而去年同期為 3.55 億美元，佔營收的 14.8%。經調整後，營業收入為 4.66 億美元，佔營收的 16.9%，去年為 3.98 億美元，佔營收的 16.6%。調整後營業收入的成長是由於最近的收購和有機收入的成長，但被薪資上漲部分抵銷。

Reported EPS was $2.47 in the quarter, compared to $2.03 a year ago. Adjusted EPS was $2.62 versus $2.35 the prior year. EPS in the second quarter was impacted by higher interest expense versus the prior year. Foreign exchange rates had no meaningful impact on our results.

本季報告每股收益為 2.47 美元，而去年同期為 2.03 美元。調整後每股收益為 2.62 美元，而去年同期為 2.35 美元。第二季的每股盈餘受到比去年同期更高的利息支出的影響。外匯匯率對我們的結果沒有顯著影響。

Cash from operations was $858 million year-to-date through the second quarter versus $514 million in the prior year. This year-over-year increase of 67.1% was driven by higher operating income, a onetime Cares Act tax credit and the timing of receipts and disbursements.

截至第二季度，年初至今的營運現金流為 8.58 億美元，而去年同期為 5.14 億美元。這一同比增長 67.1% 是由更高的營業收入、一次性《關懷法案》稅收抵免以及收支時間推動的。

Turning now to our updated full-year 2025 guidance. Revenues are expected to be between $10.8 billion and $10.92 billion. Reported EPS is now expected to be in a range of $8.60 to $8.80, and adjusted EPS in a range of $9.63 to $9.83. Cash from operations is now expected to be approximately $1.55 billion and capital expenditures are expected to be approximately $500 million.

現在來看看我們更新後的 2025 年全年指引。預計收入將在 108 億美元至 109.2 億美元之間。目前預計報告每股收益在8.60美元至8.80美元之間，調整後每股收益介於9.63美元至9.83美元之間。目前預計營運現金流約15.5億美元，資本支出約5億美元。

Our 2025 guidance reflects the following considerations. Our updated revenue guidance assumes approximately 3.5% to 4% organic revenue growth, in addition to contributions from acquisitions completed in 2024 and announced to date. It does not assume any contribution from prospective M&A. We are making investments in 2025 related to Project Nova, which we expect will modernize our entire order to cash process. Most of these investments will occur in the second half of the year.

我們的 2025 年指導反映了以下考慮。我們更新後的營收指引假設有機收入成長約為 3.5% 至 4%，此外還有 2024 年完成並迄今宣布的收購帶來的貢獻。它不承擔未來併購的任何貢獻。我們將在 2025 年對 Project Nova 進行投資，預計這將使我們的整個訂單到現金流程現代化。這些投資大部分將發生在下半年。

Operating margin is expected to expand versus the prior year. Our below-the-line assumptions for net interest expense, adjusted tax rate and full-year share count remain unchanged from our prior guidance. Finally, our updated EPS guidance assumes that we can absorb the impact of tariffs currently in place, primarily in Europe and China.

預計營業利潤率將比上年擴大。我們對淨利息支出、調整後稅率和全年股數的線下假設與先前的指引保持不變。最後，我們更新的每股盈餘指引假設我們可以吸收目前實施的關稅的影響，主要是在歐洲和中國。

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

說完這些，我現在把話題轉回給吉姆。

Thanks, Sam. To summarize, we delivered robust top line and bottom-line growth in the second quarter on strong execution of our strategy and utilization trends. Through our sharp customer focus, we grew demand for innovative clinical solutions and expanded business from enterprise accounts to complement growth from acquisitions.

謝謝，山姆。總而言之，憑藉強勁的策略執行和利用趨勢，我們在第二季度實現了強勁的營收和利潤成長。透過密切關注客戶，我們增加了對創新臨床解決方案的需求，並擴大了企業帳戶業務以補充收購帶來的成長。

Given our performance in the quarter and continued utilization trends, we are raising our full-year 2025 guidance. Finally, I want to thank our more than 55,000 colleagues for their hard work this quarter to fulfill our purpose to create a healthier world, one life at a time.

鑑於我們本季的表現和持續的利用趨勢，我們提高了 2025 年全年的預期。最後，我要感謝我們超過 55,000 名同事本季的辛勤工作，實現了我們的目標，創造一個更健康的世界，造福每一個生命。

Now we'd be happy to take your questions. Operator?

現在我們很樂意回答您的問題。接線生？

(Operator Instructions) Ann Hynes, Mizuho Securities.

（操作員指示） 安海因斯 (Ann Hynes)，瑞穗證券。

I want to focus my question just on the Washington backdrop, obviously, with the One Big Beautiful Bill passed and the CBO came out yesterday and said this will lead to 10 million more uninsured over the next few years between the ACA and Medicaid. How do you view that many people going uninsured? How should we view that impact on Quest over the coming years? And then secondly, as it relates to Washington, what are your thoughts on PAMA going into 2026?

我想把我的問題集中在華盛頓的背景下，顯然，隨著《一個美麗的大法案》的通過，國會預算辦公室昨天表示，這將導致在未來幾年內，在《平價醫療法案》和《醫療補助計劃》之間新增 1000 萬人沒有保險。您如何看待這麼多人沒有保險？我們該如何看待未來幾年對 Quest 的影響？其次，就華盛頓而言，您對 PAMA 進入 2026 年有何看法？

Okay. Thanks for the question. So first, let's put the One Big Beautiful Bill into some context here. First, the US health care system, we spend $5 trillion a year. And over the next 10 years, with a 5% inflation, that will amount to $62 trillion, $62 trillion. What the One Beautiful Bill Act is taking out is $1 trillion. So less than -- right around 1.5%. Now what we did read yesterday, yes, about 10 million lives could come out over the next 10 years. From a Medicaid standpoint, it's actually no impact in '26.

