GeneDx Holdings Corp. (WGS) 2026 Q2 法說會逐字稿

Good day, and thank you for standing by. Welcome to the GeneDx second quarter 2026 earnings conference call. (Operator Instructions) Please be advised that today's conference is being recorded.

各位好，感謝您耐心等候。歡迎參加 GeneDx 2026 年第二季財報電話會議。(接線員指示) 請注意，今天的會議將被錄音。

I would now like to hand the conference over to your first speaker today, Sabrina Dunbar of Investor Relations. Please go ahead.

現在我想把會議交給今天的第一位講者，投資人關係部的 Sabrina Dunbar。請開始。

Thank you, operator, and thank you, everyone, for joining us today. On the call, we have Katherine Stueland, Chief Executive Officer; Kevin Feeley, Chief Financial Officer; and Mark Gardner, President. Earlier today, GeneDx released financial results for the second quarter ended June 30, 2026.

謝謝您，接線員，也謝謝各位今天加入我們。今天與會者包括執行長 Katherine Stueland、財務長 Kevin Feeley，以及總裁 Mark Gardner。今天稍早，GeneDx 已發布截至 2026 年 6 月 30 日止第二季的財務結果。

Before we begin, please take note of our cautionary statement. We may make forward-looking statements on today's call, including about our business plans, updated 2026 guidance and outlook. Forward-looking statements inherently involve risks and uncertainties and only reflect our view as of today, August 3, and we are under no obligation to update.

在開始之前，請留意我們的警示性聲明。我們在今天的電話會議中可能會做出前瞻性陳述，包括關於我們的業務計畫、更新後的 2026 年指引與展望。前瞻性陳述本質上涉及風險與不確定性，且僅反映我們截至今天 8 月 3 日的觀點，我們沒有義務更新。

When discussing our results, we refer to non-GAAP measures, which exclude certain items from reported results. Please refer to our second quarter 2026 earnings release and slides available at ir.genedx.com for definitions and reconciliations of non-GAAP measures and additional information regarding our results. Additionally, please refer to our most recent annual and quarterly filings with the SEC for a discussion of factors that could cause actual results to materially differ from forward-looking statements.

在討論我們的業績時，我們會引用非 GAAP 指標，該等指標會自已報告結果中排除某些項目。請參閱我們的 2026 年第二季財報新聞稿與簡報（可於 ir.genedx.com 取得），以了解非 GAAP 指標的定義與調節，以及關於我們業績的其他資訊。此外，請參閱我們最近向美國證券交易委員會（SEC）提交的年度與季度申報文件，其中討論了可能導致實際結果與前瞻性陳述存在重大差異的因素。

With that, I will turn the call over to Katherine.

接下來，我把電話交給 Katherine。

Thank you, Sabrina, and good afternoon, everyone. Our team demonstrated incredible focus and agility to deliver a solid second quarter. We hit a new record, resulting more than 30,000 exome and genome tests in the quarter, which represents 32% year-over-year growth. We reported $114.4 million of total revenue, exceeding our guide, and returned to profitability one quarter earlier than we had previously expected. Based on our second quarter performance and our continued momentum into Q3, we are reaffirming our full year 2026 guidance.

謝謝你，Sabrina，各位下午好。我們的團隊展現了驚人的專注與敏捷性，交出穩健的第二季成績。我們創下新紀錄，本季完成超過 30,000 例外顯子與全基因組檢測，年增 32%。我們公布總營收 1.144 億美元，超出我們的指引，且比先前預期提早一季回到獲利。基於第二季表現以及我們延續至第三季的動能，我們重申 2026 全年指引。

Demand for our services has never been higher. And as we continue to drive adoption of our exome and genome, we must be relentless in our efforts to improve the rate at which we get paid for our services. It's the single biggest opportunity for us.

市場對我們服務的需求從未如此強勁。而在我們持續推動外顯子與全基因組檢測採用的同時，我們必須不懈地努力提升我們服務的收款率。這是我們最大的單一機會。

And as we shared on the last call, we've organized the business around three key imperatives: first, optimizing unit economics; second, growing utilization of exome and genome; and third, delivering leading products at unmatched scale, all while managing our capital responsibly. Optimizing unit economics is our first priority because we're underearning on our potential, and we see significant room for improvement off this Q2 baseline.

正如我們在上次電話會議中分享的，我們已將業務圍繞三項關鍵要務來組織：第一，最佳化單位經濟效益；第二，提高外顯子與全基因組的使用量；第三，以無可匹敵的規模提供領先產品，同時負責任地管理資本。最佳化單位經濟效益是我們的首要任務，因為我們目前未能充分實現應有的獲利能力，而相較於第二季的基準，我們看到顯著的改善空間。

Our long-term vision remains unchanged. We believe the genome will increasingly become the standard for diagnosing all heritable disease, and we're continuing to optimize our commercial and operational strategies to bridge this transition. Our strategies took hold in the second quarter as mix moderated with steady month-over-month mix gains back into our exome products, including reflex.

我們的長期願景維持不變。我們相信，全基因組將日益成為診斷所有可遺傳疾病的標準，而我們也持續最佳化商業與營運策略，以銜接這一轉變。我們的策略在第二季開始發揮效果，產品組合趨於穩定，且外顯子產品（包含 reflex）在月度上持續回升、組合占比逐月改善。

In tandem, we saw coverage begin to catch up with the clinical demand, with Carelon announcing a new coverage policy that expanded commercial genome coverage from 47% to 87% in just one quarter. Our team plays a pivotal role in these coverage expansions through advocacy and evidence generation, and we'll continue to pursue coverage expansion opportunities for both exome and genome.

同時，我們看到保險給付範圍開始追上臨床需求；Carelon 宣布新的給付政策，在短短一季內將商業保險的全基因組給付覆蓋率從 47% 擴大到 87%。我們的團隊透過倡議與證據生成，在這些給付擴張中扮演關鍵角色；我們也將持續尋求外顯子與全基因組的給付擴張機會。

This is our market development strategy in action. By serving the market ahead of coverage, we demonstrate demand and medical necessity. That unpaid volume is prime for us to accrete revenue in new markets as coverage expands.

這正是我們市場開發策略的具體展現。透過在給付到位之前先服務市場，我們得以證明需求與醫療必要性。這些尚未收款的檢測量，將在給付範圍擴大時，成為我們在新市場中增加營收的優質來源。

Now our greatest focus is translating coverage into payment. We'll spend the majority of our time today discussing how we'll get paid far more for our tests and in doing so, see in the fullness of time, revenue growth rates converge with or exceed volume growth in the future.

目前我們最大的重點，是把給付範圍轉化為實際付款。今天我們將把大部分時間用於討論如何讓我們的檢測獲得更高的付款；如此一來，隨著時間推進，我們將看到未來營收成長率與檢測量成長率趨於一致，甚至超越。

We're committed to serving families during their moments of greatest need. They're at the center of everything we do. To reach them, we're making strong progress against both our foundational and expansion markets, and demand continues to be a source of strength and optionality. We've proven we can maintain our leadership position through this genome transition and our competitive positioning is directly translatable.

我們致力於在家庭最需要的時刻提供服務。他們是我們一切工作的核心。為了觸及他們，我們在基礎市場與擴張市場兩方面都取得了強勁進展，而需求仍然是我們的優勢來源，也帶來更多策略選擇空間。我們已證明能在這波全基因組轉型中維持領導地位，而我們的競爭定位也能直接延伸並轉化為優勢。

Clinicians choose GeneDx and return to GeneDx because of the quality and reliability of our results, our leading turnaround times, our deep data and expertise and the customer support infrastructure we have built specifically for the complexity of rare disease. As genomic testing moves into the mainstream, our ability to transform a genome's worth of information into a single actionable answer will only increase in importance.

臨床醫師選擇 GeneDx 並持續回到 GeneDx，是因為我們結果的品質與可靠性、領先的報告週轉時間、深厚的資料與專業能力，以及我們為罕見疾病的複雜性所打造的客戶支援基礎設施。隨著基因檢測走向主流，我們將一整個基因組的資訊轉化為單一可採取行動答案的能力，只會變得更加重要。

In summary, demand is strong, and we're now leaning into a large multiyear opportunity to improve ARR, which will serve as a significant revenue tailwind. We are confident we can drive collections to the industry standard of 70%, and we're building on the strength of our team to realize this massive revenue opportunity ahead.

總結來說，需求強勁，而我們正積極把握一個跨多年、可大幅提升 ARR 的重大機會，這將成為顯著的營收順風。我們有信心將收款率提升至產業標準的 70%，並將在團隊優勢的基礎上，實現這個龐大的營收機會。

With that, I'm happy to pass the call over to the newest addition to our executive team, Mark Gardner. I was elated to welcome Mark to the team back in June, and he has brought his experience from across the industry and passion for what we do to ensure our capabilities keep pace with the growing demand for our services. I'm excited for you to hear directly from him. Mark, please take it away.

接下來，我很高興把電話交給我們執行團隊最新加入的成員 Mark Gardner。我在 6 月非常高興歡迎 Mark 加入團隊；他帶來跨產業的經驗以及對我們使命的熱情，確保我們的能力能跟上對服務日益成長的需求。我也很期待各位直接聽他分享。Mark，請開始。

Thank you, Katherine, and good afternoon, everyone. I'm excited to be here and really grateful for the opportunity to serve patients and customers in this critical segment of the advanced diagnostics industry. I joined GeneDx because I saw a company with proven clinical leadership, a strong market position and a tremendous opportunity ahead. And six weeks in, that conviction has only grown. The quality of our products, our variant classification and interpretation capabilities, our Infinity database and our scale are just some of the things that set us apart as the leader in rare disease testing. I've also observed that while we have grown quickly, we need to strengthen specific elements of our operations to unlock the next phase of growth.

