奎斯特診斷 (DGX) 2026 Q2 法說會逐字稿

Welcome to the Quest Diagnostics second-quarter 2026 conference call. At the request of the company, this call is being recorded. The entire contents of the call, including the presentation and the question-and-answer session that will follow, are the copyrighted property of Quest Diagnostics with all rights reserved. Any redistribution, retransmission or rebroadcast of this call in any form without the written consent of Quest Diagnostics is strictly prohibited. I'd now like to introduce Dan Haemmerle, Vice President of Finance for Quest Diagnostics. Please go ahead, sir.

歡迎參加 Quest Diagnostics 2026 年第二季財報電話會議。應公司要求，本次通話將被錄音。本次通話的全部內容（包括簡報以及隨後的問答環節）均為 Quest Diagnostics 的受版權保護財產，保留所有權利。未經 Quest Diagnostics 書面同意，以任何形式對本次通話進行再分發、再傳輸或再廣播均嚴格禁止。現在我想介紹 Quest Diagnostics 財務副總裁 Dan Haemmerle。先生，請開始。

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. Also joining us is Damini Chokshi, our new Head of Investor Relations, to join Quest Diagnostics last week.

謝謝，早安。與我一同出席的有我們的董事長、執行長兼總裁 Jim Davis，以及我們的財務長 Sam Samad。另外也有 Damini Chokshi 加入，她是我們新任投資人關係主管，上週加入 Quest Diagnostics。

During this call, we may make forward-looking statements and will discuss non-GAAP measures. We provide a reconciliation of non-GAAP measures to comparable GAAP measures in the tables to our earnings press release. Actual results may differ materially from those projected. Risks and uncertainties that may affect Quest Diagnostics' future results include, but are not limited to, those described in our most recent annual report on Form 10-K and subsequently filed quarterly reports on Form 10-Q and current reports on Form 8-K.

在本次通話中，我們可能會作出前瞻性陳述，並將討論非 GAAP 指標。我們在財報新聞稿的表格中提供非 GAAP 指標與可比 GAAP 指標之間的調節表。實際結果可能與預測存在重大差異。可能影響 Quest Diagnostics 未來業績的風險與不確定性包括但不限於我們最近一期 Form 10-K 年報以及其後提交的 Form 10-Q 季報與 Form 8-K 即時報告中所述內容。

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. Now here is Jim Davis.

在本次通話中，提及的 reported EPS 指 reported 稀釋每股盈餘；提及的 adjusted EPS 指 adjusted 稀釋每股盈餘。與我們長期展望預測相關的成長率（包括合併營收成長、併購帶來的營收成長、有機營收成長以及調整後盈餘成長）均為複合年成長率。接下來請 Jim Davis 發言。

Thanks, Dan, and good morning, everyone. Before we get started, I want to welcome Damini, who brings to Quest a strong record of Investor Relations and financial management experience from her nearly two decades with Merck. I also want to thank Dan for his leadership over the past few months as we completed the hiring reprocess. Dan will continue to work closely with Damini over the coming weeks as she transitions into this new role.

謝謝 Dan，大家早安。在開始之前，我想歡迎 Damini。她在 Merck 近二十年的任職期間，累積了投資人關係與財務管理方面的豐富經驗與亮眼成績，將為 Quest 帶來助益。我也要感謝 Dan 在過去幾個月的領導，協助我們完成重新招募流程。在接下來幾週 Damini 轉任新職期間，Dan 將持續與她密切合作。

Now turning to our results. Our strong performance in the second quarter demonstrates focused execution of our strategy to connect people and providers to innovative testing and actionable insights that illuminate past or better health. In the quarter, we grew revenues by over 10%, driven by broad clinical demand from physicians, hospitals, and consumers, and increased volume from our collaborations with Corewell Health and Fresenius Medical Care.

接著談我們的業績表現。第二季的強勁表現展現了我們聚焦執行策略：將人們與醫療提供者連結到創新檢測與可採取行動的洞察，以照亮過去或更好的健康狀態。本季營收成長超過 10%，主要受醫師、醫院與消費者的廣泛臨床需求帶動，並受惠於與 Corewell Health 及 Fresenius Medical Care 合作所帶來的量增。

We also grew adjusted diluted earnings per share by over 19%. Our implementation of automation and AI across our business is driving continuous improvements in quality and productivity, both in and outside our labs. We are also using advanced technologies to make it easier for our customers to engage with us and draw greater insights from our lab data.

我們的調整後稀釋每股盈餘也成長超過 19%。我們在全公司導入自動化與 AI，正持續推動品質與生產力的改善，涵蓋實驗室內外的作業。我們也運用先進技術，讓客戶更容易與我們互動，並從我們的實驗室數據中獲得更深入的洞察。

With our strategic execution and demographic and technological trends driving sustained demand, we are again raising our guidance for the year. I'll now provide more detail on how we executed our strategy across our key customer channels and operations during the quarter. Quest Diagnostics operates at the center of healthcare, providing insights to make health more proactive, personal, and connected. We deliver solutions that make testing simpler and smarter for our core clinical customers, physicians, and hospitals, as well as for our customers in the higher growth areas of consumer health, life sciences, and data analytics.

在我們的策略執行，以及人口結構與科技趨勢帶動的持續需求之下，我們再次上調全年指引。接下來我將更詳細說明本季我們如何在主要客戶通路與營運面向執行策略。Quest Diagnostics 位於醫療照護的核心，提供洞察，使健康管理更具前瞻性、更個人化且更互聯。我們為核心臨床客戶（醫師與醫院）提供讓檢測更簡單、更智慧的解決方案，同時也為成長更快的消費者健康、生命科學與數據分析領域客戶提供服務。

In the physician channel, we delivered high-single-digit revenue growth in the second quarter on broad-based demand for our clinical innovations, new customer wins, and increased business with existing customers. We continue to deliver strong growth in several geographies where we have expanded our reach to physicians through increased health plan access and acquisitions in recent years. We also continued to grow our enterprise accounts, especially in clinical areas where providers value our ability to deliver solutions that serve the growing interest in prevention and wellness.

在醫師通路方面，第二季在臨床創新帶來的廣泛需求、新客戶贏單，以及既有客戶業務增加的帶動下，我們實現了高個位數的營收成長。在若干地區，我們透過近年增加健康保險計畫的可及性以及併購擴大醫師觸達，並持續交出強勁成長。我們也持續擴大企業客戶（enterprise accounts），尤其是在臨床領域中，醫療提供者重視我們提供解決方案的能力，以回應日益提升的預防與健康促進需求。

In addition, our collaborations with Fresenius Medical Care continued to support growth in the quarter. Through this relationship, we have fostered new capabilities for serving nephrologists and other providers carrying for the nearly 36 million people in the US with chronic kidney disease. Today, we provide a highly comprehensive kidney-testing portfolio spanning risk assessment to post-transplant monitoring for providers focused on this growing area of medicine.

此外，我們與 Fresenius Medical Care 的合作在本季持續支撐成長。透過此合作關係，我們培養了新的能力，以服務腎臟科醫師及其他照護提供者，協助照護美國近 3,600 萬名慢性腎臟病患者。目前，我們為聚焦此一快速成長醫學領域的醫療提供者，提供高度完整的腎臟檢測產品組合，涵蓋從風險評估到移植後監測。

In the hospital channel, we grew revenues at a double-digit rate during the quarter, primarily from Co-Lab Solutions with Corewell Health in Michigan. In addition, revenues from reference testing grew versus the first quarter and prior year. Hospitals continue to contend with workforce, financial, and other pressures.

在醫院通路方面，本季營收以雙位數成長，主要來自我們在密西根與 Corewell Health 的 Co-Lab Solutions。此外，參考檢測（reference testing）營收較第一季及去年同期成長。醫院仍持續面臨人力、財務及其他壓力。

As a preferred strategic partner, we empower hospitals to improve quality, expand access to new test innovations, and maximize cost efficiencies and capital allocation. As one example during the quarter, we formed a new Co-Lab agreement with a non-profit regional health system in California. Through these deep relationships, we have created a strong pipeline of potential collaborations and acquisitions of hospital outreach as well as independent labs.

作為首選的策略合作夥伴，我們協助醫院提升品質、擴大取得新檢測創新的管道，並最大化成本效率與資本配置效益。以本季為例，我們與加州一家非營利區域性醫療體系簽署新的 Co-Lab 協議。透過這些深度合作關係，我們建立了強勁的潛在合作與併購管線，涵蓋醫院外展業務（hospital outreach）以及獨立實驗室。

In the consumer health channel, we deliver solutions that enable people to own their health. Wellness is not the absence of sickness. It's health that is proactive, personal, and connected, and we're helping to make wellness possible by illuminating early signals of disease and by making it easier for people and partners to link our biomarker insights with biometrics.

在消費者健康通路方面，我們提供解決方案，讓人們能掌握自己的健康。健康促進（wellness）並非只是沒有疾病。它是更具前瞻性、更個人化且更互聯的健康狀態；我們透過揭示疾病的早期訊號，並讓人們與合作夥伴更容易將我們的生物標記洞察與生理量測數據（biometrics）連結，來協助實現 wellness。

We expect to continue to expand our own platform and solutions for partners as interest and investment in preventative health and wellness continues to grow. During the quarter, questhealth.com continued to generate robust revenue growth and strong demand for existing wellness panels and new services, such as our thyroid test offering. In addition, we continue to attract new partners as a result of our diagnostic innovations, flexible technology integrations, and scale.

