Quest Diagnostics Q4 2025 Quest Diagnostics Inc Earnings Call | AllMind AI Earnings | AllMind AI
Q4 2025 Quest Diagnostics Inc Earnings Call
Speaker #1: Any entire contents of the call, including the presentation redistribution, retransmission, or rebroadcast of this call in any form without the written consent of Quest Diagnostics is strictly prohibited.
Speaker #1: Now I'd like to Thank
Speaker #1: introduce Shawn Bevec, Vice President of Investor Relations for Quest Diagnostics.
Shawn Bevec: Thank you, and good morning. I'm joined by Jim Davis, our Chairman, Chief Executive Officer, and President, and Sam Samad, our Chief Financial Officer. During this call, we may make forward-looking statements and will discuss non-GAAP measures. We provide a reconciliation of non-GAAP measures to comparable GAAP measures in the tables to our earnings press release.
Speaker #2: Jim Davis, our Chairman, Financial Officer. call, we may make During this Chief Executive Officer, and provide a reconciliation of President, and Sam Samad, our Chief measures in the tables to our earnings results may differ materially from those
Speaker #2: discuss non-GAAP measures. Quest Diagnostics' future results press release. include but are not limited Actual We and uncertainties that may affect Please go projected. subsequently filed quarterly reports on Form 10-K and recent annual report on non-GAAP measures to comparable GAAP Risks 8-K.
Operator: 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. 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's Jim Davis. Thanks, Dan, and good morning, everyone. With diligent execution of our strategy and a strong fourth quarter, we generated double-digit growth in revenues and earnings per share for the full year.
Operator: 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. 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's Jim Davis. Thanks, Dan, and good morning, everyone. With diligent execution of our strategy and a strong fourth quarter, we generated double-digit growth in revenues and earnings per share for the full year.
Operator: 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. 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's Jim Davis. Thanks, Dan, and good morning, everyone. With diligent execution of our strategy and a strong fourth quarter, we generated double-digit growth in revenues and earnings per share for the full year.
Shawn Bevec: 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. 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's Jim Davis.
Speaker #2: to those described in our most reported EPS refer to reported diluted EPS, call, references to and references to adjusted EPS refer to adjusted For this diluted EPS.
Speaker #2: Growth rates associated with our long-term outlook projections including consolidated revenue acquisitions, organic revenue growth, and adjusted earnings growth are compound Now, here's Jim
Speaker #2: Davis. Thanks, annual growth rates.
Jim Davis: Thanks, Dan, and good morning, everyone. With diligent execution of our strategy and a strong fourth quarter, we generated double-digit growth in revenues and earnings per share for the full year.
Speaker #3: Dan. And good morning, everyone. With diligent execution of our strategy and a strong fourth quarter, we generated double-digit growth in revenues and earnings per share for the full year.
Speaker #3: In 2025, we expanded our category-defining clinical innovations to meet robust collaborations with elite demand; formed strategic healthcare organizations; and further advanced our position as the premier lab engine powering the wellness industry.
Operator: In 2025, we expanded our category-defining clinical innovations to meet robust demand, formed strategic collaborations with elite healthcare organizations, and further advanced our position as the premier lab engine powering the wellness industry. We also continued to improve quality, productivity, and the customer and patient experience with process enhancements, AI, and automation. As we look ahead to 2026, our guidance reflects our continued confidence in our business strengths and market fundamentals, which include favorable demographic trends, increasing use of blood-based lab diagnostics, and growing interest in preventative health and wellness. Now, before I turn to this year's highlights, I'd like to take a moment to comment on PAMA. Last week, bipartisan legislation was enacted that delays the implementation of PAMA until the end of 2026.
Operator: In 2025, we expanded our category-defining clinical innovations to meet robust demand, formed strategic collaborations with elite healthcare organizations, and further advanced our position as the premier lab engine powering the wellness industry. We also continued to improve quality, productivity, and the customer and patient experience with process enhancements, AI, and automation. As we look ahead to 2026, our guidance reflects our continued confidence in our business strengths and market fundamentals, which include favorable demographic trends, increasing use of blood-based lab diagnostics, and growing interest in preventative health and wellness. Now, before I turn to this year's highlights, I'd like to take a moment to comment on PAMA. Last week, bipartisan legislation was enacted that delays the implementation of PAMA until the end of 2026.
Operator: In 2025, we expanded our category-defining clinical innovations to meet robust demand, formed strategic collaborations with elite healthcare organizations, and further advanced our position as the premier lab engine powering the wellness industry. We also continued to improve quality, productivity, and the customer and patient experience with process enhancements, AI, and automation. As we look ahead to 2026, our guidance reflects our continued confidence in our business strengths and market fundamentals, which include favorable demographic trends, increasing use of blood-based lab diagnostics, and growing interest in preventative health and wellness. Now, before I turn to this year's highlights, I'd like to take a moment to comment on PAMA. Last week, bipartisan legislation was enacted that delays the implementation of PAMA until the end of 2026.
Jim Davis: In 2025, we expanded our category-defining clinical innovations to meet robust demand, formed strategic collaborations with elite healthcare organizations, and further advanced our position as the premier lab engine powering the wellness industry. We also continued to improve quality, productivity, and the customer and patient experience with process enhancements, AI, and automation. As we look ahead to 2026, our guidance reflects our continued confidence in our business strengths and market fundamentals, which include favorable demographic trends, increasing use of blood-based lab diagnostics, and growing interest in preventative health and wellness. Now, before I turn to this year's highlights, I'd like to take a moment to comment on PAMA. Last week, bipartisan legislation was enacted that delays the implementation of PAMA until the end of 2026.
Speaker #3: We and patient experience with also continue to improve quality, productivity, and the customer AI, and automation. As we look ahead to continued confidence in our business strengths which include favorable demographic process enhancements, blood-based lab diagnostics, and growing interest in preventative trends, increasing use of health and wellness.
Speaker #3: and market fundamentals Now, before I turn to this year's highlights, I'd like to take a moment to week, bipartisan legislation was enacted that delays the implementation of PAMA until the end of 2026.
Speaker #3: This one-year delay in rate cuts 2026, our guidance reflects our collection period to the first half of 2025 from the first half of 2019 based on the data to be supplied comment on PAMA.
Operator: This one-year delay in rate cuts was paired with an update to the data collection period to the first half of 2025 from the first half of 2019, based on the data to be supplied by applicable laboratories to CMS later this year. We greatly appreciate Congress for recognizing the need to reform PAMA and for providing this one-year delay of PAMA cuts, which provides meaningful short-term relief. However, these steps do not fix PAMA's structural flaws, which include relying on an estimated 10,000+ labs to self-report data to establish industry-representative data for payment rate setting. As a reminder, fewer than 1% of all the clinical laboratories reported commercial payer data to CMS in 2017, resulting in three rounds of excessive rate cuts based on data that did not reflect the market. A different approach is needed to prevent a repeat of excessive rate cuts.
Operator: This one-year delay in rate cuts was paired with an update to the data collection period to the first half of 2025 from the first half of 2019, based on the data to be supplied by applicable laboratories to CMS later this year. We greatly appreciate Congress for recognizing the need to reform PAMA and for providing this one-year delay of PAMA cuts, which provides meaningful short-term relief. However, these steps do not fix PAMA's structural flaws, which include relying on an estimated 10,000+ labs to self-report data to establish industry-representative data for payment rate setting. As a reminder, fewer than 1% of all the clinical laboratories reported commercial payer data to CMS in 2017, resulting in three rounds of excessive rate cuts based on data that did not reflect the market. A different approach is needed to prevent a repeat of excessive rate cuts.
Operator: This one-year delay in rate cuts was paired with an update to the data collection period to the first half of 2025 from the first half of 2019, based on the data to be supplied by applicable laboratories to CMS later this year. We greatly appreciate Congress for recognizing the need to reform PAMA and for providing this one-year delay of PAMA cuts, which provides meaningful short-term relief. However, these steps do not fix PAMA's structural flaws, which include relying on an estimated 10,000+ labs to self-report data to establish industry-representative data for payment rate setting. As a reminder, fewer than 1% of all the clinical laboratories reported commercial payer data to CMS in 2017, resulting in three rounds of excessive rate cuts based on data that did not reflect the market. A different approach is needed to prevent a repeat of excessive rate cuts.
Jim Davis: This one-year delay in rate cuts was paired with an update to the data collection period to the first half of 2025 from the first half of 2019, based on the data to be supplied by applicable laboratories to CMS later this year. We greatly appreciate Congress for recognizing the need to reform PAMA and for providing this one-year delay of PAMA cuts, which provides meaningful short-term relief. However, these steps do not fix PAMA's structural flaws, which include relying on an estimated 10,000+ labs to self-report data to establish industry-representative data for payment rate setting. As a reminder, fewer than 1% of all the clinical laboratories reported commercial payer data to CMS in 2017, resulting in three rounds of excessive rate cuts based on data that did not reflect the market. A different approach is needed to prevent a repeat of excessive rate cuts.
Speaker #3: by applicable laboratories to CMS later this year. We greatly appreciate Congress for recognizing the need to pair this one-year delay of PAMA cuts with an update to the data, which provides meaningful short-term relief.
Speaker #3: However, these steps do not fix PAMA's structural flaws which include relying on an estimated $10,000-plus labs to self-report data to establish industry representative data reform PAMA and for providing for payment rate 1% of all the clinical laboratories reported commercial payer data to CMS in setting.
Speaker #3: three rounds of excessive rate cuts 2017, resulting in based on data that did not reflect approach is needed to prevent a repeat the market.
Speaker #3: of excessive rate As a reminder, fewer than provides a common-sense long-term A different cuts. solution that corrects these The results act deficiencies by, for example, eliminating the need for thousands of labs to self-report data and instead leveraging an independent third-party database that provides comprehensive and representative rates.
Operator: The Results Act provides a common-sense, long-term solution that corrects these deficiencies by, for example, eliminating the need for thousands of labs to self-report data and instead leveraging an independent third-party database that provides comprehensive and representative data to set accurate market-based rates. We will continue to work with our trade association, ACLA, to build on progress in securing the necessary support in Congress to pass Results into law this year. Now, I'll provide more detail on how we executed our strategy across our key customer channels and operations during the quarter and the year. We are focused on delivering solutions that meet the evolving needs of our core clinical customers, physicians and hospitals, as well as customers in the higher growth areas of consumer, life sciences, and data analytics.
Operator: The Results Act provides a common-sense, long-term solution that corrects these deficiencies by, for example, eliminating the need for thousands of labs to self-report data and instead leveraging an independent third-party database that provides comprehensive and representative data to set accurate market-based rates. We will continue to work with our trade association, ACLA, to build on progress in securing the necessary support in Congress to pass Results into law this year. Now, I'll provide more detail on how we executed our strategy across our key customer channels and operations during the quarter and the year. We are focused on delivering solutions that meet the evolving needs of our core clinical customers, physicians and hospitals, as well as customers in the higher growth areas of consumer, life sciences, and data analytics.
Operator: The Results Act provides a common-sense, long-term solution that corrects these deficiencies by, for example, eliminating the need for thousands of labs to self-report data and instead leveraging an independent third-party database that provides comprehensive and representative data to set accurate market-based rates. We will continue to work with our trade association, ACLA, to build on progress in securing the necessary support in Congress to pass Results into law this year. Now, I'll provide more detail on how we executed our strategy across our key customer channels and operations during the quarter and the year. We are focused on delivering solutions that meet the evolving needs of our core clinical customers, physicians and hospitals, as well as customers in the higher growth areas of consumer, life sciences, and data analytics.
Jim Davis: The Results Act provides a common-sense, long-term solution that corrects these deficiencies by, for example, eliminating the need for thousands of labs to self-report data and instead leveraging an independent third-party database that provides comprehensive and representative data to set accurate market-based rates. We will continue to work with our trade association, ACLA, to build on progress in securing the necessary support in Congress to pass Results into law this year. Now, I'll provide more detail on how we executed our strategy across our key customer channels and operations during the quarter and the year. We are focused on delivering solutions that meet the evolving needs of our core clinical customers, physicians and hospitals, as well as customers in the higher growth areas of consumer, life sciences, and data analytics.
