奎斯特診斷 (DGX) 2025 Q3 法說會逐字稿

Welcome to the Quest Diagnostics third 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 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 年第三季電話會議。應本公司要求，本次通話將會被錄音。本次電話會議的全部內容，包括簡報和隨後的問答環節，均為 Quest Diagnostics 的版權所有，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本次通話內容。

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

現在，我謹向大家介紹 Quest Diagnostics 的投資人關係副總裁 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。與我一同出席的還有我們的董事長、執行長兼總裁吉姆·戴維斯，以及我們的財務長薩姆·薩馬德。在本次電話會議中，我們可能會發表前瞻性聲明，並將討論非GAAP指標。我們在獲利新聞稿的表格中提供了非GAAP指標與可比較GAAP指標的調節表。實際結果可能與預期結果有重大差異。

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 the 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. 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.

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在最新的 10-K 表格年度報告、隨後提交的 10-Q 表格季度報告以及 8-K 表格當前報告中描述的風險和不確定性。在本次電話會議中，提及的每股收益是指已公佈的稀釋每股收益，提及的每股收益是指已調整的稀釋每股收益。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，均為複合年增長率。

Now here is Jim Davis.

現在，讓我們來聽聽吉姆·戴維斯的發言。

Thanks, Shawn, and good morning, everyone. Our third quarter performance underscores strong demand for our clinical solutions, our diligent execution to meet customer needs, and our commitment to advancing our strategy. We delivered robust top and bottom line growth, extended our presence in key markets, forged new collaborations with leaders across health care, and expanded our broad portfolio of diagnostic innovations to advance better health.

謝謝肖恩，大家早安。第三季業績凸顯了市場對我們臨床解決方案的強勁需求，我們為滿足客戶需求而認真執行，以及我們致力於推進策略的決心。我們實現了強勁的營收和利潤成長，擴大了在關鍵市場的業務，與醫療保健領域的領導者建立了新的合作關係，並擴大了我們廣泛的診斷創新產品組合，以促進更好的健康。

Revenues grew 13.1%, including 6.8% organic growth driven by broad-based adoption of our clinical innovations, contributions from acquisitions and growth in our consumer channel as we position Quest as the preferred lab engine inside top wellness brands. We also announced an agreement with Corewell Health to form a lab services joint venture serving the state of Michigan. In addition, we will deploy our comprehensive Co-Lab Solutions across Corewell's nearly two dozen hospitals supporting quality, innovation, access, and productivity. Given our strong performance year-to-date, we are again raising our full year 2025 guidance.

營收成長 13.1%，其中 6.8% 的有機成長得益於我們臨床創新成果的廣泛應用、收購帶來的貢獻以及我們在消費者管道的成長，我們將 Quest 定位為頂級健康品牌中首選的實驗室引擎。我們也宣布與 Corewell Health 達成協議，成立實驗室服務合資企業，為密西根州提供服務。此外，我們將在 Corewell 旗下近二十家醫院部署我們全面的 Co-Lab 解決方案，以支援品質、創新、可及性和生產力。鑑於我們今年迄今的強勁業績，我們再次上調了2025年全年業績預期。

I'd like to take a moment to comment on efforts to reform PAMA. In September, congressional leaders introduced bipartisan legislation called the Results Act. Results is a smart, pragmatic and fair reform that seeks to correct the flaws of the original PAMA implementation. It would deliver foundational payment reforms for clinical labs by dramatically improving the accuracy of data used to set reimbursement under the clinical lab fee schedule.

我想花點時間談談對PAMA進行改革的努力。9 月，國會領導人提出了一項名為《成果法案》的兩黨立法。Results 是一項明智、務實且公平的改革，旨在糾正 PAMA 最初實施過程中存在的缺陷。它將透過大幅提高用於根據臨床實驗室收費標準設定報銷金額的數據的準確性，為臨床實驗室帶來基礎性的支付改革。

If Congress does not reform or delay PAMA this year, American labs will be forced to absorb significant payment cuts next year, threatening the ability of American seniors to access critical lab testing. We are working in partnership with our trade association ACLA and with Congress to secure meaningful PAMA relief before the new year.

如果國會今年不改革或推遲PAMA法案，美國實驗室明年將被迫承受大幅削減的付款，這將威脅到美國老年人獲得關鍵實驗室檢測的能力。我們正與產業協會 ACLA 和國會合作，爭取在新年之前獲得有意義的 PAMA 救濟。

Before turning to our third quarter results, I'll share some highlights on how 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. We enable growth across our customer channels through faster-growing advanced diagnostics in five key clinical areas, which are advanced cardiometabolic, autoimmune, brain health, oncology, and women's and reproductive health.

在介紹第三季業績之前，我將先分享我們的策略如何促進成長的一些亮點。我們致力於提供能夠滿足核心臨床客戶（醫生和醫院）以及消費品、生命科學和數據分析等高成長領域客戶不斷變化的需求的解決方案。我們透過在五個關鍵臨床領域（即高級心血管代謝、自體免疫、腦健康、腫瘤學以及女性和生殖健康）快速成長的先進診斷技術，促進客戶通路的成長。

In addition, acquisitions are a key growth driver, and our strategy emphasizes purchases of accretive hospital outreach and independent labs. 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.

此外，收購是關鍵的成長驅動力，我們的策略重點是收購能夠帶來增值效益的醫院外聯機構和獨立實驗室。最後，我們致力於透過部署自動化、人工智慧和其他先進技術來推動整個業務的營運改進，從而提高品質、生產力以及客戶和員工體驗。

Here are some updates on the progress we have made in these areas during the third quarter. In the physician channel, we delivered approximately 17% revenue growth with organic revenue growth in the high single digits. We experienced broad-based demand across our clinical solutions supported by focused commercial execution and expanded health plan access in several states, including Colorado, Georgia, Nevada, and Virginia. In addition, we continue to expand business and enterprise accounts, including functional medicine providers who utilize comprehensive laboratory testing to improve health and wellness.

以下是我們第三季在這些領域取得的一些進展。在醫生管道，我們實現了約 17% 的收入成長，其中有機收入成長達到接近兩位數。在科羅拉多州、喬治亞州、內華達州和維吉尼亞州等多個州，我們透過專注的商業執行和擴大健康計劃覆蓋範圍，獲得了廣泛的臨床解決方案需求。此外，我們繼續拓展企業客戶，包括利用綜合實驗室檢測來改善健康和福祉的功能醫學提供者。

During the quarter, we completed our acquisition of select clinical testing assets from Fresenius Medical Care, which will enable us to offer lab testing used in dialysis delivery to independent dialysis clinics in the US. More significantly, under a separate enterprise agreement, we also began to roll out clinical lab testing to Fresenius Medical Care's dialysis centers which serve about 200,000 dialysis patients annually in the US. We expect to finish scaling these services in early 2026. We look forward to processing these tests during periods of the day when we have open capacity, enabling us to further optimize the productivity of our labs.

本季度，我們完成了費森尤斯醫療公司部分臨床檢測資產的收購，這將使我們能夠向美國獨立的透析診所提供透析服務的實驗室檢測。更重要的是，根據一項單獨的企業協議，我們也開始向費森尤斯醫療的透析中心推廣臨床實驗室檢測，這些中心每年為美國約 20 萬名透析患者提供服務。我們預計將於 2026 年初完成這些服務的擴展。我們期待在一天中產能空閒的時段處理這些測試，進一步優化我們實驗室的生產力。

In the hospital channel, revenues grew low single digits with collaborative lab solutions driving our growth in the quarter. We offer hospitals many flexible options for accessing our leading science, innovation, and scale. These include reference testing, our Co-Lab Solutions, outreach acquisitions, and other business relationships, all of which provide meaningful improvements in quality, patient access and cost efficiencies.

在醫院通路，收入實現了個位數低成長，協作實驗室解決方案推動了本季的成長。我們為醫院提供多種靈活的選擇，以便他們能夠利用我們領先的科學技術、創新成果和規模優勢。這些措施包括參考測試、我們的合作實驗室解決方案、拓展收購和其他業務關係，所有這些都為品質、患者可近性和成本效益帶來了有意義的改進。

During the quarter, Quest and Corewell Health, a top health system announced plans to establish a laboratory services joint venture in Michigan with an advanced state-of-the-art lab serving the entire state. In our largest implementation of Co-Lab Solutions to date, Corewell Health will utilize our comprehensive offering, including reference testing, lab analytics, supply chain management, and blood management. Once we fully scale across Corewell's 21 hospital labs next year, we expect annual revenues from Co-Lab Solutions to be approximately $1 billion.

本季度，Quest 和頂級醫療系統 Corewell Health 宣布計劃在密西根州成立實驗室服務合資企業，該合資企業將擁有先進的尖端實驗室，為全州提供服務。迄今為止，Corewell Health 在我們規模最大的 Co-Lab Solutions 實施專案中，將利用我們全面的服務，包括參考測試、實驗室分析、供應鏈管理和血液管理。一旦我們明年在 Corewell 的 21 家醫院實驗室全面推廣，我們預計 Co-Lab Solutions 的年收入將達到約 10 億美元。

Turning to our consumer channel. We are excited by increasing momentum we saw in the third quarter as we strengthen Quest as the preferred lab engine of consumer health companies. We are delivering our extensive menu and technology inside top consumer health and wellness brands. For example, our collaborations with WHOOP, the human performance company and OURA Health, maker of the world's leading smart ring, enables seamless access to our lab testing services and results in their mobile apps.