隨著預防性健康與 wellness 的關注與投資持續成長，我們預期將持續擴展自有平台以及面向合作夥伴的解決方案。本季，questhealth.com 持續帶來強勁的營收成長，既有 wellness 套組與新服務（例如甲狀腺檢測）需求旺盛。此外，憑藉我們的診斷創新、彈性的技術整合能力與規模優勢，我們持續吸引新的合作夥伴。

Our customer channels are also growing as we continue to deliver Advanced Diagnostics in five key clinical areas: advanced cardiometabolic and endocrine, autoimmune, brain health, oncology, and women's and reproductive health. During the quarter, we grew revenues by double digits across several of these areas.

隨著我們在五大關鍵臨床領域持續提供先進診斷（Advanced Diagnostics），我們的各客戶通路也在成長：先進心代謝與內分泌、自體免疫、腦健康、腫瘤，以及女性與生殖健康。本季，我們在其中數個領域的營收以雙位數成長。

These include advanced cardio metabolic tests like APO B and Lp(a) as well as liver fibrosis testing, an area poised for additional growth given new treatments for late-stage liver disease. We also continue to drive strong growth for our analyzer solution, which aids the diagnosis of autoimmune disorders. In brain health, we continued to drive robust double-digit growth across our portfolio of AD-Detect blood tests, which include amyloid beta, P-tau, and other biomarkers, demonstrating the clinical value of our multi-biomarker approach to dementia care.

其中包括 APO B 與 Lp(a) 等先進心代謝檢測，以及肝纖維化檢測；隨著末期肝病新療法推出，該領域具備進一步成長動能。我們也持續推動分析儀解決方案的強勁成長，該方案有助於自體免疫疾病的診斷。在腦健康方面，我們的 AD-Detect 血液檢測產品組合（包含類澱粉蛋白 β、P-tau 及其他生物標記）持續實現強勁的雙位數成長，展現我們多重生物標記方法在失智照護上的臨床價值。

In oncology, we achieved key milestones for Haystack MRD during the quarter. New York State approved the test, placing it among an elite group of solid tumor ctDNA MRD test to fulfill the state's rigorous quality criteria. This approval allows us to extend our commercial efforts to all 50 states.

在腫瘤領域，本季我們的 Haystack MRD 達成多項關鍵里程碑。紐約州已核准該檢測，使其躋身少數能符合該州嚴格品質標準的實體腫瘤 ctDNA MRD 檢測之列。此項核准使我們得以將商業推廣擴展至全美 50 州。

We also became the largest reference lab to extend access to cancer tests such as Haystack MRD through Flatiron Health's OncoEMR Molecular Profiling Integration platform. We began a pilot of the solution with American Oncology Network, a leading community oncology organization and plan to roll it out to Flatiron's 4,700 clinicians and other providers nationwide later this year. I'd like to turn now to operational excellence.

我們也成為最大的參考實驗室，透過 Flatiron Health 的 OncoEMR 分子特徵分析整合平台，擴大對 Haystack MRD 等癌症檢測的可近性。我們已與美國腫瘤學網路（American Oncology Network）這家領先的社區腫瘤組織啟動該解決方案的試點，並計畫於今年稍晚將其推廣至 Flatiron 的 4,700 名臨床醫師及全國其他醫療服務提供者。接下來我想談談營運卓越。

We remain on track to deliver 3% in annual cost savings and productivity improvements through our Invigorate program. We are also making testing simpler and smarter by investing in AI and automation to improve our operations, services, and experiences, both in and outside our labs. For instance, in our labs, we recently installed the Hologic Genius Digital Diagnostics system in two more locations following successful implementations at about half a dozen sites over the past year. The system first digitizes a Pap test slide and then uses AI to scan for signs of cervical cancer, helping to improve the quality of the slide review by our medical team.

我們仍按計畫透過 Invigorate 計畫實現每年 3% 的成本節省與生產力提升。我們也正透過投資 AI 與自動化，讓檢測更簡單、更智慧，以改善我們在實驗室內外的營運、服務與體驗。例如，在我們的實驗室中，繼過去一年在約半打據點成功導入後，我們最近又在另外兩個地點安裝了 Hologic Genius 數位診斷系統。該系統會先將子宮頸抹片（Pap test）玻片數位化，接著使用 AI 掃描是否有子宮頸癌徵兆，協助提升我們醫療團隊對玻片判讀的品質。

Our front-end specimen-processing automation is delivering meaningful gains in productivity, and we look forward to extending the solution to other sites later this year. Beyond our labs, we recently launched IntelliDraw, a web-based tool that guides the clinical staff of our physician customers through the process of specimen collection, improving quality and the service experience. In addition, we will be implementing an AI tool at patient service centers this year to cut the time it normally takes to track and order supplies. Overall, we are pleased with our growth momentum with customers and strategic execution in the second quarter.

我們前端檢體處理自動化正帶來顯著的生產力提升，我們也期待在今年稍晚將此解決方案擴展至其他據點。在實驗室之外，我們最近推出 IntelliDraw，這是一款網頁式工具，可引導我們醫師客戶的臨床人員完成檢體採集流程，提升品質與服務體驗。此外，我們今年也將在病患服務中心導入一項 AI 工具，以縮短通常用於追蹤與訂購耗材的時間。整體而言，我們對第二季在客戶成長動能與策略執行方面的表現感到滿意。

I'll now turn it over to Sam for more details on our performance and guidance. Sam?

接下來我把時間交給 Sam，請他提供更多關於我們表現與財測的細節。Sam？

Thanks, Jim. In the second quarter, consolidated revenues were $3.04 billion, up 10.2% versus the prior year. Consolidated organic revenues grew by 10%. Revenues for Diagnostic Information Services were up 10.3% compared to the prior year, with 10.1% organic growth, reflecting strong growth in our physician, hospital, and consumer channels. Total volume measured by the number of requisitions increased 13.1% versus the second quarter of 2025 with organic volume up 13%.

謝謝，Jim。第二季合併營收為 30.4 億美元，較去年同期成長 10.2%。合併有機營收成長 10%。診斷資訊服務（Diagnostic Information Services）營收較去年同期成長 10.3%，其中有機成長 10.1%，反映我們在醫師、醫院與消費者通路的強勁成長。以申請單（requisitions）數量衡量的總檢測量較 2025 年第二季增加 13.1%，其中有機量成長 13%。

Our Corewell Health and Fresenius Medical Care relationships contributed 9% to volume in the quarter. Excluding these two relationships, volumes grew by 4.1%. As anticipated, total revenue per requisition was down 2.8% versus the prior year due to the Corewell and Fresenius business mix. Adjusting for that business mix, revenue per requisition was up by 2.9% versus prior year, driven primarily by an increase in the number of tests per requisition. Unit price reimbursement remained flat, consistent with our expectations.

我們與 Corewell Health 及 Fresenius Medical Care 的合作關係在本季貢獻了 9% 的檢測量。若排除這兩項合作關係，檢測量成長 4.1%。如預期，受 Corewell 與 Fresenius 業務組合影響，每份申請單的總營收較去年同期下降 2.8%。若就該業務組合進行調整，每份申請單營收較去年同期上升 2.9%，主要由每份申請單的檢測項目數增加所帶動。單位價格給付（reimbursement）維持持平，符合我們的預期。

Reported operating income in the second quarter was $459 million or 15.1% of revenues, compared to $438 million or 15.9% of revenues last year. On an adjusted basis, operating income was $502 million or 16.5% of revenues compared to $466 million or 16.9% of revenues last year. The increase in adjusted operating income is largely due to organic revenue growth partially offset by wage increases. Operating income as a percent of revenues was impacted by investments in Project Nova and the lower operating margin rate associated with the ramp of the Corewell Co-Lab business. Operating income was also adversely impacted by higher supplemental deferred compensation expenses.

第二季報告營業利益為 4.59 億美元，占營收 15.1%，相較去年為 4.38 億美元，占營收 15.9%。以調整後口徑，營業利益為 5.02 億美元，占營收 16.5%，相較去年為 4.66 億美元，占營收 16.9%。調整後營業利益的增加主要來自有機營收成長，但部分被薪資上調所抵銷。營業利益率受到對 Project Nova 的投資，以及 Corewell Co-Lab 業務爬坡所伴隨的較低營業利潤率影響。營業利益亦受到較高的補充性遞延薪酬費用不利影響。

The total of all three drivers amounted to a 70-basis-point reduction of operating income as a percent of revenues. Reported EPS was $2.84 in the quarter, compared to $2.47 a year ago. Adjusted EPS was $3.12 versus $2.62 the prior year. The improvement in EPS in the second quarter was largely driven by strong organic operating performance as well as the favorable resolution of various tax contingencies, which contributed $0.10 of EPS in the quarter.