Speaker #3: We will continue to data to set accurate, market-based work with our trade association, ACLA, to build on progress in securing the necessary support in Congress to pass results into law this year.
Speaker #3: Now, I'll provide more detail on how we executed our strategy across our key customer channels and operations during the quarter and the year. We are focused on delivering solutions that meet the evolving needs of our core clinical hospitals.
Speaker #3: The higher-growth areas of consumer, life sciences, and as well as customers in data analytics. In the customers: physicians and physician channel, we delivered high single-digit organic revenue growth in the fourth quarter on broad-based demand for our clinical solutions, including several areas of advanced diagnostics and from geographic expansion resulting from increased health plan access.
Operator: In the physician channel, we delivered high single-digit organic revenue growth in Q4 on broad-based demand for our clinical solutions, including several areas of advanced diagnostics, and from geographic expansion resulting from increased health plan access. We also grew revenues in enterprise accounts as we added new customers and extended business with existing customers. In addition, during the quarter, we scaled our lab testing to serve more than 200,000 patients at Fresenius Medical Care's dialysis centers in the United States. We also added water purity testing capabilities to our menu to support dialysis customers nationwide. In the hospital channel, revenues grew low single digits with collaborative lab solutions driving our growth in the quarter. Our co-lab solutions harness our lab and process management expertise to optimize quality and drive cost efficiencies in areas ranging from hospital lab and supply chain management to analytics and blood utilization.
Operator: In the physician channel, we delivered high single-digit organic revenue growth in Q4 on broad-based demand for our clinical solutions, including several areas of advanced diagnostics, and from geographic expansion resulting from increased health plan access. We also grew revenues in enterprise accounts as we added new customers and extended business with existing customers. In addition, during the quarter, we scaled our lab testing to serve more than 200,000 patients at Fresenius Medical Care's dialysis centers in the United States. We also added water purity testing capabilities to our menu to support dialysis customers nationwide. In the hospital channel, revenues grew low single digits with collaborative lab solutions driving our growth in the quarter. Our co-lab solutions harness our lab and process management expertise to optimize quality and drive cost efficiencies in areas ranging from hospital lab and supply chain management to analytics and blood utilization.
Operator: In the physician channel, we delivered high single-digit organic revenue growth in Q4 on broad-based demand for our clinical solutions, including several areas of advanced diagnostics, and from geographic expansion resulting from increased health plan access. We also grew revenues in enterprise accounts as we added new customers and extended business with existing customers. In addition, during the quarter, we scaled our lab testing to serve more than 200,000 patients at Fresenius Medical Care's dialysis centers in the United States. We also added water purity testing capabilities to our menu to support dialysis customers nationwide. In the hospital channel, revenues grew low single digits with collaborative lab solutions driving our growth in the quarter. Our co-lab solutions harness our lab and process management expertise to optimize quality and drive cost efficiencies in areas ranging from hospital lab and supply chain management to analytics and blood utilization.
Jim Davis: In the physician channel, we delivered high single-digit organic revenue growth in Q4 on broad-based demand for our clinical solutions, including several areas of advanced diagnostics, and from geographic expansion resulting from increased health plan access. We also grew revenues in enterprise accounts as we added new customers and extended business with existing customers. In addition, during the quarter, we scaled our lab testing to serve more than 200,000 patients at Fresenius Medical Care's dialysis centers in the United States. We also added water purity testing capabilities to our menu to support dialysis customers nationwide. In the hospital channel, revenues grew low single digits with collaborative lab solutions driving our growth in the quarter. Our co-lab solutions harness our lab and process management expertise to optimize quality and drive cost efficiencies in areas ranging from hospital lab and supply chain management to analytics and blood utilization.
Speaker #3: We also grew revenues in enterprise accounts as we added new customers and extended business with existing customers. In addition, during the quarter, we scaled our lab testing to serve more than 200,000 patients at Fresenius Medical Care's dialysis centers in the United States.
Speaker #3: We also to our menu to support dialysis customers nationwide. In the hospital channel, revenues grew low single digits with collaborative lab solutions added water purity testing capabilities driving our growth in the quarter.
Speaker #3: Our Co-Lab solutions harness expertise to optimize our lab and process management quality, and drive cost efficiencies in areas ranging from management to analytics and blood utilization.
Speaker #3: At the start of 2026, we began to scale our co-lab solutions across all 21 hospitals of Corwell Health, a leading health system in these solutions to date.
Operator: At the start of 2026, we began to scale our co-lab solutions across all 21 hospitals of Corwell Health, a leading health system in Michigan, and our largest implementation of these solutions to date. We expect co-lab solutions to generate approximately $1 billion in annual revenues in 2026. Additionally, we recently finalized our laboratory joint venture with Corwell Health and are jointly constructing a state-of-the-art laboratory in Southeast Michigan from which we plan to serve the state in 2027. Hospitals value our flexible solutions for accessing expertise, innovation, and capital. We are pursuing several potential hospital outreach and independent lab acquisitions as well as co-lab opportunities while also continuing to integrate and generate value from our recent transactions. In the consumer channel, we are leveraging our diagnostics expertise and technology to drive growth through our consumer-initiated test platform, QuestHealth.com, as well as through collaborations with industry-leading wellness and wearables companies.
Operator: At the start of 2026, we began to scale our co-lab solutions across all 21 hospitals of Corwell Health, a leading health system in Michigan, and our largest implementation of these solutions to date. We expect co-lab solutions to generate approximately $1 billion in annual revenues in 2026. Additionally, we recently finalized our laboratory joint venture with Corwell Health and are jointly constructing a state-of-the-art laboratory in Southeast Michigan from which we plan to serve the state in 2027. Hospitals value our flexible solutions for accessing expertise, innovation, and capital. We are pursuing several potential hospital outreach and independent lab acquisitions as well as co-lab opportunities while also continuing to integrate and generate value from our recent transactions. In the consumer channel, we are leveraging our diagnostics expertise and technology to drive growth through our consumer-initiated test platform, QuestHealth.com, as well as through collaborations with industry-leading wellness and wearables companies.
Operator: At the start of 2026, we began to scale our co-lab solutions across all 21 hospitals of Corwell Health, a leading health system in Michigan, and our largest implementation of these solutions to date. We expect co-lab solutions to generate approximately $1 billion in annual revenues in 2026. Additionally, we recently finalized our laboratory joint venture with Corwell Health and are jointly constructing a state-of-the-art laboratory in Southeast Michigan from which we plan to serve the state in 2027. Hospitals value our flexible solutions for accessing expertise, innovation, and capital. We are pursuing several potential hospital outreach and independent lab acquisitions as well as co-lab opportunities while also continuing to integrate and generate value from our recent transactions. In the consumer channel, we are leveraging our diagnostics expertise and technology to drive growth through our consumer-initiated test platform, QuestHealth.com, as well as through collaborations with industry-leading wellness and wearables companies.
Jim Davis: At the start of 2026, we began to scale our co-lab solutions across all 21 hospitals of Corwell Health, a leading health system in Michigan, and our largest implementation of these solutions to date. We expect co-lab solutions to generate approximately $1 billion in annual revenues in 2026. Additionally, we recently finalized our laboratory joint venture with Corwell Health and are jointly constructing a state-of-the-art laboratory in Southeast Michigan from which we plan to serve the state in 2027. Hospitals value our flexible solutions for accessing expertise, innovation, and capital. We are pursuing several potential hospital outreach and independent lab acquisitions as well as co-lab opportunities while also continuing to integrate and generate value from our recent transactions. In the consumer channel, we are leveraging our diagnostics expertise and technology to drive growth through our consumer-initiated test platform, QuestHealth.com, as well as through collaborations with industry-leading wellness and wearables companies.
Speaker #3: We expect co-lab solutions to hospital lab and supply chain generate approximately $1 billion in annual revenues in Michigan, and our largest implementation of we recently finalized our laboratory joint venture with Corwell Health and our jointly constructing a 2026.
Speaker #3: 2027. Hospitals value our flexible solutions for innovation, and capital. We accessing expertise, serve the state in hospital outreach and independent lab state-of-the-art laboratory in Southeast opportunities while also continuing acquisitions as well as co-lab to integrate and generate value Additionally, we are leveraging our diagnostics expertise and technology to drive from our recent growth through our consumer-initiated test transactions.
Speaker #3: wearables companies. In the QuestHealth.com, as well as through collaborations QuestHealth.com to offer more than 150 tests, including platform, with industry-leading wellness and profile. Our innovation, quality, our new 85 biomarker existing apps and and technology integration into experiences make us the clear choice for organizations seeking to add fourth quarter, we expanded diagnostic insights to their In the consumer channel, offerings, and we added new consumer brands to our extensive roster of collaborations in the fourth quarter.
Operator: In the fourth quarter, we expanded QuestHealth.com to offer more than 150 tests, including our new 85 biomarker Elite Health profile. Our innovation, quality, and technology integration into existing apps and experiences make us the clear choice for organizations seeking to add diagnostic insights to their offerings, and we added new consumer brands to our extensive roster of collaborations in the fourth quarter. At our investor day in March last year, we said that we would expect consumer-initiated testing to generate revenue growth in excess of 20%, and we exceeded that growth rate in 2025. Across the consumer channel, we delivered nearly $250 million in revenues for the full year. We enable growth across our customer channels through faster-growing advanced diagnostics in five key clinical areas: advanced cardiometabolic and endocrine, autoimmune, brain health, oncology, and women's and reproductive health.
Operator: In the fourth quarter, we expanded QuestHealth.com to offer more than 150 tests, including our new 85 biomarker Elite Health profile. Our innovation, quality, and technology integration into existing apps and experiences make us the clear choice for organizations seeking to add diagnostic insights to their offerings, and we added new consumer brands to our extensive roster of collaborations in the fourth quarter. At our investor day in March last year, we said that we would expect consumer-initiated testing to generate revenue growth in excess of 20%, and we exceeded that growth rate in 2025. Across the consumer channel, we delivered nearly $250 million in revenues for the full year. We enable growth across our customer channels through faster-growing advanced diagnostics in five key clinical areas: advanced cardiometabolic and endocrine, autoimmune, brain health, oncology, and women's and reproductive health.
Operator: In the fourth quarter, we expanded QuestHealth.com to offer more than 150 tests, including our new 85 biomarker Elite Health profile. Our innovation, quality, and technology integration into existing apps and experiences make us the clear choice for organizations seeking to add diagnostic insights to their offerings, and we added new consumer brands to our extensive roster of collaborations in the fourth quarter. At our investor day in March last year, we said that we would expect consumer-initiated testing to generate revenue growth in excess of 20%, and we exceeded that growth rate in 2025. Across the consumer channel, we delivered nearly $250 million in revenues for the full year. We enable growth across our customer channels through faster-growing advanced diagnostics in five key clinical areas: advanced cardiometabolic and endocrine, autoimmune, brain health, oncology, and women's and reproductive health.
Jim Davis: In the fourth quarter, we expanded QuestHealth.com to offer more than 150 tests, including our new 85 biomarker Elite Health profile. Our innovation, quality, and technology integration into existing apps and experiences make us the clear choice for organizations seeking to add diagnostic insights to their offerings, and we added new consumer brands to our extensive roster of collaborations in the fourth quarter. At our investor day in March last year, we said that we would expect consumer-initiated testing to generate revenue growth in excess of 20%, and we exceeded that growth rate in 2025. Across the consumer channel, we delivered nearly $250 million in revenues for the full year. We enable growth across our customer channels through faster-growing advanced diagnostics in five key clinical areas: advanced cardiometabolic and endocrine, autoimmune, brain health, oncology, and women's and reproductive health.
Speaker #3: At our investor day in March last year, we said that elite health we would expect consumer-initiated testing to generate revenue growth in excess of rate in 2025.
Speaker #3: Across the consumer channel, we delivered nearly 20%. 250 million dollars in revenues for the full year. We enabled growth across our customer channels through faster-growing advanced And we exceeded that growth diagnostics in five key cardiometabolic and endocrine, autoimmune, brain health, oncology, and women's and reproductive delivered double-digit revenue growth clinical areas.