好的。謝謝你的提問。首先，讓我們先來了解《美麗大法案》的一些背景。首先，美國醫療保健系統每年花費5兆美元。而在未來 10 年內，如果通貨膨脹率為 5%，這一數字將達到 62 兆美元，62 兆美元。《美麗法案》的支出高達 1 兆美元。所以少於——大約 1.5%。我們昨天讀到的是，是的，未來 10 年可能會有大約 1000 萬人失去生命。從醫療補助的角度來看，它實際上對 26 年沒有影響。

Very, very little impact in '27 given that they're giving the states time to react to these changes. On the exchange, we estimate that no more than 4% to 5% of our revenue today comes from the exchange. And again, given the timing of when these lives would come out of those plans, at best, we -- worst-case scenario, we estimate no more than a 30 to 40 basis point impact on volume in 2026.

考慮到他們給各州時間去應對這些變化，所以對 27 年的影響非常小。在交易所方面，我們估計目前我們來自交易所的收入不超過4%到5%。再一次，考慮到這些生命何時會脫離這些計劃，在最好的情況下，我們估計最壞的情況，對 2026 年的交易量的影響不會超過 30 到 40 個基點。

So we don't really see that big of an impact in '26 or in '27. I think the other thing to keep in mind is with the people that are on the exchange, these people are working they have jobs. In some cases, they're small business owners or they're self-employed. And so they have incomes. And so they may be able to pay higher premiums to keep their insurance.

因此，我們實際上並不認為 26 年或 27 年會產生那麼大的影響。我認為要記住的另一件事是，對於在交易所的人來說，這些人正在工作，他們有工作。在某些情況下，他們是小企業主或個體經營者。因此他們有收入。因此他們可能需要支付更高的保費來保留他們的保險。

We also know that some people go to the exchange because they are subsidized, and they could hop on to their employers' health insurance, but they're choosing the exchange today because it is a cheaper alternative than signing on to their own employers' health plan.

我們也知道，有些人去交易所是因為他們有補貼，他們可以加入雇主的健康保險，但他們今天選擇交易所是因為它比簽署自己雇主的健康計畫更便宜。

So Ann, this is Sam. Just to underscore or reemphasize the financial assumptions that Jim briefly mentioned, and make sure that -- I'm sure we'll get more questions on this on the call, so I just want to make sure people are clear. For the Medicaid impact, we don't believe there's a material impact. We don't believe there's any impact in '26 an immaterial impact in '27.

安，這是薩姆。只是為了強調或重申吉姆簡要提到的財務假設，並確保——我相信我們會在電話會議上就此提出更多問題，所以我只是想確保人們清楚這一點。對於醫療補助的影響，我們認為不會產生實質影響。我們認為這不會對 26 年產生任何影響，也不會對 27 年產生非實質影響。

For the exchange impact, assuming these subsidies are not renewed at the end of this year, we expect in '26 approximately 30 basis points of impact on our volumes. That's what we've sized. Obviously, there's assumptions around that, but that's what we believe.

對於匯率影響，假設這些補貼在今年底不再續約，我們預期 26 年我們的銷售量將受到約 30 個基點的影響。這就是我們確定的尺寸。顯然，對此存在假設，但這就是我們所相信的。

And you also asked about PAMA. So here's the most recent update. So look, we're pursuing two strategies. Number one is PAMA reform. And number two is a sixth delay in the cuts. With respect to PAMA reform, our ACLA Trade Association has introduced language that would turn into legislation and a bill to the three committees, two in the House and one in the Senate, that ultimately decide on health care policy in the US.

您也詢問了 PAMA。這是最新的更新。所以看，我們正在推行兩種策略。第一是PAMA改革。第二是第六次延後減產。關於 PAMA 改革，我們的 ACLA 貿易協會已向最終決定美國醫療保健政策的三個委員會（眾議院兩個委員會和參議院一個委員會）提出了將轉化為立法和法案的語言。

That language is in front of the committees. We expect that to be turned into a bill later this summer. And then the traditional process will start from there. The committees discuss the bills. If there's differences between the two communities in the House and the one in the Senate together, they reconcile this and our hope is that it will turn into a bill and whether it gets voted on as an independent bill or it gets put into some larger health care type of package towards the end of the year, that remains to be seen.

這一語言已提交給委員會。我們預計該法案將在今年夏天晚些時候出台。然後傳統流程將從那裡開始。委員會討論該法案。如果眾議院和參議院的兩個團體之間存在分歧，他們會調解，我們希望它能夠變成一項法案，至於它是否會作為一項獨立法案進行投票，或者在年底前被納入某種更大的醫療保健方案，這還有待觀察。

The alternative path is obviously continue to push for another delay if we don't see the PAMA reform getting enacted this year. But I can tell you, we have strong bipartisan support in each of the three committees where this legislation will be discussed.

如果 PAMA 改革今年無法實施，那麼顯然，替代方案就是繼續推動再次延後。但我可以告訴你們，在討論這項立法的三個委員會中，我們都得到了兩黨的大力支持。

Kevin Caliendo, UBS.

瑞銀的 Kevin Caliendo。

I wanted to talk about the comment, the modernization investments. It sounds like some of it may have come forward into 2Q. Are you still anticipating sort of $0.20 for the full year? And I guess the second part of that is in the context of margins expanding year over year, you've been able to do that the first two quarters. Do you still anticipate that happening in the second half even with these modernization investments?

我想談談有關現代化投資的評論。聽起來其中一些可能已經在第二季顯現出來。您仍預計全年獲利約 0.20 美元嗎？我想，第二部分是在利潤率逐年擴大的背景下，你們在前兩個季度已經做到了這一點。即使進行了這些現代化投資，您是否仍預期下半年還會出現這種情況？

Yes. So Kevin, so this is Sam. Let me tackle the two components of your question here. With regards to modernization expenses, we had called out approximately $0.20 around modernization, and we have talked about also some QRA expenses that we're going to incur as well. And we said that we're going to incur these expenses this year.