上述三項因素合計使營業利益率下降 70 個基點。本季報告每股盈餘（EPS）為 2.84 美元，去年同期為 2.47 美元。調整後 EPS 為 3.12 美元，去年同期為 2.62 美元。第二季 EPS 的改善主要由強勁的有機營運表現所帶動，並受惠於多項稅務不確定事項的有利結案，本季因此貢獻 EPS 0.10 美元。

As previously indicated, adjusted EPS grew by 19.1% and excluding the onetime tax benefit, grew by 15.3%. Cash from operations was $875 million year to date through the second quarter versus $858 million in the prior year. This year-over-year increase is the result of higher operating income in the current year, largely offset by a onetime CARES Act tax credit a year ago.

如先前所述，調整後 EPS 成長 19.1%；若排除一次性稅務利益，則成長 15.3%。截至第二季的年初至今營運現金流為 8.75 億美元，去年同期為 8.58 億美元。此年增主要來自本年度較高的營業利益，但大致被去年一次性的《CARES 法案》稅額抵免所抵銷。

Turning now to our updated full-year 2026 guidance. With our strong first half performance and continued momentum, we are raising our full-year revenue and EPS estimates. We now expect revenues to be between $11.95 billion and $12.05 billion, reflecting a growth rate of 8.3% to 9.2%.

接下來說明我們更新後的 2026 全年財測。憑藉上半年強勁表現與持續動能，我們上調全年營收與 EPS 預估。我們目前預期營收介於 119.5 億至 120.5 億美元，對應成長率為 8.3% 至 9.2%。

Reported EPS to be in a range of $9.97 to $10.17 and adjusted EPS in a range of $11.05 to $11.25. Cash from operations to be approximately $1.8 billion and capital expenditures to be approximately $550 million. Our 2026 full-year guidance reflects the following considerations. The revenue guide does not include any contribution from prospective M&A.

報告 EPS 預期介於 9.97 至 10.17 美元，調整後 EPS 預期介於 11.05 至 11.25 美元。營運現金流約 18 億美元，資本支出約 5.5 億美元。我們的 2026 全年財測反映以下考量。營收指引未包含任何潛在併購（M&A）的貢獻。

Nova expenses are unchanged for the full year, but we anticipate increased spend in the second half of the year compared to prior expectations. Higher fuel costs in the second half of 2026 versus prior expectations. Operating margin is expected to expand versus the prior year. Share count is expected to be slightly below 2025. Interest expense to be consistent with 2025 and adjusted effective tax rate is now expected to be consistent with 2025. With that, I'll now turn it back to Jim.

Nova 費用全年維持不變，但我們預期下半年支出將高於先前預期。2026 年下半年燃料成本高於先前預期。預期營業利潤率將較去年擴張。預期股數將略低於 2025 年。利息費用預期與 2025 年一致，調整後有效稅率目前也預期與 2025 年一致。接下來我把時間交還給 Jim。

Thanks, Sam. In summary, during the quarter, we generated robust top- and bottom-line growth on focused execution of our strategy and sustained demand across physicians, hospitals and consumers. Revenues increased by over 10%, almost all from organic revenues while adjusted diluted EPS grew by over 19%. Given our growth momentum and continued interest in our lab insights, we are again raising our guidance for the full year.

謝謝，Sam。總結來說，本季我們在聚焦執行策略、且醫師、醫院與消費者端需求持續的情況下，實現了強勁的營收與獲利成長。營收成長超過 10%，幾乎全部來自有機營收；同時調整後稀釋 EPS 成長超過 19%。鑑於我們的成長動能以及市場對我們實驗室洞察的持續興趣，我們再次上調全年財測。

As we head into the back half of the year, we remain focused on our strategy to connect people and providers to innovative testing and actionable insights that illuminate path for better health. I'm going to close by thanking my colleagues across Quest to enable those insights with care and commitment every day.

進入下半年之際，我們仍專注於我們的策略：將民眾與醫療服務提供者連結到創新檢測與可採取行動的洞察，照亮通往更佳健康的道路。最後，我要感謝 Quest 全體同仁每天以關懷與承諾促成這些洞察。

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

現在我們很樂意回答各位的提問。接線員？

(Operator Instructions) Erin Wright, Morgan Stanley.

（接線員指示）Erin Wright，摩根士丹利。

Great. I think you mentioned in your prepared remarks, double-digit growth across the hospital channel. I'm just curious what you're seeing across that channel right now, how those relationships are progressing? And just given some of the headwinds, whether it's reimbursement or otherwise across the hospital segment, I guess, are you seeing a building hospital deal pipeline? And how do some of those relationships work? How do we think about bad debt exposure, that kind of stuff when we think about your Co-Lab relationships on that front. But anything to call out on the hospital side from a utilization standpoint would be great.

很好。我想你在事先準備的發言中提到，醫院通路呈現雙位數成長。我只是好奇你們目前在該通路看到的情況，以及這些合作關係的進展如何？另外，考量到一些逆風因素，不論是給付（reimbursement）或醫院部門的其他因素，我想問你們是否看到醫院合作案的洽談管線正在建立？以及其中一些合作關係是如何運作的？當我們思考你們在 Co-Lab 合作關係方面時，壞帳曝險之類的議題應如何看待？此外，若能分享任何關於醫院端從使用量（utilization）角度值得注意的重點，也會很有幫助。

Sure. Thanks, Erin. So when we look at our hospital business, as you know, we look at it in two pieces. One is our pure reference business and the second is our Co-Lab business. Now in total, that portfolio was up significantly, driven primarily by the Corewell Health relationship. But let me give you a couple of the pieces underneath. Our core reference business, which is hospital labs referring work out to Quest Diagnostics, the revenue growth was mid-single digits and actually the volume growth slightly higher than that. So we are seeing no slowdown at all from reference testing coming to Quest Diagnostics.

當然。謝謝你，Erin。所以當我們看我們的醫院業務時，如你所知，我們把它分成兩個部分來看。一個是我們純粹的參考檢測（reference）業務，第二個是我們的 Co-Lab 業務。整體而言，該投資組合大幅成長，主要由與 Corewell Health 的合作關係所帶動。不過我再補充幾個底下的細項。我們的核心參考檢測業務，也就是醫院實驗室把檢測外送給 Quest Diagnostics 的部分，營收成長為中個位數百分比，實際上檢測量成長略高於此。因此，我們完全沒有看到送到 Quest Diagnostics 的參考檢測有任何放緩。

Now if we look at our Co-Lab business ex Corewell and we just look at same-store sales year over year, we see, again, mid-single-digit growth in that book of business. So we're not seeing any slowdown in our hospital business, whether it's Co-Lab or reference. You mentioned bad debt that is not a concern with our -- with hospitals or any of our client bills. We're not seeing any bad-debt trends at all.

現在如果我們看不含 Corewell 的 Co-Lab 業務，僅以同店銷售（same-store sales）逐年比較來看，我們同樣看到該業務組合呈現中個位數百分比的成長。所以無論是 Co-Lab 或參考檢測，我們的醫院業務都沒有看到任何放緩。你提到的壞帳，對我們——對醫院或任何客戶帳單而言都不是問題。我們完全沒有看到任何壞帳趨勢。

We mentioned in the prepared remarks that we took on one new relationship with a regional hospital in California, supply chain relationship and the opportunities as we look into our funnel and look out for the rest of the year, look good.

我們在事先準備的講稿中提到，我們在加州與一家區域性醫院建立了一個新的合作關係，屬於供應鏈合作；而且就我們檢視目前的商機管道並展望今年剩餘時間，前景看起來不錯。

Lisa Gill, JPMorgan.

Lisa Gill，摩根大通（JPMorgan）。

Previously, you had 30 basis points of a headwind because of changes in ACA and Medicaid. I'm just curious, one, what you saw in the quarter specific to ACA changes; and two, if you still have something in the updated guidance around potential headwinds?

先前你們提到因 ACA 與 Medicaid 的變動帶來 30 個基點的不利影響。我想請教兩點：第一，本季就 ACA 變動而言你們看到了什麼；第二，在更新後的指引中，是否仍納入任何潛在的不利因素？

Yeah. So the guidance, Lisa, has not changed. We still think it's a 30-basis-point impact. Now look, we've all seen the data on enrollment. Enrollment is down north of 20%, estimates of 21%, I think we've read. But that's not translating into our business. So what we do see is the following. We see a rec volume growth, that's down around 8%. However, the test per req are up 6%. So we see fewer reqs but we're getting more test per req. Now why is that? Because I think the common wisdom is prevailing here that the healthier people dropped off, the sicker people remained.

是的。所以 Lisa，指引沒有改變。我們仍然認為影響是 30 個基點。你看，我們都看過投保人數的數據。投保人數下降超過 20%，我們讀到的估計大約是 21%。但這並沒有反映到我們的業務上。因此我們實際看到的是：申請單（req）量的成長下降到約 8%。然而，每張申請單的檢測數（tests per req）上升了 6%。所以我們看到申請單變少，但每張申請單帶來的檢測更多。那為什麼會這樣？因為我認為普遍的看法在這裡成立：較健康的人退出了，較不健康的人留下來了。

So what we see is a book of business that is only down 2% from a test standpoint. And quite frankly, it's flattish from a revenue standpoint because the mix of test, the test per req, and a little bit of payer mix is keeping our revenue from the exchange relatively flat. Now could it get worse in the back half of the year? Maybe. But at this point, we're not seeing a major impact on our business.