謝謝你，Katherine，各位下午好。我很高興來到這裡，也非常感謝有機會在先進診斷產業這個關鍵領域服務病患與客戶。我加入 GeneDx，是因為我看到這是一家在臨床領導力上已被驗證、具備強勁市場地位，且前方擁有巨大機會的公司。而在加入六週後，這份信念只增不減。我們產品的品質、變異分類與解讀能力、Infinity 資料庫以及我們的規模，都是讓我們在罕見疾病檢測領域脫穎而出、成為領導者的因素之一。我也觀察到，雖然我們成長迅速，但仍需要強化營運中的特定環節，以解鎖下一階段的成長。

Today, I'll walk you through what I believe to be the two most impactful areas for improvement: revenue cycle management and commercial operations. We bring significant value to the healthcare system, and we should be paid fairly for our services. I agree with Katherine that we are underearning today on both exome and genome testing, and this is a significant opportunity that the whole of our company has rallied around.

今天，我將帶各位了解我認為最具影響力的兩個改善領域：營收循環管理與商業營運。我們為醫療體系帶來顯著價值，我們也應該因所提供的服務而獲得公平的報酬。我同意 Katherine 的看法：我們目前在外顯子與全基因組檢測上都未能充分實現應有的收益，而這是一個全公司共同聚焦的重要機會。

To be specific, we are focused on four operational levers to improve the blended average reimbursement rate of the company. First, mix management. By managing our exome versus genome mix in the near term, we have more time to build the internal processes needed to maximize payment on whole genome volume in the long term. Mix improved during the second quarter and continued to improve throughout July.

具體而言，我們聚焦於四個營運槓桿，以提升公司整體加權平均報銷率。第一，產品組合管理。透過在短期內管理外顯子與全基因組的組合比例，我們能爭取更多時間建立內部流程，以在長期最大化全基因組檢測量的收款。第二季期間組合已有改善，且在 7 月持續改善。

Second, expand payer coverage. Payer coverage is moving in the right direction. That's a direct result of GeneDx's evidence and advocacy, but it still lags clinical demand and includes too much red tape.

第二，擴大付款方覆蓋範圍。付款方覆蓋正朝著正確方向發展。這是 GeneDx 的證據累積與倡議所帶來的直接成果，但仍落後於臨床需求，且包含過多的繁文縟節。

Third, implement payer-specific workflows. Medical necessity criteria, documentation requirements and prior authorization processes vary across payers, and we need to build workflows to ensure that we meet every administrative requirement to collect payment. When done well, this approach improves prior authorization approval rates, reduces avoidable denials and increases the percentage of tests for which we are ultimately paid. While we're focused in the near term on improving RCM processes for genome, I would note that our exome business will also continue to see improvements in collection rate.

第三，導入付款方特定的工作流程。醫療必要性標準、文件要求與事前授權流程在不同付款方之間各不相同，我們需要建立工作流程，以確保滿足每一項行政要求，才能收取款項。若執行得當，此作法可提高事前授權核准率、降低可避免的拒付，並提升最終能收到款項的檢測比例。雖然短期內我們聚焦於改善全基因組的營收循環管理（RCM）流程，但我也要指出，我們的外顯子組業務在收款率方面也將持續改善。

Fourth, we have to invest in technology. We're applying artificial intelligence and other systems and processes around or across our entire revenue cycle operations to build a more intelligent and scalable function. This includes internal controls and customer experience features to collect and submit billing information that enables consistent and reliable payment. This is a longer-term capability and under development.

第四，我們必須投資科技。我們正將人工智慧以及其他系統與流程應用於我們整個營收循環營運的各個環節，以打造更智慧且可擴展的職能。這包括內部控制與客戶體驗功能，用於蒐集並提交帳單資訊，以促成一致且可靠的付款。這是一項較長期的能力，目前仍在開發中。

We've already made progress on all four of these actions, and we expect they'll begin to influence rates in the quarters to come. I'm confident based on the data we've seen during Q2 and our ability to drive ARR improvements off this Q2 baseline.

我們在上述四項行動上都已取得進展，並預期它們將在未來幾季開始影響相關比率。根據我們在 2026 年第二季看到的數據，以及我們有能力以第二季的基準推動平均報銷率（ARR）改善，我對此充滿信心。

Next, on commercial. Our core market of geneticists and pediatric neurologists continue to perform well. We maintained our approximately 80% market share among geneticists while expanding our pediatric neurology market share to roughly 50%. So while geneticists may have moved from exome to genome over the past year, they did not leave GeneDx.

接下來談商業端。我們的核心市場——遺傳科醫師與小兒神經科醫師——持續表現良好。我們在遺傳科醫師中的市占率維持約 80%，同時將小兒神經科市場的市占率擴大至約 50%。因此，儘管過去一年遺傳科醫師可能從外顯子組轉向全基因組，但他們並未離開 GeneDx。

At the same time, it could still take years to reach a geneticist. Thus, diversifying call points will enable us to unlock our total addressable market and bring the power of genomic testing to patients with a much shorter diagnostic journey. This strategy is driving our investment approach. For example, based on changes in the AAP guidelines, we invested in building out our commercial team to serve general pediatrics in early 2026.

同時，患者要見到遺傳科醫師仍可能需要數年時間。因此，多元化拜訪對象將使我們得以釋放可服務市場總量，並讓患者以更短的診斷旅程獲得基因組檢測的力量。此策略正驅動我們的投資方式。例如，基於 AAP 指南的變更，我們投資擴建商業團隊，以在 2026 年初服務一般兒科。

In Q2, we saw our highest growth ever in this channel, and we're seeing the early signals that typically precede larger scale adoption, including increased engagement with our field reps and medical science liaisons, new account creation and first orders from new clinicians. Across all markets, we'll continually adjust coverage models as necessary to ensure that each dollar we invest in the sales force has an appropriate return on investment in the longer term. In summary, by driving process excellence and revenue cycle management and prudently investing in call point diversification, we will drive sustainable long-term growth for the company.

在第二季，我們在此通路看到史上最高的成長，且也看到通常會先於更大規模採用的早期訊號，包括與我們的外勤業務代表與醫學科學聯絡員（MSL）的互動增加、新帳戶建立，以及新臨床醫師的首筆訂單。在所有市場中，我們將視需要持續調整覆蓋模型，以確保我們對銷售團隊投入的每一美元，長期而言都能獲得適當的投資報酬。總結而言，透過推動流程卓越與營收循環管理，並審慎投資於拜訪對象多元化，我們將為公司帶來可持續的長期成長。

I'll now pass it to Kevin to walk through our financials and the leading indicators we will use to track progress over time.

接下來我把時間交給 Kevin，請他帶大家回顧我們的財務表現，以及我們將用來長期追蹤進展的領先指標。

Thanks, Mark, and good afternoon, everyone. Total revenues were $114.4 million, up 11% year-over-year. Exome and genome revenues were $100.3 million, up 17%, with exome and genome result volume of 30,785 tests, up 32%. Unit growth was broad-based across geneticist, pediatric neurology and the NICU, with early contributions from general pediatrics and prenatal. Total company gross margin was 70%, up sequentially from 69% in the first quarter.

謝謝你，Mark，各位下午好。總營收為 1.144 億美元，年增 11%。外顯子組與全基因組營收為 1.003 億美元，年增 17%；外顯子組與全基因組結果量為 30,785 例檢測，年增 32%。單位量成長在遺傳科、小兒神經科與新生兒加護病房（NICU）等領域均呈現廣泛成長，一般兒科與產前檢測也開始有早期貢獻。公司整體毛利率為 70%，較第一季的 69% 連續提升。

We returned to profitability with adjusted net income of $0.4 million, an $8.6 million improvement from the first quarter. The blended average reimbursement rate in the second quarter was $3,258 per test, roughly flat quarter-over-quarter and in line with expectations. The primary driver of the larger ARR variability against 2025 is the product mix shift into genome. There have been no meaningful changes to our contracted pricing.

我們恢復獲利，調整後淨利為 40 萬美元，較第一季改善 860 萬美元。第二季加權平均報銷率為每次檢測 3,258 美元，與前一季大致持平，符合預期。相較於 2025 年，ARR 波動較大的主要驅動因素是產品組合轉向全基因組。我們的合約定價並無任何重大變動。

We view this Q2 blended ARR as the new baseline for the remainder of the year and are working against three key levers to improve it: product mix, payer coverage and underlying collection rates. First, on mix. In the second quarter of 2026, genome represented 32% of all insurance-based outpatient volume mix, down from close to 40% in the first quarter, demonstrating steady mix share gains back into exome and reflex each month of Q2 and continuing through July. That second quarter genome mix is up from only 15% in 2025 and is what drives the divergence between our volume and revenue growth rates year-over-year. Although genome contracted rates are lower than exome by comparison, I'll underscore that genome gross margins are healthy.