是的。凱文，這是山姆。讓我在這裡解決您問題的兩個部分。關於現代化費用，我們已經花費了大約 0.20 美元，我們還討論了我們將要產生的一些 QRA 費用。我們說過我們今年將會產生這些費用。

We've had some QRA expenses already in the first half. We haven't had much in terms of modernization expenses yet in the first half. So the bulk of those are going to occur in the second half. In terms of margin expansion, yes, we had good healthy margin expansion in Q2 and in the first half. And our expectation for the full year is that we continue to have operating margin expansion for the full year. So that's still the prevailing assumption in our guidance.

我們在上半年已經產生了一些 QRA 支出。我們上半年的現代化支出還不多。因此，大部分變化將在下半年發生。就利潤率擴張而言，是的，我們在第二季和上半年實現了良好的利潤率擴張。我們對全年的預期是，全年營業利潤率將持續擴大。因此，這仍然是我們指導中的主流假設。

Elizabeth Anderson, Evercore ISI.

伊麗莎白·安德森，Evercore ISI。

Maybe a follow-up from Ann's question about the [HIX] exposure and maybe more broadly. If we think back to sort of uninsured utilization rates, the 30 bps of impact that you're talking about, what are you assuming in your assumptions for potential utilization of an uninsured population? And how do we think about that as maybe a potential offset to some of the headwinds that you described from that One Big Beautiful Bill?

這可能是安關於 [HIX] 曝光問題的後續問題，也可能是更廣泛的問題。如果我們回想一下無保險利用率，也就是您所說的 30 個基點的影響，您對無保險人口的潛在利用率的假設是什麼？我們如何看待它，也許可以抵消您所描述的“一項美麗大法案”帶來的一些不利因素？

Yes. Thanks for the question. So the uninsured is a very small portion of our revenue today. Now again, if you take all the lives that you expect to fall out of the exchange, again, we believe, call it, 65%, 70% are going to find other alternatives, okay?

是的。謝謝你的提問。因此，無保險人群僅占我們目前收入的一小部分。現在再說一遍，如果你把所有你預計會從交換中消失的生命都考慮進去，我們相信，65%、70% 的人會去尋找其他的選擇，好嗎？

Alternative, number one is they just simply pay the higher rate. Alternative number two is they hop on to an employer's insurance plan that already exists out there. The third alternative is that they go uninsured. But again, we don't think that's going to be the majority of the people because, again, the majority of the folks that are on exchange programs today, they have income.

替代方案之一是他們只需支付更高的費率。第二個選擇是，他們加入已經存在的雇主保險計劃。第三種選擇就是不投保。但是，我們不認為這會成為大多數人，因為今天參加交換計畫的大多數人都有收入。

By definition, they're not on Medicaid because they have incomes. And again, they've got the two alternatives. So we don't feel like it's going to be a major impact. As Sam said, 30 basis point impact on volume in 2026.

根據定義，他們不享有醫療補助，因為他們有收入。而且，他們又面臨兩種選擇。因此我們認為這不會產生重大影響。正如 Sam 所說，2026 年的交易量將受到 30 個基點的影響。

Erin Wright, Morgan Stanley.

摩根士丹利的艾琳·賴特。

So last quarter, you talked a little bit about how it progressed throughout the quarter in terms of utilization trends and how that was accelerating some of that was because of the weather dynamics at the time. But how are we trending now into kind of the third quarter? I guess, how would you characterize the utilization throughout the quarter as well and with a relatively consistent -- and anything you can, I guess, parse out in terms of underlying utilization versus market share gains, that would be helpful.

因此，上個季度，您談到了整個季度利用率趨勢的進展情況，以及利用率如何加速，其中一些是由於當時的天氣動態。但是我們現在進入第三季的趨勢如何？我想，您如何描述整個季度的使用率以及相對一致的情況？我想，您可以從基礎利用率與市場佔有率成長的角度進行分析，這將會很有幫助。

Yes. Thanks for the question. So we did see strong utilization in the second quarter. And yes, it was a definite uptick from the first quarter. I would tell you that the drivers of that utilization, first and foremost, it's our expanded access that we gained on January 1 of this year.

是的。謝謝你的提問。因此我們確實看到第二季的利用率很高。是的，與第一季相比，這確實是一個上升趨勢。我想告訴你們，這種利用的驅動因素首先是我們在今年 1 月 1 日獲得的擴大使用權。

And you don't instantly just start to pick up that business. So we saw a nice steady increase from Q1 to Q2. And what I'm talking about is our access through Elevance and our access through Sentara. Elevance, got us -- we're in network in Nevada, Colorado, West Virginia, Georgia, and together with the Sentara plan, we picked up a million new lives. So we feel good about the progress that we're making there.

而且你不會立即開始開展這項業務。因此，我們看到從第一季到第二季出現了良好的穩定成長。我所說的是我們透過 Elevance 和 Sentara 實現的訪問。Elevance 幫助我們——我們的網路覆蓋內華達州、科羅拉多州、西維吉尼亞州、喬治亞州，再加上 Sentara 計劃，我們幫助了一百萬人重獲新生。因此，我們對在那裡取得的進展感到滿意。

Second is our advanced diagnostic tests, our Alzheimer's AB 42/40 test, our advanced cardiometabolic test, we continue to see nice, nice volume growth in some of these advanced diagnostics testing. And then finally, as you cite, yes, weather had a big impact in our Q1 results.

第二是我們的先進診斷測試，我們的阿茲海默症 AB 42/40 測試，我們的先進心臟代謝測試，我們繼續看到其中一些先進診斷測試的數量出現良好的增長。最後，正如您所說，天氣對我們的第一季業績有很大影響。

So I'm sure just the timing of people coming back into the health care system after they missed general health wellness exams certainly did help in the second quarter. In terms of utilization rates, as we sit here in the first part of Q3, were no real changes, where it's consistent with what we've been seeing. And again, there's a combination of good utilization plus some big wins and the expanded access through the new health plan access.