因此我們看到，從檢測量角度來看，這個業務組合只下降了 2%。坦白說，從營收角度看幾乎持平，因為檢測組合、每張申請單的檢測數，以及一點點付款方組合（payer mix），使得我們來自交易所的營收相對持平。那今年下半年會不會變得更糟？也許。但就目前而言，我們沒有看到對我們業務有重大影響。

So Lisa, just to reaffirm what Jim said in terms of our guidance for the year, we're still assuming for the full year that there's a 30-basis-point impact on revenue from the ACA exchange subsidy expiration.

所以 Lisa，為了再次確認 Jim 對全年指引的說法，我們仍假設全年因 ACA 交易所補貼到期，對營收有 30 個基點的影響。

Michael Cherny, Leerink Partners.

Michael Cherny，Leerink Partners。

Maybe if I can just jump into the back-half assumed margins. You talked about year-over-year margin improvement. That means that the second-half margins just based on year-to-date math have to be a bit better. When we square together the timing of the Nova expenses and the gas-price increases, can you give us the offsets that help build towards that second half margin ramp embedded in getting you year-over-year margin expansion?

也許我可以直接切入下半年假設的利潤率。你提到利潤率將較去年同期改善。這表示依照年初至今的數學推算，下半年的利潤率必須更好一些。在把 Nova 費用的時點與油價上漲的影響一起考量時，你能否說明有哪些抵銷因素，能支撐你們在下半年利潤率爬升、並實現年對年利潤率擴張的假設？

Yeah, for sure, Michael. So I mean, first, let me talk a little bit about Q2 and then I'll talk about the second half. Again, to reconfirm in terms of Q2, our operating margin was 16.5% was down 40 basis points from the same quarter last year. Now that was impacted by, I would say, three key things that I think we need to keep in mind. One is Nova, which was probably about 20 basis points of that. You've got also the impact of Corewell and Fresenius, which is about 30 basis points. And then you've got SDCP, so supplemental deferred compensation plans, which is how we value this plan, these investments that we have, we essentially mark to market them.

當然可以，Michael。我先談一下第二季，然後再談下半年。再次確認第二季，我們的營業利潤率為 16.5%，較去年同季下降 40 個基點。我認為這主要受到三個關鍵因素影響，需要記住。第一是 Nova，大約影響 20 個基點。第二是 Corewell 與 Fresenius 的影響，約 30 個基點。第三是 SDCP，也就是補充性遞延薪酬計畫（supplemental deferred compensation plans）；我們對這個計畫的估值方式，是對我們持有的這些投資基本上採用按市價計量（mark to market）。

And that was a 20-basis-point impact on the quarter. So if you put all those together, that was a 70-basis-point impact. Now as we look forward for the rest of the year, yes, we are still expecting for the full year that we are going to be up in terms of operating margin. So what are the things that change? We do have in the back half of the year, on the headwind side, we have fuel costs, as you said, right? Now we're expecting the fuel-cost impact for the year to be at the high end of the range that we previously gave, which is equivalent to close to about $10 million.

而這在本季造成 20 個基點的影響。所以把這些加總起來，合計影響 70 個基點。展望今年剩餘時間，是的，我們仍預期全年營業利潤率會上升。那有哪些因素會改變？在下半年，不利因素方面，如你所說，我們有燃料成本，對吧？我們預期全年燃料成本的影響會落在先前提供區間的高端，約等同接近 1,000 萬美元。

We're expecting Nova expenses in the second half to be about 70% of the full year. Previously, we have set about 60%. So we've changed that expectation a bit. But the things that are offsetting that are two key things. I mean, number one, continued growth in volumes and continued strength of volumes. Number two is we lap Corewell and Fresenius in Q4 of the second half. So you see less of a dilutive impact from Corewell and Fresenius in the second half on our total operating margins. So again, still expecting operating margins to be up for the full year versus prior year.

我們預期下半年的 Nova 費用約占全年 70%。先前我們設定約 60%。所以我們把這個預期稍微調整了。但用來抵銷的有兩個關鍵因素。第一，檢測量持續成長且維持強勁。第二，我們在下半年第四季會與 Corewell 和 Fresenius 的比較基期對齊（lap）。因此，下半年 Corewell 與 Fresenius 對我們整體營業利潤率的稀釋影響會較小。所以再次強調，我們仍預期全年營業利潤率會較前一年上升。

Michael Ryskin, Bank of America.

Michael Ryskin，美國銀行（Bank of America）。

This is [Lu] on for Michael. I just wanted to go back to the Corewell relationship. Anything like -- any changes in the full-year revenue guide? Is it still the same versus prior quarter? And then also I want to double click on the pricing. It does seem a little bit worse than Q1, but you only have like 2% sequential increase in volume. Just wanted to double check on that and then kind of the impact to the margin in the second half.

我是 [Lu]，代 Michael 發問。我想回到 Corewell 的合作關係。全年營收指引有任何變動嗎？是否仍與上一季相同？另外我也想更深入確認一下定價。看起來比第一季稍微更差一些，但你們的量只有約 2% 的季增。想請你們再確認一下這點，以及對下半年利潤率的影響。

Yeah. So thank you for the question. This is Sam. So with regards to Corewell, still in line with what we had said at the beginning of the year, which is basically that it's a $250 million impact -- positive impact on our revenues this year in total, so it's largely playing as expected. I would say the margin rate, which we had set is going to be in the low-single digits, improving to mid-single digits, is still largely playing out as we expected. So really no meaningful change in terms of our expectations from Corewell.

好的。謝謝你的問題。我是 Sam。關於 Corewell，仍符合我們年初所說的內容，基本上它對我們今年總營收的影響是 2.5 億美元——正向影響，因此整體進展大致如預期。我會說，我們先前設定的利潤率水準將落在低個位數百分比，並改善至中個位數百分比，這也大致如我們預期在發展。因此，就 Corewell 而言，我們的預期沒有任何實質性的改變。

The deal is going -- or the Co-Lab relationship right now is going really well. We anticipate to scale us up to a JV next year as we build the lab in Michigan, and we look to launch that JV in early next year. With regards to pricing, so I'm not sure if your question was specific to Corewell or overall. But with regards to overall pricing for the company, our pricing expectations are still the same, which is we expect basically roughly flattish pricing year over year, and that's what we're seeing actually in Q2.

這筆交易進展順利——或者說目前的 Co-Lab 合作關係進展得非常好。隨著我們在密西根建置實驗室，我們預期明年把合作擴大為一家合資企業（JV），並希望在明年年初啟動該 JV。就定價而言，我不確定你的問題是針對 Corewell 還是整體。但就公司整體定價來看，我們的定價預期仍然相同，也就是我們基本上預期年對年價格大致持平，而這也是我們在第二季實際看到的情況。

And we see, I would say, a positive -- flat to slightly positive impact from the health plans. We see a slightly negative impact from the hospital reference business, which is largely playing out as expected. No change there. It's a competitive sector, and the pricing is slightly negative there. So -- but overall, I would say pricing for the company overall is still relatively flat.

而且我會說，來自健康保險計畫的影響是正面——持平到略為正面。我們看到來自醫院參考檢驗業務的影響略為負面，而這在很大程度上是如預期般發展。那部分沒有變化。那是個競爭激烈的領域，那裡的定價略為負面。所以——但整體而言，我會說公司整體的定價仍相對持平。

The other thing you didn't ask, but it came up in the prior question. Look, the Fresenius book of business is a significant revenue increase year over year as well, close to $100 million. And the margin profile of that business continues to improve from Q1 to Q2 to Q3 and into Q4. So that is also giving us lift from an operating margin perspective in the second half of the year.

另外一件你沒有問到、但在前一個問題中被提及的事情是：你看，Fresenius 的業務組合年對年也帶來顯著的營收增加，接近 1 億美元。而且該業務的毛利/利潤結構從第一季到第二季到第三季並延續到第四季持續改善。因此，從營業利益率的角度來看，這也在今年下半年為我們帶來助益。

Ann Hynes, Mizuho Securities.

Ann Hynes，瑞穗證券。

So I think in your remarks on one of your answers, you said you have not seen any change in bad debt. Obviously, one of the big hospital companies preannounced and most of that was just an increase in bad debt. But can you make us comfortable, maybe talk about what your bad debt is as a percentage of revenue, what you have it embedded in guidance? And why wouldn't we see kind of that downstream impact the clinical labs? And maybe in your answer if you can just let us know what your bad debt policy is regarding look backs and how timely it is.

我想在你對其中一個問題的回答中，你提到你們沒有看到壞帳有任何變化。顯然，其中一家大型醫院公司先行預告，而其中大部分只是壞帳增加。但你能否讓我們更安心一些——也許談談你們的壞帳占營收的比例、你們在財測指引中如何反映？以及為什麼我們不會看到那種對臨床實驗室的下游影響？另外，如果可以的話，也請在回答中告訴我們你們關於回溯（look backs）的壞帳政策，以及其時效性有多即時。

Yeah. Thank you, Ann. So this is Sam. I would say to reemphasize or reconfirm what Jim said earlier, we are not seeing any meaningful change in terms of bad debt. Okay. Bad debt is still very much in line with our expectations with what we were seeing last year and in previous periods. So I know the hospitals have talked about some challenges there, but we have really not seen any meaningful impact for us.