我們將第二季的加權 ARR 視為今年剩餘期間的新基準，並針對三個關鍵槓桿努力以改善：產品組合、付款方覆蓋，以及底層收款率。首先談組合。在 2026 年第二季，全基因組占所有保險給付之門診量組合的 32%，低於第一季接近 40%，顯示第二季每個月外顯子組與 reflex（反射式）檢測的組合占比穩定回升，且此趨勢延續至 7 月。第二季的全基因組組合占比高於 2025 年僅 15% 的水準，這也是我們年對年檢測量與營收成長率出現分歧的原因。雖然相較外顯子組，全基因組的合約費率較低，但我要強調，全基因組的毛利率仍然健康。

Second, on payer coverage. While payer coverage is moving in the right direction, coverage varies significantly between exome and genome, and understanding that gap is important context for the forward-looking ARR outlook.

第二，談付款方覆蓋。雖然付款方覆蓋正朝正確方向前進，但外顯子組與全基因組之間的覆蓋差異仍相當顯著；理解這個落差，是展望未來 ARR 的重要背景。

On the commercial side, approximately 98% of commercial lives have some level of exome coverage, up from approximately 90% in the first quarter. Genome is earlier in that journey. Approximately 87% of commercial lives now have some level of genome coverage, up significantly from 47% last quarter, representing a structural shift in reimbursement outlook for genomes. The primary driver of that increase was Carelon.

在商業保險方面，約 98% 的商業保險人群在某種程度上已涵蓋外顯子組，較第一季約 90% 提升。全基因組仍處於較早期階段。目前約 87% 的商業保險人群在某種程度上已涵蓋全基因組，較上季的 47% 大幅提升，代表全基因組報銷前景出現結構性轉變。該增幅的主要驅動因素是 Carelon。

On the Medicaid side, 39 states now cover exome or genome testing, with Mississippi coming online July 1. The full impact of coverage expansion takes time to flow through our blended ARR and revenue based on collections and accrual lags.

在 Medicaid 方面，目前已有 39 個州涵蓋外顯子組或全基因組檢測，密西西比州已於 7 月 1 日上線。覆蓋擴張的完整影響需要時間，才會因收款與應計落後而反映在我們的加權 ARR 與營收中。

It's important to acknowledge that across both commercial and Medicaid plans, not all coverage policies are created equal. Even with written policy, genomic testing remains out of reach for too many children, as claims are denied by overly restricted eligibility criteria and administrative barriers.

需要強調的是，無論是商業保險或 Medicaid 計畫，各項覆蓋政策並非一律同等。即使有書面政策，基因組檢測對太多兒童而言仍遙不可及，因為理賠會因過度嚴格的資格標準與行政障礙而遭到拒付。

In the second quarter, approximately 67% of our outpatient genome volume was submitted to payers with an active positive coverage policy. Looking at the evolution here, that rate is up from 38% in the second quarter of last year and up from 46% just last quarter. The uptrend has continued in July, given the rolling advancements of policy coverage.

在第二季，我們約 67% 的門診全基因組量是提交給具有有效正向覆蓋政策的付款方。從演進來看，該比率高於去年第二季的 38%，也高於僅上一季的 46%。隨著覆蓋政策持續推進，這一上升趨勢在 7 月仍在延續。

And third, outpatient genome collection rates, which are affected by both coverage and our own operational effectiveness. Our operational underlying outpatient genome collection rate, which is the percentage of claims paid, today stands at approximately 32%, flat with the first quarter and down from 43% in the second quarter of 2025. That decline in collections from last year reflects an investment we made into developing the market by accepting volume ahead of coverage.

第三，門診全基因組收款率，這同時受覆蓋情況與我們自身營運效能影響。我們的營運層面門診全基因組底層收款率（即理賠獲支付的比例）目前約為 32%，與第一季持平，低於 2025 年第二季的 43%。相較去年收款下滑，反映我們為了培育市場而做出的投資——在覆蓋到位之前先行承接檢測量。

Importantly, it reflects a tremendous opportunity for us when, in the fullness of time, we get paid more often for these volumes with greater coverage and with better RCM. As Katherine rightly pointed out, we are underearning versus our full potential. As an illustration of the opportunity, if we were to double that 32% collection rate, what are zeros in our blended ARR today become paid units, driving revenue uplift that falls directly to the bottom line.

重要的是，這也代表一個巨大的機會：隨著時間推進，在覆蓋更完善且 RCM 更佳的情況下，我們將能更常收到這些檢測量的款項。正如 Katherine 正確指出的，我們目前的獲利低於自身的完整潛力。舉例而言，若我們將 32% 的收款率提高一倍，當前加權 ARR 中的「零」將轉為已付款的單位，帶動營收上升，且幾乎直接落到最終利潤。

Now I focus on genome here because of the large year-over-year mix shift and its larger place in the future of the business, and also the fact that exome already operates at a gross margin above the total company average. However, outpatient exome collection rates are comparable to genome, which means there's a ton of room to improve. Most denials are addressable and we'll work to put into -- the work we'll put into RCM aims to benefit the entire portfolio. We do not expect improvements to be perfectly linear, but in terms of pacing, Q3 collection rates should remain roughly flat as our payer-specific workflows are still being built out and incrementally implemented.

我之所以在此聚焦於全基因組（genome），是因為其年對年產品組合轉移幅度很大、且在公司未來業務中占比更高；同時也因為外顯子（exome）目前的毛利率已高於公司整體平均。然而，門診外顯子採檢的收款率與全基因組相當，這代表仍有很大的改善空間。多數拒付是可處理的，我們將投入的營收循環管理（RCM）工作，目標是讓整個產品組合都受益。我們不預期改善會完全線性發生；就節奏而言，由於我們仍在建置並逐步導入按付款方（payer）區分的作業流程，第三季的收款率應大致維持持平。

As a reminder, our revenue recognition reflects collection experience over a trailing period, and thus, it takes a couple of quarters to fully capture improvements in coverage and the impact of operational actions. We expect to see meaningful improvements in Q4 2026 with the most significant uplift coming in 2027, as both expanded coverage and stronger operational execution compound together. Beyond operational effectiveness, that collection rate and thus ARR could always have some underlying variability from the single payer's administrative behaviors, tightening coverage policy or contracting change. However, we serve a diversified payer base, so the impact of any single payer action is usually moderated.

提醒一下，我們的收入認列反映的是一段回溯期間的收款經驗，因此要用幾個季度才能完整呈現承保改善與營運措施的影響。我們預期在2026年第四季會看到顯著改善，而最明顯的提升將出現在2027年，因為承保擴大與更強的營運執行將相互疊加。除了營運效能之外，收款率、進而ARR，仍可能因單一付款方的行政作為、收緊承保政策或合約變更而出現一定的內在波動。不過，我們服務的付款方基礎相當多元，因此任何單一付款方行動的影響通常會被稀釋。

Moving down the income statement, beyond ARR uplift, genome gross margins have room to expand from lower COGS over time. Today, whole genome cost us nearly twice as much to produce than exome. The difference there is almost entirely higher reagent costs, which we expect will come down as utilization for genome grows and manufacturers advance their technology. We expect cost per test to stay relatively flat for the second half of 2026 with step improvements in 2027.

再往下看損益表，除了ARR提升之外，全基因組的毛利率也有空間隨時間因銷貨成本（COGS）下降而擴張。目前，全基因組檢測的製作成本幾乎是外顯子的兩倍。差異幾乎完全來自較高的試劑成本；我們預期隨著全基因組使用量提升以及製造商技術進步，這些成本將下降。我們預期2026年下半年單次檢測成本將相對持平，並在2027年出現階梯式改善。

Operating expenses were approximately $80 million, which was slightly better than expected. We completed the full $25 million of annual cost actions committed to on our last call. And we've recalibrated our investment pace while continuing to protect core investments in our proven growth channels and operational infrastructure.

營業費用約為8,000萬美元，略優於預期。我們已完成在上次電話會議中承諾的每年2,500萬美元全面成本行動。同時，我們在持續保護已驗證的成長通路與營運基礎設施等核心投資的前提下，重新校準了投資節奏。

On to the balance sheet. Subsequent to the close of the quarter, we further fortified our financial position through a $50 million expansion of our existing debt facility and a concurrent equity investment from a valued strategic partner, Blackstone Life Sciences. This brings our pro forma liquidity to approximately $188 million as of June 30, 2026. This opportunistic capital expansion ensures that GeneDx is fully capitalized well beyond sustained positive cash flow while maintaining the flexibility to invest in high-growth strategic opportunities.

接著看資產負債表。在本季結束後，我們透過將既有債務融資額度擴增5,000萬美元，並由重要策略夥伴Blackstone Life Sciences同步進行股權投資，進一步強化了財務狀況。截至2026年6月30日，這使我們的備考（pro forma）流動性約為1.88億美元。這次把握時機的資本擴充，確保GeneDx在持續達成正向現金流之後仍具備充足資本，同時保有投資高成長策略機會的彈性。

Turning to guidance. We're reaffirming our full year guidance range of $475 million to $490 million in revenues. We continue to expect exome and genome volume growth of at least 30%, exome and genome revenue growth of at least 20%, gross margin of approximately 70% and to be profitable for the full year. For the third quarter, we expect revenues between $122 million and $124 million, exome and genome revenue of $110 million to $112 million on volume of approximately 33,200 tests. The blended ARR there is approximately $3,300 a test. Expect gross margins of approximately 70% and approximately $2 million in adjusted net income.