因此，我確信，人們在錯過一般健康檢查後重返醫療保健系統的時機肯定會對第二季有所幫助。就利用率而言，截至第三季前半段，並沒有出現真正的變化，這與我們所看到的情況一致。再次強調，這是良好的利用率、一些重大勝利以及透過新的健康計劃訪問擴大訪問範圍的結合。

Michael Cherny, Leerink Partners.

Leerink Partners 的 Michael Cherny。

Maybe if I can just ask a question on mix. I think, Jim, you said a 3.3% organic rev per req mix. Can you dive a little bit more into what were the drivers of that dynamic? How much of it was contracting on your side, offensive moves versus just the way the market developed? And how that should factor into your guidance for the remainder of the year?

也許我可以問一個關於混合的問題。吉姆，我想你說的是每份需求混合物的有機收入為 3.3%。您能否更深入地解釋一下這種動態的驅動因素是什麼？其中有多少是你們方面的收縮、進攻性舉措，而不是市場發展的方式？這對您今年剩餘時間的指導有何影響？

Yes. I would say the majority of it is offensive. So you're right, 3.3% organic rev per req increase. We've said for the year, price is flattish. It will come in somewhere between plus or minus 30 basis points. So the other components in rev per req are test per req and test mix and business mix, payer mix. Test per req, again, continue to be very strong.

是的。我想說大部分都是令人反感的。所以你是對的，每個請求的有機收入增加了 3.3%。我們說過，今年的價格基本上持平。其波動範圍將在正負 30 個基點之間。因此，rev per req 中的其他組成部分是 test per req、測試組合、業務組合、付款人組合。再次，根據要求進行測試，繼續保持非常強勁。

And we see it, again, with the advanced diagnostics testing, our AB 42/40 significantly -- significant growth quarter over quarter as well as year over year. Our work with functional medicine entities continues to grow in a very meaningful way. Our own CIT business, as we mentioned in the script, was up 40%, and with that comes strong test mix, strong test per req improvement.

我們再次看到，透過先進的診斷測試，我們的 AB 42/40 實現了環比和同比的顯著增長。我們與功能醫學實體的合作繼續以非常有意義的方式發展。正如我們在腳本中提到的那樣，我們自己的 CIT 業務成長了 40%，隨之而來的是強大的測試組合和強大的每個請求測試改進。

So those are the underlying drivers. I don't see a change in those drivers to tell you the truth. And we just kind of expect it will continue here in the rest of the year.

這些就是潛在的驅動因素。說實話，我沒有看到這些司機有任何改變。我們只是預計這種情況將在今年剩餘時間繼續下去。

Patrick Donnelly, Citi.

花旗銀行的 Patrick Donnelly。

Maybe quick one for Sam, just on the cadence in the second half. Can you just talk about the 3Q setup in terms of margins or earnings would be helpful. And then a follow-up on PAMA. Can you just talk about the financial setup here, what the implications are? How you guys think about potential offsets, what the pacing there. Would be helpful just to frame up the PAMA piece of it.

對 Sam 來說也許很快，只是在下半場的節奏上。您能否從利潤率或收益的角度談談第三季的安排，這會很有幫助。然後是 PAMA 的後續行動。能談談這裡的財務狀況嗎？其影響是什麼？你們對潛在的補償措施有何看法？進展如何？如果能幫我理清一下PAMA的部分就好了。

Yes. Thanks, Patrick. I think I heard your question, just let me know if I didn't quite capture it all. So I think you had mentioned what's the pacing here, especially as it relates to Q3 in terms of margin and earnings, and then you wanted some more color on PAMA, the financial impact and potential actions. So in terms of the pacing, really, I'd reiterate what we've said at the beginning of the year and I think on the Q1 call as well, which is we do expect that the pacing usually is that Q2 is our best margin and earnings quarter of the year.

是的。謝謝，派崔克。我想我聽到了您的問題，如果我沒有完全聽清楚，請告訴我。所以我認為你已經提到了這裡的節奏，特別是與第三季度的利潤率和收益相關的節奏，然後你希望更多地了解 PAMA、財務影響和潛在行動。因此，就節奏而言，實際上，我想重申我們在年初說過的話，我想在第一季度電話會議上也是如此，那就是我們確實預計節奏通常是第二季度是我們今年利潤率和收益最好的季度。

Q3 is usually, and I'm talking about traditionally what we've seen, and especially if you take out and normalize some of the COVID impacts that we've seen in past years, at least the last few years. But usually Q3 is a slight step down from Q2. And then Q4 is a step down from Q3, with Q1 being the weakest quarter. And so that's usually our, I would say, normal pacing in terms of margin and earnings. In terms of PAMA, I would say the impact that we currently size is approximately $100 million.

第三季度通常是，我談論的是傳統上我們所看到的，特別是如果你消除並正常化我們在過去幾年、至少是過去幾年看到的一些 COVID 影響。但通常 Q3 會比 Q2 略微下降。第四季較第三季有所下滑，而第一季則是表現最疲軟的一個季度。所以我想說，這通常是我們利潤率和收益方面的正常節奏。就 PAMA 而言，我想說我們目前的影響規模約為 1 億美元。

If PAMA does not get deferred for another year or if we don't get a permanent fix, we're looking at about $100 million in terms of pricing impact on our business. We've mentioned that previously. Now we will take some actions to offset some of that. I will not give you a number in terms of how much exactly that would be, but we will offset a portion of that. It's not going to be the majority. We're unable to take actions to offset the majority of $100 million. But we will take some actions to offset a portion of this negative impact if there is no permanent fix or if there is no delay.

如果 PAMA 不能再延期一年，或者我們不能得到永久的解決方案，我們的業務將受到約 1 億美元的定價影響。我們之前已經提到過這一點。現在我們將採取一些行動來抵消其中的一些影響。我不會告訴你具體是多少，但我們會抵消一部分。這不會占到大部分。我們無法採取行動抵銷這1億美元的大部分損失。但如果沒有永久性的解決方案或沒有拖延，我們將採取一些措施來抵消部分負面影響。

Pito Chickering, Deutsche Bank.