Operator: During the quarter and full year, we delivered double-digit revenue growth across several clinical areas of our advanced portfolio. I'd like to highlight a couple of these innovations today. Our ANA-lyzer solution provides a comprehensive yet simple approach for aiding the diagnosis of the eight most common autoimmune disorders. About 24 million Americans suffer from at least one of over 100 autoimmune disorders. Because symptoms of these disorders often overlap and a shortage of rheumatologists exists nationwide, patients may go for years before receiving the correct diagnosis. ANA-lyzer helps primary care clinicians identify the likely category of disease affecting the patient and thereby speeding referral to the right specialist for faster diagnosis and treatment.
Operator: During the quarter and full year, we delivered double-digit revenue growth across several clinical areas of our advanced portfolio. I'd like to highlight a couple of these innovations today. Our ANA-lyzer solution provides a comprehensive yet simple approach for aiding the diagnosis of the eight most common autoimmune disorders. About 24 million Americans suffer from at least one of over 100 autoimmune disorders. Because symptoms of these disorders often overlap and a shortage of rheumatologists exists nationwide, patients may go for years before receiving the correct diagnosis. ANA-lyzer helps primary care clinicians identify the likely category of disease affecting the patient and thereby speeding referral to the right specialist for faster diagnosis and treatment.
Operator: During the quarter and full year, we delivered double-digit revenue growth across several clinical areas of our advanced portfolio. I'd like to highlight a couple of these innovations today. Our ANA-lyzer solution provides a comprehensive yet simple approach for aiding the diagnosis of the eight most common autoimmune disorders. About 24 million Americans suffer from at least one of over 100 autoimmune disorders. Because symptoms of these disorders often overlap and a shortage of rheumatologists exists nationwide, patients may go for years before receiving the correct diagnosis. ANA-lyzer helps primary care clinicians identify the likely category of disease affecting the patient and thereby speeding referral to the right specialist for faster diagnosis and treatment.
Jim Davis: During the quarter and full year, we delivered double-digit revenue growth across several clinical areas of our advanced portfolio. I'd like to highlight a couple of these innovations today. Our ANA-lyzer solution provides a comprehensive yet simple approach for aiding the diagnosis of the eight most common autoimmune disorders. About 24 million Americans suffer from at least one of over 100 autoimmune disorders. Because symptoms of these disorders often overlap and a shortage of rheumatologists exists nationwide, patients may go for years before receiving the correct diagnosis. ANA-lyzer helps primary care clinicians identify the likely category of disease affecting the patient and thereby speeding referral to the right specialist for faster diagnosis and treatment.
Speaker #3: across several clinical areas of our portfolio. I'd like to highlight a couple of these innovations today. Our analyzer solution provides a comprehensive yet simple advanced approach for aiding the diagnosis Advanced health.
Speaker #3: About 24 million Americans suffer from autoimmune disorders. Nationwide, patients may go for years before receiving the correct diagnosis. Because symptoms of these disorders can mimic other conditions, it's often difficult to identify. There are at least 100 autoimmune disorders.
Speaker #3: Analyzer helps primary care clinicians identify the likely disorders often overlap category of disease affecting the and a shortage of rheumatologists exists patient, and thereby speeding referral to the right specialist for faster diagnosis and treatment.
Speaker #3: In Brain Health, our portfolio of Quest disease extended its year-long double-digit growth momentum into the fourth quarter, as providers increasingly adopted the high-quality blood-based biomarker tests for the most prevalent type of dementia.
Operator: In brain health, our portfolio of Quest AD-Detect blood tests for Alzheimer's disease extended its year-long double-digit growth momentum into Q4 as providers increasingly adopted the high-quality blood-based biomarker tests for the most prevalent type of dementia. A recent study by our scientific team suggests that blood tests like our newest AD-Detect panel, which fulfills guideline criteria for confirmatory blood testing, could decrease costs to the healthcare system by reducing the use of higher-cost PET/CT imaging for diagnosis, improving access and affordability. In oncology, we continue to build our presence in blood-based minimal residual disease testing. New research presented at ASCO GI in early January highlighted the strong clinical value of our Haystack MRD test in monitoring for colorectal cancer. We further expanded in the MRD space with the launch last week of our cutting-edge Flow MRD test for blood-based cancer myeloma.
Operator: In brain health, our portfolio of Quest AD-Detect blood tests for Alzheimer's disease extended its year-long double-digit growth momentum into Q4 as providers increasingly adopted the high-quality blood-based biomarker tests for the most prevalent type of dementia. A recent study by our scientific team suggests that blood tests like our newest AD-Detect panel, which fulfills guideline criteria for confirmatory blood testing, could decrease costs to the healthcare system by reducing the use of higher-cost PET/CT imaging for diagnosis, improving access and affordability. In oncology, we continue to build our presence in blood-based minimal residual disease testing. New research presented at ASCO GI in early January highlighted the strong clinical value of our Haystack MRD test in monitoring for colorectal cancer. We further expanded in the MRD space with the launch last week of our cutting-edge Flow MRD test for blood-based cancer myeloma.
Operator: In brain health, our portfolio of Quest AD-Detect blood tests for Alzheimer's disease extended its year-long double-digit growth momentum into Q4 as providers increasingly adopted the high-quality blood-based biomarker tests for the most prevalent type of dementia. A recent study by our scientific team suggests that blood tests like our newest AD-Detect panel, which fulfills guideline criteria for confirmatory blood testing, could decrease costs to the healthcare system by reducing the use of higher-cost PET/CT imaging for diagnosis, improving access and affordability. In oncology, we continue to build our presence in blood-based minimal residual disease testing. New research presented at ASCO GI in early January highlighted the strong clinical value of our Haystack MRD test in monitoring for colorectal cancer. We further expanded in the MRD space with the launch last week of our cutting-edge Flow MRD test for blood-based cancer myeloma.
Jim Davis: In brain health, our portfolio of Quest AD-Detect blood tests for Alzheimer's disease extended its year-long double-digit growth momentum into Q4 as providers increasingly adopted the high-quality blood-based biomarker tests for the most prevalent type of dementia. A recent study by our scientific team suggests that blood tests like our newest AD-Detect panel, which fulfills guideline criteria for confirmatory blood testing, could decrease costs to the healthcare system by reducing the use of higher-cost PET/CT imaging for diagnosis, improving access and affordability. In oncology, we continue to build our presence in blood-based minimal residual disease testing. New research presented at ASCO GI in early January highlighted the strong clinical value of our Haystack MRD test in monitoring for colorectal cancer. We further expanded in the MRD space with the launch last week of our cutting-edge Flow MRD test for blood-based cancer myeloma.
Speaker #3: A recent study by our scientific team suggests that blood tests like our newest AD Detect panel, which fulfills blood testing, could decrease cost to the healthcare system by reducing the use of higher-cost affordability.
Speaker #3: In oncology, we continue to build on PET/CT imaging for our presence in blood-based minimal guideline criteria for confirmatory residual disease testing. New research presented at ASCOGI in early January highlighted the strong clinical value of our Haystack MRD test in monitoring for colorectal cancer.
Speaker #3: We further expanded in the our cutting-edge Flow MRD test for blood-based cancer myeloma. This MRD space with the launch last week of the test enables ultrasensitive disease detection in a blood specimen, sparing patients the pain and complications of conventional testing of residual biopsies.
Speaker #3: We further expanded in the our cutting-edge Flow MRD test for blood-based cancer myeloma. This MRD space with the launch last week of test enables ultrasensitive disease in a blood specimen sparing patients the pain and complications of conventional testing of detection of residual bone marrow top-line growth across our business, we are focused on delivering operational excellence with enhanced processes and strategic implementation of automation, AI, and other advanced technologies.
Operator: This test enables ultra-sensitive detection of residual disease in a blood specimen, sparing patients the pain and complications of conventional testing of bone marrow biopsies. Along with driving top-line growth across our business, we are focused on delivering operational excellence with enhanced processes and strategic implementation of automation, AI, and other advanced technologies. Through our Invigorate program, we achieved our full-year target of 3% annual cost savings and productivity improvements in 2025. Inside our labs, we deployed automated sample processing across our network and collaborative accessioning at multiple sites to streamline and optimize our processes. We also implemented the Hologic Genius Digital Diagnostic System at two of our laboratories and look forward to scaling the solution for enhancing quality and productivity in cervical cancer screenings at several of our labs this year. Outside the lab, we're using AI to make the customer and employee experiences easier, faster, and more insightful.
Operator: This test enables ultra-sensitive detection of residual disease in a blood specimen, sparing patients the pain and complications of conventional testing of bone marrow biopsies. Along with driving top-line growth across our business, we are focused on delivering operational excellence with enhanced processes and strategic implementation of automation, AI, and other advanced technologies. Through our Invigorate program, we achieved our full-year target of 3% annual cost savings and productivity improvements in 2025. Inside our labs, we deployed automated sample processing across our network and collaborative accessioning at multiple sites to streamline and optimize our processes. We also implemented the Hologic Genius Digital Diagnostic System at two of our laboratories and look forward to scaling the solution for enhancing quality and productivity in cervical cancer screenings at several of our labs this year. Outside the lab, we're using AI to make the customer and employee experiences easier, faster, and more insightful.
Operator: This test enables ultra-sensitive detection of residual disease in a blood specimen, sparing patients the pain and complications of conventional testing of bone marrow biopsies. Along with driving top-line growth across our business, we are focused on delivering operational excellence with enhanced processes and strategic implementation of automation, AI, and other advanced technologies. Through our Invigorate program, we achieved our full-year target of 3% annual cost savings and productivity improvements in 2025. Inside our labs, we deployed automated sample processing across our network and collaborative accessioning at multiple sites to streamline and optimize our processes. We also implemented the Hologic Genius Digital Diagnostic System at two of our laboratories and look forward to scaling the solution for enhancing quality and productivity in cervical cancer screenings at several of our labs this year. Outside the lab, we're using AI to make the customer and employee experiences easier, faster, and more insightful.
Jim Davis: This test enables ultra-sensitive detection of residual disease in a blood specimen, sparing patients the pain and complications of conventional testing of bone marrow biopsies. Along with driving top-line growth across our business, we are focused on delivering operational excellence with enhanced processes and strategic implementation of automation, AI, and other advanced technologies. Through our Invigorate program, we achieved our full-year target of 3% annual cost savings and productivity improvements in 2025. Inside our labs, we deployed automated sample processing across our network and collaborative accessioning at multiple sites to streamline and optimize our processes. We also implemented the Hologic Genius Digital Diagnostic System at two of our laboratories and look forward to scaling the solution for enhancing quality and productivity in cervical cancer screenings at several of our labs this year. Outside the lab, we're using AI to make the customer and employee experiences easier, faster, and more insightful.
Speaker #3: Through our Invigorate program, we achieved our full-year target of 3% annual cost savings and productivity improvements in 2025. Inside our labs, we deployed automated accessioning at multiple sites to sample processing across our laboratories and look forward to scaling the solution for enhancing processes.
Speaker #3: quality and productivity in cervical cancer screenings at several Diagnostic System at two of our year. Outside the lab, we're using AI to of our labs this make the customer and employee experiences easier, faster, We also implemented and more insightful.
Speaker #3: For network and collaborative example, our virtual AI agent has reduced routine logistics calls by up to 50%, and we expect a new AI roll it out this logistics tool will help us reduce year.
Operator: For example, our virtual AI agent has reduced routine logistics calls by up to 50%, and we expect a new AI logistics tool will help us reduce courier transportation times as we roll it out this year. And now, Sam will provide more details on our performance and our 2026 guidance. Sam? Thanks, Jim. In the fourth quarter, consolidated revenues were $2.81 billion, up 7.1% versus the prior year. Consolidated organic revenues grew by 6.4%. Revenues for diagnostic information services were up 7.3% compared to the prior year, reflecting organic growth in our physician, hospital, and consumer channels as well as recent acquisitions. Total volume measured by the number of requisitions increased 8.5% versus the fourth quarter of 2024, with organic volume up 7.9%. Total revenue per requisition was down 0.1% versus the prior year.