接著談財測指引。我們重申全年營收指引區間為4.75億至4.90億美元。我們仍預期外顯子與全基因組檢測量（volume）成長至少30%，外顯子與全基因組營收成長至少20%，毛利率約70%，且全年將實現獲利。就第三季而言，我們預期營收介於1.22億至1.24億美元；外顯子與全基因組營收為1.10億至1.12億美元，檢測量約33,200次。其加權平均ARR約為每次檢測3,300美元。預期毛利率約70%，調整後淨利約200萬美元。

With that, I'll turn it back to Katherine prior to Q&A.

接下來，我把時間交還給Katherine，在問答環節之前。

Thank you, Kevin. GeneDx is positioned for long-term sustainable profitable growth. For 25 years, clinicians have relied on GeneDx to resolve their most challenging cases because our accuracy is proven. Deep clinical loyalty has enabled us to shepherd the market through major shifts before, beginning 15 years ago with the transition from single gene test and multi-gene panels to exome, and beginning now from exome to genome. Innovation accelerates, and we're leading the way. We have the strategy, the team and the operating plan to capture the significant opportunity ahead. I want to say thank you to our dedicated employees for all of their extraordinary work and to our shareholders for their continued support. Without you, our work and service of the ever-growing number of families needing answers would not be possible.

謝謝你，Kevin。GeneDx已具備長期、可持續的獲利成長定位。25年來，臨床醫師一直仰賴GeneDx解決最具挑戰性的病例，因為我們的準確性已被驗證。深厚的臨床忠誠度使我們得以在過去引導市場完成重大轉變：15年前從單基因檢測與多基因面板轉向外顯子，而現在正從外顯子轉向全基因組。創新正在加速，而我們走在最前面。我們具備策略、團隊與營運計畫，能把握前方龐大的機會。我想感謝我們敬業的員工所付出的非凡努力，也感謝股東持續的支持。沒有你們，我們的工作，以及為越來越多需要答案的家庭提供服務，都不可能實現。

With that, operator, please, let's open up the line for questions.

那麼，接線員，麻煩開放電話線讓大家提問。

(Operator Instructions) Dan Brennan, TD Cowen.

（接線員指示）Dan Brennan，TD Cowen。

You gave a lot of -- obviously, a ton of detail on the focus on getting better payment rates. I was hoping maybe you could just -- yes, there's a lot of numbers in there. I was hoping maybe you can just elaborate a little bit on the pacing in 3Q, 4Q. Kevin, I heard you say that it seems like 4Q could see a meaningful uplift just given the timing it takes. Maybe can you just review -- I got the numbers in 3Q. So maybe, a, like, why is the pace a little slower? And then b, what's the kind of upside case you're exiting 4Q at? And what could that mean for next year?

你們談了很多——顯然也提供了大量細節——關於提升回款率的重點。我想或許你們可以——是的，裡面有很多數字。我希望你們能再多說一點第三季、第四季的節奏。Kevin，我聽到你說，考量到所需的時間點，第四季似乎可能會有顯著提升。也許你能再回顧一下——我已經記下第三季的數字了。所以可能，a，為什麼節奏會慢一些？然後b，你們在第四季結束時的上行情境大概會是什麼？那對明年可能意味著什麼？

Yes. Thanks, Dan. Look, there's a natural lag between operational improvements and those improvements blending through our accrual rates. We'd expect the collection rate to remain roughly flat with Q3 with meaningful improvements beginning in Q4. And in 2027, the upside is real. It just takes time to flow through. We're placing a premium on getting paid and guiding with that discipline.

是的。謝謝你，Dan。你看，營運改善與這些改善反映到我們的應計（accrual）比率之間，存在自然的時間落差。我們預期第三季的收款率大致持平，並在第四季開始出現顯著改善。而在2027年，上行空間確實存在。只是需要時間才能逐步反映出來。我們把「確實收到款」視為優先事項，並以這樣的紀律來提供指引。

Okay. And maybe just on the mix, you have the reflex, you're getting the whole genomes down. I know on the last call, you talked about, obviously, you want to provide the best service to customers, you don't want to dissuade them from getting what they want. But maybe just speak to a little bit of how you're managing that mix. You've got it down, kind of what you're baking into the back half of the year. And from a competitive standpoint, if the competitors are pushing whole genomes, does that put you at a disadvantage at all that you're trying to favor the exome against that?

好的。另外關於產品組合，你們有reflex（追加/轉做）機制，正在把全基因組的比例降下來。我知道在上次電話會議中你們提到，顯然你們想為客戶提供最佳服務，不想勸退他們不要做他們想要的檢測。但能否談談你們如何管理這個組合？你們已經把它降下來了，想了解你們在今年下半年納入假設的是什麼。以及從競爭角度來看，如果競爭對手在推全基因組，你們試圖相對偏重外顯子，會不會因此處於任何劣勢？

Certainly. Well, first, we continue to see, as I said in my prepared remarks, the future is indeed genome. We expect that all inherited disease will be diagnosed off of a genome. But in the meantime, we have several services that we're able to provide to give our clinicians regardless of what channel they're in, the right technology to get the diagnostic yield that they need to get the right answer to their patient.

當然。首先，正如我在事先準備的發言中所說，我們仍然看到未來確實是全基因組。我們預期所有遺傳性疾病最終都會以全基因組來完成診斷。但在此期間，我們有多項服務可提供，讓臨床醫師不論透過哪個通路，都能使用合適的技術，以取得他們所需的診斷率並為病患找到正確答案。

Remember, 80% of the time, patients with genetic disease can be diagnosed with an exome. And so we see really good uptake with that product. And if they need more information, then we can quickly reflex them beyond that exome to a genome. And because we've been able to drive down our turnaround times, we can do all of that faster than other labs can run a genome. So we've been successful in really managing this transition. We saw it in Q2, and we continue to drive, I would say, a really meticulous approach to the sales force to ensure that we are giving customers what they want, utilizing the various tools that we have.

請記得，約有80%的情況下，帶有遺傳疾病的病患可透過外顯子檢測完成診斷。因此我們看到該產品有非常好的採用率。若他們需要更多資訊，我們也能很快地在外顯子之後進行reflex，進一步轉做全基因組。而且因為我們已能縮短檢測週轉時間（turnaround time），我們可以比其他實驗室執行全基因組更快完成這一整套流程。因此，我們在管理這項轉型上相當成功。我們在第二季已看到成果，並持續推動——我會說——對銷售團隊採取非常嚴謹的做法，以確保我們運用手上各種工具，提供客戶真正想要的服務。

If I'm still live, maybe this last one to sneak in. We had modeled realized price to kind of flattish after '26 because you were just getting to this level. And I think the Street and us probably had similar, maybe low single-digit pricing. I know, Kevin, in the past, you've talked about how you'd be willing to go in contract with payers to secure higher payment rates even if it meant like you don't -- you give away some of the upside. This one sounds different now with Mark. It sounds like you feel there's like all this upside on getting realized price. Any way for us to think about where this -- what this could mean beyond '26 in terms of what the capture could look like?

如果我還在線的話，也許可以趁最後再塞一題。我們原先模型假設在 '26 之後的已實現價格大致持平，因為你們剛好達到這個水準。我想華爾街和我們的看法可能差不多，可能是低個位數的定價成長。Kevin，我知道你過去曾談到，你願意與付款方簽約以確保更高的支付費率，即使這意味著你不會——你會讓出部分上行空間。但現在這題在 Mark 的說法下聽起來不太一樣。聽起來你們覺得在提升已實現價格方面還有很大的上行空間。我們該如何思考這件事——也就是在 '26 之後，這可能意味著什麼、可捕捉的幅度可能會長什麼樣？

Yes. Look, in terms of '27, I think to keep flat in '27 and beyond misses a core central opportunity for us. Look, today, at 32% genome collection rates reflect where we are in the coverage maturity, not where we think we're going. We've brought in that volume to deliberately build the clinical evidence to expand payer policies that's worked as represented by that, frankly, massive jump in commercial coverage from 47% to 87% in just one quarter.

是的。你看，就 '27 而言，我認為把 '27 及之後假設為持平，會錯失我們一個核心且關鍵的機會。你看，今天 32% 的全基因體收款率反映的是我們目前在保險覆蓋成熟度上的位置，而不是我們認為將要達到的水準。我們刻意導入那樣的量，來建立臨床證據以擴大付款方政策；這已經奏效了，正如所呈現的——坦白說，商業保險覆蓋率在短短一個季度內從 47% 大幅跳升到 87%。

But look, both collection rates for exome and genome are well below where we think a mature diagnostic test should typically live at or around 70%. That would be doubling today's collection rate. And we think that represents a meaningful structural opportunity for us as we progress. As we said, it won't be linear. But in 2027 and beyond, we expect this work to pay off handsomely in that regard.

但你看，無論是外顯子或全基因體的收款率，都遠低於我們認為一項成熟的診斷檢測通常應該落在、約 70% 左右的水準。那將是把今天的收款率翻倍。我們認為，隨著我們推進，這代表一個重要的結構性機會。如我們所說，這不會是線性的。但在 2027 年及之後，我們預期這些工作在這方面會帶來相當可觀的回報。

Mark Massaro, BTIG.