好的。謝謝你，Ann。我是 Sam。我想再次強調或確認 Jim 先前所說的，我們在壞帳方面沒有看到任何具實質意義的變化。好的。壞帳仍然非常符合我們的預期，與我們去年以及先前期間所看到的情況一致。所以我知道醫院方面談到一些挑戰，但我們這邊確實沒有看到對我們有任何顯著影響。

We track, obviously, hospital collections very closely. We make sure that we are on top of those and in fact, we have not seen any deterioration in terms of the rate of collections or the timing of collections from hospitals. We track those really on a very diligently every quarter.

我們當然會非常密切地追蹤醫院端的收款情況。我們確保掌握這些狀況；事實上，我們並未看到醫院在收款率或收款時點方面有任何惡化。我們每一季都非常勤勉地追蹤這些。

In terms of -- I'd say the one thing that we also look at is patient concessions, which we track closely as well to see if there's any deterioration in terms of our ability to collect from patients for co-pay for amounts that patients owe us. And usually, that hovers around, I would say, 5% or so of revenues. And that, in fact, has also not seen any material or any deterioration at all. In fact, it's slightly improved this quarter versus last year, same quarter. So both in terms of bad debt, which we track really closely and we manage very closely and in terms of patient concessions, we are not seeing any adverse impact of both of those.

就——我會說我們也會看的另一件事是病患減免（patient concessions），我們同樣密切追蹤，以觀察我們向病患收取自付額（co-pay）或病患欠款的能力是否有任何惡化。而那通常約占營收的 5% 左右。而那部分事實上也沒有出現任何重大變化或任何惡化。實際上，本季相較於去年同期還略有改善。因此，無論是我們非常密切追蹤並嚴格管理的壞帳，或是病患減免，我們都沒有看到任何不利影響。

And you asked on what our policies are. With respect to patient concessions, first of all, we have a sliding scale for people that are at the poverty, below the poverty, slightly above the poverty line. Second is after time, we do turn the receivables over to collections agencies, and we have some success with that.

你也問到我們的政策是什麼。就病患減免而言，首先，對於處於貧困線、低於貧困線或略高於貧困線的人，我們有一套累進式（sliding scale）的標準。其次，經過一段時間後，我們會把應收帳款轉交給催收機構，而我們在這方面也有一些成效。

The last thing I would tell you is that when a patient comes back into our patient service center, if they owe us a significant amount of money, we actually require them to pay off before we provide that next service. So we have pretty tight controls over patient balances, and I think we manage it very effectively.

最後我想說的是，當病患再次回到我們的病患服務中心時，如果他們欠我們一筆相當可觀的金額，我們實際上會要求他們在我們提供下一次服務之前先行清償。所以我們對病患餘額有相當嚴格的控管，我認為我們管理得非常有效。

Luke Sergott, Barclays.

Luke Sergott，巴克萊。

This is Anna Kruszenski on for Luke. Congrats on the quarter. I was wondering if you could talk about -- help us understand why DSOs are up again both year over year and sequentially in the quarter.

我是代 Luke 提問的 Anna Kruszenski。恭喜本季表現。我想請你談談——幫助我們理解為什麼 DSO（應收帳款週轉天數）無論年對年或按季都再次上升。

Yeah. So there's a couple of reasons for that. One is minor, which is technical around the number of deposit days that we had in the quarter, which is really just a technical item. It doesn't have anything to do with performance of receivables.

好的。這有幾個原因。其中一個是較小的原因，屬於技術性因素，與本季我們的入帳（deposit）天數有關，這真的只是技術性項目。這與應收帳款的表現無關。

The other one has to do with mix, our business mix. As we see some of our client bill portion of the business, specifically our consumer business as well increase, and it's increasing quite robustly. Those have higher DSOs and higher collection or longer collection periods than our health-plan reimbursed business, our third-party payer business. So really, this has just to do with a business-mix nuance in that -- in our revenues overall.

另一個原因與組合（mix）有關，也就是我們的業務組合。當我們看到部分客戶自付（client bill）業務的占比提升，特別是我們的消費者業務也在增加，而且增長相當強勁。這些業務的 DSO 較高、收款期也較長，相較於由健康保險計畫給付的業務、也就是第三方支付方業務。所以這主要只是我們整體營收中業務組合細微變化所造成的。

Tycho Peterson, Jefferies.

Tycho Peterson，Jefferies。

This is Noah on for Tycho. I wanted to ask about PAMA as we get closer to the next phase of implementation here. How are you thinking about the potential reimbursement outcomes? And what actions can you take to offset potential future reimbursement risk?

我是代 Tycho 提問的 Noah。我想在我們更接近下一階段實施之際，問一下關於 PAMA 的問題。你們如何看待潛在的給付（reimbursement）結果？以及你們可以採取哪些行動來抵銷未來可能的給付風險？

Yeah. So thanks for the question. So look, at this point, there's three possible outcomes on PAMA. I think as you know, the first is there's a current data collection process going on by CMS and that data collection process ends on July 30. We expect to hear something, let's say, late September, early August. Now at this point, we don't have any idea on how many of the 10,000 labs are going to report the data. What we do know last time is that only 1% of the labs submitted data. But if that process continues on, there could be new rates that are implemented by CMS effective January 1.

好的。謝謝你的問題。你看，就目前而言，PAMA 有三種可能的結果。我想如你所知，第一種是 CMS 正在進行資料蒐集流程，而該資料蒐集流程在 7 月 30 日結束。我們預期會在大約 9 月下旬、8 月上旬左右聽到一些消息。目前我們還不知道 1 萬家實驗室中會有多少家回報資料。我們所知道的是，上一次只有 1% 的實驗室提交資料。但如果這個流程持續下去，CMS 可能會制定新的費率，並自 1 月 1 日起生效。

The second outcome is we get the RESULTS Act passed. The bill -- the RESULTS Act it was introduced last September, September of '25. It has incredibly strong bipartisan support, over 115 cosponsors have signed on. In addition, there's 60-ish patients and consumer-based organizations that are endorsing the bill. There's been one successful hearing in the House Energy and Commerce Committee. But it still needs to go through a markup process. It has to be scored by CBO, and CMS needs to do their own tech assessment of that.

第二種結果是我們讓《RESULTS Act》獲得通過。該法案——《RESULTS Act》是在去年 9 月提出的，也就是 25 年 9 月。它獲得極為強勁的跨黨派支持，已有超過 115 位共同提案人（cosponsors）加入。此外，約有 60 個以病患與消費者為基礎的組織正在背書支持該法案。眾議院能源與商業委員會已成功舉行過一次聽證會。但它仍需要進入審議（markup）程序。它必須由 CBO 進行預算評分（scored），而 CMS 也需要對其進行自身的技術評估。

So no matter what, we are going to continue to push for the RESULTS Act. Even if CMS does go ahead and implement new rates, we would still push for the RESULTS Act because we believe it's a better and fair way of collecting the data and collect some of the flaws under that original process.

因此無論如何，我們都會持續推動《RESULTS 法案》。即使 CMS 確實繼續推行新的費率，我們仍會推動《RESULTS 法案》，因為我們相信這是一種更好且更公平的資料蒐集方式，並能修正原始流程中的一些缺陷。

As you know, as part of the RESULTS Act, we've advocated for a third-party group that collects adjudicated claims across the industry. And we believe it's a much more effective, higher quality, and more efficient way to arrive at what is the market price for lab data. The third possible outcome is if results is not passed, we will again push for another delay.

如你所知，作為《RESULTS 法案》的一部分，我們一直主張由第三方團體蒐集全產業已裁定（adjudicated）的理賠申請資料。我們相信，這是更有效、更高品質且更具效率的方法，用以得出實驗室資料的市場價格。第三種可能的結果是：如果 RESULTS 未能通過，我們將再次推動再度延後。

As you know, there's been six delays now. Congress has acknowledged that the original PAMA cuts were not sustainable. The original estimates on those cuts by the way, provided by CBO was on the order of $2.5 billion in savings over 10 years. But the first three cuts that were executed in '18, '19, and '20 actually saved the government $4 billion over a three-year period. So there's acknowledgment that the process, as originally designed, did not work as intended. And so if we don't get results done this year, we will push, obviously, for another delay.

如你所知，現在已經延後六次了。國會已承認，最初的 PAMA 調降幅度並不可持續。順帶一提，CBO 對這些調降的原始估算，是在 10 年內節省約 25 億美元。但在 2018、2019 與 2020 年實施的前三次調降，實際上在三年期間就為政府節省了 40 億美元。因此大家也承認，原先設計的流程並未如預期運作。所以如果我們今年無法完成 RESULTS，我們顯然會再推動一次延後。

Elizabeth Anderson, Evercore ISI.