皮托·奇克林，德意志銀行。

A question to you on tariffs for your presentation that you talked about, how you're absorbing the impact of tariffs from China and Europe. Can you quantify the impact that you're absorbing? Any color on how that hits the third quarter and fourth quarter? And should we analyze the fourth-quarter impact as you [go into] 2026?

您在演講中談到了關稅問題，我想問您一個問題，您如何吸收來自中國和歐洲的關稅的影響。你能量化你所吸收的影響嗎？這對第三季和第四季有何影響？我們是否應該分析 2026 年第四季的影響？

Yes. We're not going to give a specific number, Pito. But as we've said before, I'll go back to our previous comments. We think the impact is manageable within our guidance. And so we are estimating that we would absorb this impact.

是的。我們不會給出具體的數字，皮托。但正如我們之前所說，我將回到我們先前的評論。我們認為影響在我們的指導範圍內是可控的。因此我們估計我們會吸收這種影響。

Did we have tariff impact in Q2, yes, we had some impact from tariffs in Q2 that we absorbed in our results. Q3 and Q4, we do expect some negative impact. But again, we can manage it within our guidance and the updated guidance that we provided on the call. What's assumed in our guidance today is the tariffs that are in place, that are currently in place and currently implemented per law.

是的，關稅對第二季的影響確實有一些，但我們已將其計入業績。Q3 和 Q4，我們確實預期會產生一些負面影響。但同樣，我們可以在我們的指導和我們在電話中提供的最新指導範圍內進行管理。我們今天的指導中假設的是現有的、目前已實施的和目前依法執行的關稅。

I know there's a lot of uncertainty around what's going to happen August 1. I mean, there's always a lot of scenarios around that. We have contracts in place with almost 80% of our spend on the supply side. So again, we believe that even with an August 1 scenario where tariffs do go up on certain products that we can offset, that impact through the contracts that we have in place and through the alternate sourcing supply channels that we have looking at different vendors where we can resource some of the supplies from US manufacturers or at least US-based manufacturing, not China-based manufacturing.

我知道 8 月 1 日會發生什麼事情存在著許多不確定性。我的意思是，圍繞這一點總是存在著很多情況。我們已簽訂合同，幾乎 80% 的支出用於供應方。因此，我們再次相信，即使在 8 月 1 日某些產品的關稅確實上漲的情況下，我們也可以抵消這種影響，透過我們現有的合約和透過替代採購供應管道，我們可以從不同的供應商那裡採購部分供應品，或者至少是從美國製造商，而不是中國製造商那裡採購。

Yes. Just again, to frame this, our spend of $2 billion, 80% of that spend is in the US. We've said less than 1% was China. We had already executed on some moves away from China that minimized, as Sam said, the impact in Q1 and Q2. The other 20% is spread outside the US, outside of China, with the majority of that coming from Europe with our traditional big suppliers that are located there. But as Sam said, we have contracts in place. The language is favorable to us. So we feel very comfortable that it is manageable within the guidance that we've given this year.

是的。再說一遍，我們的支出為 20 億美元，其中 80% 是在美國。我們說過，中國佔不到 1%。正如 Sam 所說，我們已經採取了一些遠離中國的舉措，將第一季和第二季的影響降至最低。剩下的20%分佈在美國以外，中國以外，其中大部分來自歐洲，我們的傳統大型供應商就位於那裡。但正如Sam所說，我們已經簽訂了合約。這種語言對我們有利。因此，我們感到非常放心，這是在今年我們給予的指導範圍內可控的。

Jack Meehan, Nephron Research.

傑克·米漢（Jack Meehan），腎元研究。

I wanted to ask about the LifeLabs acquisition. Is it possible you could call out within the $240 million or so of M&A contribution in the quarter? How much came from LifeLabs versus other deals? And then just more broadly, how is the integration going and just latest thoughts around EPS accretion?

我想問有關 LifeLabs 收購的問題。您是否可以透露本季約 2.4 億美元的併購貢獻？與其他交易相比，LifeLabs 的投資金額為何？然後更廣泛地說，整合進展如何以及有關 EPS 成長的最新想法？

I'll start and maybe talk just briefly on the financials. Maybe Jim can give some qualitative commentary on the acquisition. Listen, the acquisition is going really well is the punch line. But in terms of the contribution, Jack, on revenue. So we had 10% growth from M&A in the quarter.

我將首先簡要地談論一下財務狀況。也許吉姆可以對此次收購給予一些定性的評論。聽著，收購進展順利，這是笑點。但就貢獻而言，傑克，在收入方面。因此，本季我們的併購業務實現了 10% 的成長。

I would say approximately 8% was from LifeLabs. So that's the portion of the growth that came from LifeLabs of the 10% contribution from M&A. In terms of financial cadence or improvements that we're seeing, we had set operating margin, it's going to take a couple of years to get to be on parity with overall enterprise Quest rates. I think we're tracking to that goal, if not better. And it's generating the EPS contribution that we expect when we size this deal and when we put our plans in place for this year.

我想說大約 8% 來自 LifeLabs。這就是來自 LifeLabs 的成長部分，佔併購貢獻的 10%。就我們所看到的財務節奏或改進而言，我們已經設定了營業利潤率，需要幾年時間才能與整體企業 Quest 費率相同。我認為我們正在朝著這個目標邁進，甚至可能更好。它正在產生我們預期的每股收益貢獻，正如我們在確定這筆交易的規模並製定今年的計劃時所預期的那樣。

So progressing really well, but maybe I'll let Jim speak to the other qualitative.

進展確實很好，但也許我會讓吉姆談談其他定性問題。

Yes. So Jack, first, we have a very strong management team in place in Canada that is doing a terrific job from an execution standpoint. I would tell you that we've already gotten some really good procurement synergies, as you would expect, when we look at contracts that we have, contracts that they have. We've gotten what I would call nice operational know-how synergies, right, how we do things, how they do things. And by the way, some things, it's not just a one-way street.