Mark Massaro，BTIG。

I was hoping that maybe you could double-click on the Carelon opportunity, recognizing that, that is a very, very significant lift that you talked about. But I was just wondering if you could maybe frame what needs to happen next? Is this just getting in front of commercial payers? And I think I heard you say this is a big lift in 2027. But can you just walk me through why it wouldn't be a lift in Q3 and Q4 and any potential for that?

我希望你們也許可以更深入談談 Carelon 的機會，因為你們提到那是一個非常、非常顯著的提升。但我想請問接下來需要發生什麼？這只是去面對商業保險付款方嗎？而且我想我聽到你說這會在 2027 年帶來很大的提升。但你能否帶我走一遍，為什麼它不會在 Q3、Q4 就帶來提升，以及是否存在任何可能性？

Yes. So Mark, thank you for that. It is indeed in a single quarter, just a massive opening up of possible patients and revenue for us moving forward. So it's a really positive development. As Kevin had shared in his comments, coverage leads and payment lags. So there's just a massive opportunity ahead to raise our collection rates and revenue based on Carelon and extended coverage to about 56 million lives, but payers don't always operationalize everything immediately. So it takes some time. Kevin, anything you want to add?

是的。Mark，謝謝你的問題。確實，在單一季度內，這對我們未來可觸及的患者與收入而言，是一個巨大的開放。所以這是一個非常正面的發展。正如 Kevin 在他的評論中分享的，覆蓋先行、付款滯後。因此，基於 Carelon 以及將覆蓋擴展到約 5,600 萬人，我們前方有巨大的機會來提高收款率與收入，但付款方不一定會立刻把所有事項營運化落地。所以需要一些時間。Kevin，你還想補充什麼嗎？

Yes. I would just add that certainly, we're not counting on anything in that regard for the third quarter here, but some contribution beginning in the fourth quarter of 2026, but then more fully in 2027 to account for that natural lag.

是的。我只想補充，當然，我們在這方面並沒有把第三季的任何貢獻納入預期；可能會從 2026 年第四季開始有一些貢獻，但更完整地反映則會在 2027 年，以符合那個自然的滯後。

Okay. Perfect. And then if you don't mind, I want to ask the same question on Medi-Cal. Obviously, these are different payers, but can you just walk us through the same thought process as to when you expect a benefit in -- if there could be anything in Q3 versus Q4?

好的。完美。接著如果你不介意，我想對 Medi-Cal 問同樣的問題。顯然這些是不同的付款方，但你能否用同樣的思路帶我們走一遍：你們預期何時會看到效益——Q3 相較於 Q4 是否可能有任何貢獻？

Yes, monitoring it closely. The California pricing for their genome within Medi-Cal fee-for-service, they published a rate a couple of months ago, and that became effective just July 1. And so it's pretty early, but monitoring adjudication experience closely to see that they're paying often and at that price. I think some of the larger work to do is to make sure that MCOs in the state of California are following Medi-Cal policies and guidelines, which they're required to do under regulatory frameworks. But we want to see some data further accumulate that the MCOs, which is the largest proportion of volume, are going to follow policy. We have counted on some uplift based on recent trends that we can see, but continue to view it as a massive long-term win that Medi-Cal has put out policy, but still monitoring it closely and expect greater uplift in 2027.

是的，我們正在密切監控。加州在 Medi-Cal 按服務計費（fee-for-service）體系下的全基因體定價，他們在幾個月前公布了一個費率，並於 7 月 1 日正式生效。所以現在還很早，但我們正密切觀察理賠裁定（adjudication）的經驗，確認他們是否經常支付且以該價格支付。我認為更大的工作之一，是確保加州的 MCO（管理式照護組織）遵循 Medi-Cal 的政策與指引；在監管框架下，他們是被要求這麼做的。但我們希望看到更多數據累積，確認 MCO——也就是量體占比最大的部分——會遵循政策。我們已根據近期可見的趨勢，將一些提升納入考量，但我們仍將 Medi-Cal 發布政策視為一個巨大的長期勝利；同時持續密切監控，並預期在 2027 年會有更大的提升。

Fantastic. Last one for me. It was encouraging to hear the progress with rising engagement with the general pediatrician market with orders coming in. Is there any way to quantify what those orders are? When do you think it might be material enough to quantify them? And then are there any lessons learned? I know it's early, but perhaps can you talk about ways that maybe you've optimized the early launch and how you can attack that in a bigger way in 2027?

太好了。我最後一題。聽到一般兒科醫師市場的互動度提升、也開始有訂單進來，令人鼓舞。有沒有辦法量化那些訂單？你們認為何時它會重要到足以量化？另外，有沒有任何經驗教訓？我知道還很早，但也許你可以談談你們如何優化早期上市推進，以及在 2027 年如何以更大規模來攻這個市場？

Certainly. Well, as a reminder, it's been just over a year since the guidelines published. We're still in the early stages of commercial activity post guidelines. We're pleased that we are investing in this channel. We're seeing clinicians in the gen peds channel ordering exome testing predominantly, and we're seeing some good interest there. It's a different call point, though. I'll let Mark comment a little bit more on this.

當然可以。提醒一下，自指引發布以來才剛過一年多。在指引發布後的商業化活動方面，我們仍處於早期階段。我們很高興我們正在投資這個通路。我們看到一般兒科（gen peds）通路的臨床醫師主要在下外顯子檢測的訂單，也看到一些不錯的興趣。不過這是一個不同的拜訪對象（call point）。我讓 Mark 再多評論一點。

Obviously, this is one where depending on the specifics of each of the practices, some of those practices are more attractive than the others. There's obviously a greater emphasis amongst developmental and behavioral specialists to order more exomes than you might see amongst the rest of the general peds call point. So we're definitely seeing that there's -- there are differences even within the overall general pediatrics channel.

顯然，這一塊會因各診所的具體情況而異，有些診所比其他診所更具吸引力。在發展與行為專科醫師之間，下外顯子檢測訂單的重視程度顯然更高；相較之下，你在其他一般兒科拜訪對象中未必會看到同樣程度。所以我們確實看到，即便在整體一般兒科通路內部，也存在差異。

The other thing I would note is that we think that this is an area where as more and more general practitioners are becoming corporatized or part of larger groups that, that's actually an opportunity to aggregate demand and to set policy for the larger corporate entity. So we think that by being really focused on higher productivity physicians and by concentrating on how we win corporate accounts, we think that that's a way to expand the market. But so far, the evidence is that it has a very high return on investment.

另外我想指出的是，我們認為這是一個領域：隨著越來越多的一般執業醫師被公司化、或成為更大型集團的一部分，這其實是一個機會，可以彙整需求，並為更大的企業實體制定政策。因此我們認為，透過高度聚焦於生產力較高的醫師，並把重點放在如何贏得企業型客戶（corporate accounts），這是擴大市場的一種方式。但到目前為止，證據顯示它的投資報酬率非常高。

William Bonello, Craig-Hallum.

William Bonello，Craig-Hallum。

I'll ask my two questions. One, I'm trying to understand -- so it sounded like you said a pretty significant improvement in mix, actually, in Q2 versus Q1, but we actually saw the ASP or ARR go down, not a ton, but slightly. And with the improvement in mix, we might have thought it would move the other direction. So is something else getting worse? Are you seeing an uptick in the rate of denials? Are you seeing pricing pressure? I mean why wouldn't it flow through to higher ARR rather than lower ARR?

我問兩個問題。第一，我想理解——聽起來你們說 Q2 相較 Q1 的組合（mix）其實有相當顯著的改善，但我們卻看到 ASP 或 ARR 下降了，不多，但略微下滑。在組合改善的情況下，我們原本可能以為它會往相反方向走。所以是有其他因素在惡化嗎？你們是否看到拒付率（denials）上升？你們是否看到定價壓力？我的意思是，為什麼它不會反映到更高的 ARR，而是更低的 ARR？

Yes, it's a great question, Bill. Look, the mix improvement is real moving from 40% to 32% with the differential there flowing back into the reflex product, an important bridge that allows us more time to mature collection processes for genome. But the reality is exome collection rates roughly flat underlying from quarter-to-quarter. There was some slight variation in payer mix that led to about that $50 variation that's within 1% of Q1. I think the way we would read that is the blended ARR has stabilized. It's flat and now represents a new base for us to work off of.

是的，Bill，這是個很好的問題。你看，組合改善是真實存在的，從40%降到32%，其中的差額回流到reflex產品，這是一座重要的橋樑，讓我們有更多時間去成熟化基因組的收款流程。但實際情況是，外顯子（exome）的收款率在本質上季度對季度大致持平。付款方組合有些微變動，導致大約50美元的變化，這在第一季的1%以內。我認為我們的解讀方式是：混合ARR已經穩定下來。它持平，現在代表我們可以據以運作的一個新基準。

The building blocks that we described in terms of operational improvements is being deployed now that will take some time. But we're not happy with the 32% collection rate on genome and exome collection rates are comparable to that. We have work to do. And frankly, we think that represents the largest opportunity the company has to meaningfully increase our earnings power over time.

我們所描述、就營運改善而言的那些構成要素，現在正在部署中，這需要一些時間。但我們對基因組32%的收款率並不滿意，而外顯子收款率也與此相近。我們還有工作要做。坦白說，我們認為這代表公司隨時間推進、能夠顯著提升獲利能力的最大機會。

If you'll indulge me and let me sneak in a third, I don't have to, but just, I want to follow up on that. When you're saying exome collection is roughly the same. I mean I thought in the past, we had gotten all the way up to like 55% collection rates or something on exome. And so if we're down at sort of 32-ish or something, maybe I'm just not understanding what you're saying.