Elizabeth Anderson，Evercore ISI。

You talked a lot about sort of the hospital and the changing environment. Could you update us on the pipeline of hospital deals? Are some of the pressures that they're seeing as a result of the ACA, which as you talked about, you haven't seen in your side, causing them to be more interested in perhaps partnering with you guys going forward? Are you seeing any changes in that perspective?

你談了很多關於醫院以及環境變化的部分。你能否更新一下醫院交易（deal）管線的情況？他們因 ACA 所承受的一些壓力——如你所說，你們這邊尚未看到——是否讓他們更有興趣在未來與你們合作或建立夥伴關係？你是否看到他們在這方面的觀點有任何改變？

Yeah. So again, on the hospital side, there's multiple ways we work with hospitals. One is just we take on their reference work, work that they choose not to do. So I indicated in previous comments, that book of business grew nicely in the second quarter. So maybe what we are seeing is a willingness to outsource more tests, those tests that they don't feel they can make money on.

是的。所以再說一次，在醫院端，我們與醫院合作有多種方式。其中一種是我們承接他們的轉介檢驗（reference work），也就是他們選擇不做的檢驗項目。我在先前的評論中提到，這塊業務在第二季成長得不錯。所以我們可能看到的是，他們更願意外包更多檢驗，特別是那些他們覺得無法獲利的檢驗。

The second way we work with them is through these Co-Lab arrangements. Again, we closed one arrangement in the second quarter in our pipeline of other opportunities from managing the health system's laboratories that funnel of opportunities looks good. The third way we work with them is on outreach deals. And the funnel of outreach deals continues to be good.

第二種合作方式是透過這些 Co-Lab 安排。同樣地，我們在第二季於既有管線中完成了一項安排；而在管理醫療體系實驗室的其他機會方面，那個機會漏斗看起來也不錯。第三種合作方式是外展（outreach）交易。而外展交易的機會漏斗也持續保持良好。

Some deals are better than other deals. We would like to work with health systems that are growing, that are expanding their services, expanding their doctors as opposed to working with health systems that are closing hospitals, shedding hospitals, and fending doctors. So those are the kinds of health systems that we search for. We also look into markets where our presence may not be that strong and is a good way to get a foothold into that local market, we'll reach out to these hospitals and see if we can't work with them more closely.

有些交易比其他交易更好。我們希望與正在成長、擴張服務、擴增醫師人數的醫療體系合作，而不是與正在關閉醫院、縮減院區、並流失醫師的醫療體系合作。因此，這些就是我們尋找的醫療體系類型。我們也會關注一些我們據點可能不夠強的市場，因為這是切入當地市場、建立立足點的好方式；我們會主動接觸這些醫院，看看是否能更緊密地合作。

Kevin Caliendo, UBS.

Kevin Caliendo，UBS。

Congrats. I wanted to talk about the rev req number. It was really strong. 2.9% is up from even what you did in the first quarter. And just what's the makeup of that? Is it a number of tests per session is driving that? Is it more consumer testing that's causing that? Is it a different mix of more esoteric or higher cost testing? And is this number sustainable going forward? How should we think about that actual -- the trends in the rev req number into the second half even beyond?

恭喜。我想談談 rev req 這個數字。它非常強勁，2.9% 甚至高於你們第一季的表現。想請問其組成是什麼？是每張申請單（requisition）上的檢驗數量在推動嗎？是更多消費者檢測帶來的嗎？還是因為組合不同，更多偏向更專門（esoteric）或更高成本的檢測？而這個數字未來是否可持續？我們該如何看待下半年、甚至更往後 rev req 的實際趨勢？

Kevin, this is Sam. So I think you've hit on the key things there frankly, in terms of some of the things that are driving rev req. So yeah, revenue per requisition was very strong in the quarter. It was up 2.9%. If you exclude the Corewell and Fresenius mix impact on that. And really, the key things, number one, I would say, test per req is definitely continuing to improve. So we continue to see that test per require number creep up every quarter.

Kevin，我是 Sam。坦白說，我認為你已經點出了推動 rev req 的關鍵因素。所以是的，本季每張申請單收入（revenue per requisition）非常強勁。成長了 2.9%。若排除 Corewell 與 Fresenius 的組合影響。而真正的關鍵因素，第一，我會說每張申請單的檢驗數（tests per req）確實持續改善。所以我們持續看到每張申請單的檢驗數每季都在緩步上升。

And I think I've mentioned before the stat where prior to COVID, we were sitting at somewhere between 3.5 and 4 tests per req. And today, we're somewhere almost north of 4.5. So we've added almost an additional test per rep, which really makes a big difference on the revenue per requisition. You mentioned consumer, and that's definitely also helping revenue per requisition.

我想我之前提過一個數據：在 COVID 之前，我們每張申請單大約介於 3.5 到 4 項檢驗。而今天，我們幾乎已經超過 4.5。也就是說，我們幾乎每張申請單多增加了 1 項檢驗，這對每張申請單收入的影響非常大。你提到消費者端，這也確實在幫助提升每張申請單收入。

These are high value or high-value, or high -- very robust panels, let's put it this way, with a very high-value rev per req as well. So some of that consumer business that we have where we power a lot of these functional and wellness companies that are operating in this space. And Advanced Diagnostics or esoteric mix also helps drive rev per req as well. So I think you mentioned the key things, but I would say test per req is really the key one consumer is definitely helping as well. Those are the two key main ones.

這些是高價值、或高——我們這樣說吧，是非常完整、很強的檢測組合（panel），其每張申請單收入也非常高。因此，我們的一部分消費者業務，是我們為許多在此領域運作的功能醫學與健康（wellness）公司提供檢測能力。此外，先進診斷（Advanced Diagnostics）或更專門（esoteric）的組合也有助於推動每張申請單收入。所以我認為你提到的都是關鍵，但我會說每張申請單的檢驗數是最核心的一項；消費者端也確實在幫忙。這兩個是最主要的關鍵因素。

Yeah. And just to add a little color there. On the Advanced Diagnostics, it's -- our brain health portfolio continues to grow at high double-digit rates. And it's both the peak tow markers as well as the amyloid plaque markers, the AB42/40. Our cardiometabolic, advanced cardiometabolic, book-to-business continues to grow at significant rates. The AB, the [AOB], the [Lpa] and also the insulin resistance test are robust. And then finally, autoimmune disorders continue to grow. And this analyzer assay that we have put out for primary care physicians that help them diagnose autoimmune disorders and helps them refer the patient to the right specialist.

是的。再補充一些細節。在先進診斷方面，我們的腦健康產品組合持續以高雙位數成長。其中包含 p-tau 標記以及類澱粉斑塊標記，也就是 AB42/40。我們的心代謝（cardiometabolic）、先進心代謝業務（book-to-business）也持續以顯著速度成長。AB、[AOB]、[Lpa]，以及胰島素阻抗檢測都很強勁。最後，自體免疫疾病相關檢測也持續成長。而我們推出的這項分析儀檢測（analyzer assay）是提供給基層照護醫師使用，協助他們診斷自體免疫疾病，並幫助他們將病患轉介到正確的專科醫師。

Now all of those things, by the way, are not mutually exclusive, right? These kind of work together. Many of these Advanced Diagnostics we're seeing in the functional health space, and because of many of the chronic conditions, whether it's diabetes, HIV, hepatitis C, hepatitis B, we're seeing a pickup of testing from those types of patients as well.

順帶一提，這些事情並不是互斥的，對吧？它們彼此是相互配合的。我們在功能健康領域看到許多這類先進診斷；而由於許多慢性病狀況，不論是糖尿病、HIV、C 型肝炎、B 型肝炎，我們也看到來自這些類型病患的檢測量有所回升。

Pito Chickering, Deutsche Bank.

Pito Chickering，德意志銀行。

Could you talk a little bit more about Haystack, like how we think the volumes can increase post the New York State approval? And also talk about the deal is flat higher and how we should think about that partnership?

你能否再多談一點 Haystack，例如在取得紐約州核准後，我們應該如何看待量能（volumes）提升？也請談談與 Flatiron 的合作案，以及我們應該如何看待那個夥伴關係？

Yes. Thanks, Pito. So importantly, we did get New York State approval of our Haystack tumor-informed test in the quarter. I believe there's only one other company that has approval from New York State from a tumor-informed standpoint, I think there's some naive tests that they've approved as well. But look, the New York State approval process is very, very rigorous. So we believe it sends a strong signal about the quality and efficacy of the assay that we have.

好的。謝謝你，Pito。重要的是，我們在本季取得了紐約州對 Haystack 腫瘤知情（tumor-informed）檢測的核准。我相信從腫瘤知情的角度來看，只有另一家公司也取得紐約州核准；我想他們也有一些腫瘤非知情（naive）的檢測獲得核准。但你看，紐約州的核准流程非常、非常嚴格。因此我們相信，這對我們這項檢測（assay）的品質與效能釋放出強烈訊號。

New York is also, as you know, an important market from a cancer standpoint. You have Memorial Sloan Kettering, we have Cornell Hospital, Roswell in Buffalo leading cancer hospital and [Swan] Memorial, the upstate institutions. So a lot of big cancer institutions in New York that this will open us up to. So we feel good about that. The Flatiron relationship is significant. It just provides ease of ordering to a large, large group of medical oncologists across the country. So we're now integrated into [Epicora]. We're now integrated into Flatiron. We have our own portal as well. And these are all things that just make ordering and tracking of test results simpler and easier for clinicians.