轉向我們的消費者管道。我們對第三季取得的成長動能感到興奮，我們不斷鞏固 Quest 作為消費者健康公司首選實驗室引擎的地位。我們將豐富的菜單和技術帶入頂級消費者健康和保健品牌。例如，我們與人體機能公司 WHOOP 和世界領先的智慧戒指製造商 OURA Health 的合作，使得用戶可以透過他們的行動應用程式無縫存取我們的實驗室測試服務和結果。

In the quarter, we also saw strong doupble-digit growth from our questhealth.com consumer-initiated test platform. In Advanced Diagnostics, we delivered double-digit revenue growth across several clinical areas of our portfolio. This includes advanced cardiometabolic and endocrine as well as autoimmune disease testing with our analyzer autoimmune solution. Analyzer experienced strong growth as primary care physicians increasingly utilize this solution to direct high-risk patients to specialty care.

本季度，我們的 questhealth.com 消費者自主檢測平台也實現了強勁的兩位數成長。在高階診斷領域，我們在多個臨床領域實現了兩位數的收入成長。這包括使用我們的自體免疫分析儀解決方案進行先進的心血管代謝和內分泌以及自體免疫疾病檢測。隨著初級保健醫生越來越多地利用該解決方案將高風險患者轉診至專科治療，分析器實現了強勁增長。

In brain health, demand for our Quest AD-Detect blood test for Alzheimer's disease accelerated and more than doubled in the third quarter. New guidelines introduced in July recognized the value of blood-based biomarker testing in assessing Alzheimer's disease pathology in patients with cognitive impairment. At the same time, we continue to publish evidence on our AD-Detect test, including a study published this month that found two of our innovative panels provide confirmatory accuracy for aiding Alzheimer's diagnosis.

在腦健康領域，我們針對阿茲海默症的 Quest AD-Detect 血液檢測的需求在第三季度加速成長，翻了一番還多。7 月推出的新指南認可了基於血液的生物標記檢測在評估認知障礙患者的阿茲海默症病理學方面的價值。同時，我們繼續發布有關 AD-Detect 測試的證據，包括本月發表的一項研究，該研究發現我們的兩個創新面板為輔助診斷阿茲海默症提供了確認準確性。

In oncology, during the quarter, we received breakthrough device designation from the FDA for our Haystack MRD test. This milestone reinforces the high caliber of our cancer monitoring innovation and opens avenues for developing companion diagnostics. We also commenced separate trials with Mass General Brigham and Rutgers Cancer Institute to further research Haystack MRD's clinical utility as a guide in making postoperative therapy decisions. We are also pleased that HPH, a major lab provider in Hamburg, recently introduced an in-house MRD test in Germany based on a license to our Haystack MRD technology.

在腫瘤學領域，本季我們的 Haystack MRD 檢測獲得了 FDA 的突破性醫療器材認定。這一里程碑鞏固了我們在癌症監測創新方面的高水準，並為開發伴隨診斷開闢了道路。我們也與麻省總醫院布萊根醫院和羅格斯癌症研究所分別進行了試驗，以進一步研究 Haystack MRD 在指導術後治療決策方面的臨床應用價值。我們也很高興看到，漢堡的一家大型實驗室供應商 HPH 最近在德國推出了一項基於我們 Haystack MRD 技術許可的內部 MRD 測試。

We are highly focused on delivering innovations that can identify risk of cancer and other diseases in early preventable stages. During the quarter, we announced collaborations that leverage Quest's national scale in phlebotomy and connectivity to broaden access to cancer screening liquid biopsy tests, including Guardant's Health Shield's test for colorectal cancer.

我們高度專注於研發能夠及早發現癌症和其他疾病風險並加以預防的創新技術。本季度，我們宣布了利用 Quest 在靜脈採血和連接方面的全國規模來擴大癌症篩檢液體活檢測試的合作，包括 Guardant 的 Health Shield 結直腸癌測試。

Turning 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. During the quarter, we announced Epic as our technology partner for Project Nova, our multiyear order-to-cash transformation. By deploying a suite of Epic Solutions, including Beaker, MyChart, and Care Everywhere, we will deliver deeper, more connected insights with easier, faster, and more efficient experiences.

轉向卓越營運。我們將繼續透過「活力提升計畫」實現每年 3% 的成本節約和生產力提升目標。我們正在部署創新的自動化和人工智慧技術，包括流程數位化，以提高品質、生產力以及客戶和員工體驗。本季度，我們宣布 Epic 成為我們「Nova 計畫」（一項為期多年的訂單到現金轉型計畫）的技術合作夥伴。透過部署包括 Beaker、MyChart 和 Care Everywhere 在內的一系列 Epic 解決方案，我們將提供更深入、更緊密聯繫的洞察，以及更輕鬆、更快捷、更有效率的體驗。

Combining these leading technologies with our breadth and scale will help all patients and providers regardless of their EHR provider, get the information they need to make critical care decisions. We are in the early planning stages of this work and look forward to sharing more about the implementation on future calls. Our growth in productivity gains in the quarter demonstrate that we are executing our strategy and serving our customers and patients with both energy and purpose.

將這些領先技術與我們廣泛的資源和規模相結合，將幫助所有患者和醫療服務提供者，無論他們使用哪家電子病歷提供商，都能獲得做出關鍵護理決策所需的資訊。這項工作目前還處於早期規劃階段，期待在未來的電話會議上分享更多關於實施方面的資訊。本季生產力提升表明，我們正在執行我們的策略，並以飽滿的熱情和明確的目標為我們的客戶和患者服務。

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

接下來，Sam 將詳細介紹我們的業績和 2025 年的業績預期。山姆？

Thanks, Jim. In the third quarter, consolidated revenues were $2.82 billion, up 13.1% versus the prior year. Consolidated organic revenues grew by 6.8%. Revenues for Diagnostic Information Services were up 13.5% compared to the prior year, reflecting organic growth in our physician, hospital, and consumer channels, as well as recent acquisitions.

謝謝你，吉姆。第三季度，合併收入為 28.2 億美元，比上年同期成長 13.1%。綜合有機收入成長了6.8%。診斷資訊服務收入比去年增加 13.5%，反映了我們在醫生、醫院和消費者管道的自然成長，以及最近的收購。

Total volume measured by the number of requisitions, increased 12.5% versus the third quarter of 2024, with organic volume up 3.9%. Recall the impact of weather and the CrowdStrike global IT outage was a headwind on our volume in the third quarter last year. We estimate that our volume in the third quarter of 2025 experience a benefit of approximately 50 basis points due to the impact from those disruptions in the same period last year.

以申請數量衡量的總數量比 2024 年第三季增加了 12.5%，其中有機成長量增加了 3.9%。回想一下，去年第三季天氣和 CrowdStrike 全球 IT 系統故障對我們的業務量造成了不利影響。我們預計，由於去年同期這些中斷的影響，我們在 2025 年第三季的銷售將受益約 50 個基點。

Total revenue per requisition was up 0.8% versus the prior year as an increase in organic revenue per requisition was substantially offset by the impact of the LifeLabs acquisition which carries a lower revenue per requisition. On an organic basis, revenue per requisition was up 3% in the quarter versus last year driven primarily by an increase in the number of tests per requisitions and test mix. Unit price reimbursement remained consistent with our expectations.

與前一年相比，每份採購申請的總收入增長了 0.8%，這是因為每份採購申請的有機收入增長被 LifeLabs 收購的影響大幅抵消，而 LifeLabs 的每份採購申請收入較低。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%，這主要得益於每份申請的測試數量和測試組合的增加。單價補償與我們的預期一致。

Reported operating income in the third quarter was $386 million or 13.7% of revenues compared to $330 million or 13.3% of revenues last year. On an adjusted basis, operating income was $458 million or 16.3% of revenues compared to $385 million or 15.5% of revenues last year. The increase in adjusted operating income was due to recent acquisitions and organic revenue growth, partially offset by wage increases and higher-than-expected employee healthcare costs.

第三季報告的營業收入為 3.86 億美元，佔營收的 13.7%，而去年同期為 3.3 億美元，佔營收的 13.3%。經調整後，營業收入為 4.58 億美元，佔營收的 16.3%，去年同期為 3.85 億美元，佔營收的 15.5%。調整後營業收入的成長是由於近期收購和內生收入成長，但部分被薪資上漲和高於預期的員工醫療保健成本所抵銷。

Reported EPS was $2.16 in the quarter compared to $1.99 a year ago. Adjusted EPS was $2.60 versus $2.30 the prior year. EPS in the third quarter was impacted by higher net interest expense versus the prior year. Foreign exchange rates had no meaningful impact on our results.