如果你願意讓我再插入第三個問題，我其實不一定要問，但我想追問一下。你說外顯子收款大致相同。我的意思是，我記得過去外顯子的收款率曾經一路提升到大約55%之類的。所以如果我們現在降到大概32%左右，可能是我沒有理解你在說什麼。

No, you're tracking well, Bill. The nuance there is those collection rates we cited are for the outpatient insurance-based volume only. And so what I mean by that is excluding the NICU, the NICU is collected at 100% and what buoys that rate back up towards the 50% range in total. What we'll be tracking and calling out specifically so you can all track along with us is the improvements in the underlying outpatient insurance-based rate, which is where we see the largest opportunity at.

不，你理解得很到位，Bill。其中的細微差別在於，我們引用的那些收款率只針對門診、以保險為基礎的量。也就是說，不包含NICU；NICU的收款率是100%，而它會把整體收款率拉回到接近50%的區間。我們將會追蹤並特別揭露，讓你們都能跟著我們一起追蹤的，是門診保險基礎收款率的改善，因為我們認為最大的機會就在那裡。

Okay. That makes a ton of sense. If I can ask what was going to be my second question. I'm just trying to wrap my head around the guidance. And I may be remembering commentary a little bit wrong from last quarter. But I thought we were kind of expecting some steady improvement in ARR over the course of the year. And I appreciate all the reasons not to necessarily expect that, and that seems really prudent. But you held your volume growth rate flat and your revenue guidance flat or your volume guidance and your revenue guidance flat. I'm just sort of wondering how we reconcile maybe ARR not improving at the same rate, but revenue and volume being still where you expected.

好的。這非常合理。如果我可以問原本要問的第二個問題。我只是想把指引（guidance）想清楚。而且我可能對上季的評論記得有點不太準。但我原本以為我們預期ARR在今年會逐步穩定改善。我理解不一定要期待那樣的所有原因，而且那樣的保守看法確實很審慎。但你把量的成長率維持不變，營收指引也維持不變——或者說量的指引與營收指引都維持不變。我只是想知道，我們要如何調和：也許ARR沒有以同樣速度改善，但營收與量仍然符合你們原先的預期。

Yes. I mean, look, the guide reflects July trends that we had the benefit of seeing, which showed mix continuing to move in the right direction and core channel demand really healthy at this point, and reflex volume for the first time on a single-month basis since we've launched that product, reflex volumes exceeding genomes in the month of July. And so we took stock of the totality of what we see as really positive trends that played out throughout the second quarter and into July, and incorporated all that into the new guide that we just provided here.

是的。我的意思是，你看，這份指引反映了我們有機會看到的7月趨勢：顯示組合持續朝正確方向移動，核心通路需求在此刻非常健康，而且reflex量在7月首次以單月口徑、在我們推出該產品以來，reflex量超過了基因組（genome）量。因此，我們綜合評估了我們所看到的整體情況——這些都是在第二季期間並延續到7月的非常正向趨勢——並把這些都納入我們剛在此提供的新指引之中。

David Westenberg, Piper Sandler.

David Westenberg，Piper Sandler。

Okay. I'm going to truly ask just one and one follow-up here. So can you just -- I'm going to get into the H2 guidance. How much visibility do you have on collection rates in Q4? Secondly, on kind of like the sales force ramp and their productivity, how much productivity are you seeing right now? And how much of productivity gains are in the Q4 guidance I'm thinking about specifically? I'll ask one follow-up.

好的。我真的只問一個問題再加一個追問。所以你能不能——我會切入下半年（H2）的指引。你們對第四季（Q4）的收款率有多少能見度？第二，關於銷售團隊的擴編（ramp）與其生產力，你們目前看到多少生產力？而我特別在想，第四季指引中包含了多少生產力提升？我會再問一個追問。

Yes. Look, in terms of visibility, it was a commitment of ours to improve that following the first quarter call. And we think we've done that. I've had the benefit of adding a number of folks to my financial leadership team. We brought in some exciting revenue cycle leaders with experience doing this at very large scale at companies you all know very well in addition to Mark.

是的。你看，就能見度而言，在第一季電話會議之後，提升能見度是我們的承諾之一。而我們認為我們已經做到了。我也受益於在我的財務領導團隊中增補了多位成員。除了Mark之外，我們也引進了一些令人振奮的營收循環（revenue cycle）領導者，他們曾在你們都非常熟悉、規模非常大的公司中做過這件事。

So beyond Mark joining, a whole host of new talent, really, with the goal of upping experience levels operating at much larger scale than we have. And we've accumulated data trends, like I said, through July and those data points throughout the second quarter and into July inform what we see as the outlook that we provided.

所以除了Mark加入之外，還有一整批新的人才；真正的目標是提升我們在比目前更大規模下運營的經驗水準。而我們也如我所說，累積了截至7月的數據趨勢；第二季期間以及延續到7月的這些數據點，構成了我們所提供展望的依據。

And on the sales force productivity.

以及關於銷售團隊的生產力。

With regard to the sales force, I would just say that what we've seen is that while our traditional call points continue to deliver at a very high rate per rep, if you actually look at the incremental number of new physicians, the incremental number of new orders, we think that these emerging markets actually represent a significant amount of our future growth. They by now actually represent a meaningful and impactful amount of our overall volume growth for the quarter. And frankly, a lot of those folks we just hired in the first part of this year. So traditionally, they would have a learning curve and they would get more productive as the year goes on. So we see that accelerating in the back half of the year.

就銷售團隊而言，我只想說，我們看到的是：雖然我們傳統的拜訪點（call points）每位業務代表仍持續以非常高的效率產出，但如果你實際看新增醫師數、以及新增訂單數的增量，我們認為這些新興市場其實代表了我們未來成長的相當大一部分。到目前為止，它們實際上已占我們本季整體量成長中一個有意義且具影響力的部分。而坦白說，這些人當中有很多是在今年前半段才剛聘用的。所以按傳統來說，他們會有學習曲線，並且會在一年進行的過程中變得更有生產力。因此我們看到這在下半年會加速。

Kevin, just going to stick with the question on you. And congrats on the return to profitability in Q2. The operating cash flow was one of the high points we've seen in quite a while. And I think investors are also kind of seeing the Blackstone facility and that happening in the quarter. So we just want to think about how you're thinking about cash flow expenses from here out for the rest of the quarter and what GeneDx needs to be -- do to become a sustainably cash flow positive company over the next couple of years?

Kevin，我想繼續追問你這個問題。也恭喜第二季（Q2）恢復獲利。營運現金流是我們好一段時間以來看到的亮點之一。我想投資人也在關注Blackstone融資安排，以及它在本季發生。所以我們想了解，你們如何看待從現在起到本季剩餘期間的現金流支出？以及GeneDx在未來幾年要做到什麼，才能成為一家可持續現金流為正的公司？

Sure. And Dave, thanks for the question. I'll kick it off and then hand it over to Kevin. Just to say, as we committed on the last call, we have succeeded in that $25 million OpEx cut. And we've organized the company around the three biggest levers, which is: improving unit economics, driving utilization of exome and genome, and delivering best-in-class products. And we have organized everyone around all of our capital deployment around those three efforts. Anything that doesn't fall into that is opportunity to continue to make sure that we've got the right capital management strategy. So we feel like we've got the right focus in place.

當然。Dave，謝謝你的問題。我先開頭，然後交給Kevin。先說，我們如同在上次電話會議所承諾的，我們已成功完成2,500萬美元的營運費用（OpEx）削減。我們也把公司組織聚焦在三個最大的槓桿上，也就是：改善單位經濟效益、推動外顯子與基因組的使用率、以及交付同級最佳（best-in-class）的產品。我們已讓所有人、以及我們所有的資本配置，都圍繞這三項工作來運作。任何不屬於這三項的，都代表我們可以持續檢視、確保我們具備正確資本管理策略的機會。所以我們覺得目前已建立正確的聚焦方向。

Yes. And as you pointed out, Dave, Q2 certainly will be the high point of the year. Q2 reflecting the lag from the first quarter operating loss, which in large part was driven by the heavy commercial investment into expanding the sales team as well as some other investments.

是的。而如你所指出的，Dave，第二季無疑會是今年的高點。第二季反映了第一季營運虧損的滯後影響，而第一季的虧損在很大程度上是由於為擴大銷售團隊所做的大量商業投資，以及其他一些投資所驅動。

The second quarter was a heavier CapEx cycle than what we might expect moving forward as we've significantly increased the sequencing fleet to keep pace with the increase in genome volume that we've seen over the past year. We think that has now reached a point of leveling out. And Q2 did have some certain onetime payments as well as the lag between the fact that earning $1 today takes some more time to collect it in cash.

第二季的資本支出（CapEx）週期比我們預期未來的情況更為吃重，因為為了跟上過去一年我們所看到的基因組量增加，我們大幅擴增了定序機隊規模。我們認為目前已經到達趨於持平的階段。此外，第二季也包含一些一次性付款，以及「今天賺到 1 美元」到實際以現金收回之間存在的時間落差。

Three things kind of improve that picture moving forward. First, as I mentioned, we've completed the execution at a net $25 million in cost from our plan. That work is behind us and in current run rates. Second, the RCM improvements we've talked about will begin to increase our earnings power more so in the fourth quarter as collection rates rise. And then third, as volumes continue to grow, we do get some compounding COGS leverage that improves operating margins over time. So would expect about $10 million approximately in the third quarter, but the fourth quarter returning to cash flow generation, and that Blackstone financing gives us ample runway to get there without any sort of compromise. And by 2027, we expect all of those factors to converge in strong sustained cash generation.