Operator: For example, our virtual AI agent has reduced routine logistics calls by up to 50%, and we expect a new AI logistics tool will help us reduce courier transportation times as we roll it out this year. And now, Sam will provide more details on our performance and our 2026 guidance. Sam? Thanks, Jim. In the fourth quarter, consolidated revenues were $2.81 billion, up 7.1% versus the prior year. Consolidated organic revenues grew by 6.4%. Revenues for diagnostic information services were up 7.3% compared to the prior year, reflecting organic growth in our physician, hospital, and consumer channels as well as recent acquisitions. Total volume measured by the number of requisitions increased 8.5% versus the fourth quarter of 2024, with organic volume up 7.9%. Total revenue per requisition was down 0.1% versus the prior year.
Operator: For example, our virtual AI agent has reduced routine logistics calls by up to 50%, and we expect a new AI logistics tool will help us reduce courier transportation times as we roll it out this year. And now, Sam will provide more details on our performance and our 2026 guidance. Sam? Thanks, Jim. In the fourth quarter, consolidated revenues were $2.81 billion, up 7.1% versus the prior year. Consolidated organic revenues grew by 6.4%. Revenues for diagnostic information services were up 7.3% compared to the prior year, reflecting organic growth in our physician, hospital, and consumer channels as well as recent acquisitions. Total volume measured by the number of requisitions increased 8.5% versus the fourth quarter of 2024, with organic volume up 7.9%. Total revenue per requisition was down 0.1% versus the prior year.
Jim Davis: For example, our virtual AI agent has reduced routine logistics calls by up to 50%, and we expect a new AI logistics tool will help us reduce courier transportation times as we roll it out this year. And now, Sam will provide more details on our performance and our 2026 guidance. Sam?
Speaker #3: And now, Sam will provide more details on our performance and our
Speaker #3: 2026 guidance.
Speaker #2: Thanks,
Speaker #2: Thanks, Jim. In the fourth quarter, consolidated
Sam Samad: Thanks, Jim. In the fourth quarter, consolidated revenues were $2.81 billion, up 7.1% versus the prior year. Consolidated organic revenues grew by 6.4%. Revenues for diagnostic information services were up 7.3% compared to the prior year, reflecting organic growth in our physician, hospital, and consumer channels as well as recent acquisitions. Total volume measured by the number of requisitions increased 8.5% versus the fourth quarter of 2024, with organic volume up 7.9%. Total revenue per requisition was down 0.1% versus the prior year.
Speaker #2: billion dollars. Up 7.1% versus the prior year. Consolidated organic revenues were 2.81 revenues grew by for diagnostic information services were up 7.3% compared to the prior year, reflecting organic growth in our physician, hospital, and consumer 6.4%.
Speaker #2: billion dollars. Up 7.1% versus the prior year. Consolidated organic revenues were 2.81 revenues grew by for diagnostic information services were up 7.3% compared to the prior year, reflecting organic growth in our physician, hospital, and consumer 6.4%. Sam?
Speaker #2: channels as well as recent acquisitions. Total requisitions increased volume measured by the number of 8.5% versus the fourth quarter of 7.9%. Total 2024, with organic 0.1% versus the prior year.
Speaker #2: As a reminder, Corwell Health and Fresenius growth at a lower revenue per revenue per requisition was down requisition than our company Revenues average. Excluding these two relationships, our organic volume growth volume up accelerated to 4.1% in the fourth quarter, while our revenue per requisition growth Medical Care deliver significant volume 3%.
Operator: As a reminder, Corwell Health and Fresenius Medical Care deliver significant volume growth at a lower revenue per requisition than our company average. Excluding these two relationships, our organic volume growth accelerated to 4.1% in the fourth quarter, while our revenue per requisition growth remained solid at approximately 3%. Unit price remained consistent with our expectations. Reported operating income in the fourth quarter was $386 million, or 13.8% of revenues, compared to $361 million, or 13.8% of revenues last year. On an adjusted basis, operating income was $429 million, or 15.3% of revenues, compared to $409 million, or 15.6% of revenues last year. The adjusted operating income dollar increase was due to organic revenue growth and revenue growth from recent acquisitions, partially offset by wage increases.
Operator: As a reminder, Corwell Health and Fresenius Medical Care deliver significant volume growth at a lower revenue per requisition than our company average. Excluding these two relationships, our organic volume growth accelerated to 4.1% in the fourth quarter, while our revenue per requisition growth remained solid at approximately 3%. Unit price remained consistent with our expectations. Reported operating income in the fourth quarter was $386 million, or 13.8% of revenues, compared to $361 million, or 13.8% of revenues last year. On an adjusted basis, operating income was $429 million, or 15.3% of revenues, compared to $409 million, or 15.6% of revenues last year. The adjusted operating income dollar increase was due to organic revenue growth and revenue growth from recent acquisitions, partially offset by wage increases.
Operator: As a reminder, Corwell Health and Fresenius Medical Care deliver significant volume growth at a lower revenue per requisition than our company average. Excluding these two relationships, our organic volume growth accelerated to 4.1% in the fourth quarter, while our revenue per requisition growth remained solid at approximately 3%. Unit price remained consistent with our expectations. Reported operating income in the fourth quarter was $386 million, or 13.8% of revenues, compared to $361 million, or 13.8% of revenues last year. On an adjusted basis, operating income was $429 million, or 15.3% of revenues, compared to $409 million, or 15.6% of revenues last year. The adjusted operating income dollar increase was due to organic revenue growth and revenue growth from recent acquisitions, partially offset by wage increases.
Sam Samad: As a reminder, Corwell Health and Fresenius Medical Care deliver significant volume growth at a lower revenue per requisition than our company average. Excluding these two relationships, our organic volume growth accelerated to 4.1% in the fourth quarter, while our revenue per requisition growth remained solid at approximately 3%. Unit price remained consistent with our expectations. Reported operating income in the fourth quarter was $386 million, or 13.8% of revenues, compared to $361 million, or 13.8% of revenues last year. On an adjusted basis, operating income was $429 million, or 15.3% of revenues, compared to $409 million, or 15.6% of revenues last year. The adjusted operating income dollar increase was due to organic revenue growth and revenue growth from recent acquisitions, partially offset by wage increases.
Speaker #2: Unit price remained consistent with our expectations. Reported operating income in the fourth remained solid at approximately quarter was $386 of revenues, compared to $361 million or 13.8% of year.
Speaker #2: On an adjusted basis, operating income was 15.3% of revenues, compared to $429 million, $409 million a year ago. The adjusted operating income dollar increase was due to organic revenue growth and revenue growth from recent acquisitions, partially offset by wage increases.
Speaker #2: Operating income percent was reduced in the quarter by startup expenses related to Fresenius Medical Care and Corwell Health, as well as project Nova expenses.
Operator: Operating income percent was reduced in the quarter by startup expenses related to Fresenius Medical Care and Corwell Health, as well as Project Nova expenses. Reported EPS was $2.18 in the quarter, and adjusted EPS was $2.42, compared to $1.95 and $2.23 the prior year, respectively. Foreign exchange rates had no meaningful impact on our results. Cash from operations was $1.89 billion for the full year 2025 versus $1.33 billion in the prior year. This significant year-over-year increase was driven by higher operating income, favorable working capital due to timing of disbursements, a cash tax benefit related to recent tax legislation, and the One-Time CARES Act tax credit. As Jim said, we successfully executed on our strategy in 2025 to deliver these results, and we will continue to build on this as we progress through 2026. Turning now to our full year 2026 guidance.
Operator: Operating income percent was reduced in the quarter by startup expenses related to Fresenius Medical Care and Corwell Health, as well as Project Nova expenses. Reported EPS was $2.18 in the quarter, and adjusted EPS was $2.42, compared to $1.95 and $2.23 the prior year, respectively. Foreign exchange rates had no meaningful impact on our results. Cash from operations was $1.89 billion for the full year 2025 versus $1.33 billion in the prior year. This significant year-over-year increase was driven by higher operating income, favorable working capital due to timing of disbursements, a cash tax benefit related to recent tax legislation, and the One-Time CARES Act tax credit. As Jim said, we successfully executed on our strategy in 2025 to deliver these results, and we will continue to build on this as we progress through 2026. Turning now to our full year 2026 guidance.
Operator: Operating income percent was reduced in the quarter by startup expenses related to Fresenius Medical Care and Corwell Health, as well as Project Nova expenses. Reported EPS was $2.18 in the quarter, and adjusted EPS was $2.42, compared to $1.95 and $2.23 the prior year, respectively. Foreign exchange rates had no meaningful impact on our results. Cash from operations was $1.89 billion for the full year 2025 versus $1.33 billion in the prior year. This significant year-over-year increase was driven by higher operating income, favorable working capital due to timing of disbursements, a cash tax benefit related to recent tax legislation, and the One-Time CARES Act tax credit. As Jim said, we successfully executed on our strategy in 2025 to deliver these results, and we will continue to build on this as we progress through 2026. Turning now to our full year 2026 guidance.
Sam Samad: Operating income percent was reduced in the quarter by startup expenses related to Fresenius Medical Care and Corwell Health, as well as Project Nova expenses. Reported EPS was $2.18 in the quarter, and adjusted EPS was $2.42, compared to $1.95 and $2.23 the prior year, respectively. Foreign exchange rates had no meaningful impact on our results. Cash from operations was $1.89 billion for the full year 2025 versus $1.33 billion in the prior year. This significant year-over-year increase was driven by higher operating income, favorable working capital due to timing of disbursements, a cash tax benefit related to recent tax legislation, and the One-Time CARES Act tax credit. As Jim said, we successfully executed on our strategy in 2025 to deliver these results, and we will continue to build on this as we progress through 2026. Turning now to our full year 2026 guidance.
Speaker #2: Reported EPS was $2.18 in EPS was $2.42. $1.95 and Compared to $2.23 the prior year, respectively. Foreign exchange rates had no meaningful impact on our billion for the full year 2025 versus $1.33 billion in the prior results. year.
Speaker #2: Reported EPS was $2.18 in EPS was $2.42. $1.95 and Compared to $2.23 the prior year, respectively. Foreign exchange rates had no meaningful impact on our billion for the full year 2025 versus $1.33 billion in the prior results.
Speaker #2: The increase was driven by higher operating income, favorable working capital due to timing of disbursements, a cash tax benefit related to recent tax operations, $1.89 million from legislation, and a one-time CARES Act tax in 2025 to deliver these cash results.
Speaker #2: And we will continue to build on this as we progress through 2026. Turning now to our full-year 2026 successfully executed on our strategy
Operator: Revenues are expected to be between $11.7 billion and $11.82 billion, which represents a growth rate of 6% to 7.1%. Reported EPS is expected to be in a range of $9.45 to $9.65, and adjusted EPS in a range of $10.50 to $10.70. Cash from operations is expected to be approximately $1.75 billion. Capital expenditures are expected to be approximately $550 million. Our share count and interest expense are expected to be consistent with 2025. This guidance reflects the following considerations: We assume approximately 6% to 7.1% in revenue growth, and this does not include any contribution from prospective M&A. The severe weather impact experienced in January 2026 is creating a greater headwind than what we experienced during the same period a year ago. We have contemplated the impact to date in our full year guidance.
Operator: Revenues are expected to be between $11.7 billion and $11.82 billion, which represents a growth rate of 6% to 7.1%. Reported EPS is expected to be in a range of $9.45 to $9.65, and adjusted EPS in a range of $10.50 to $10.70. Cash from operations is expected to be approximately $1.75 billion. Capital expenditures are expected to be approximately $550 million. Our share count and interest expense are expected to be consistent with 2025. This guidance reflects the following considerations: We assume approximately 6% to 7.1% in revenue growth, and this does not include any contribution from prospective M&A. The severe weather impact experienced in January 2026 is creating a greater headwind than what we experienced during the same period a year ago. We have contemplated the impact to date in our full year guidance.
Operator: Revenues are expected to be between $11.7 billion and $11.82 billion, which represents a growth rate of 6% to 7.1%. Reported EPS is expected to be in a range of $9.45 to $9.65, and adjusted EPS in a range of $10.50 to $10.70. Cash from operations is expected to be approximately $1.75 billion. Capital expenditures are expected to be approximately $550 million. Our share count and interest expense are expected to be consistent with 2025. This guidance reflects the following considerations: We assume approximately 6% to 7.1% in revenue growth, and this does not include any contribution from prospective M&A. The severe weather impact experienced in January 2026 is creating a greater headwind than what we experienced during the same period a year ago. We have contemplated the impact to date in our full year guidance.