本季公佈的每股收益為 2.16 美元，而去年同期為 1.99 美元。調整後每股收益為 2.60 美元，而去年同期為 2.30 美元。第三季每股收益受到淨利息支出較上年同期增加的影響。外匯匯率對我們的結果沒有產生實質影響。

Cash from operations was $1.42 billion year-to-date through the third quarter versus $870 million in the prior year. This year-over-year increase of 63.1% was driven by higher operating income, favorable working capital due to timing of receipts and disbursements, a onetime CARES Act tax credit and the cash tax benefit related to recent tax legislation.

截至第三季末，公司經營活動產生的現金流量為 14.2 億美元，而去年同期為 8.7 億美元。年增 63.1%，主要得益於營業收入增加、收支時間安排帶來的有利營運資金、一次性 CARES 法案稅收抵免以及與近期稅收立法相關的現金稅收優惠。

Turning now to our updated full year 2025 guidance. Revenues are expected to be between $10.96 billion and $11 billion. Reported EPS is expected to be in a range of $8.58 to $8.66 and adjusted EPS in the range of $9.76 to $9.84. Cash from operations is now expected to be approximately $1.8 billion, and capital expenditures are expected to be approximately $500 million.

接下來，我們來看看更新後的 2025 年全年業績指引。預計營收將在 109.6 億美元至 110 億美元之間。預計公佈的每股收益在 8.58 美元至 8.66 美元之間，調整後的每股收益在 9.76 美元至 9.84 美元之間。經營活動產生的現金流預計約 18 億美元，資本支出預計約 5 億美元。

Our 2025 guidance reflects the following considerations. Our updated revenue guidance assumes approximately 4.5% to 5% 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.

我們的 2025 年指導方針反映了以下考慮因素。我們更新後的收入預期假設有機收入成長約為 4.5% 至 5%，此外還包括 2024 年完成和迄今為止宣布的收購所帶來的貢獻。它不假設未來併購會帶來任何貢獻。

We are making investments in 2025 related to Project Nova, which we expect will modernize our entire order to cash process. We expect these expenses to ramp in the fourth quarter. Operating margin is expected to expand versus the prior year. Our updated operating cash flow guidance reflects a cash tax benefit related to recent tax legislation as well as favorability in working capital.

我們將在 2025 年對 Nova 項目進行投資，我們預計該項目將使我們的整個訂單到現金流程現代化。我們預計這些支出將在第四季大幅增加。預計營業利潤率將比上年有所成長。我們更新後的經營現金流預期反映了近期稅收立法帶來的現金稅收優惠以及營運資金的有利因素。

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

接下來，我將把麥克風交還給吉姆。

Thanks, Sam. To summarize, our third quarter performance of robust top and bottom line growth underscores strong demand for our clinical solutions, our diligent execution to meet customer needs and our commitment to advancing our strategy. We formed collaborations to support future growth, including with Corewell Health in Michigan, top consumer health brands and Epic for Project Nova. Given our strong performance year-to-date, we are raising our full year 2025 guidance.

謝謝你，山姆。總而言之，我們第三季強勁的營收和利潤成長凸顯了市場對我們臨床解決方案的強勁需求，我們為滿足客戶需求而認真執行，以及我們致力於推進策略的決心。我們建立了合作關係以支持未來的發展，包括與密西根州的 Corewell Health、頂級消費者健康品牌以及 Epic 合作進行 Project Nova 計畫。鑑於我們今年迄今的強勁業績，我們上調了2025年全年業績預期。

Finally, I want to thank our more than 55,000 colleagues for their hard work this quarter. They are the force that delivers on our purpose to create a healthier world, one life at a time.

最後，我要感謝我們超過 55,000 名同事在本季付出的辛勤努力。他們是實現我們「創造一個更健康的世界，從每個人的生命做起」這一目標的動力。

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

現在，我們很樂意回答您的問題。操作員？

(Operator Instructions) Patrick Donnelly, Citi.

（操作說明）Patrick Donnelly，花旗銀行。

Jim, maybe just on the backdrop, the utilization backdrop, it looks like it remains elevated. What are you guys seeing there and expectations into year-end?

吉姆，也許只是從背景來看，從利用率的角度來看，它似乎仍然保持高位。你們看到了什麼？對年底有什麼預期？

And then just a quick follow-up for Sam. Maybe on the PAMA side, latest expectations, what you're hearing there and the potential offsets you would have as we head into '26, maybe just the probability of how you're thinking about that.

然後，我再快速問一下 Sam 一個問題。或許在 PAMA 方面，最新的預期，你聽到的消息，以及隨著我們進入 2026 年，你可能會遇到的潛在抵消，或許只是你對此的看法。

Hey. Thanks, Patrick. So on the utilization, as we said in the script, our raw req volume was up 3.9% and then organic revpar up 3%. So let me comment on each one of those.

嘿。謝謝你，派崔克。因此，就利用率而言，正如我們在腳本中所說，我們的原始需求量增長了 3.9%，然後有機每間可供出租客房收入增長了 3%。那麼，讓我逐一談談我的看法。

On the req volume side, first, as you know, we're back in network with Elevance in some key states, Nevada, Colorado, in Virginia, and we're certainly picking up share and picking up momentum as we progress through the year. So you're just seeing a continuation of those volumes building in each of those states. In addition, CENTERA is another health plan that we're back in network with in the Virginia area as well, actually goes down the coast a bit. And so all of that has helped our -- aided the 3.9% organic req growth.

在需求方面，首先，如您所知，我們已經在一些關鍵州（內華達州、科羅拉多州、維吉尼亞州）與 Elevance 重新建立了合作關係，而且隨著今年的推進，我們的市場份額和發展勢頭肯定會越來越強勁。所以你看到的只是這些州的交易量持續成長的趨勢。此外，CENTERA 是我們在維吉尼亞地區重新合作的另一個健康保險計劃，實際上它的服務範圍也延伸到了沿海地區。因此，所有這些都幫助我們實現了 3.9% 的有機成長。

Now, in addition to that, we mentioned the strong mix on the call, autoimmune testing way up, advanced cardiometabolic testing way up, our brain health volumes more than doubled in the quarter. So all of that helping both test req plus test volume.

此外，我們在電話會議上也提到了強勁的業務組合，自體免疫檢測大幅成長，高級心血管代謝檢測大幅成長，我們的腦健康業務量在本季翻了一番還多。所以所有這些都有助於提高測試需求和測試量。

And then the thing I'd mention is our consumer business. The consumer health business, our own consumer -- our own direct channel has been incredibly strong, growing 30% to 40% on a year-to-date basis. And then our partnerships with companies like Function Health, also helping our growth on the consumer side.

然後我想提一下我們的消費者業務。消費者健康業務，我們自己的消費者—我們自己的直接管道，表現非常強勁，今年迄今成長了 30% 至 40%。此外，我們與 Function Health 等公司的合作也有助於我們在消費者方面的成長。

In the quarter, we announced partnerships. It didn't really impact our volume in the quarter, but your comment about how do we think about things going into the fourth quarter. Our partnerships with WHOOP and OURA, we definitely expect that to contribute volume on the consumer health side. So I would tell you, the expectations for Q4 is that the utilization levels will continue as we've seen them in Q3.

本季度，我們宣布了多項合作夥伴關係。雖然這並沒有真正影響到我們本季的銷量，但你關於我們如何看待第四季度前景的評論卻引起了我的思考。我們與 WHOOP 和 OURA 的合作，我們絕對期望能為消費者健康領域帶來銷售成長。因此，我可以告訴大家，預計第四季的利用率水準將與第三季一樣保持穩定。

Yeah. On PAMA, so to kind of probabilizes it here or put odds on it is difficult. I would tell you the Results Act has been proposed. We still think it's going to be not an easy one to pass, but there's also a likelihood of a PAMA delay, which we think has likely more probability than the Results Act actually passing. So we remain optimistic about a PAMA delay, although it's really hard to kind of put odds on it right now.

是的。所以，對於 PAMA 來說，很難對其進行機率預測或給出賠率。我可以告訴你，《成果法案》已經提出了。我們仍然認為通過這項法案並不容易，但《公共行政管理法案》(PAMA) 也有可能被推遲，我們認為這種情況發生的可能性比《成果法案》(Results Act) 實際通過的可能性更大。因此，我們仍然對PAMA法案的延期持樂觀態度，儘管現在很難預測其可能性。

In terms of the impact of the P&L, as we have indicated before, it's a $100 million impact next year if PAMA does come back. We will offset a portion of it. It will not be the majority of it. We will offset a portion of it that's portion of that $100 million. And remember, we control the pace of some of the investments that we have next year. So we can control and pay some of these investments if PAMA does come back, and we have to offset a portion of this hit.

就損益表的影響而言，正如我們之前所指出的，如果 PAMA 真的回歸，明年將造成 1 億美元的影響。我們將抵消其中一部分。這不會是其中的大部分。我們將抵銷其中的一部分，也就是那1億美元中的一部分。記住，我們能夠控制明年部分投資項目的進度。因此，如果 PAMA 真的回歸，我們可以控制並支付其中的一些投資，我們也必須抵消一部分損失。

Michael Cherny, Leerink Partners.