是的。傑克，首先，我們在加拿大擁有一支非常強大的管理團隊，從執行的角度來看，他們的工作非常出色。我想告訴你，正如你所期望的那樣，當我們查看我們擁有的合約以及他們擁有的合約時，我們已經獲得了一些非常好的採購協同效應。我們獲得了我所說的出色的營運技術協同效應，對吧，我們如何做事，他們如何做事。順便說一句，有些事情不是單行道。

We've certainly learned some things from them from an operational standpoint that it helped us. So put all that together, and as Sam said, we're really pleased with the execution. We're pleased with the acquisition. It's generating nice top-line growth for us. Obviously, it's inorganic, but when we look at the growth of LifeLabs itself, even though it was in our numbers last Q2, we're pleased with that growth.

從營運的角度來看，我們確實從他們那裡學到了一些對我們有幫助的東西。所以把所有這些放在一起，正如 Sam 所說，我們對執行效果非常滿意。我們對此次收購感到滿意。它為我們帶來了良好的收入成長。顯然，這是無機的，但是當我們看看 LifeLabs 本身的成長時，儘管它是在我們去年第二季的數據中，但我們對這種成長感到滿意。

So all in all, we're really happy with how we're tracking.

總而言之，我們對我們的追蹤情況感到非常滿意。

David Westenberg, Piper Sandler.

大衛‧韋斯滕伯格、派珀‧桑德勒。

Congrats on a good quarter. Well, first of all, I want to talk about one of the slides that had client pay. It looks like it's contracted by about 5% over the last few years and then government has kind of gone up. Is some of that LifeLabs? And if not, what else would that be?

恭喜本季取得良好業績。好吧，首先，我想談談客戶付款的其中一張投影片。看起來，過去幾年它收縮了約 5%，然後政府的開支又有所增加。其中一些是 LifeLabs 嗎？如果不是，那還有什麼呢？

And then how should we look at that on kind of a go-forward basis? And then just a clarity on wage increases. You kind of mentioned acquisitions helped drive net operating income, offset by a little bit of wage inflation. Are we trending back to normal? Is that at least still going down? I know that's been a headwind for the last few years. So I mean, at least is that heading in the right direction now?

那我們該如何從未來的角度來看待這個問題呢？然後澄清一下薪資成長的問題。您提到收購有助於推動營業淨收入，但被一點工資上漲所抵消。我們正在回歸正常嗎？至少還在下降嗎？我知道這在過去幾年裡一直是一個阻力。所以我的意思是，至少現在這是朝著正確的方向前進嗎？

Yes. Just in terms of the payer mix, it's all driven -- you're adding in what will be over $700 million of LifeLabs revenue this year. So all of the other categories are just going to mix down by that amount. So that's what's driving that.

是的。就付款人組合而言，這一切都是由因素驅動的——今年您將增加超過 7 億美元的 LifeLabs 收入。因此，所有其他類別都將按該數量混合。這就是推動這項進程的原因。

Yes. And David, we kind of lost you there on the other parts of the question. Can you repeat because we -- maybe it's on our end, but we didn't hear the other part of the question.

是的。大衛，關於這個問題的其他部分，我們有點不明白你的意思。您能重複一遍嗎？因為我們——也許是我們這邊的問題，但我們沒有聽到問題的另一部分。

It was on the wage increases.

這是關於薪資成長的問題。

Yes, the wage increases.

是的，工資增加了。

Yes. Wage inflation has stayed in the 3% to 4% range for the first half of the year, and we don't expect that to change in the second half of the year. What has changed from a labor standpoint, though, is our attrition continues to come down, and we're in the mid-teens and getting very, very close to where we were pre-pandemic. And so as you know, that really helps us from a productivity standpoint. So pleased with that.

是的。今年上半年薪資通膨率一直維持在3%至4%的範圍內，我們預計下半年這一情況不會改變。然而，從勞動力的角度來看，情況發生了變化，我們的員工流失率持續下降，目前處於十幾歲的水平，非常非常接近疫情前的水平。所以如你所知，從生產力的角度來看，這確實對我們有幫助。我對此非常滿意。

Andrew Brackmann, William Blair.

安德魯布拉克曼、威廉布萊爾。

Jim, a few times you mentioned working with functional medicine as sort of a larger growth driver for you guys. Can you maybe help us size that as a broader opportunity? And what further investments are you making there?

吉姆，你曾多次提到，功能醫學是你們公司更大的成長動力。您能否幫助我們將其視為一個更廣闊的機會？您在那裡還進行了哪些進一步的投資？

Yes, I don't want to give exact numbers, but it's a sizable chunk of our business that's growing almost in line with our own consumer-initiated testing business. And in many ways, when we sell through functional health, it is generally either patient paid or physician paid, and then the physician is charging the consumer. As you know, in functional medicine, the goal is to analyze a lot of things in the human body, hormone levels, obviously, all the cardiometabolic, all the chemistry testing.

是的，我不想給出確切的數字，但這是我們業務中相當大的一部分，其成長幾乎與我們自己的消費者發起的測試業務同步。在很多方面，當我們透過功能健康進行銷售時，通常是患者付費或醫生付費，然後醫生向消費者收費。如您所知，功能醫學的目標是分析人體內的許多東西，荷爾蒙水平，顯然還有所有的心臟代謝，所有的化學測試。

And then functional medicine seeks to treat the patient through nutritional changes, exercise changes, sleep changes, may be supplements, but treat the patient in a very natural and holistic way. And we're seeing just a surge in this across the US, with all the focus on prevention, wellness and just people wanting to live longer. You see it in the podcasters, [Peter Atiya, Retrol, Andrew Humerman].