Sam Samad: Revenues are expected to be between $11.7 billion and $11.82 billion, which represents a growth rate of 6% to 7.1%. Reported EPS is expected to be in a range of $9.45 to $9.65, and adjusted EPS in a range of $10.50 to $10.70. Cash from operations is expected to be approximately $1.75 billion. Capital expenditures are expected to be approximately $550 million. Our share count and interest expense are expected to be consistent with 2025. This guidance reflects the following considerations: We assume approximately 6% to 7.1% in revenue growth, and this does not include any contribution from prospective M&A. The severe weather impact experienced in January 2026 is creating a greater headwind than what we experienced during the same period a year ago. We have contemplated the impact to date in our full year guidance.
Speaker #1: to be Guidance $11.7 billion between and $11.82 billion , which of represents EPs is expected to $82 billion , which rate of 6% to 7.1% .
Speaker #1: is Reported a range a growth to 6% growth $9.45 to $9.65 , and in a EPs represents a range adjusted operations is Cash expected $10.50 to $10.70 .
Speaker #1: from expected to to be of $1.75 billion . Capital approximately be expected to $550 million . expense are count and to be interest Our share consistent expected This guidance with reflects the following considerations .
Speaker #1: We approximately prospective does not growth , M&A 6% to 7.1% in revenue include January 2026 is impact weather severe . 2025 . The we than what experienced during the same ago .
Operator: We expect the seasonality of our business to be generally in line with last year's and pre-COVID seasonality. Based on the passage of federal funding legislation last week, there will be no impact from PAMA in 2026. For Project Nova, our multi-year initiative to modernize our order-to-cash process, we expect approximately 0.25 cents of EPS dilution related to increased investment spend versus 2025. Operating margin is expected to expand versus the prior year. The co-lab relationship with Corwell Health will add approximately $250 million in organic revenue at low single-digit margins in 2026. We continue to make progress with our launch of Haystack MRD and expect it will be less dilutive versus the prior year as we ramp volumes. We expect our adjusted effective tax rate to increase approximately 100 basis points in 2026 versus 2025.
Operator: We expect the seasonality of our business to be generally in line with last year's and pre-COVID seasonality. Based on the passage of federal funding legislation last week, there will be no impact from PAMA in 2026. For Project Nova, our multi-year initiative to modernize our order-to-cash process, we expect approximately 0.25 cents of EPS dilution related to increased investment spend versus 2025. Operating margin is expected to expand versus the prior year. The co-lab relationship with Corwell Health will add approximately $250 million in organic revenue at low single-digit margins in 2026. We continue to make progress with our launch of Haystack MRD and expect it will be less dilutive versus the prior year as we ramp volumes. We expect our adjusted effective tax rate to increase approximately 100 basis points in 2026 versus 2025.
Operator: We expect the seasonality of our business to be generally in line with last year's and pre-COVID seasonality. Based on the passage of federal funding legislation last week, there will be no impact from PAMA in 2026. For Project Nova, our multi-year initiative to modernize our order-to-cash process, we expect approximately 0.25 cents of EPS dilution related to increased investment spend versus 2025. Operating margin is expected to expand versus the prior year. The co-lab relationship with Corwell Health will add approximately $250 million in organic revenue at low single-digit margins in 2026. We continue to make progress with our launch of Haystack MRD and expect it will be less dilutive versus the prior year as we ramp volumes. We expect our adjusted effective tax rate to increase approximately 100 basis points in 2026 versus 2025.
Sam Samad: We expect the seasonality of our business to be generally in line with last year's and pre-COVID seasonality. Based on the passage of federal funding legislation last week, there will be no impact from PAMA in 2026. For Project Nova, our multi-year initiative to modernize our order-to-cash process, we expect approximately 0.25 cents of EPS dilution related to increased investment spend versus 2025. Operating margin is expected to expand versus the prior year. The co-lab relationship with Corwell Health will add approximately $250 million in organic revenue at low single-digit margins in 2026. We continue to make progress with our launch of Haystack MRD and expect it will be less dilutive versus the prior year as we ramp volumes. We expect our adjusted effective tax rate to increase approximately 100 basis points in 2026 versus 2025.
Speaker #1: have contribution from creating a to in our date . We expect the seasonality of our We in line period last pre-COVID be with seasonality impact on the passage of federal week .
Speaker #1: There will last from experienced in Pama a year guidance Project Nova , our multi-year legislation initiative modernize our order to , based generally to impact expect funding dilution be no $0.25 of EPs margin is operating versus expand versus the expected to year .
Speaker #1: The Colab process . health relationship with will add approximately cash single digit margins in low We 2026 . our launch of progress with continue to make $250 million in and expect it will increased investment versus the prior year as we dilutive .
Speaker #1: our adjusted tax rate to We 100 basis points in 2026 prior 2025 . Our lower operating cash flow in 2025 , to reflects compared several one time benefits 2026 prior year approximately and one more payroll 2026 cycle in than 2025 .
Operator: Our lower operating cash flow guidance in 2026 compared to 2025 reflects several one-time benefits in the prior year and one more payroll cycle in 2026 than 2025. The one-time benefits in 2025 were approximately $150 million, and the impact of the one additional payroll cycle in 2026 is approximately $120 million. With that, I will now turn it back to Jim. Thanks, Sam. To summarize, with diligent execution of our strategy and a strong Q4, we generated double-digit growth in revenues and earnings per share for the full year. In 2025, we delivered category-defining clinical innovations that fulfill customer needs, formed strategic collaborations to create new growth opportunities, and further advanced our position as the premier lab engine in consumer health. Our 2026 guidance reflects our continued confidence in our business strengths and market fundamentals supporting enduring interest in our diagnostic innovations.
Operator: Our lower operating cash flow guidance in 2026 compared to 2025 reflects several one-time benefits in the prior year and one more payroll cycle in 2026 than 2025. The one-time benefits in 2025 were approximately $150 million, and the impact of the one additional payroll cycle in 2026 is approximately $120 million. With that, I will now turn it back to Jim. Thanks, Sam. To summarize, with diligent execution of our strategy and a strong Q4, we generated double-digit growth in revenues and earnings per share for the full year. In 2025, we delivered category-defining clinical innovations that fulfill customer needs, formed strategic collaborations to create new growth opportunities, and further advanced our position as the premier lab engine in consumer health. Our 2026 guidance reflects our continued confidence in our business strengths and market fundamentals supporting enduring interest in our diagnostic innovations.
Operator: Our lower operating cash flow guidance in 2026 compared to 2025 reflects several one-time benefits in the prior year and one more payroll cycle in 2026 than 2025. The one-time benefits in 2025 were approximately $150 million, and the impact of the one additional payroll cycle in 2026 is approximately $120 million. With that, I will now turn it back to Jim. Thanks, Sam. To summarize, with diligent execution of our strategy and a strong Q4, we generated double-digit growth in revenues and earnings per share for the full year. In 2025, we delivered category-defining clinical innovations that fulfill customer needs, formed strategic collaborations to create new growth opportunities, and further advanced our position as the premier lab engine in consumer health. Our 2026 guidance reflects our continued confidence in our business strengths and market fundamentals supporting enduring interest in our diagnostic innovations.
Sam Samad: Our lower operating cash flow guidance in 2026 compared to 2025 reflects several one-time benefits in the prior year and one more payroll cycle in 2026 than 2025. The one-time benefits in 2025 were approximately $150 million, and the impact of the one additional payroll cycle in 2026 is approximately $120 million. With that, I will now turn it back to Jim.
Speaker #1: benefits in increase approximately $150 million , time and impact of the one additional the cycle The one 2026 in is approximately $120 million , with that , I effective turn payroll Jim Thanks ,
Jim Davis: Thanks, Sam. To summarize, with diligent execution of our strategy and a strong Q4, we generated double-digit growth in revenues and earnings per share for the full year. In 2025, we delivered category-defining clinical innovations that fulfill customer needs, formed strategic collaborations to create new growth opportunities, and further advanced our position as the premier lab engine in consumer health. Our 2026 guidance reflects our continued confidence in our business strengths and market fundamentals supporting enduring interest in our diagnostic innovations.
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Speaker #2: Sam . To summarize with diligent
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Operator: Looking ahead, I'm excited about our path forward. We are focused on connecting everyone, from clinicians to consumers, to illuminate a path to better health and are well-positioned to serve growing interest in accessing the health insights that only laboratory diagnostics can deliver. Quest sits at the center of healthcare as a trusted provider, and that's because of the dedication of our nearly 57,000 colleagues to living our purpose, working together to create a healthier world, one life at a time. I'd like to close by thanking each of my colleagues for what we accomplished together in 2025 and for their ongoing commitment to transforming lives for the better in the years ahead. Now, we'd be happy to take your questions. Operator? Thank you. We will now open up to questions. At the request of the company, we ask that you please limit yourself to one question.
Operator: Looking ahead, I'm excited about our path forward. We are focused on connecting everyone, from clinicians to consumers, to illuminate a path to better health and are well-positioned to serve growing interest in accessing the health insights that only laboratory diagnostics can deliver. Quest sits at the center of healthcare as a trusted provider, and that's because of the dedication of our nearly 57,000 colleagues to living our purpose, working together to create a healthier world, one life at a time. I'd like to close by thanking each of my colleagues for what we accomplished together in 2025 and for their ongoing commitment to transforming lives for the better in the years ahead. Now, we'd be happy to take your questions. Operator? Thank you. We will now open up to questions. At the request of the company, we ask that you please limit yourself to one question.
Operator: Looking ahead, I'm excited about our path forward. We are focused on connecting everyone, from clinicians to consumers, to illuminate a path to better health and are well-positioned to serve growing interest in accessing the health insights that only laboratory diagnostics can deliver. Quest sits at the center of healthcare as a trusted provider, and that's because of the dedication of our nearly 57,000 colleagues to living our purpose, working together to create a healthier world, one life at a time. I'd like to close by thanking each of my colleagues for what we accomplished together in 2025 and for their ongoing commitment to transforming lives for the better in the years ahead. Now, we'd be happy to take your questions. Operator? Thank you. We will now open up to questions. At the request of the company, we ask that you please limit yourself to one question.
Jim Davis: Looking ahead, I'm excited about our path forward. We are focused on connecting everyone, from clinicians to consumers, to illuminate a path to better health and are well-positioned to serve growing interest in accessing the health insights that only laboratory diagnostics can deliver. Quest sits at the center of healthcare as a trusted provider, and that's because of the dedication of our nearly 57,000 colleagues to living our purpose, working together to create a healthier world, one life at a time. I'd like to close by thanking each of my colleagues for what we accomplished together in 2025 and for their ongoing commitment to transforming lives for the better in the years ahead. Now, we'd be happy to take your questions. Operator?
Speaker #2: are focused on everyone connecting clinicians to to a illuminate consumers better path to growing serve And are well interest in health . health accessing the insights laboratory only diagnostics can deliver .
Speaker #2: Quest of healthcare as trusted ahead , provider that center sits at the because of the our nearly positioned to 57,000 colleagues our purpose living dedication of that's together to create a healthier to world .
Speaker #2: . One life at a close by to I'd like we for what accomplished together in 2025 , and for their ongoing commitment to transforming better for the years lives in the ahead .
Operator: Thank you. We will now open up to questions. At the request of the company, we ask that you please limit yourself to one question.
Speaker #2: Now , we'd be to take your . happy Operator .
Operator: If you have additional questions, we ask that you fall back in the queue. To be placed in the queue, please press star 1 from your phone. To withdraw, press star 2. Again, to ask a question, please press star 1. Our first question comes from Luke Sergot with Barclays. Your line is open. You may ask your question. Great. Thanks for the questions, guys. I guess as you're looking for '26, can you just give a sense of what the underlying growth drivers are as you think about or the assumptions on the growth drivers? As you think about the consumer piece, new tests as you think, MRD coming on, potential reimbursement there, chronic disease management, etc., just kind of break it out as to what you guys are thinking from the as we kind of bridge that build. Yeah. Hey, good morning, Luke.