Michael Cherny，Leerink Partners。

Maybe if I can build a little bit more on the mix in the quarter and how you think about that relative to jump off point to next year relative to the LRP. As you look back versus what you outlined in March, are some of these aspects of wellness testing and specialty testing performing above expectations in line with --? And how are you thinking about framing those in terms of the contribution rate they can provide relative to where you laid out the LRP for overall organic volume, organic revenue growth back in March?

也許我可以在本季進一步完善產品組合，以及您如何看待它與明年 LRP 的起點之間的關係。回顧您在三月概述的內容，這些健康檢測和專案檢測的某些方面是否超出預期，符合預期？——？那麼，您打算如何根據這些成長所能提供的貢獻率來建立這些成長，並與您在 3 月制定的 LRP（長期計畫）中針對整體有機銷售和有機收入成長的目標進行比較呢？

Yeah. So versus expectations we set in March, I'd say the consumer channels are both our direct, and our relationships with other partners are performing slightly above what we expected going into the year. Our own direct channel is performing very well. And in addition to wellness testing that we get through that channel, there's what I would call episodic testing. So these are things like STDs, tick testing, allergy testing that people just want and -- want privacy for other reasons, they come to us directly. So our own direct channel performing better than expected.

是的。因此，與我們在 3 月設定的預期相比，我認為消費者管道，無論是我們的直接管道還是我們與其他合作夥伴的關係，其表現都略高於我們年初的預期。我們自己的直銷管道表現非常出色。除了我們透過該管道進行的健康檢測之外，還有我稱之為階段性檢測的東西。所以，像是性傳染病檢測、蜱蟲檢測、過敏測試這類人們想要的服務，以及出於其他原因想要保護隱私的服務，他們都會直接來找我們。因此，我們自己的直銷管道表現優於預期。

You can all see, I'm sure, on social media and things like that, what companies like Function Health and WHOOP and OURA are doing, and certainly, that is aiding our progress on the indirect channel as part of consumer health.

我相信大家都能在社群媒體之類的平台上看到像 Function Health、WHOOP 和 OURA 這樣的公司正在做的事情，當然，這正在幫助我們在消費者健康領域的間接管道取得進展。

Look, it's just huge momentum that is building across the country as individuals become CEOs of their own health. And with that, they turn to companies like Quest Diagnostics to get access to testing that otherwise they may not be able to get through their traditional health plans or some of the tests that these consumers want may not be acceptable through the plans. They could get denied. So that's why they turn to consumer health channels, okay? So again, as we go into the fourth quarter, and we're in the fourth quarter, as we go into the early part of next year, we expect these consumer channels to continue to gain momentum.

你看，這股勢頭正在全國範圍內不斷增強，因為每個人都開始掌控自己的健康。因此，他們會求助於像 Quest Diagnostics 這樣的公司，以獲得他們可能無法透過傳統健康計劃獲得的檢測，或者這些消費者想要的某些檢測可能不會被這些計劃所接受。他們的申請可能會被拒絕。所以這就是他們轉向消費者健康管道的原因，懂嗎？所以，隨著我們進入第四季度，也就是明年年初，我們預期這些消費通路將繼續獲得成長動能。

Michael, if I take it back to your comment compared to March or to compare to March, largely the assumptions are still intact versus what we shared during our Investor Day in March. The mid-single-digit revenue growth, including the contribution of 1% to 2% from M&A, high single-digit EPS growth, the margin expansion over the three years that we shared. All those, I would say, are pretty intact.

Michael，如果我回到你之前對三月份的評論，或者說與三月份的情況相比，基本上假設仍然與我們在三月投資者日上分享的內容相同。營收實現了中等個位數成長，其中併購貢獻了 1% 至 2%，每股盈餘實現了高個位數成長，利潤率也實現了我們之前提到的三年成長。我認為，這些都保存得相當完好。

I mean there are some definitely positive things that we're seeing around utilization, around the consumer business, around the wellness business, all the things that Jim shared. And also on the revenue side, the test per req and mix improvements that we're seeing that have a direct impact on contribution and operating margins. So all of those are really positive but not to change the long-term outlook that we provided.

我的意思是，我們在利用率、消費者業務、健康業務等方面確實看到了一些積極的方面，吉姆分享的所有內容都是如此。此外，在收入方面，我們看到每次測試需求和組合的改進對貢獻和營業利潤率產生了直接影響。所以所有這些都是非常積極的，但並不會改變我們提供的長期展望。

Elizabeth Anderson, Evercore ISI.

Elizabeth Anderson，Evercore ISI。

I have a question about sort of how you're thinking about the 4Q margins. Obviously, I think, Sam, you highlighted the step-up in Project Nova expenses, which you guys have obviously called out before. Can you talk about some of the other pluses and takes because obviously, you've had very strong margin expansion over the last four (inaudible) and I just want to make sure I understand all of the puts and takes as we think about the fourth quarter and then a jump-off into '26, but like I understand that PAMA -- ex-potential PAMA impact.

我有個問題，關於您如何看待第四季度的利潤率。顯然，我認為，Sam，你強調了 Project Nova 費用的大幅上漲，而你們之前也確實提到過這一點。您能談談其他一些利多因素和不足之處嗎？因為很明顯，過去四個季度你們的利潤率擴張非常強勁（聽不清），我只是想確保我理解所有利好因素和不足之處，因為我們要考慮第四季度以及2026年的開局，但我理解PAMA——不包括潛在的PAMA影響。

Sure, Elizabeth. Yeah, happy to talk about it. So starting with Q3 because that's the jump-off point to your question. Starting with Q3, we saw strong margins in Q3, 16.3% operating margins, healthy expansion versus same period prior year. And a lot of that is driven by utilization and driven by mix as well, both in terms of the revenue per req overall, but also the business mix, the test mix.

當然，伊麗莎白。是的，我很樂意談論這個主題。那就從問題 3 開始吧，因為這是回答你問題的切入點。從第三季開始，我們看到了強勁的利潤率，第三季營業利潤率為 16.3%，與去年同期相比實現了健康成長。其中許多因素都受到利用率和組合的影響，既包括每個需求的整體收入，也包括業務組合和測試組合。

Now, we did see an offset to the strength in operating margins in Q3 related to group health expenses, our employee medical expenses. Those came in higher than we expected in Q3. And we're fairly significant headwind on margins in Q3. I would size it as roughly 40 basis points to 50 basis points in terms of impact on operating margins.

不過，第三季營業利潤率的強勁成長確實被團體健康支出（即員工醫療支出）所抵銷。第三季這些數字都高於我們的預期。第三季利潤率面臨相當大的不利因素。就對營業利益率的影響而言，我認為大約會造成 40 到 50 個基點的影響。

We do expect those to continue at this elevated level going into Q4. I won't talk about '26 yet. It's too early. We need to look at all of our group health plans for '26 before we can guide anything towards the impact of those in '26. But I can tell you, in Q4, our expectation is they'll continue somewhat elevated and have a negative impact on margins.

我們預計這些指標在第四季將繼續保持在高位。我現在還不想談2026年的事。現在還太早了。我們需要查看所有 2026 年的團體健康計劃，才能對 2026 年的計劃產生的影響做出任何指導。但我可以告訴你，我們預計第四季度這些指標將繼續保持在較高水平，並對利潤率產生負面影響。

In terms of Q4, the only other thing I would call out is, yes, we did have -- we do expect to ramp in Nova investments in Q4. Those have largely due to the timing of signing with Epic have been pushed more into Q4. So we expect more of those in Q4 than we initially expected.

關於第四季度，我唯一要指出的是，是的，我們確實有——我們預計在第四季度加大對Nova的投資。由於與 Epic 簽約的時間安排，這些項目大多被推遲到了第四季度。因此，我們預計第四季度這類產品的數量會比我們最初預期的要多。

And then in terms of seasonality, I mean, I'd remind you of a couple of things that we traditionally see, nothing that's different. One is that if you look pre-COVID seasonality Q3 to Q4, usually, the OM trend is to be about 50 basis points to 100 basis points lower in Q4 versus Q3. So I think the seasonality trends are pretty similar in general to what we used to see pre-COVID.

至於季節性方面，我想提醒大家一些我們傳統上看到的情況，並沒有什麼不同。一是，如果你觀察新冠疫情前的第三季到第四季的季節性變化，通常情況下，第四季的 OM 趨勢會比第三季低 50 到 100 個基點。所以我認為，總體而言，季節性趨勢與新冠疫情之前我們看到的非常相似。

Elizabeth, just to summarize, on a year-to-date basis, our OM rate is up 60 basis points. And so it really does point to our productivity efforts, our Invigorate program continues to pay dividends for us. There's no let up. There's never an end goal. The goal always moves forward, and we expect those productivity efforts to continue in the back half of the year and into next year.

伊麗莎白，總結一下，今年迄今為止，我們的營運管理費率上升了 60 個基點。因此，這確實表明我們在提高生產力方面所做的努力，我們的「活力提升計劃」繼續為我們帶來回報。沒有絲毫鬆懈。永遠沒有最終目標。目標始終向前推進，我們預計這些提高生產力的努力將在今年下半年和明年繼續進行。

Kevin Caliendo, UBS.