然後，功能醫學尋求透過營養變化、運動變化、睡眠變化（可能是補充劑）來治療患者，但以非常自然和整體的方式治療患者。我們看到全美範圍內這種現象正在激增，人們的注意力都集中在預防、健康以及希望長壽上。您可以在播客 [Peter Atiya、Retrol、Andrew Humerman] 中看到它。

These guys, in essence, are generating a lot of free markets for us. They have these podcasts, they start talking about ApoB and Lp(a). And the next thing you know, we see a surge in ApoB and Lp(a) testing. So it's become a real trend in the US as people are focused again on prevention and wellness and longevity. And it's sizable, and we expect it to grow double digits here as we move forward.

從本質上來說，這些人正在為我們創造大量自由市場。他們有這些播客，他們開始談論 ApoB 和 Lp(a)。接下來你會發現，ApoB 和 Lp(a) 檢測數量激增。因此，隨著人們再次將注意力集中在預防、健康和長壽上，這已成為美國的真正趨勢。而且它的規模相當大，我們預計隨著我們的發展，它將實現兩位數的成長。

(Operator Instructions) Tycho Peterson, Jefferies.

（操作員指示） Tycho Peterson，Jefferies。

This is Noah on for Tycho. I wanted to unpack the revenue guidance a little bit. You had raised it by around $80 million, $85 million. And I'm wondering what contribution you have baked in from new tests, things like Haystack, AD-Detect (inaudible) and then other buckets there, like acquisitions, would really be helpful.

這是 Noah 為 Tycho 所做的。我想稍微解釋一下收入指導。你已經將其籌集了大約 8000 萬美元到 8500 萬美元。我想知道您從新測試中得到了什麼貢獻，例如 Haystack、AD-Detect（聽不清楚）以及其他儲存桶，例如收購，這些真的會很有幫助。

Yes. So just in terms of breaking it down between acquisitions and organic growth, Noah. So we talked about the fact that we expect organic revenue growth now to be between 3.5% to 4%. So by default, that would tell you that the acquisitions are 6% to 6.5%. Listen, we're seeing strong -- so two things that are driving this, and I won't go into the specifics as to which tests are driving how much.

是的。因此，諾亞，就收購和有機成長之間的區別而言。因此，我們談到我們預計有機收入成長率將在 3.5% 至 4% 之間。因此預設情況下，這會告訴您收購率為 6% 到 6.5%。聽著，我們看到了強勁的——有兩件事在推動這一趨勢，我不會詳細說明哪些測試在多大程度上推動了這一趨勢。

But we have talked about the fact that some of our advanced diagnostic tests in those high-growth areas that Jim quoted earlier are driving good upside and good performance. AD-Detect being one of them, but we have many tests across these high-growth areas that are contributing to it.

但我們已經討論過這樣一個事實：我們在吉姆之前提到的那些高成長領域的一些先進的診斷測試正在推動良好的上升空間和良好的表現。AD-Detect 是其中之一，但我們在這些高成長領域進行了許多測試，這些測試也為其做出了貢獻。

Utilization is strong. As you saw in Q2, we are seeing positive utilization driven by increased access in some of those states where we got access as of January 1 this year. And we saw a good bounce back from some tough weather months in January and February and Q2 generally was strong utilization, which gives us confidence in increasing the guidance for the full year.

利用率強。正如您在第二季度看到的那樣，我們看到，自今年 1 月 1 日起，部分州的接入量有所增加，推動了利用率的積極增長。我們看到，在經歷了 1 月和 2 月的惡劣天氣後，公司業績出現了良好的反彈，第二季的利用率總體較高，這讓我們有信心提高全年業績預期。

We're seeing very strong revenue per requisition, 3.3% organic revenue per requisition in Q2, which again gives us confidence on the fact that the test per req assumptions that we have are durable and sustainable, and we're seeing good healthy mix in terms of payer mix. So all of those things are really driving our confidence in terms of increasing the revenue guide by this $85 million at the midpoint that you quoted.

我們看到每份申請的收入非常強勁，第二季度每份申請的有機收入為 3.3%，這再次讓我們相信，我們對每份申請的測試假設是持久和可持續的，而且我們看到付款人組合方面呈現良好的健康組合。因此，所有這些因素都真正增強了我們的信心，讓我們能夠按照您所說的中間值將收入指南提高 8500 萬美元。

And one other thing I would just add at the end, Noah, is the fact that pricing is still -- we are still expecting our price overall across the Quest book of business to be flattish with a potential range of outcomes of plus or minus 30 basis points. So pricing is still within the assumptions that we had earlier.

最後我還要補充一點，諾亞，事實是定價仍然 - 我們仍然預計整個 Quest 業務的整體價格將保持平穩，潛在結果範圍為正負 30 個基點。因此定價仍然在我們先前的假設範圍內。

Michael Ryskin, Bank of America.

美國銀行的邁克爾·里斯金（Michael Ryskin）。

This is Aaron on for Mike. Congrats on the quarter. I wanted to touch on Haystack a little bit and ask about any oncologist feedback or impressions and just get an overall update on progress made there.

這是 Aaron 為 Mike 表演的。恭喜本季取得佳績。我想稍微談談 Haystack，詢問腫瘤學家的反饋或印象，並了解那裡取得的進展的總體情況。

Yes. So we're making good progress. And as we stated previously, we ran this early experience program. We're seeing really nice conversion of people that sent us work as part of the early experience program in becoming full-time customers. The feedback from oncologists thus far has been very positive.

是的。所以我們正在取得良好的進展。正如我們之前所說，我們運行了這個早期體驗計劃。我們看到，在早期體驗計劃中向我們發送作品的人們已經轉變為全職客戶。到目前為止，腫瘤學家的回饋非常積極。

They recognize the superior limits of detection that we have with this test. They like the turnaround time. They like the hands-on touch that they get, the personal touch from our client team. So we're pleased with the progress. We continue to make progress from Q1 to Q2, and we expect to continue to grow that business significantly Q3, Q4 and into 2026.

他們認識到我們透過該測試所達到的較高檢測極限。他們喜歡週轉時間。他們喜歡我們客戶團隊提供的親身體驗和個人化服務。所以我們對進展感到滿意。我們從第一季到第二季持續取得進展，我們預計該業務將在第三季、第四季以及 2026 年繼續大幅成長。

Luke Sergott, Barclays.