展望未來，有三件事會改善這個情況。第一，如我提到的，我們已完成執行，較原計畫淨節省 2,500 萬美元成本。這些工作已經告一段落，並已反映在目前的常態化營運費率中。第二，我們談到的 RCM（營收循環管理）改善，隨著收款率上升，將在第四季更明顯地提升我們的獲利能力。第三，隨著量能持續成長，我們會獲得一些 COGS（銷貨成本）的複利式槓桿效益，隨時間推移改善營業利益率。因此，我們預期第三季約 1,000 萬美元左右，而第四季將回到現金流產生；同時，Blackstone 的融資讓我們有充足的跑道在不做任何妥協的情況下達成。到 2027 年，我們預期所有這些因素將匯聚，帶來強勁且可持續的現金產生能力。

Kyle Mikson, Canaccord Genuity.

Kyle Mikson，Canaccord Genuity。

It's good to see a clean quarter. I wanted to ask about the reflex testing. So if that volume mix continues to expand at a pretty rapid clip like you saw recently, and the reflex mix is much higher in 4Q than you would have expected, how does that impact the guidance, especially ARR?

很高興看到一個乾淨的季度。我想問一下 reflex testing（反射式檢測）。如果這個量的組合（volume mix）像你們最近看到的那樣持續以相當快的速度擴大，而且第四季的 reflex 組合占比遠高於你們原先預期，這會如何影響你們的指引，特別是 ARR（年度經常性收入）？

What's in the guide is our expectation of how those mix would evolve over time. And look, think about reflex together with exome. It's designed to be reimbursed at the exome rate. So there could be some interplaying between exome and reflex. But ultimately, see that genome mix rate at or slightly lower than where it is today in the back half of the year, and we've incorporated that into the guide.

指引中反映的是我們對這些組合占比隨時間演變的預期。而且，請把 reflex 與 exome（外顯子）一起看。它的設計是以 exome 的費率獲得給付。因此，exome 與 reflex 之間可能會有一些互相影響。但最終，我們預期今年下半年基因組（genome）組合占比會維持在目前水準或略低一些，並已將此納入指引。

All right. Great. And then if the outpatient genome mix decreased by so much here, what other end markets kind of benefited the most? Was it the emerging, like, the NICU and the gen peds? Or the established kind of end markets, volume -- which area did volume increase the most?

好的。很棒。那如果門診端的基因組組合占比在這裡下降了這麼多，哪些其他終端市場（end markets）受益最多？是新興市場，例如 NICU（新生兒加護病房）和一般兒科（gen peds）嗎？還是既有的終端市場？量能——哪個領域的量增加最多？

Yes. Look, the reflex product, like I said, is in large part meant to be a bridge offering. Where we're seeing the greatest interest is in the geneticist forum. As Mark said, the secular shift to genome and its interest has not slowed down. But what we have seen is many of those genome orders moving to reflex, taking advantage of the exome to reflex structure that we've put up. The product is operating better than initial expectations when we first launched it in February.

是的。你看，正如我說的，reflex 產品在很大程度上是作為一個過渡性的橋接方案。我們看到最大興趣來自遺傳科醫師（geneticist）這個圈子。如 Mark 所說，向基因組的長期結構性轉移及其關注度並沒有放緩。但我們確實看到，許多原本的基因組訂單轉向 reflex，利用我們建立的「外顯子到 reflex」的架構。自二月推出以來，這個產品的表現優於我們最初的預期。

And I would just add, in the gen ped sector, we're seeing good utilization of our exome products. So it's predominantly exome. And so there's a healthy mix. Again, as we're in each channel, we learn more about what product works, what services work and what the sales force needs to do to make sure we've got the right mix.

我再補充一下，在一般兒科（gen ped）領域，我們看到外顯子產品的使用率不錯。所以主要是外顯子。因此整體組合是健康的。同樣地，當我們在各個通路深耕時，我們會更了解哪種產品有效、哪種服務有效，以及銷售團隊需要做什麼，才能確保我們有正確的組合。

Tycho Peterson, Jefferies.

Tycho Peterson，Jefferies。

Welcome, Mark. Curious how you'd characterize the competitive landscape now. I mean I think you called out at some of the conferences, competitive forces as a factor of that whole genome shift. Any comments you'd make on, kind of, just the shifting competitive landscape?

歡迎你，Mark。我很好奇你會如何描述目前的競爭態勢。我記得你在一些會議上提到，競爭力量是整個轉向全基因組（whole genome）的一個因素。你對這種變動中的競爭格局有什麼看法嗎？

Sure. I'll kick it off and then would love Mark to share his fresh perspective on it. One, I would say we're still the dominant player. We still have 80% market share amongst geneticists. We're now at 50% for pediatric specialists. So we're continuing to be the market leader, and we're evolving and developing new markets in gen peds, mainly because of the quality and accuracy of our product, the customer experience, the underlying data that ensures that people have confidence in our answers.

當然。我先開頭，然後也很希望 Mark 分享他最新的觀點。第一，我會說我們仍然是主導者。在遺傳科醫師中，我們仍有 80% 的市占率。在兒科專科醫師方面，我們現在達到 50%。因此我們持續是市場領導者，並且在一般兒科（gen peds）開拓與發展新市場，主要是因為我們產品的品質與準確性、客戶體驗，以及底層數據能確保大家對我們的答案有信心。

But yes, we keep our eyes on competition. We've made it clear this is a really attractive and it's a very large market that will require more than GeneDx. Having more voices out there really opens up markets faster. It helps shape payer policy faster, helps shape policy in general faster. So we're going to continue to be the leader, and we also welcome competition for those reasons. Mark?

不過是的，我們也密切關注競爭。我們已經很清楚地表示，這是一個非常有吸引力且規模很大的市場，未來不會只需要 GeneDx 一家公司。有更多聲音在市場上，確實能更快打開市場。也能更快推動付款方（payer）政策的形成，更快推動整體政策的形成。因此我們會持續當領導者，同時也基於這些原因歡迎競爭。Mark？

Tycho, it's great to hear your voice again. And I would just say that what really characterizes a lot of our competition right now is who's able to both measure variation and match variation the best. And there are a lot of different ways to measure genomic variation.

Tycho，很高興再次聽到你的聲音。我會說，目前我們許多競爭的核心特徵在於：誰能同時把變異（variation）量測得最好，並且把變異匹配（match）得最好。而量測基因組變異有很多不同的方法。

But at the end of the day, the Infinity database is a unique asset for matching that variation to drive discovery. And so what we find is that our customers are loyal to that because it produces a higher diagnostic yield and it gets better answers for the patients. So we feel like we can maintain our leadership through continuing to invest in that data asset and continue to drive discovery in the market.

但歸根結底，Infinity 資料庫是一項獨特資產，能用來匹配這些變異並推動發現（discovery）。因此我們發現客戶對此很忠誠，因為它能帶來更高的診斷產出率（diagnostic yield），並為病患提供更好的答案。所以我們覺得，只要持續投資這項數據資產並持續推動市場上的發現，我們就能維持領導地位。

Okay. That's helpful. And then the one-minute genome, where are you in rolling that out? And how critical is that to the ramp in the back half of the year?

好的。這很有幫助。另外，一分鐘基因組（one-minute genome），你們推行到哪個階段了？這對今年下半年成長加速有多關鍵？

Certainly. So we've made some really good progress with one-minute ordering, which in the past, we've talked about as an unlock predominantly for general pediatricians. It was designed by them for them. We think it has the potential to unlock more volume across all the channels. So it will be later this summer with, I would say, a rolling set of features. We're going to continue to put out kind of an MVP and continue to iterate on it, but all is on track there.

當然。我們在一分鐘下單（one-minute ordering）方面取得了很好的進展；過去我們談到，這主要是為一般兒科醫師解鎖的一個關鍵。它是由他們設計、為他們而設計。我們認為它有潛力在所有通路解鎖更多量能。因此會在今年夏末較晚的時候推出，我會說會以一系列功能逐步上線。我們會先推出類似 MVP（最小可行產品），並持續迭代，但目前一切都按計畫進行。

Kevin, I would just add that, obviously, that one of the things about these emerging markets is that the customer service expectations are different. And so we're obviously learning from that, and we're adjusting our approach commensurate with the maturity of those markets. And so I feel really proud of the work of the team on that. And I think we're really going to be able to accelerate growth with people who are frankly not that used to ordering exome and genome testing.

Kevin，我再補充一下，顯然這些新興市場的一個特點是，客戶服務的期待不同。因此我們也在從中學習，並依照這些市場的成熟度調整我們的方法。我對團隊在這方面的工作感到非常自豪。我認為，對於那些坦白說還不太習慣下單外顯子與基因組檢測的人，我們真的能夠加速成長。

Subbu Nambi, Guggenheim.