瑞銀集團的凱文·卡利恩多。

Sam, I know you just said you don't want to talk about '26, but I have to ask a little bit just thinking about now that we sort of understand the jump-off point, we understand your LRP. PAMA aside, what other sort of headwinds and tailwinds should we be contemplating? I know there was some other investment spend that was planned. Corewell might be incremental. Is there anything sort of fundamentally or company-specific we should be thinking about when thinking about '26 relative to the LRP?

Sam，我知道你剛才說過你不想談論 '26，但既然我們現在大致了解了出發點，了解了你的 LRP，我還是得問一下。除了 PAMA 之外，我們還應該考慮哪些其他類型的逆風和順風？我知道還有其他一些投資支出計畫。Corewell 可能是漸進式的。在考慮 2026 年與長期規劃 (LRP) 的關係時，我們有哪些基本面或公司特有的因素需要考慮？

Yeah, Kevin, let me start, and then I'll turn it over to Sam here. So I think we've talked volume and utilization trends. The test per req growth, the req per req increases that come with that, we feel good about that continuing into next year. Our commitment to advanced diagnostics, the autoimmune testing, brain health, as I talked about, doubled in the quarter. All of those point to, again, increased volume and utilization trends.

好的，凱文，讓我先開始，然後我把麥克風交給山姆。所以我覺得我們已經討論了銷售和利用率趨勢。我們對測試需求成長以及隨之而來的測試需求增加感到樂觀，並認為這種趨勢將持續到明年。正如我剛才提到的，本季我們對先進診斷、自體免疫檢測和腦健康的投入翻了一番。所有這些都再次表明，銷量和利用率呈上升趨勢。

We've talked about earlier, and we mentioned in the script, we've just begun to take on the testing from Fresenius. So were two parts to that. One is Fresenius' the testing that comes from over 200,000 dialysis patients across the 3,100-plus dialysis centers were in the very early innings of integrating that work into Quest Diagnostics, plus Fersenius provided lab testing for other third-party dialysis centers.

我們之前討論過，也在劇本裡提到過，我們剛開始接受費森尤斯公司的測試。所以這其中有兩個部分。其中之一是費森尤斯公司，該公司對遍布 3100 多個透析中心的 20 多萬名透析患者進行了檢測，當時正處於將這項工作整合到 Quest Diagnostics 的早期階段，此外，費森尤斯還為其他第三方透析中心提供實驗室檢測。

That's the piece of the business that we bought, and we certainly expect to expand on that as we go into next year. Corewell, the Co-Lab portion of that just gets going here in the fourth quarter. That will expand as we -- across all 21 hospitals as we move into 2026. And then again, the strong consumer health channel.

這是我們收購的那部分業務，我們當然希望在明年擴大這部分業務。Corewell 的 Co-Lab 部分要到第四季才會啟動。隨著我們邁入 2026 年，這一目標將擴展到所有 21 家醫院。此外，強大的消費者健康管道也不容忽視。

Now, headwinds, we've talked about PAMA. Yes, there's the expiration of the health exchange, the subsidies for the health exchange, I still don't know how that's going to come out. Obviously, that's one of the big concerns during the shutdown here. And then other headwinds -- look, hospital reimbursement remains a challenging environment. Pricing on the hospital side remains challenging. And then as Sam indicated, yes, there will be a ramp up of Nova investments as we move through next year.

現在，關於逆風，我們已經討論過PAMA了。是的，還有醫療保險交易平台到期、醫療保險交易平台補貼的問題，我仍然不知道最終結果會如何。顯然，這是疫情封鎖期間人們最關心的問題之一。此外，還有其他不利因素——例如，醫院報銷仍然是一個充滿挑戰的環境。醫院方面的定價仍面臨挑戰。正如 Sam 所指出的那樣，是的，隨著明年的到來，Nova 的投資將會逐步增加。

And from -- so Kevin, from an impact on margins perspective, if I take some of Jim's comments and just give you some color around margins, not to give percentage right now or any numbers. But the utilization, the healthy environment is going to continue to drive margin expansion. Similar thing with the revenue per requisition, the test mix and also the test per req is going to drive improvements in margin. I think you're going to see the Invigorate program continue to drive the 3% productivity and cost reduction next year as well. So that's a tailwind as well.

所以凱文，從對利潤率的影響角度來看，如果我採納吉姆的一些評論，並就利潤率給你一些具體的描述，現在不給出百分比或任何數字。但是，良好的利用率和健康的經營環境將繼續推動利潤率的擴張。類似地，每次申請的收入、測試組合以及每次申請的測試次數都將推動利潤率的提高。我認為明年「活力提升計畫」也將繼續推動生產力提高 3%，成本降低。所以這也是個順風。

PAMA is obviously an uncertain one, so I'll kind of set it off to the side for now as a potential headwind. The ramping Nova investments are going to generate more expenses next year, but that's in line with what we shared back in March when we first announced this program. There's nothing new there in terms of additional cost. And also generally, in terms of all the investments that we have next year, including Nova, depending on PAMA, we have the ability to sort of ramp those and basically time those and pace those accordingly to offset the impact of any negative pricing effect from PAMA.

PAMA 顯然是一個不確定的因素，所以我暫時把它放在一邊，把它當作一個潛在的阻力。不斷增加的 Nova 投資將在明年產生更多支出，但這與我們在 3 月首次宣布該計劃時所分享的內容一致。就額外成本而言，並沒有什麼新變化。此外，就我們明年所有的投資而言，包括Nova，根據PAMA的情況，我們有能力逐步增加這些投資，並根據PAMA的定價情況調整投資時間和節奏，以抵消PAMA可能帶來的任何負面價格影響。

Jack Meehan, Nephron Research.

Jack Meehan，腎單位研究。

I wanted to talk about cash flow. So it's been really strong conversion so far this year, and you increased the guide here to $1.8 billion, up $250 million. Maybe for Sam, just are there any onetimers you would call out this year besides kind of the CARES Act payment? I'm just trying to think about the puts and takes on this line into 2026 and understanding what the right baseline might be to work off of?

我想談談現金流。所以今年到目前為止轉換率非常強勁，你們將這裡的指導目標提高到了 18 億美元，增加了 2.5 億美元。或許對薩姆來說，除了《新冠病毒援助、救濟和經濟安全法案》（CARES Act）的補助金之外，今年還有什麼其他一次性事件值得一提嗎？我只是想思考這條線到 2026 年的買賣策略，並了解一下合適的基準線應該是什麼？

Yeah. Thanks, Jack. So yeah, cash flow has been strong. I mean we took up operating cash flow, as you indicated, to $1.8 billion as our guide so an increase of $250 million. I think we're seeing some increases and some positives related to the strength of the business, also the timing of receipts as well in collections. But there are onetimers in that that you should not expect to necessarily continue. You called out the CARES Act payment of $46 million. That is a one-timer that we don't expect to repeat next year.

是的。謝謝你，傑克。是的，現金流一直很強勁。我的意思是，正如您所指出的，我們將經營現金流目標定為 18 億美元，比之前增加了 2.5 億美元。我認為我們看到了一些成長和一些積極因素，這與業務的強勁發展以及收款的時間表有關。但其中有些是一次性的，你不應該期望它們一定會繼續下去。你提到了《新冠病毒援助、救濟和經濟安全法案》（CARES Act）提供的 4,600 萬美元撥款。這是一次性活動，我們預計明年不會再發生。

And then there are onetime benefits related to the recent tax legislation, the One Big Beautiful Bill Act that helped us in 2025 that don't necessarily produce the same magnitude of benefit in 2026. One is related to the acceleration of bonus depreciation and the ability to take deductions on that and gives you a cash tax benefit. And the other one is also related to R&D, accelerated R&D expenses or expensing R&D and being able to take a tax deduction on that as well, which helps you from a cash tax benefit, too. So those, in total, I would call out between sort of just over $100 million, $100 million to $130 million or so of benefits in addition to the $46 million of CARES Act.

此外，最近的稅收立法，《一項偉大的法案》也帶來了一些一次性的好處，這些好處在 2025 年對我們有所幫助，但在 2026 年不一定能產生同樣大的好處。其中一項與加速額外折舊以及就此進行扣除的能力有關，並能為您帶來現金稅優惠。另一個也與研發有關，即加速研發支出或將研發費用計入支出，並能夠就此獲得稅收減免，這也有助於您獲得現金稅收優惠。因此，總的來說，我認為這些福利總額在 1 億美元到 1.3 億美元左右，此外還有《新冠病毒援助、救濟和經濟安全法案》(CARES Act) 提供的 4,600 萬美元。

Yeah. Jack, the other thing I'd point to is the beauty of the consumer channel, it's a direct cash business. You get payment at the time of order and there's no patient concessions or bad debt. So to the extent we continue to grow that consumer channel, it certainly helps bring in the cash, the timeliness of the cash, and the certainty of the cash.