Operator: If you have additional questions, we ask that you fall back in the queue. To be placed in the queue, please press star 1 from your phone. To withdraw, press star 2. Again, to ask a question, please press star 1. Our first question comes from Luke Sergot with Barclays. Your line is open. You may ask your question. Great. Thanks for the questions, guys. I guess as you're looking for '26, can you just give a sense of what the underlying growth drivers are as you think about or the assumptions on the growth drivers? As you think about the consumer piece, new tests as you think, MRD coming on, potential reimbursement there, chronic disease management, etc., just kind of break it out as to what you guys are thinking from the as we kind of bridge that build. Yeah. Hey, good morning, Luke.
Operator: If you have additional questions, we ask that you fall back in the queue. To be placed in the queue, please press star 1 from your phone. To withdraw, press star 2. Again, to ask a question, please press star 1. Our first question comes from Luke Sergot with Barclays. Your line is open. You may ask your question. Great. Thanks for the questions, guys. I guess as you're looking for '26, can you just give a sense of what the underlying growth drivers are as you think about or the assumptions on the growth drivers? As you think about the consumer piece, new tests as you think, MRD coming on, potential reimbursement there, chronic disease management, etc., just kind of break it out as to what you guys are thinking from the as we kind of bridge that build. Yeah. Hey, good morning, Luke.
Operator: If you have additional questions, we ask that you fall back in the queue. To be placed in the queue, please press star 1 from your phone. To withdraw, press star 2. Again, to ask a question, please press star 1. Our first question comes from Luke Sergot with Barclays. Your line is open. You may ask your question.
Speaker #3: will now Thank
Speaker #3: will now Thank to .
Speaker #3: open up at company . We ask that you please limit yourself to one question . If you have additional back in request of ask that the questions , we queue .
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Speaker #3: to Please press you fall colleagues phone Press star again a to ask to press star one . question , comes from Luke the questions with placed in the Barclays .
Luke Sergott: Great. Thanks for the questions, guys. I guess as you're looking for '26, can you just give a sense of what the underlying growth drivers are as you think about or the assumptions on the growth drivers? As you think about the consumer piece, new tests as you think, MRD coming on, potential reimbursement there, chronic disease management, etc., just kind of break it out as to what you guys are thinking from the as we kind of bridge that build.
Speaker #3: Your line is ask your question
Speaker #4: Great . Thanks questions ,
Speaker #4: Great . Thanks questions ,
Speaker #4: guys looking for 26 ,
Speaker #4: growth drivers are as you think
Speaker #4: growth
Speaker #4: about or
Speaker #4: about or
Speaker #4: drivers as
Speaker #4: you think about , like consumer piece new as you what the tests think you know , coming open . potential
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Jim Davis: Yeah. Hey, good morning, Luke.
Speaker #4: management , etc. . You know , just kind one from your of please break the it out on you guys are thinking from the
Operator: I think you touched on most of those. Look, we expect the organic growth to remain strong, as Sam indicated. I think from a testing standpoint, we're seeing tremendous uplift in our Alzheimer's portfolio of tests. Those include the Abeta42/40, several pTau markers, as well as our algorithms that assess the likelihood of disease. Our autoimmune testing, as I indicated in the script, is, again, very, very strong. The new diagnosis rate of autoimmune disorders continues to grow. Diabetes continues to grow. Cardiovascular testing and not just the routine testing. The more advanced testing, what we call Cardio IQ, that includes Lp(a), ApoB, insulin resistance, all of those doing very, very well, some of that being generated by the consumer segment. Our own QuestHealth.com just saw tremendous growth throughout last year.
Operator: I think you touched on most of those. Look, we expect the organic growth to remain strong, as Sam indicated. I think from a testing standpoint, we're seeing tremendous uplift in our Alzheimer's portfolio of tests. Those include the Abeta42/40, several pTau markers, as well as our algorithms that assess the likelihood of disease. Our autoimmune testing, as I indicated in the script, is, again, very, very strong. The new diagnosis rate of autoimmune disorders continues to grow. Diabetes continues to grow. Cardiovascular testing and not just the routine testing. The more advanced testing, what we call Cardio IQ, that includes Lp(a), ApoB, insulin resistance, all of those doing very, very well, some of that being generated by the consumer segment. Our own QuestHealth.com just saw tremendous growth throughout last year.
Operator: I think you touched on most of those. Look, we expect the organic growth to remain strong, as Sam indicated. I think from a testing standpoint, we're seeing tremendous uplift in our Alzheimer's portfolio of tests. Those include the Abeta42/40, several pTau markers, as well as our algorithms that assess the likelihood of disease. Our autoimmune testing, as I indicated in the script, is, again, very, very strong. The new diagnosis rate of autoimmune disorders continues to grow. Diabetes continues to grow. Cardiovascular testing and not just the routine testing. The more advanced testing, what we call Cardio IQ, that includes Lp(a), ApoB, insulin resistance, all of those doing very, very well, some of that being generated by the consumer segment. Our own QuestHealth.com just saw tremendous growth throughout last year.
Jim Davis: I think you touched on most of those. Look, we expect the organic growth to remain strong, as Sam indicated. I think from a testing standpoint, we're seeing tremendous uplift in our Alzheimer's portfolio of tests. Those include the Abeta42/40, several pTau markers, as well as our algorithms that assess the likelihood of disease. Our autoimmune testing, as I indicated in the script, is, again, very, very strong. The new diagnosis rate of autoimmune disorders continues to grow. Diabetes continues to grow. Cardiovascular testing and not just the routine testing. The more advanced testing, what we call Cardio IQ, that includes Lp(a), ApoB, insulin resistance, all of those doing very, very well, some of that being generated by the consumer segment. Our own QuestHealth.com just saw tremendous growth throughout last year.
Speaker #2: Yeah .
Speaker #2: think you touched Hey good on most morning Luke . those . Look , we expect I
Speaker #2: think you touched Hey good on most morning Luke . those . Look , we expect I growth to to Our first question strong .
Speaker #2: think you touched Hey good on most morning Luke . those . Look , we expect I growth to to Sergott the star two think from a testing standpoint , you I seeing tremendous .
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Speaker #2: Alzheimer's know , we're
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Speaker #2: That includes cardio , little a apob insulin resistance , , diabetes very well . being by the consumer segment . generated just saw quest growth throughout last Some of that tremendous year Our partnerships , what we developed whoop , with with Ora , testing .
Operator: The partnerships that we've developed with WHOOP, with Oura, with Function Health, with several other types of wellness companies, all of that helping. The last thing I'd mention is we got back into network with Elevance in several key states last year: Nevada, Colorado, Georgia, and Virginia. And I'd still say we're in the early innings of winning our fair share in those states. So all of that continues to just propel the organic growth as we enter this year. Great. And then a follow-up here, as you think about Q1, you talked about the bigger weather impact that had when you think about consumer ramping and just from a pacing perspective, how are you guys thinking about Q1 and then how that ramps throughout the year? Yeah. Let me just comment on the weather impact.
Operator: The partnerships that we've developed with WHOOP, with Oura, with Function Health, with several other types of wellness companies, all of that helping. The last thing I'd mention is we got back into network with Elevance in several key states last year: Nevada, Colorado, Georgia, and Virginia. And I'd still say we're in the early innings of winning our fair share in those states. So all of that continues to just propel the organic growth as we enter this year. Great. And then a follow-up here, as you think about Q1, you talked about the bigger weather impact that had when you think about consumer ramping and just from a pacing perspective, how are you guys thinking about Q1 and then how that ramps throughout the year? Yeah. Let me just comment on the weather impact.
Operator: The partnerships that we've developed with WHOOP, with Oura, with Function Health, with several other types of wellness companies, all of that helping. The last thing I'd mention is we got back into network with Elevance in several key states last year: Nevada, Colorado, Georgia, and Virginia. And I'd still say we're in the early innings of winning our fair share in those states. So all of that continues to just propel the organic growth as we enter this year. Great. And then a follow-up here, as you think about Q1, you talked about the bigger weather impact that had when you think about consumer ramping and just from a pacing perspective, how are you guys thinking about Q1 and then how that ramps throughout the year? Yeah. Let me just comment on the weather impact.
Jim Davis: The partnerships that we've developed with WHOOP, with Oura, with Function Health, with several other types of wellness companies, all of that helping. The last thing I'd mention is we got back into network with Elevance in several key states last year: Nevada, Colorado, Georgia, and Virginia. And I'd still say we're in the early innings of winning our fair share in those states. So all of that continues to just propel the organic growth as we enter this year.
Speaker #2: Function Health , several doing very , of . with , all other types helping of that . The last thing I'd The mention is , you know , we got back into network own call companies in L'avance several key last year , Colorado , Georgia , Colorado and Virginia , still say all of we're in the early and I'd those states innings fair share our of winning So all of continues to that , you know , propel states .
Speaker #2: Function Health , several doing very , of . with , all other types helping of that . The last thing I'd The mention is , you know , we got back into network own call companies in L'avance several key last year , Colorado , Georgia , Colorado and Virginia , still say all of we're in the early and I'd those states innings fair share our of winning So all of continues to that , you know , propel states . just organic enter this growth as we year
Luke Sergott: Great. And then a follow-up here, as you think about Q1, you talked about the bigger weather impact that had when you think about consumer ramping and just from a pacing perspective, how are you guys thinking about Q1 and then how that ramps throughout the year?
Speaker #4: Great . And then follow up here , as you that we've about
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Speaker #4: the impact weather when had you think about like , ramping and just , from a perspective , how are you guys thinking bigger that about you know , Q and then how that ramps the consumer .
Jim Davis: Yeah. Let me just comment on the weather impact.
Operator: It was a tough January versus last January, but the good news is it was in January. So we have the rest of the quarter, the rest of the year to make it up. Now, we can't predict the weather in the last 6 weeks of the quarter here. But what I'll tell you is the first 3, 3 and a half weeks of January, we're very strong, very strong growth. And so we're convinced that the majority of some portion of it comes back, whether it's 30%, 40%, it's hard to predict. The general health and wellness types of work always comes back to us. Some of the episodic work, if people were getting tested every 2 weeks for some chronic care condition, maybe they missed that appointment.
Operator: It was a tough January versus last January, but the good news is it was in January. So we have the rest of the quarter, the rest of the year to make it up. Now, we can't predict the weather in the last 6 weeks of the quarter here. But what I'll tell you is the first 3, 3 and a half weeks of January, we're very strong, very strong growth. And so we're convinced that the majority of some portion of it comes back, whether it's 30%, 40%, it's hard to predict. The general health and wellness types of work always comes back to us. Some of the episodic work, if people were getting tested every 2 weeks for some chronic care condition, maybe they missed that appointment.
Operator: It was a tough January versus last January, but the good news is it was in January. So we have the rest of the quarter, the rest of the year to make it up. Now, we can't predict the weather in the last 6 weeks of the quarter here. But what I'll tell you is the first 3, 3 and a half weeks of January, we're very strong, very strong growth. And so we're convinced that the majority of some portion of it comes back, whether it's 30%, 40%, it's hard to predict. The general health and wellness types of work always comes back to us. Some of the episodic work, if people were getting tested every 2 weeks for some chronic care condition, maybe they missed that appointment.
Jim Davis: It was a tough January versus last January, but the good news is it was in January. So we have the rest of the quarter, the rest of the year to make it up. Now, we can't predict the weather in the last 6 weeks of the quarter here. But what I'll tell you is the first 3, 3 and a half weeks of January, we're very strong, very strong growth. And so we're convinced that the majority of some portion of it comes back, whether it's 30%, 40%, it's hard to predict. The general health and wellness types of work always comes back to us. Some of the episodic work, if people were getting tested every 2 weeks for some chronic care condition, maybe they missed that appointment.
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Speaker #2: just Yeah , let me
Speaker #2: tough versus January but the comment good news January . So
Speaker #2: of the rest last weather of the year to make it up . Now ,
Speaker #2: of the rest last
Speaker #2: weather in the six weeks of the quarter here rest January , . But what can't is it is , you know , the first year three , weeks of very January were strong , very strong And so growth .