紐約同樣地，如你所知，從癌症的角度來看也是一個重要市場。你們有紀念斯隆凱特琳癌症中心（Memorial Sloan Kettering），我們有康乃爾醫院（Cornell Hospital），以及水牛城的羅斯威爾（Roswell）這家領先的癌症醫院和[Swan] Memorial，還有上州的各個機構。因此，紐約有很多大型癌症機構，這將讓我們得以接觸到它們。所以我們對此感到很有信心。與 Flatiron 的合作關係很重要。它只是讓全國非常、非常龐大的一群腫瘤內科醫師更容易下單。所以我們現在已經整合進[Epicora]。我們現在也已整合進 Flatiron。我們也有自己的入口網站。而這些都是讓臨床醫師下單與追蹤檢測結果變得更簡單、更容易的事情。

What I would tell you, look, we're pacing our commercial investments, and we're pacing the growth of tests that we're doing commensurate with reimbursement. We don't want to get too far out in front of ourselves. We don't need to get too far out in front of ourselves because the switching costs are next to nothing, a clinician can switch. So we're driving reimbursement. As you know, we sit in the Novitas [MAC] and then we've submitted to MolDx for Medicare Advantage reimbursement, and hopefully that comes in the back half of this year.

我會跟你說，你看，我們正在控制商業投資的節奏，並且讓我們所做檢測的成長速度與給付（reimbursement）相匹配。我們不想讓自己走得太超前。我們也不需要走得太超前，因為轉換成本幾乎為零，臨床醫師隨時可以切換。所以我們正在推動給付。如你所知，我們是在 Novitas [MAC] 轄區，並且我們已向 MolDx 提交申請以取得 Medicare Advantage 的給付，並希望能在今年下半年獲得結果。

Patrick Donnelly, Citi.

Patrick Donnelly，花旗（Citi）。

Maybe a follow-up on all of the earlier ones. Just in terms of the utilization backdrop, what you guys are seeing overall, what you're assuming as we work our way into the back half? And then on the back of that, just the pricing conversations, I know those roll each quarter. Any changes in terms of the tone from the payer side as you guys have those pricing discussions?

也許延續前面幾個問題追問一下。就整體使用量（utilization）的背景而言，你們目前看到的整體情況如何？以及當我們進入下半年時，你們的假設是什麼？另外基於此，再談一下定價的討論，我知道這些每季都會更新。在你們與付款方（payer）進行這些定價討論時，對方的語氣或態度有任何變化嗎？

Yeah. Thanks. So again, the utilization remains strong. So if we look at the primary segments in the business, we talked about hospital systems, our reference book of business, mid-single-digit growth, our core physician business. So [exec] -- or ex all the wellness, our core consumer business also is getting growth in the high-single digits, both volume and revenue.

是的。謝謝。所以再說一次，使用量仍然很強勁。如果我們看業務中的主要區隔，我們談到醫院體系、我們的參考檢測業務（reference book of business）呈現中個位數成長，以及我們核心的醫師端業務。所以[exec]——或者說扣除所有健康（wellness）後，我們核心的消費者業務在量與營收上也都有高個位數成長。

And then finally, our Consumer business, last year, we sized the entirety of that consumer business, both direct and indirect at about $250 million. We said it would grow in 2027, somewhere between 20% and 30%. And I would tell you right now, it's on the high side of that estimate. So we feel good about the utilization through those channels as well. So put all that together and it's painting a good utilization story.

最後，我們的消費者業務，去年我們估算整體消費者業務（包含直接與間接）約為 2.5 億美元。我們說到 2027 年它會成長約 20% 到 30%。而我現在可以告訴你，它正處於該估計區間的高端。所以我們對這些通路的使用量也感到很有信心。把這些綜合起來，就呈現出一個很好的使用量故事。

Now look, it's driven by two things, driven by multiple things. One is the chronic conditions that continue to exist in this country as well as this consumer taking on of their own health and taking charge of their health and looking for the signals off their body to get in front of sickness trends. So we feel good. And the only other thing I would add is we're three weeks here into July and the volumes thus far, three weeks into the quarter are consistent with what we saw in the second quarter.

現在你看，這是由兩件事驅動的，或者說由多個因素驅動。其中之一是這個國家持續存在的慢性病狀況；另外是消費者更主動承擔自身健康、掌握自己的健康，並從身體訊號中尋找線索，以便在疾病趨勢出現前先行因應。所以我們感覺很好。我唯一還想補充的是，我們現在進入 7 月已三週，截至目前本季前三週的量，與我們在第二季看到的情況一致。

I'd add a couple of things, Patrick. This is Sam. So first of all, really to add to what Jim said, the utilization has been very strong, and we really are expecting the same tailwind to continue in the second half. So really, no assumption of any slowdown or anything different on utilization.

Patrick，我再補充幾點。我是 Sam。首先，延續 Jim 所說的，使用量一直非常強勁，我們確實預期同樣的順風會在下半年持續。所以在使用量方面，我們完全沒有假設會有任何放緩或出現不同的情況。

There are two or three key things, I think, that are more around -- that are more discrete, let me put it this way. The ACA subsidies, we're still expecting that there's going to be, call it, approximately 30-basis-point impact on the year. So obviously, that will have a higher impact on the second half. We lap Corewell and Fresenius in Q4, so that has an impact on the year-over-year growth rate, at least in the second half and specifically in Q4.

我認為有兩三個關鍵事項，更多是——更具體地說，是比較離散的因素。ACA 補貼，我們仍預期全年大約會有 30 個基點的影響。所以很明顯，這在下半年的影響會更大。我們在第四季會與 Corewell 和 Fresenius 形成比較基期（lap），因此這會影響年對年成長率，至少在下半年、尤其是第四季。

Elevance, where we gained access in four key states back in Q1 of 2025 that we continue to see good progress and progression on that, but we're deep into the second year, at least in the second half, and that's going to start to slow down as we lap some of those wins. And then finally, I would say one key thing is weather in Q3, always a wildcard. Last year, we had very little weather disruption, thankfully. We hope it's the same in Q3, but that's not what we're counting on at this point when we look at our outlook and when we build some, what we call weather req in our outlook.

Elevance 方面，我們在 2025 年第一季於四個關鍵州取得准入（access），目前仍看到良好的進展與推進；但在下半年我們至少已進入第二年較深的階段，當我們與部分勝利形成比較基期時，成長將開始放緩。最後，我會說第三季的天氣一直是個不確定因素。去年很幸運，天氣造成的干擾很少。我們希望第三季也是如此，但在我們看展望、以及在展望中建立我們所謂的天氣需求（weather req）時，目前並不是以此作為前提。

So those are the few key discrete things that impact growth in the second half, but everything else in terms of the core utilization is just very strong. In terms of pricing, you asked on the pricing with health plans. I would say those conversations, those renewals are very constructive. We have great partners that we are working constructively with. They recognize and see the value that we bring in terms of high-quality testing, but really lower cost testing into their network. So I think that's playing out as we expected in terms of, as I said earlier, flattish pricing.

所以，這些就是影響下半年成長的幾個關鍵且相對離散的因素；但除此之外，就核心使用量而言仍然非常強勁。至於你問到與健康保險計畫（health plans）的定價。我會說，那些對話、那些續約都非常具建設性。我們有很棒的合作夥伴，彼此以建設性的方式合作。他們認可並看見我們所帶來的價值：高品質檢測，但同時以更低成本的檢測納入他們的網絡。所以我認為這正如我們預期地發展，也就是如我先前所說，定價大致持平（flattish pricing）。

David Westenberg, Piper Sandler.

David Westenberg，Piper Sandler。

Congrats on the quarter. This is [Karan] on for David. Maybe a couple on oncology. First, the Shield-Guardant partnership, if you can maybe speak to early adoption there? And then going back to Haystack, can you maybe speak to priorities around maybe evidence generation to compete with the MRD test and drive further adoption and reimbursement?

恭喜本季表現。我是代表 David 的[Karan]。想問幾個關於腫瘤的問題。首先是 Shield-Guardant 的合作夥伴關係，你能否談談目前的早期採用情況？另外回到 Haystack，你能否談談在證據生成（evidence generation）方面的優先事項，例如如何與 MRD 檢測競爭、並推動進一步的採用與給付？

Yeah. So on the first part of your question, Shield-Guardant, we don't comment on volumes of that test. As you know, we offer -- we offer it on our menu and we offer to do draws at a price, obviously, the Guardant pays us for that. So -- but they'll talk to volumes, I'm sure, on their call.

好的。就你問題的第一部分，Shield-Guardant，我們不評論該檢測的量。如你所知，我們——我們把它納入我們的檢測選單，也提供抽血服務並收取費用，當然 Guardant 會為此付費給我們。所以——但我相信他們會在他們的電話會議上談到量。

On Haystack, from a clinical evidence standpoint, look, we're solid from a colorectal cancer standpoint, we had some great studies that have been published along the way and feel good about that. We have ongoing studies across breast and lung that will also pay fruit. But look, at the end of the day, there's both clinical evidence and just proving that your assay from a sensitivity and specificity is leading and one of the best in the industry and better than some of the competitors that are out there.