是的。傑克，我想指出的另一點是消費者管道的優勢，它是直接現金交易的業務。您在下單時即可獲得付款，沒有病患優惠或壞帳。因此，如果我們繼續發展這個消費管道，它肯定有助於帶來現金流，確保現金流的及時性和確定性。

Luke Sergott, Barclays.

盧克·塞爾戈特，巴克萊銀行。

I just wanted to dig in a little bit on the consumer health momentum that you guys have in light of some of these like new partnerships you have with WHOOP and OURA. How to think about like the partnership here? And what's being marketed and what kind of tests you guys are going to be driving through there? And any type of benefit that you could see to help the requisition volumes stay elevated within that business?

我想稍微深入探討一下你們在消費者健康領域的進展，特別是你們與 WHOOP 和 OURA 等公司建立的新合作關係。如何看待這種合作關係？你們在那裡推廣的是什麼？你們打算進行哪些類型的測試？您認為有哪些方法可以幫助維持該業務的高需求量？

Yeah. So I can talk about each of those. First of all, let's start with WHOOP. They have somewhere between, I don't know, 1.5 million and 2 million WHOOP users in the country. WHOOP announced that there were roughly 350,000 people that had signed up for advanced labs.

是的。所以我可以逐一談談這些。首先，讓我們從 WHOOP 開始。我不知道，他們在美國擁有的 WHOOP 用戶數量大概在 150 萬到 200 萬之間。WHOOP宣布，大約有35萬人報名參加了高級實驗室。

Now, how quickly those people have signed up, how quickly they convert and actually get lab testing done, it's very hard to tell at this point. The faucet is open, people have come forward, so we are seeing demand from that. You've seen the pricing that WHOOP announced in the marketplace, $199 for a limited panel of roughly 65 biomarkers. And if you do that twice, it's twice in a year, it's a $350 charge.

現在，這些人註冊的速度有多快，轉換率有多高，以及他們實際完成實驗室檢測的速度有多快，目前還很難說。水龍頭已經打開，人們也紛紛前來，所以我們看到了這方面的需求。你已經在市場上看到了 WHOOP 公佈的價格，199 美元即可獲得包含大約 65 種生物標記的有限檢測組合。如果你一年內這樣做兩次，就要收取 350 美元的費用。

OURA on the other hand, we're still in the final stages of the technical integration with OURA. OURA is much bigger in terms of users. They've got about 5.5 million globally, not 100% how many are in the US, but probably 60%-ish, 65% are probably US-based. They've chosen a more limited panel, a $99 a panel that has roughly 50 biomarkers on it. And so we don't have an indication of a backlog yet or anything like that.

另一方面，我們與OURA的技術整合仍處於最後階段。OURA 的使用者規模要大得多。他們在全球約有 550 萬用戶，雖然無法 100% 確定有多少在美國，但可能 60% 左右，65% 可能在美國。他們選擇了一個功能更有限的檢測方案，每個方案售價 99 美元，包含約 50 種生物標記。因此，我們目前還沒有任何關於積壓訂單或其他類似情況的跡象。

And then obviously, again, our own direct channel has put up growth numbers that are really impressive on a year-to-date basis between 30% and 40%. And and then obviously, Function Health continues to grow, and we are the sole lab that does all the testing for function health. So put all of those pieces together, and it really points to a segment that we're getting terrific road map.

顯然，我們自己的直銷管道今年迄今的成長數據也相當驚人，成長幅度在 30% 到 40% 之間。而且很顯然，功能健康領域也不斷發展壯大，而我們是唯一能夠進行所有功能健康測試的實驗室。所以把所有這些因素綜合起來，就可以看出我們正在獲得一份非常棒的路線圖。

David Westenberg, Piper Sandler.

大衛‧韋斯滕伯格，派珀‧桑德勒。

Congrats on a good quarter. So in fact on the consumer channel, we are seeing a lot of great growth in this channel. We're also seeing some adds for some of the home delivery blood testing kits. Do you believe that could be a key part of consumer health? And then are there any strategies to participate in that market?

恭喜你本季業績出色。因此，實際上在消費者管道方面，我們看到這個管道正在取得巨大的成長。我們也看到了一些關於送貨上門送血檢測套裝的廣告。你認為這可能是消費者健康的關鍵組成部分嗎？那麼，有哪些策略可以參與這個市場呢？

Yeah. First of all, yeah, there is strategies for us to participate. There's devices out there today for self-collect for both STDs as well as HPV. Today, those collections have to take place actually in one of our patient service centers. But in the future, we would expect consumers, patients to be able to do those collections in the home.

是的。首先，是的，我們有參與的策略。目前市面上已有用於自取樣檢測性傳染病和人類乳突病毒的設備。如今，這些收集工作必須在我們其中一個病患服務中心進行。但未來，我們希望消費者和患者能夠在家中進行這些採集工作。

We're working with a third-party provider on mobile -- on blood collection kits that go well beyond finger prick and finger sticks. We don't actually think that is an optimal way to collect enough blood that can be used to run the test that we typically run here in Quest Diagnostics. But in time, those self-collect devices will improve. And as they do, we're going to participate in that game as well.

我們正在與第三方供應商合作開發行動式血液採集套件，這種套件的功能遠遠超出了指尖採血。我們並不認為這是採集足夠血液樣本進行我們在 Quest Diagnostics 通常進行的測試的最佳方法。但隨著時間的推移，這些自助回收設備將會得到改善。當他們這樣做的時候，我們也會參與這場遊戲。

Erin Wright, Morgan Stanley.

艾琳·賴特，摩根士丹利。

So in the 10-Q filing, you reiterated the expectation around the impact on the One Big Beautiful Bill and the expiration of ACA subsidies, I guess, in that 50 bps, 60 bps range. I guess, how would you break the two of those out if we do get some sort of more favorable negotiation on the exchange subsidies?

所以在 10-Q 文件中，您重申了對《一項偉大的法案》和 ACA 補貼到期的影響的預期，我猜是在 50 個基點到 60 個基點的範圍內。我想，如果我們在匯率補貼方面達成某種更有利的談判，你會如何把這兩項分開考慮呢？

And then a completely separate question, but can you speak a little bit about the partnership with Epic a little bit more? I guess, can you talk a little bit about the genesis of that relationship and the nature of it and when we will care more on that front, too? .

還有一個完全不同的問題，您能否再詳細談談與 Epic 的合作？我想，您能否談談這段關係的起源和性質，以及我們何時會更關注這方面的內容？。

Yeah. Thanks, Erin. This is Sam. So on the impact in 2028 that you called out that we disclosed in our 10-Q, the way I would think about it is the majority of that is really related to the health insurance exchanges and the potential expiration of those subsidies and not being renewed. So that roughly, let's call it, 60 basis points. I would say about at least 40 to 45 basis points of that is coming from the exchanges and the rest driven by Medicaid. Medicaid ramps over time to get to a certain impact by 2034. But the impact on '27, '28 is fairly minimal still.

是的。謝謝你，艾琳。這是薩姆。所以，關於您提到的我們在 10-Q 文件中披露的 2028 年的影響，我的看法是，其中大部分實際上與醫療保險交易市場以及這些補貼可能到期且不再續簽有關。所以，粗略地說，我們姑且稱之為 60 個基點。我認為其中至少有 40 到 45 個基點來自交易所，其餘部分則來自醫療補助計劃。醫療補助計劃將逐步擴大規模，到 2034 年達到一定影響。但對 2027 年、2028 年的影響仍然相當小。

And Jim, talk about the other.

吉姆，說說另一個人吧。

Yeah. On the Epic implementation, so the foundational element of this is the conversion and upgrading of all of our laboratory information systems to their LIS product, which is called Beaker. We're going to start that process. Obviously, a lot of planning is taking place right now. Planning will continue into 2026. We plan on starting those implementations more in our esoteric sites and then rolling it out across the regions over the next several years.

是的。在 Epic 系統實施方面，其基礎要素是將我們所有的實驗室資訊系統轉換和升級到他們的 LIS 產品，即 Beaker。我們將啟動這個過程。顯然，目前正在進行大量的規劃工作。規劃工作將持續到2026年。我們計劃先在一些較小眾的網站上開始實施這些方案，然後在未來幾年內將其推廣到各個地區。

We will also standardize. Today, we have the application called MyQuest, which allows patients to appointments, view your test results, pay your bills. And that application will be upgraded to what most people know is MyChart in the Epic world that provides a lot of benefits, including patients will be able to see all of their information regardless if it's from Quest Diagnostics or a health system on one MyChart site, if you will. And so it provides the integration of lab work with other medical records that they may be getting from their physicians, their health systems. And so we believe that really has tremendous benefits as well.

我們還將進行標準化。如今，我們有了名為 MyQuest 的應用程序，患者可以透過它預約就診、查看檢測結果和支付帳單。該應用程式將升級為大多數人所熟知的 Epic 系統中的 MyChart，它提供了許多好處，包括患者可以在一個 MyChart 網站上查看他們的所有信息，無論這些信息來自 Quest Diagnostics 還是其他醫療系統。因此，它可以將實驗室工作結果與他們可能從醫生、醫療系統獲得的其他醫療記錄整合起來。因此，我們也相信這確實會帶來巨大的好處。

So as we've described in the past, it's a five- to seven-year implementation timeline. And as Sam has said, we're going to pace that appropriately. It's a lot of change both internally for our own employees, a lot of change for our customers, and we're going to be very thoughtful and methodical as we embark on this change going forward.