Speaker #2: three and a half convinced that pacing we're last throughout the you the majority quarter , the of one ? some portion of comes it whether it's 30% , 40% , it's predict the hard to and types wellness Always of back comes to us work .
Operator: But the other thing I'd tell you is we have really good systems in place today to track the appointments that were canceled, to track the appointments that we canceled because we couldn't open our patient service centers. We continue to remind patients that they missed their appointment, and we see nice uptick from those reminders in terms of patients rescheduling. In terms of the pacing of the quarter, I'll let Sam comment on that. Yeah. So, Luke, I mean, I'd echo, first of all, the comment that Jim made around very strong utilization in the first part of January. Then we had some real historically bad storms across the country that impacted the month, but we're still confident about the recovery in the quarter. What we're seeing is also that strength coming back.
Operator: But the other thing I'd tell you is we have really good systems in place today to track the appointments that were canceled, to track the appointments that we canceled because we couldn't open our patient service centers. We continue to remind patients that they missed their appointment, and we see nice uptick from those reminders in terms of patients rescheduling. In terms of the pacing of the quarter, I'll let Sam comment on that. Yeah. So, Luke, I mean, I'd echo, first of all, the comment that Jim made around very strong utilization in the first part of January. Then we had some real historically bad storms across the country that impacted the month, but we're still confident about the recovery in the quarter. What we're seeing is also that strength coming back.
Operator: But the other thing I'd tell you is we have really good systems in place today to track the appointments that were canceled, to track the appointments that we canceled because we couldn't open our patient service centers. We continue to remind patients that they missed their appointment, and we see nice uptick from those reminders in terms of patients rescheduling. In terms of the pacing of the quarter, I'll let Sam comment on that. Yeah. So, Luke, I mean, I'd echo, first of all, the comment that Jim made around very strong utilization in the first part of January. Then we had some real historically bad storms across the country that impacted the month, but we're still confident about the recovery in the quarter. What we're seeing is also that strength coming back.
Jim Davis: But the other thing I'd tell you is we have really good systems in place today to track the appointments that were canceled, to track the appointments that we canceled because we couldn't open our patient service centers. We continue to remind patients that they missed their appointment, and we see nice uptick from those reminders in terms of patients rescheduling. In terms of the pacing of the quarter, I'll let Sam comment on that.
Speaker #2: episodic people were getting tested health two weeks for some care every condition , maybe they chronic the work , if appointment missed that general .
Speaker #2: episodic people were getting tested health two weeks for some care every condition , maybe they chronic the work , if appointment missed that general . you is But the we other thing have really good systems in place to today the appointments that .
Speaker #2: the appointments that we canceled because we couldn't open patient our service Some of and continue to centers , remind patients track that they missed their we appointment .
Speaker #2: And we see a nice uptick, reminders in terms of patients rescheduling, and from those, pacing in terms of the quarter. I'll let Sam track and comment on that.
Sam Samad: Yeah. So, Luke, I mean, I'd echo, first of all, the comment that Jim made around very strong utilization in the first part of January. Then we had some real historically bad storms across the country that impacted the month, but we're still confident about the recovery in the quarter. What we're seeing is also that strength coming back.
Speaker #1: Yeah . So , Luke
Speaker #1: , I mean , I'd echo , all , the first of comment Jim made around that strong very on utilization in the January , and first part of then we real had some historic , historically bad storms across the country that impacted the month .
Operator: But in terms of seasonality, I think what you should expect is something similar to what we saw last year in terms of pacing across the quarters over the full year, and something similar to what we saw pre-COVID seasonality, if you go back before 2020, specifically referring to the 2016-2019 period. That type of seasonality is very, I would say, consistent in our business. It was disrupted during COVID. But if you compare to 2025, I think the seasonality is very similar in terms of how you should think about the pacing. Great. Operator, next question. Thank you. Our next question comes from Aaron Wright with Morgan Stanley. Your line is open. You may ask your question. Aaron, your line is open. Please check your mute feature. Aaron, your line is open. Operator, let's go to the next question. Yep. Thank you.
Operator: But in terms of seasonality, I think what you should expect is something similar to what we saw last year in terms of pacing across the quarters over the full year, and something similar to what we saw pre-COVID seasonality, if you go back before 2020, specifically referring to the 2016-2019 period. That type of seasonality is very, I would say, consistent in our business. It was disrupted during COVID. But if you compare to 2025, I think the seasonality is very similar in terms of how you should think about the pacing. Great. Operator, next question. Thank you. Our next question comes from Aaron Wright with Morgan Stanley. Your line is open. You may ask your question. Aaron, your line is open. Please check your mute feature. Aaron, your line is open. Operator, let's go to the next question. Yep. Thank you.
Operator: But in terms of seasonality, I think what you should expect is something similar to what we saw last year in terms of pacing across the quarters over the full year, and something similar to what we saw pre-COVID seasonality, if you go back before 2020, specifically referring to the 2016-2019 period. That type of seasonality is very, I would say, consistent in our business. It was disrupted during COVID. But if you compare to 2025, I think the seasonality is very similar in terms of how you should think about the pacing. Great. Operator, next question. Thank you. Our next question comes from Aaron Wright with Morgan Stanley. Your line is open. You may ask your question. Aaron, your line is open. Please check your mute feature. Aaron, your line is open. Operator, let's go to the next question. Yep. Thank you.
Sam Samad: But in terms of seasonality, I think what you should expect is something similar to what we saw last year in terms of pacing across the quarters over the full year, and something similar to what we saw pre-COVID seasonality, if you go back before 2020, specifically referring to the 2016-2019 period. That type of seasonality is very, I would say, consistent in our business. It was disrupted during COVID. But if you compare to 2025, I think the seasonality is very similar in terms of how you should think about the pacing.
Speaker #1: we're still confident about recovery in the the quarter and what we're seeing is also that coming back . But in terms of strength , you know , the what I should seasonality expect is think what you something similar to what we saw last year in terms across the quarters over the full pacing year and something similar to what we saw Seasonality .
Speaker #1: If pre-COVID . you go back before 2020 , specifically referring to the 2016 2019 period , that type of is seasonality very I consistent in our disrupted was during Covid , but if you compare to would say I think the business .
Luke Sergott: Great.
Operator: Operator, next question. Thank you. Our next question comes from Aaron Wright with Morgan Stanley. Your line is open. You may ask your question. Aaron, your line is open. Please check your mute feature. Aaron, your line is open.
Speaker #1: seasonality is very similar in terms should think about the pacing Operator question . .
Speaker #1: Great .
Speaker #3: Thank you . question Our next comes from Aaron Wright with Morgan Stanley . Your line is open . ask your You may
Speaker #3: Please check your mute feature. And your line is open. Here is your question.
Jim Davis: Operator, let's go to the next question.
Operator: Yep. Thank you.
Operator: Our next question then comes from Patrick Donnelly with Citi. Your line is open. You may ask your question. Hey, guys. Thank you for taking the questions. Sam, probably one for you. I just want to talk through the moving pieces on the margins. And it seems like a lot is going on in 2026 between Corwell, Project Nova, Haystack, and an extra week of the payroll, which you mentioned. It does sound like they'll be slightly up year over year. So can you talk through the impact, a little bit of a bridge if you're able to, and then the cadence? It sounds like typical seasonality. I know typically Q2s are the highest. It will be helpful just to talk through the cadence and then the moving pieces on the margins. And if you're able to quantify, that'd be even better. Thank you, guys. Yeah. Thanks, Patrick.
Operator: Our next question then comes from Patrick Donnelly with Citi. Your line is open. You may ask your question. Hey, guys. Thank you for taking the questions. Sam, probably one for you. I just want to talk through the moving pieces on the margins. And it seems like a lot is going on in 2026 between Corwell, Project Nova, Haystack, and an extra week of the payroll, which you mentioned. It does sound like they'll be slightly up year over year. So can you talk through the impact, a little bit of a bridge if you're able to, and then the cadence? It sounds like typical seasonality. I know typically Q2s are the highest. It will be helpful just to talk through the cadence and then the moving pieces on the margins. And if you're able to quantify, that'd be even better. Thank you, guys. Yeah. Thanks, Patrick.
Operator: Our next question then comes from Patrick Donnelly with Citi. Your line is open. You may ask your question. Hey, guys. Thank you for taking the questions. Sam, probably one for you. I just want to talk through the moving pieces on the margins. And it seems like a lot is going on in 2026 between Corwell, Project Nova, Haystack, and an extra week of the payroll, which you mentioned. It does sound like they'll be slightly up year over year. So can you talk through the impact, a little bit of a bridge if you're able to, and then the cadence? It sounds like typical seasonality. I know typically Q2s are the highest. It will be helpful just to talk through the cadence and then the moving pieces on the margins. And if you're able to quantify, that'd be even better. Thank you, guys. Yeah. Thanks, Patrick.
Operator: Our next question then comes from Patrick Donnelly with Citi. Your line is open. You may ask your question.
Speaker #3: line .
Speaker #1: go to the
Speaker #1: question Let's .
Patrick Donnelly: Hey, guys. Thank you for taking the questions. Sam, probably one for you. I just want to talk through the moving pieces on the margins. And it seems like a lot is going on in 2026 between Corwell, Project Nova, Haystack, and an extra week of the payroll, which you mentioned. It does sound like they'll be slightly up year over year. So can you talk through the impact, a little bit of a bridge if you're able to, and then the cadence? It sounds like typical seasonality. I know typically Q2s are the highest. It will be helpful just to talk through the cadence and then the moving pieces on the margins. And if you're able to quantify, that'd be even better. Thank you, guys.
Speaker #3: You. Your next is open from Patrick Donnelly with Citi. Your line is open. Patrick, you may ask your question.
Speaker #5: Hey guys . Thank you for taking the questions . Sam . Probably one for you . I just want to moving talk through the pieces on the margins .
Speaker #5: And it seems is going on 26 between in Corewell project Nova , haystack , an extra week of the mentioned , payroll , which you does sound like they'll it be up slightly year over year .
Speaker #5: can you So just talk through the impacts ? A little bridge if to . you're able And then bit of a the cadence , it typical sounds like seasonality .
Speaker #5: I know typically two is the highest . It will be helpful just to talk through cadence . And then the moving pieces on the margins .
Jim Davis: Yeah. Thanks, Patrick.
Operator: So let me go through all the moving parts here, or at least the moving parts that we have in 2026. First of all, let me just say operating margin is expected to increase in 2026 versus 2025. That's the starting point here in terms of how you think about 2026. It is impacted somewhat negatively by the ramp of Corewell and Fresenius businesses, mostly Corewell, actually, in terms of the roughly $250 million of Corewell revenue increasing in 2026, which comes at a lower margin. It's a co-lab business. It's low single-digit margin in 2026, improving to normal co-lab margins later in 2027 and beyond. But in 2026, it's impacting operating margin rate. It is very good business. It's $250 million in terms of additional revenues, but at low single-digit margins this year. That's impacting the operating margin rate expansion.
Operator: So let me go through all the moving parts here, or at least the moving parts that we have in 2026. First of all, let me just say operating margin is expected to increase in 2026 versus 2025. That's the starting point here in terms of how you think about 2026. It is impacted somewhat negatively by the ramp of Corewell and Fresenius businesses, mostly Corewell, actually, in terms of the roughly $250 million of Corewell revenue increasing in 2026, which comes at a lower margin. It's a co-lab business. It's low single-digit margin in 2026, improving to normal co-lab margins later in 2027 and beyond. But in 2026, it's impacting operating margin rate. It is very good business. It's $250 million in terms of additional revenues, but at low single-digit margins this year. That's impacting the operating margin rate expansion.
Operator: So let me go through all the moving parts here, or at least the moving parts that we have in 2026. First of all, let me just say operating margin is expected to increase in 2026 versus 2025. That's the starting point here in terms of how you think about 2026. It is impacted somewhat negatively by the ramp of Corewell and Fresenius businesses, mostly Corewell, actually, in terms of the roughly $250 million of Corewell revenue increasing in 2026, which comes at a lower margin. It's a co-lab business. It's low single-digit margin in 2026, improving to normal co-lab margins later in 2027 and beyond. But in 2026, it's impacting operating margin rate. It is very good business. It's $250 million in terms of additional revenues, but at low single-digit margins this year. That's impacting the operating margin rate expansion.