至於 Haystack，從臨床證據的角度來看，你看，在大腸直腸癌方面我們基礎很扎實，過程中發表了幾項很好的研究，我們對此感到很有信心。我們也在乳癌與肺癌方面進行中的研究，之後也會開花結果。但你看，歸根結底，既有臨床證據，也要證明你的檢測（assay）在靈敏度（sensitivity）與特異性（specificity）上是領先的、是業界最好的之一，並且優於市面上一些競爭對手。

So a dual approach. We're going to present the clinical evidence, but we also have very good evidence that when we look at the sensitivity, specificity of the Haystack assay, when we look at the detection in terms of parts per million, it's a leading test.

所以是雙軌策略。我們會提出臨床證據，同時我們也有非常好的證據顯示，當我們看 Haystack 檢測的靈敏度、特異性，以及以百萬分之一（parts per million）衡量的檢出能力時，它是一項領先的檢測。

[Jay Lewis], Baird.

[Jay Lewis]，Baird。

Elevance recently added coverage for certain blood-based biomarker tests for Alzheimer's. I think that makes it one of, if not the first major payer to do so, how big of an opportunity or driver of this new coverage policy for a major payer? And was anything like this embedded in 2026 expectations? And as a quick follow-up, if you'd be able to size the Alzheimer's book of testing right now and the growth that you're seeing there, that would be great.

Elevance 最近新增對某些以血液為基礎的阿茲海默症生物標記檢測的給付範圍。我認為這使其成為第一家、或至少是第一批這麼做的主要支付方之一；這項新的主要支付方給付政策帶來多大的機會或驅動力？另外，這類因素是否已納入 2026 年的預期之中？再快速追問一下，如果你們能估算目前阿茲海默症檢測業務的規模，以及你們看到的成長幅度，那就太好了。

Okay. So on Elevance, yes, they are now reimbursing for the P-tau217 biomarker. It's a biomarker we offer. It's actually we get it through one of our suppliers. There's a range of suppliers that offer the test, they're all very similar. They are not yet reimbursing though, on the other very important biomarker called AB-4240. At the recent International Alzheimer's conference, there is widespread perspective of the importance of both biomarkers, both the P-tau biomarker as well as the AB, the amyloid biomarker, we call AB-4240.

好的。關於 Elevance，是的，他們現在會對 P-tau217 生物標記進行給付。這是我們提供的一項生物標記。實際上我們是透過其中一家供應商取得。市場上有一系列供應商提供這項檢測，彼此都非常相似。不過，他們目前尚未對另一個非常重要、稱為 AB-4240 的生物標記進行給付。在最近的國際阿茲海默症會議上，普遍認為兩種生物標記都很重要：P-tau 生物標記以及 AB（類澱粉）生物標記，我們稱之為 AB-4240。

And by the way, that's the panel, that combined panel, along with an algorithmic interpretation of that, that provide -- that we are selling today, and it's doing quite well. The -- in terms of -- look, there's other payers that are certainly reimbursing for one or both of these tasks. Medicare, there's broad reimbursement in Medicare Advantage. There's broad reimbursement of those panels. And you can imagine, the majority of the testing we see is patients that are above 60 years of age. I'm not -- we're not going to provide today the absolute size of that business. But what I did say in an earlier question is that it is growing in the high-, high-double digits.

順帶一提，這個組合檢測面板——也就是合併面板，再加上對其進行的演算法式解讀——能提供……這正是我們目前正在銷售的產品，而且表現相當不錯。就……就這方面而言——你看，當然也有其他支付方會對其中一項或兩項檢測進行給付。在 Medicare 方面，Medicare Advantage 有廣泛的給付。這些面板也有廣泛的給付。你可以想像，我們看到的大多數檢測對象是 60 歲以上的患者。我不會——我們今天不會提供該業務的絕對規模。但我在先前一個問題中提到的是，它正以高、高雙位數的速度成長。

Jack Meehan, [Operan] Research.

Jack Meehan，[Operan] Research。

I wanted to get your latest thoughts on the policy outlook with PAMA and outlook for the RESULTS Act and how you were thinking about how things play out through the rest of the year?

我想了解你們對 PAMA 的政策前景、以及 RESULTS Act 前景的最新看法，以及你們如何看待今年剩餘時間的發展走向？

Great. And good to hear from you, Jack. We're glad you're still on the call with us here. So I -- there was an earlier question, maybe quite catch it. But I'll just repeat it quickly. So again, three possible outcomes from a PAMA perspective. First is the current data collection process, which I think everyone knows about. It ends on July 31. We have submitted by the way. We would expect CMS to report out on that in the September -- late September, early October time frame. What we hope to hear is also some assessment of the quality of the data and the number of labs, out of the 10,000 labs that submitted.

很好。也很高興聽到你的聲音，Jack。我們很高興你仍然在線上與我們一起參與。所以我——先前有個問題，我可能沒有完全聽清楚。不過我快速再重述一次。同樣地，從 PAMA 的角度來看，有三種可能的結果。第一種是目前的資料蒐集流程，我想大家都知道。它將於 7 月 31 日結束。順帶一提，我們已經提交了。我們預期 CMS 會在 9 月——9 月下旬到 10 月上旬這段時間公布結果。我們也希望能聽到他們對資料品質以及提交的實驗室數量的評估——在 10,000 家提交的實驗室之中。

As you know, last time, only about 1% of the labs submitted, and it was a very, very biased statistical sample of actual laboratory market-based pricing. The second possible outcome is we get the RESULTS Act passed. There is broad support bipartisan support, over 115 co-sponsors have signed on as well as many other patient and consumer organizations. There's been a hearing with the House Energy and Commerce that was viewed as favorable.

如你所知，上一次只有約 1% 的實驗室提交，而且那是一個非常、非常有偏差的統計樣本，無法反映實際實驗室市場化定價。第二種可能結果是 RESULTS Act 得以通過。它獲得廣泛的跨黨派支持，已有超過 115 位共同提案人連署，並且也有許多其他病患與消費者組織支持。眾議院能源與商業委員會已舉行聽證會，整體被視為有利。

And as you know, as part of the RESULTS Act, what we've put forward or what our trade association and others have put forward, is that there's a third party used to provide a really good, robust statistical sample of all the adjudicated claims in the industry. If the results at is passed by the way, rates stay flat for '27 and '28, there'd be a data collection of the 2027 data and new rates would go into effect in 2029. And with a cap of no more than 5% cuts per year. And then the third possible outcome if we can't get results through this year is another delay. And as you know, there's been six delays.

而且如你所知，作為 RESULTS Act 的一部分，我們提出的——或我們的產業公會與其他單位提出的——是使用第三方來提供一個真正良好、具韌性的統計樣本，涵蓋產業中所有已裁定（adjudicated）的理賠。順帶一提，如果 RESULTS Act 通過，'27 與 '28 的費率將維持不變；將蒐集 2027 年的資料，新的費率會在 2029 年生效。並且每年降幅上限不超過 5%。第三種可能結果是，如果我們今年無法推動 RESULTS 通過，那就會再度延後。而如你所知，已經延後過六次。

Why? Because Congress is acknowledged that the PAMA cuts were not sustainable and the process was not -- didn't come out as intended. So those are the possible outcomes under any scenario we push for results, even if CMS was to set new rates based on this data collection process that's going on, we'll still push our results. We're never going to give up on that because we think that is the best approach to figuring out what the actual market rates are for laboratory testing.

為什麼？因為國會已承認 PAMA 的降價不可持續，而且該流程並未——沒有如原先預期那樣產出結果。因此，在任何情境下，這些都是可能的結果；我們都會推動 RESULTS。即使 CMS 依據目前正在進行的資料蒐集流程來設定新費率，我們仍會推動 RESULTS。我們永遠不會放棄，因為我們認為那是用來釐清實驗室檢測實際市場費率的最佳方法。

Great. Operator, those are our last question. (inaudible).

很好。接線員，以上是我們最後一個問題。（聽不清楚）。

Okay. Thank you, everyone, for joining in today. We certainly appreciate the continued support. We'll see some of you soon. And thank you, and have a great day.

好的。感謝各位今天加入。我們非常感謝大家持續的支持。我們很快會再見到其中一些人。謝謝，祝各位有美好的一天。

Thank you for participating in the Quest Diagnostics second-quarter conference call. A transcript of prepared remarks on this call will be posted later today on Quest Diagnostics website at www.questdiagnostics.com.

感謝您參與 Quest Diagnostics 第二季電話法說會。本次電話會議的事先準備講稿逐字稿將於今日稍晚發布於 Quest Diagnostics 官網 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 July 23, 2026, and until midnight Eastern time on August 6, 2026. Thank you, and goodbye.

本次電話會議的重播可於線上 www.questdiagnostics.com/investor 收聽，或致電（866）388-5361（美國境內來電），或（203）369-0416（國際來電）。電話重播將自 2026 年 7 月 23 日美東時間上午約 10:30 起提供，並持續至 2026 年 8 月 6 日美東時間午夜。謝謝，再見。