正如我們之前所描述的那樣，這是一個五到七年的實施時間表。正如薩姆所說，我們會適當地控制節奏。對於我們公司內部的員工和客戶來說，這都是很大的變化，我們將以非常謹慎和有條不紊的方式來推進這項變革。

Andrew Brackmann, William Blair.

安德魯·布拉克曼，威廉·布萊爾。

Jim, you highlighted some of the work that you're doing, expanding partnerships with some of the cancer screening players that are out there. Can you maybe just sort of talk about those opportunities broadly what they mean for Quest? But I guess more importantly, how do you balance those types of distribution partnerships with potentially doing some of the tests in yourselves in the future?

吉姆，你重點介紹了你正在進行的一些工作，包括擴大與一些癌症篩檢機構的合作關係。您能否大致談談這些機會對 Quest 的意義？但我想更重要的是，你們如何平衡這類分銷合作關係與未來可能自行進行一些測試之間的關係？

Yeah. Well, the first decision we look at is do we have a test for that segment of the market. Now, when it comes to some of these early-stage cancer screening tests, the answer is it's not an area where we've made significant investments. So as we've discussed in the past, you can order the GRAIL test through Quest Diagnostics. It's on our menu and we make it available to over 100,000 primary care physicians that's integrated from an IT standpoint.

是的。首先，我們要考慮的是，我們是否有針對該細分市場的測試。至於某些早期癌症篩檢測試，答案是：我們還沒有在這個領域投入大量資金。正如我們之前討論過的，您可以透過 Quest Diagnostics 訂購 GRAIL 測試。它已列入我們的菜單，並已從 IT 角度整合到 10 多萬名初級保健醫生的菜單中。

We announced with colo with Guardant. Their new blood-based colon cancer test. Again, we don't have a test in that segment. We were seeing -- we were getting questions from our physicians. And so it's on our menu. Physicians will be able to access that. There's complete IT integration. We do the collections and the test gets sent to the Guardant lab to be done. We have collection agreements with other players in the industry. But those two tests are actually on our menu, and we enable physician offices to order through Quest Diagnostics.

我們與 Guardant 合作發布了公告。他們新研發了一種基於血液的結腸癌檢測方法。再次強調，我們在這個領域沒有測試。我們看到──我們收到了醫生們的提問。所以它就在我們的菜單上。醫生們將能夠存取這些資訊。已實現完全的IT整合。我們負責採集樣本，然後將樣本送到 Guardant 實驗室進行檢測。我們與業內其他企業簽訂了收款協議。但實際上，這兩項檢測都在我們的服務範圍內，我們允許醫生辦公室透過 Quest Diagnostics 訂購檢測服務。

Michael Ryskin, Bank of America.

邁克爾·里斯金，美國銀行。

You kind of just touched on there on the advanced diagnostics side and just a follow-up specific to Haystack. If you could just provide an update on the integration and how that's going, just reaffirm some of the comments you made in terms of how it's going to flow into the model in 2026?

您剛才稍微提到了高階診斷方面的內容，現在我想補充一些關於 Haystack 的具體資訊。您能否提供一下整合工作的最新進展情況，並重申您之前關於它將如何在 2026 年融入現有模式的一些評論？

Yeah. So look, I'll talk about the integration, Sam can touch on some of the financial aspects. So it's totally integrated into the company. So it's part of the inner fabric of Quest Diagnostics. We've created with -- the test is run at our Center of Excellence in Texas, in our Cancer Center of Excellence. And the volumes are building. We feel good about that. We mentioned on the call, we continue to do new and innovative research with -- we mentioned Mass General Brigham, Mass Brigham in Boston, Rucker's Cancer Institute here in New Jersey and numerous other cancer studies to continue to build evidence.

是的。所以，我來談談整合方面，Sam 可以談談一些財務方面的問題。所以它已經完全融入公司了。所以它是 Quest Diagnostics 內部結構的一部分。我們已經創建了——該測試在我們位於德克薩斯州的卓越中心，也就是我們的癌症卓越中心進行。而且數量還在增加。我們對此感到很滿意。我們在電話會議中提到，我們將繼續與麻省總醫院布萊根醫院、波士頓的麻省布萊根醫院、新澤西州的魯剋癌症研究所和其他眾多癌症研究機構進行新的創新研究，以繼續累積證據。

From a reimbursement standpoint, we are getting paid by Medicare today. And we expect this November that you'll see final reimbursement decisions in the final clinical lab fee schedule that gets published just before Thanksgiving of this year. So continued progress, continued to build volume and completely integrated into Quest Diagnostics.

從報銷角度來看，我們目前是由聯邦醫療保險（Medicare）支付的。我們預計今年 11 月，您將在今年感恩節前夕發布的最終臨床實驗室收費標準中看到最終的報銷決定。因此，公司持續取得進展，業務量不斷成長，並完全融入了 Quest Diagnostics。

Yeah, I'll talk a little bit about the financials or at least in terms of what we expect the projections to be without giving a number because we're still working through our annual planning now for 2026. But listen, Mike, we're really excited about this test. It's definitely one that I think has the potential to be a leading MRD test in the market. We have had some learnings around the actual commercial presence that we need to have the number of reps that we need to put behind it. The EMR investment that we need to make in terms of the Epic, OURA investment that we're making this year.

是的，我會稍微談談財務狀況，或至少談談我們對預測的預期，但不會給出具體數字，因為我們目前仍在製定 2026 年的年度計畫。但是聽著，麥克，我們對這次測試真的非常興奮。我認為它絕對有潛力成為市場上領先的微小殘留病灶檢測方法。我們已經了解到，在實際的商業推廣方面，我們需要投入一定數量的銷售代表。我們今年需要在 Epic 和 OURA 等 EMR 系統上進行投資。

So this year, we're expecting it to be relatively on pace in terms of dilution versus last year. And we do expect in 2026 to be -- for it to be a tailwind in terms of less dilution in 2026 versus 2025. But very pleased with the market response to this test.

因此，我們預計今年的稀釋速度將與去年基本持平。我們預計 2026 年將會是有利因素，因為與 2025 年相比，2026 年的稀釋程度會更低。但對市場對此測試的反應非常滿意。

Pito Chickering, Deutsche Bank.

皮托·奇克林，德意志銀行。

Nice job in the quarter. As we roll forward, the organic growth for next year, if I focus on the number of tests per requisition. Can you refresh us how that grew year-to-date, how we should think about the durability of that growth going forward?

本季表現不錯。展望未來，如果我關注每個申請的測試數量，那麼明年的有機成長將會如何？能否簡要介紹今年迄今的成長情況，以及我們應該如何看待這種成長在未來能否持續？

Yeah. In terms of test per req, Pito, we have said that it's definitely elevated versus what we were seeing pre-COVID, okay? So without getting too specific and too many -- provide too many details and numbers, which we don't necessarily share. But definitely, it has continued to improve quarter after quarter since 2019. So right now, we are north of, I would say, 4.2 in terms of test per req. And prior to 2019 in the pre-COVID time frame, we were somewhere between 3.5 and 4, okay, maybe on the high end of that. But this constant evolution of test per req, we're seeing improved test per req and also improved mix.

是的。皮托，就每次檢測的需求量而言，我們已經說過，與新冠疫情爆發前相比，這個數字肯定要高得多，好嗎？所以，不要說得太具體、太多——不要提供太多我們不一定分享的細節和數字。但可以肯定的是，自 2019 年以來，它每個季度都在持續改善。所以目前，就每個需求的測試次數而言，我認為已經超過了 4.2 次。在 2019 年新冠疫情爆發之前，我們的數值大概在 3.5 到 4 之間，好吧，也許接近上限。但是隨著每個需求測試的不斷改進，我們看到每個需求的測試數量和測試組合都得到了改善。

On the test per req, it's a number of things. I mean, it's clinical guidelines that physicians over time have been gradually adhering to. It's our clinical franchise strategy. It's the availability of a broader test menu that we have. It's the default to more screening tests like advanced -- like AD-Detect, for instance, which is a blood-based Alzheimer's, dementia screening test that we didn't -- wasn't available before, that's now producing lift.

每個要求的測試都包含很多方面。我的意思是，這是醫生們隨著時間的推移逐漸遵循的臨床指南。這是我們的臨床特許經營策略。我們提供更廣泛的檢測項目。預設選項是更多高級篩檢測試，例如 AD-Detect，這是一種基於血液的阿茲海默症和失智症篩檢測試，我們以前沒有這種測試，現在它正在產生效果。

And then on top of that, there's also the wellness portion of our business that's driving also an improvement in terms of test per req. So all of these things that I mentioned are helping with test per req and also on top of that revenue per requisition.