巴克萊銀行的盧克‧塞戈特 (Luke Sergott)。

This is [Anna Pruzanski] on for Luke. I wanted to ask about organic tests per day. So a nice 2.5 step-up this quarter. Just curious how should we be thinking about this going forward since, last year, this only increased about 1% each quarter? And if you could just talk about what's driving that upside.

我是 [Anna Pruzanski]，為 Luke 報道。我想詢問每天進行的有機測試。因此本季實現了 2.5 倍的成長。只是好奇我們應該如何看待這個問題，因為去年，每個季度這個數字只增加了約 1%？您能否談談推動這項上漲的因素？

Yes. So let me start and Sam can add. As we said, what's really driving it from Q1 to Q2 was our access, right? We got into network with Elevance and Sentara on January 1 of this year. And so we've seen a nice, steady ramp-up of new clients as a result of having access to over 1 million new lives.

是的。那麼讓我開始吧，Sam 可以補充。正如我們所說，真正推動其從第一季到第二季的是我們的訪問權限，對嗎？我們於今年 1 月 1 日與 Elevance 和 Sentara 建立網路連線。由於我們接觸了超過 100 萬個新生命，因此我們看到新客戶數量穩定成長。

That includes in the states of Nevada, Colorado, West Virginia, and Georgia. The other thing driving it, we said, was our advanced diagnostics testing, just an uptick in some of these advanced cardiometabolic, autoimmune testing, women's health care testing, especially the advanced diagnostics and IPT and QHerit, and then obviously, our new brain health offerings has also helped.

其中包括內華達州、科羅拉多州、西維吉尼亞州和喬治亞州。我們說，推動這一進程的另一個因素是我們先進的診斷測試，其中一些先進的心臟代謝、自體免疫測試、女性保健測試，特別是先進的診斷和 IPT 和 QHerit 有所增加，顯然，我們的新大腦健康產品也有幫助。

We did say, yes, weather impacted the business in Q1, and so people that missed appointments, especially general health and wellness, popped back in Q2. So all of that contributed to the strong organic revenue growth. Now the other thing we saw in the quarter is -- recall last year, we have said that our employer businesses, the two employer businesses, employer pop health, plus our employer drug testing business, were a significant headwind in terms of volume and revenue growth.

我們確實說過，是的，天氣影響了第一季的業務，因此錯過預約的人，尤其是一般健康和保健方面的人，在第二季度又回來了。所有這些都促進了強勁的有機收入成長。現在我們在本季度看到的另一件事是 - 回想一下去年，我們說過我們的雇主業務，兩個雇主業務，雇主流行健康，加上我們的雇主藥物測試業務，在數量和收入增長方面面臨重大阻力。

I would tell you those two businesses have stabilized this year. It's still a bit of a volume headwind, but it actually -- those two businesses combined had revenue growth in the quarter, which obviously means if it's a volume headwind, but it helped from a growth standpoint, it means we've been raising prices in those two segments. And we've raised those prices, and they're sticky, especially in our employer drug testing business, which we're very pleased with.

我想告訴你，這兩家企業今年已經穩定下來。這仍然是一個銷量上的逆風，但實際上——這兩個業務本季的總收入都有所增長，這顯然意味著，如果這是一個銷量上的逆風，但從增長的角度來看是有幫助的，那就意味著我們一直在提高這兩個部門的價格。我們已經提高了這些價格，而且這些價格具有固定性，特別是在我們的雇主藥物測試業務中，我們對此感到非常滿意。

So put all of those things together, and that's what got us the strong organic volume growth. And our expectations is going to continue in that range for the rest of the year.

所以把所有這些因素放在一起，這就是我們實現強勁有機銷售成長的原因。我們預計今年剩餘時間的漲幅將維持在這一範圍內。

And just one last point maybe to add to Jim's great explanation is -- because I'm not sure if this is also something that you wanted color on. Rev per req as well organic rev per req was up 3.3% in the quarter, and a big portion of that was driven by test per req.

最後，也許需要補充 J​​im 的精彩解釋的是——因為我不確定這是否也是您想要的顏色。本季度，每筆訂單收入和每筆訂單有機收入上漲了 3.3%，其中很大一部分是由每筆訂單測試推動的。

I would say almost close to 70% of that was test per req appreciation. And the growth of test per req that we've seen over the past few years before the pandemic, it was less than four tests per req that we were seeing. And now we're seeing more than four tests per req. So the req density that we see from across our business has improved as well.

我想說其中幾乎接近 70% 是按要求進行的測試。在疫情爆發前的過去幾年中，我們看到每項要求的測試數量有所增長，當時每項要求的測試數量不到四次。現在我們看到每個請求有超過四次測試。因此，我們從整個業務中看到的需求密度也有所提高。

At this time, I'm showing no further questions.

目前，我沒有其他問題。

Okay. Thanks, everyone, for joining in today. I appreciate all your questions and feedback and look forward to talking to you all soon. Have a great week ahead. Thank you.

好的。感謝大家今天的參與。我感謝您提出的所有問題和回饋，並期待很快與您交談。祝您有個愉快的一周。謝謝。

Thank you for participating in the Quest Diagnostics second-quarter 2025 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 2025 年第二季電話會議。本次電話會議的準備好的發言記錄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 866-388-5361 for domestic callers or 203-369-0416 for international callers. Telephone replays will be available from approximately 10:30 AM Eastern Time on July 22, 2025, until midnight Eastern time on August 5, 2025. Goodbye.

您可以透過網站 www.questdiagnostics.com/investor 在線收聽此電話會議的重播，或撥打 866-388-5361（國內）或 203-369-0416（國際）收聽。電話重播將於 2025 年 7 月 22 日美國東部時間上午 10:30 左右開始，直至 2025 年 8 月 5 日美國東部時間午夜為止。再見。