Subbu Nambi，Guggenheim。

Kevin, last quarter, you were really helpful in telling us the exome genome mix. And it would be really helpful if you could tell us what your assumptions are for exome genome mix in 3Q and then in 4Q? And where do you see yourself exiting this year? This is all acknowledging that payer coverage is improving at a rapid rate for genome.

Kevin，上季你在告訴我們外顯子與基因組的組合占比方面非常有幫助。如果你能分享你們對第三季、以及第四季外顯子/基因組組合占比的假設，會非常有幫助。以及你們預期今年年底會以什麼樣的占比收官？這些問題都建立在一個前提：付款方對基因組的給付覆蓋正在以很快的速度改善。

Yes. In terms of mix, we would expect that genome mix that we cited to come down some, hovering at around approximately 30%, maybe slightly lower in the second half of the year. And recent data order flows over the past several weeks helped frame that expectation.

是的。就組合而言，我們預期我們先前提到的全基因組（genome）組合會有所下降，大約維持在約30%左右，可能在下半年略低一些。而過去幾週的近期訂單流量數據也有助於形成這樣的預期。

And then I want to probe a bit on the operational pillars and focus in the prepared remarks. Mark, can you expand a bit on what's different about this approach compared to what was being done before? Just trying to understand how this new approach will materially change things in the near term.

接著我想就營運支柱與在事先準備的發言中提到的重點再深入問一下。Mark，你能否多談一些，這個做法相較於之前的作法有何不同？我只是想了解，這個新方法在短期內將如何實質改變情況。

I would say that with regard to, like, developing payer-specific processes, that's something where historically, we've frankly not invested enough in the systems and process muscle to really execute against that. The team had already brought on a number of key personnel to help lead that. So I'm just sort of shepherding that further along. But I think with some of the people that we brought in from the industry who really have sort of been there and done that before, you really have a playbook that's relatively straightforward. It just comes down to complying with exactly what the payers need you to comply with in order to get paid. And it's a very attention and detail-oriented process, but it's something where I think that we're seeing dramatic improvement in that.

我會說，就例如建立針對不同付款方（payer）的專屬流程而言，歷史上我們坦白說在系統與流程能力上投入不足，導致無法真正有效執行。團隊已經延攬了多位關鍵人員來協助領導這項工作。所以我只是進一步推動並引導它往前走。但我認為，隨著我們從產業中引進一些真正有實戰經驗的人才，你其實就有一套相對直接的作戰手冊（playbook）。歸根結底，就是要完全符合付款方要求你遵循的規範，才能拿到款項。這是一個非常講究專注與細節的流程，但我認為我們在這方面正看到顯著的改善。

Team, you hired a bunch of sales rep. How is the productivity going on with the new reps? Are we seeing returns from that investment already? Should we expect that group to still be ramping to full productivity throughout the end of the year?

團隊方面，你們聘了不少業務代表。新進業務的生產力表現如何？我們是否已經看到這項投資的回報？我們是否應預期這個團隊會一路到年底都仍在爬坡、提升到完全生產力？

Well, I would say that we already see what we would say is a positive return on investment so far. And absolutely, we think that those teams will continue to accelerate in their productivity. And things like one-minute ordering actually just complement that. It's not just about adding reps. It's also about adding processes and market-specific customer service elements to really drive adoption. So we feel like that should continue to accelerate with time.

我會說，到目前為止我們已經看到可稱為正向的投資報酬。而且絕對地，我們認為這些團隊的生產力會持續加速提升。像是一分鐘下單（one-minute ordering）這類措施其實正好相輔相成。這不只是增加業務人數。也包括增加流程，以及因地制宜的客戶服務要素，來真正推動採用。所以我們覺得這會隨著時間持續加速。

Keith Hinton, Freedom Capital Markets.

Keith Hinton，Freedom Capital Markets。

I have one on volumes and then a follow-up on gross margin. So for volumes in the quarter and the back half of the year, can you just talk a little bit about the contributions from the foundational markets versus how much of the growth came from the various expansion markets? So sort of any granularity you can give there for the quarter and kind of what's baked into the guide? And then I'll follow up on gross margin.

我有一個關於量（volumes）以及一個關於毛利率的追問。先談本季與下半年量的部分，你能否談談基礎市場（foundational markets）的貢獻，與各個擴張市場（expansion markets）帶來的成長各占多少？也就是說，能否提供一些本季的細分，以及指引（guide）中隱含的假設？然後我再追問毛利率。

Yes. Look, we've seen broad-based contribution. The majority of growth in terms of units, of course, coming from geneticist, ped neuro and the NICU maybe in that ranked order, just given the much larger base. If you were to double-click into those newer markets of general pediatricians and prenatal, lower unit contribution, but significant year-over-year growth rates or even quarter-over-quarter growth rates just off of a much smaller base. And we would expect through the second half of the year to see contribution from all those channels. I think signals through July continues to show we're in the right markets, and they're growing in the direction that we'd expect them to. I think, frankly, if you look at contribution, we still have significant headroom to penetrate and grow in those core foundational markets of geneticist, ped neuro and the NICU alike, notwithstanding early contributions we're seeing from the new markets.

是的。你看，我們看到的是廣泛的貢獻來源。以檢測量（units）的成長來看，多數成長當然來自遺傳科醫師（geneticist）、小兒神經科（ped neuro）以及新生兒加護病房（NICU），大概依此排序，主要是因為基礎盤子更大。如果你再深入看那些較新的市場，例如一般小兒科醫師與產前（prenatal），單位量貢獻較低，但由於基期很小，年增率甚至季增率都相當顯著。而我們預期在下半年，所有這些通路都會有貢獻。我認為7月的訊號持續顯示我們在正確的市場，而且它們的成長方向符合我們的預期。坦白說，如果你看貢獻度，我們在遺傳科醫師、小兒神經科與NICU等核心基礎市場仍有很大的滲透與成長空間，儘管我們也已看到新市場的早期貢獻。

Great. That's helpful. And then on gross margin, I believe based on the numbers I'm looking at, that you guys were able to improve gross margin almost 200 bps quarter-over-quarter, even though the ExGen ASP was slightly down. So can you just talk a little bit about sort of what drove that quarter-over-quarter efficiency gains and how we should think about the sustainability going forward as hopefully ASP starts to come up?

很好。這很有幫助。接著談毛利率，我相信根據我看到的數字，即使ExGen的平均售價（ASP）略有下降，你們的毛利率仍能季對季提升將近200個基點（bps）。你能否談談是什麼驅動了這些季對季的效率提升，以及在未來（希望ASP開始回升時）我們該如何看待其可持續性？

Yes. Maybe I'll start and then see if Mark has some additional color to layer in. Thanks for pointing that out. I think the team here continues to focus really on two fronts: how do we continue to improve wet lab efficiency, certainly see reductions in input costs as utilization for genome grows; but also, we are still in the early innings of deploying advanced technology across the dry side stack.

是的。也許我先開始，然後看看Mark是否能補充一些細節。謝謝你指出這點。我認為這裡的團隊持續聚焦在兩個面向：我們如何持續提升濕實驗室（wet lab）的效率，並且隨著全基因組使用量增加而看到投入成本下降；同時，我們在乾端（dry side）技術堆疊上部署先進技術仍處於早期階段。

Having made significant efficiency gains, there still remains a large opportunity to further expand gross margins. We saw some of that this past quarter that's helping us get more efficient. We have reached a point of pretty impressive economies of scale. But I think one area we're most excited is to get Mark's fresh perspective on where we can continue to see step change and realize even greater efficiencies over time.

在已取得顯著效率提升之後，仍然存在進一步擴大毛利率的巨大機會。我們在上一季看到其中一部分，這正幫助我們變得更有效率。我們已達到相當令人印象深刻的規模經濟。但我認為我們最興奮的一個領域，是從Mark的新視角來看，我們還能在哪些地方持續看到階躍式（step change）的改善，並隨時間實現更高的效率。

I think this is one of the more exciting opportunities that we actually have as a company is leveraging the power of machine learning and AI and other tools like that, coupled with our data, coupled with the talented, brilliant scientists that we have on the team to really drive productivity on that. And I would say that we had very significant improvements in dry lab productivity in Q2, and we're obviously trying to continue to drive that for several years to come. By now, in a lot of ways, the amount of productivity that comes from the dry lab, in some cases, actually is larger than that than you would see from the wet lab. So exciting stuff.

我認為這其實是我們公司最令人振奮的機會之一：運用機器學習、AI以及其他類似工具的力量，結合我們的數據，再結合團隊中才華洋溢、非常傑出的科學家，來真正推動生產力提升。我會說，我們在第二季（Q2）的乾實驗室（dry lab）生產力有非常顯著的改善，而我們顯然會在未來好幾年持續推動這件事。到目前為止，在很多方面，乾實驗室帶來的生產力提升幅度，在某些情況下甚至比濕實驗室還要大。所以這很令人興奮。

Thank you. This concludes our question-and-answer session. I'd like to turn it back to Katherine Stueland for closing remarks.

謝謝。我們的問答環節到此結束。我想把時間交回給Katherine Stueland做結語。

Excellent. Well, we appreciate everyone's time tonight. We look forward to talking to you soon over the coming days, and have a good evening. Thank you.

太好了。我們感謝各位今晚撥冗參與。我們期待在接下來幾天很快再與各位交流，祝各位晚安。謝謝。

This concludes today's conference call. Thank you for participating, and you may now disconnect.

今天的電話會議到此結束。感謝各位參與，現在您可以掛線。