除此之外，我們業務中的健康管理部分也在推動每次檢測需求的提升。因此，我提到的所有這些因素都有助於提高每次需求的測試量，並且還能提高每次需求的收入。

If you take that into 2026, do I expect continued improvement in terms of revenue per requisition and test per req? Potentially, but it's going to get to a point where it slows down. We're not going to continue to see the same pace of improvement that we've seen traditionally. So yeah, I think the direction is positive for next year, but I think at some point, we're going to see a slowing down of that improvement.

如果把這個預期延續到 2026 年，我是否預期每次申請的收入和每次申請的測試次數會繼續提高？有可能，但總有一天會慢下來。我們將無法繼續看到像以往那樣快速的進步。所以，我認為明年的發展方向是正面的，但我認為在某個時候，這種改善速度會放緩。

Tycho Peterson, Jefferies.

泰科·彼得森，傑富瑞集團。

I wanted to just to a little more on the oncology initiatives. I appreciate the color you provided. But I know evidence generation, you're working with some of the academic medical centers for Haystack, I think on head and neck, breast, lung. I guess how do we think about additional indications being introduced for Haystack? And then any thoughts on just guideline inclusion for NCCN?

我想再多談談腫瘤學的舉措。我很喜歡你提供的顏色。但我知道證據生成，你正在與一些學術醫療中心合作進行 Haystack 項目，我認為是關於頭頸部、乳腺和肺部的。我想我們應該如何看待為 Haystack 引入更多適應症？那麼對於將NCCN納入指引有什麼想法嗎？

And then separately on Guardant, I think Shield has going to cross $100 million or so in revenues next year. So at what point did that partnership start to get more meaningful? And is that just for colorectal or is an option for multi-cancer with Guardant as well?

另外，就 Guardant 而言，我認為 Shield 明年的營收將超過 1 億美元左右。那麼，這段合作關係是從什麼時候開始變得更有意義的呢？那麼，Guardant 是否僅適用於大腸癌，還是也適用於多種癌症？

Yeah. Let me just take the last question first. So first, on Guardant, right now, it is just colorectal. That's what we've agreed to do. That's what we've put up on our test menu. And we expect growth out of that next year.

是的。讓我先回答最後一個問題。首先，在 Guardant 上，目前只有大腸癌。我們已經同意這樣做。這就是我們列入測試選單的內容。我們預計明年將實現成長。

With respect to evidence generation on the Haystack MRD test. So first, first indications are obviously colo, and we're going after that hard. And I think hopefully, we'll see favorable reimbursement in the fee schedule that comes out in November for that indication. As you mentioned, head and neck are important, and we're doing that research, doing those studies with Mass General. We've got several funded studies on breast and lung as well. We have over 25 studies ongoing right this moment.

關於 Haystack MRD 檢測的證據產生。所以首先，初步跡像很明顯是顏色，我們正在全力以赴地爭取顏色。我希望我們能在 11 月公佈的收費標準中看到該適應症的有利報銷方案。正如您所提到的，頭部和頸部很重要，我們正在與麻省總醫院合作進行這方面的研究。我們還有幾項關於乳癌和肺癌的資助研究。我們目前有超過25項研究正在進行中。

So the studies get completed. We do the publications. So we expect to continue to get broader and broader base coverage on multiple cancer indications with this test. Look, we're really, really pleased with the uptake of this task by some of the more academic sites that really value precision. They value the sensitivity of the test. They value the specificity of the test. And we're seeing nice uptake from thought leaders in the industry that value these characteristics.

所以研究得以完成。我們負責出版工作。因此，我們期望透過這項檢測，能夠持續擴大對多種癌症適應症的覆蓋範圍。你看，我們非常高興看到一些非常重視精確性的學術網站接受了這項任務。他們重視檢測的靈敏度。他們重視檢測的特異性。我們看到，業內一些重視這些特質的思想領袖也對此表示贊同。

Eric Coldwell, Baird.

埃里克·科德威爾，貝爾德。

A lot of moving pieces on the margin profile in 3Q and 4Q. You called out the employee health benefits as one of the short-term headwinds. I'm curious about Project Nova and other investments around that. You mentioned some slippage from 3Q to 4Q, an increase in 4Q. Is it possible to size if there's some way to frame these investments relative to last year or relative to original expectations? I'm just trying to get a sense of what the order of magnitude of the impact in 4Q is? And then how that might play out in 2026 in terms of a year-over-year investment comparison?

第三季和第四季利潤率狀況有很多變數。你指出員工健康福利是短期內面臨的不利因素之一。我對Nova項目以及圍繞該項目的其他投資很感興趣。您提到第三季到第四季出現了一些下滑，第四季有所成長。是否有可能將這些投資與去年或最初的預期進行比較，從而評估其規模？我只是想了解一下第四季受到的影響程度大概是多少？那麼，到 2026 年，與往年相比，投資情況又會如何呢？

Yeah. Thanks, Eric. So I'll give you portion of what you asked for, but I won't give you everything that you asked for in terms of the numbers. But listen, we started the year, we said we had investment spend this year of roughly $30 million. We said there was about $10 million related to the LDT reqs and there was about $20 million related to Project NOVA investments.

是的。謝謝你，埃里克。所以我會給你一部分你要求的東西，但我不會給你所有你要求的數字。但是，聽著，年初的時候我們說過，今年的投資支出大約是 3,000 萬美元。我們說，與 LDT 要求相關的費用約為 1000 萬美元，與 Project NOVA 投資相關的費用約為 2000 萬美元。

So the QARA, the quality and regulatory, and we didn't -- the LDT regs obviously didn't go through, but we still have to make some investments to really improve that organization and our reporting capabilities. So I would say roughly of that $10 million that we had earmarked, we spent most of that. The $20 million for Nova, we have not spent a big portion of it. And so some of it went into Q4, and we're going to spend a portion in Q4, and that was largely due to timing.

所以，品質保證和監管方面，我們沒有——LDT法規顯然沒有通過，但我們仍然需要進行一些投資來真正改進組織和我們的報告能力。所以，我估計我們預留的1000萬美元中，大部分都花了。我們為Nova計畫投入的2000萬美元，還沒有花掉很大一部分。因此，其中一部分資金被撥到了第四季度，我們將在第四季度投入一部分資金，這主要是由於時間安排的原因。

Now, there's not going to be a bleed over effect into 2026, if kind of if you're trying to read into that. I wouldn't consider it as something that's going to impact 2026 negatively. It was really more of a timing thing within 2025. We just didn't spend it earlier and it just went into Q4. So that's how I'd look at it.

現在，不會對 2026 年產生任何影響，如果你想從中解讀出什麼的話。我不認為這會對2026年產生負面影響。實際上，這更多的是一個時間上的問題，目標是在2025年內實現。我們之前沒花掉這筆錢，所以它就一直留到了第四季。這就是我的看法。

In terms of just Nova spend overall. As we have called out over the next three years -- or sorry, over the next six or seven years through the implementation, we're expecting about a $310 million investment -- somewhere between $250 million and $310 million investment in Nova. And that's going to be a combination of OpEx and CapEx.

單就Nova的總支出而言。正如我們之前所指出的，在接下來的三年裡——或者抱歉，在接下來的六七年裡，透過實施，我們預計將有大約 3.1 億美元的投資——其中 2.5 億美元到 3.1 億美元將用於 Nova 項目。這將是營運支出和資本支出的組合。

And a portion of that is going to impact 2026, but it's consistent with our expectations when we shared that range back in Investor Day. Nothing has changed. And as I said earlier, depending on PAMA, depending on the headwinds of the business, the macro environment, potential any challenges that we see, we control the pace of those investments and we will flex and pace accordingly. So just want to make sure that's clear.

其中一部分將對 2026 年產生影響，但這與我們在投資者日分享的預期範圍一致。一切都沒有改變。正如我之前所說，根據 PAMA 的情況，根據業務的逆風、宏觀環境以及我們看到的任何潛在挑戰，我們會控制這些投資的步伐，並會相應地靈活調整步伐。所以我想確認一下這一點是否清楚。

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

目前，我不再提出其他問題。

Okay. Thank you again for joining in. And again, strong performance for Quest Diagnostics. We again thank our 55,000 employees who made this happen in the quarter, and we'll continue to make it happen. Have a great day. Thank you.

好的。再次感謝您的參與。Quest Diagnostics再次表現出色。我們再次感謝本季為實現這一目標而辛勤工作的 55,000 名員工，我們將繼續努力實現這一目標。祝你有美好的一天。謝謝。

Thank you for participating in the Quest Diagnostics third 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. 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 October 21, 2025, and until midnight Eastern Time, November 4, 2025. Goodbye.

感謝您參加 Quest Diagnostics 2025 年第三季電話會議。本次電話會議的演講稿將於今日稍後發佈在Quest Diagnostics的網站www.questdiagnostics.com上。您可以透過造訪www.questdiagnostics.com/investor線上收聽電話會議錄音，或撥打(866) 388-5361（美國境內）或(203) 369-0416（國際）收聽。電話重播服務將於上午 10:30 左右開始提供。2025 年 10 月 21 日美國東部時間，至 2025 年 11 月 4 日美國東部時間午夜。再見。