Jim Davis: So let me go through all the moving parts here, or at least the moving parts that we have in 2026. First of all, let me just say operating margin is expected to increase in 2026 versus 2025. That's the starting point here in terms of how you think about 2026. It is impacted somewhat negatively by the ramp of Corewell and Fresenius businesses, mostly Corewell, actually, in terms of the roughly $250 million of Corewell revenue increasing in 2026, which comes at a lower margin. It's a co-lab business. It's low single-digit margin in 2026, improving to normal co-lab margins later in 2027 and beyond. But in 2026, it's impacting operating margin rate. It is very good business. It's $250 million in terms of additional revenues, but at low single-digit margins this year. That's impacting the operating margin rate expansion.
Speaker #5: And if you're able to quantify that'd be even Thank you better . guys .
Speaker #1: Yeah thanks , Patrick . So let me let me go through all the moving parts moving here . At least the parts that we have in 26 .
Speaker #1: just say all , let me operating margin is First of expected to increase in 26 versus 25 . So that's the that's point here in terms starting of how you think about 26 .
Speaker #1: It is impacted somewhat negatively by the ramp of And Corwell . Fresenius businesses , mostly Cowell actually , in terms of the roughly $250 million of Cowell revenue increasing in 26 , which comes at a lower margin .
Speaker #1: colab . It's business low single digit margin in 26 , It's a improving to , you know , normal Colab margins later in 27 and beyond .
Speaker #1: But in 26 it's impacting operating margin is rate . very good It business . It's 250 million in terms of additional revenues . But at low single digit margins this year .
Operator: But even with that, operating margin rate is improving. Obviously, we have very strong organic volumes. The 6.6% at the midpoint guide that we've given is mostly organic growth. It's almost all organic growth. Actually, there's only about roughly 15 basis points of M&A carryover in that. So think about it as all organic growth and driving margin expansion. In terms of price impact, again, another piece of the story here, price is relatively flat year over year, consistent with our expectations and consistent with what we've been seeing in practice over the last couple of years. So no negative impact from price, roughly flat within that plus or minus 30 basis points that we've talked about. In terms of Haystack, Haystack is less dilutive in 2026, so it's actually helping. That's consistent with what we've shared in terms of 2026.
Operator: But even with that, operating margin rate is improving. Obviously, we have very strong organic volumes. The 6.6% at the midpoint guide that we've given is mostly organic growth. It's almost all organic growth. Actually, there's only about roughly 15 basis points of M&A carryover in that. So think about it as all organic growth and driving margin expansion. In terms of price impact, again, another piece of the story here, price is relatively flat year over year, consistent with our expectations and consistent with what we've been seeing in practice over the last couple of years. So no negative impact from price, roughly flat within that plus or minus 30 basis points that we've talked about. In terms of Haystack, Haystack is less dilutive in 2026, so it's actually helping. That's consistent with what we've shared in terms of 2026.
Operator: But even with that, operating margin rate is improving. Obviously, we have very strong organic volumes. The 6.6% at the midpoint guide that we've given is mostly organic growth. It's almost all organic growth. Actually, there's only about roughly 15 basis points of M&A carryover in that. So think about it as all organic growth and driving margin expansion. In terms of price impact, again, another piece of the story here, price is relatively flat year over year, consistent with our expectations and consistent with what we've been seeing in practice over the last couple of years. So no negative impact from price, roughly flat within that plus or minus 30 basis points that we've talked about. In terms of Haystack, Haystack is less dilutive in 2026, so it's actually helping. That's consistent with what we've shared in terms of 2026.
Jim Davis: But even with that, operating margin rate is improving. Obviously, we have very strong organic volumes. The 6.6% at the midpoint guide that we've given is mostly organic growth. It's almost all organic growth. Actually, there's only about roughly 15 basis points of M&A carryover in that. So think about it as all organic growth and driving margin expansion. In terms of price impact, again, another piece of the story here, price is relatively flat year over year, consistent with our expectations and consistent with what we've been seeing in practice over the last couple of years. So no negative impact from price, roughly flat within that plus or minus 30 basis points that we've talked about. In terms of Haystack, Haystack is less dilutive in 2026, so it's actually helping. That's consistent with what we've shared in terms of 2026.
Speaker #1: So that's impacting the operating margin rate expansion . But even with that operating margin rate is improving strong have very . Obviously we volumes .
Speaker #1: organic The 6.6% at the midpoint guide that we've given is mostly organic growth . It's almost all growth , organic actually , there's only you about , roughly 15 basis points of M&A carryover in that .
Speaker #1: So think about it as all organic growth and driving margin expansion there . You know , in terms of price impact . Again another piece of the story here .
Speaker #1: Prices flat relatively year over year consistent with our expectations . And consistent with what we've been seeing in practice over the last know , couple of years .
Speaker #1: So you know , no negative from impact price roughly flat within that plus or -30 basis points that we've talked about , you know , in terms of haystack , haystack is less dilutive in 26 .
Operator: So the test is ramping, good volume, ramp that leads to less dilution on Haystack. And then you have, as an offset, Project Nova. We've quantified that in the guide that we provided. It's roughly $0.25 of incremental expenses in 2026 that's impacting our margins. So that's going to happen across 2026. It started to ramp more significantly in Q4 of 2025, and it's going to continue in 2026 as we stated prior, and we've quantified it now for 2026. In terms of seasonality, the last thing I think that you asked, Patrick, and then I'll hand it over to Jim, who wanted to add a couple of comments. But seasonality, consistent with what we saw last year.
Operator: So the test is ramping, good volume, ramp that leads to less dilution on Haystack. And then you have, as an offset, Project Nova. We've quantified that in the guide that we provided. It's roughly $0.25 of incremental expenses in 2026 that's impacting our margins. So that's going to happen across 2026. It started to ramp more significantly in Q4 of 2025, and it's going to continue in 2026 as we stated prior, and we've quantified it now for 2026. In terms of seasonality, the last thing I think that you asked, Patrick, and then I'll hand it over to Jim, who wanted to add a couple of comments. But seasonality, consistent with what we saw last year.
Operator: So the test is ramping, good volume, ramp that leads to less dilution on Haystack. And then you have, as an offset, Project Nova. We've quantified that in the guide that we provided. It's roughly $0.25 of incremental expenses in 2026 that's impacting our margins. So that's going to happen across 2026. It started to ramp more significantly in Q4 of 2025, and it's going to continue in 2026 as we stated prior, and we've quantified it now for 2026. In terms of seasonality, the last thing I think that you asked, Patrick, and then I'll hand it over to Jim, who wanted to add a couple of comments. But seasonality, consistent with what we saw last year.
Jim Davis: So the test is ramping, good volume, ramp that leads to less dilution on Haystack. And then you have, as an offset, Project Nova. We've quantified that in the guide that we provided. It's roughly $0.25 of incremental expenses in 2026 that's impacting our margins. So that's going to happen across 2026. It started to ramp more significantly in Q4 of 2025, and it's going to continue in 2026 as we stated prior, and we've quantified it now for 2026. In terms of seasonality, the last thing I think that you asked, Patrick, and then I'll hand it over to Jim, who wanted to add a couple of comments. But seasonality, consistent with what we saw last year.
Speaker #1: So it's actually helping us . You know that's consistent with what we've shared in terms of 26 . So the test is ramping volume good ramp that leads to less on dilution haystack have .
Speaker #1: know you an And then you offset project Nova . We've quantified that in the guide that we provided . It's roughly $0.25 of incremental expenses in 26 .
Speaker #1: That's impacting our margins . So that's going to happen across 2026 . It started to ramp more significantly in Q4 of 25 . And it's going to continue in 26 .
Speaker #1: As we've stated prior . And we've quantified it now for 26 , in terms of seasonality , the last thing I think that you asked Patrick , and then I'll hand it over to Jim , who wanted to add a couple of comments , but you know , seasonality , consistent with what we saw last year .
Operator: But if you think about it in terms of maybe more specific terms across the quarters, Q1 is usually our weakest quarter, as we say, in terms of EPS contribution to the year. Q2 is the strongest quarter. Q3 is a step down from Q2, and Q4 is a step down from Q3. In terms of seasonality, first half, second half, I think you should expect somewhere just north of 49% in the first half and just north of 50% in the second half in terms of EPS contribution to the full year. That's just giving you more specifics. That's the seasonality pacing. Jim? Yeah. Patrick, a couple of the things that are enhancing the margins, margin rate. One is our consumer business. We mentioned in the script; it's a $250-ish million book of business that continues to grow at 20%.
Operator: But if you think about it in terms of maybe more specific terms across the quarters, Q1 is usually our weakest quarter, as we say, in terms of EPS contribution to the year. Q2 is the strongest quarter. Q3 is a step down from Q2, and Q4 is a step down from Q3. In terms of seasonality, first half, second half, I think you should expect somewhere just north of 49% in the first half and just north of 50% in the second half in terms of EPS contribution to the full year. That's just giving you more specifics. That's the seasonality pacing. Jim? Yeah. Patrick, a couple of the things that are enhancing the margins, margin rate. One is our consumer business. We mentioned in the script; it's a $250-ish million book of business that continues to grow at 20%.
Operator: But if you think about it in terms of maybe more specific terms across the quarters, Q1 is usually our weakest quarter, as we say, in terms of EPS contribution to the year. Q2 is the strongest quarter. Q3 is a step down from Q2, and Q4 is a step down from Q3. In terms of seasonality, first half, second half, I think you should expect somewhere just north of 49% in the first half and just north of 50% in the second half in terms of EPS contribution to the full year. That's just giving you more specifics. That's the seasonality pacing. Jim? Yeah. Patrick, a couple of the things that are enhancing the margins, margin rate. One is our consumer business. We mentioned in the script; it's a $250-ish million book of business that continues to grow at 20%.
Jim Davis: But if you think about it in terms of maybe more specific terms across the quarters, Q1 is usually our weakest quarter, as we say, in terms of EPS contribution to the year. Q2 is the strongest quarter. Q3 is a step down from Q2, and Q4 is a step down from Q3. In terms of seasonality, first half, second half, I think you should expect somewhere just north of 49% in the first half and just north of 50% in the second half in terms of EPS contribution to the full year. That's just giving you more specifics. That's the seasonality pacing. Jim?
Speaker #1: But if you think about it in terms maybe of more specific terms across the quarters , you know , Q1 is usually our weakest quarter as we we in terms say of EPs contribution to the year , Q2 is the strongest quarter .
Speaker #1: Q3 is a step down from Q2 , and Q4 is a step down from Q3 in seasonality . terms of First half , second half .
Speaker #1: I think you should expect just north of 49% in the first half . somewhere just north of 50% in the second half . In terms of contribution to the full year , that's that's just giving you more specifics .
Sam Samad: Yeah. Patrick, a couple of the things that are enhancing the margins, margin rate. One is our consumer business. We mentioned in the script; it's a $250-ish million book of business that continues to grow at 20%.
Speaker #1: That's that's the seasonality , pacing . Jim .
Speaker #2: Patrick , a Yeah . couple other things that are enhancing the margins , margin rate . One is our consumer business . You know , we in the script it's a $250 million book of business that continues to grow at 20% .
Operator: Remember, with that business, there's no denials, and there's no patient concessions or bad debt. It is definitely a help from a margin/margin rate standpoint as we continue to grow that business north of 20% relative to the portfolio growing 6 to 7%. The other thing I would mention is LifeLabs in Canada. The margin rate continues to improve. We said by year three, it would be at the company average, and it is definitely heading in that direction, very close to that. And as that margin rate of that business continues to improve, it will help our margin rate as well. Great. Operator, next question. Thank you. Our next question comes from Michael Cherney with Leerink Partners. Your line is open. You may ask your question. Good morning, and thanks for taking the question. Maybe if we can talk about the competitive environment as you see it.
Operator: Remember, with that business, there's no denials, and there's no patient concessions or bad debt. It is definitely a help from a margin/margin rate standpoint as we continue to grow that business north of 20% relative to the portfolio growing 6 to 7%. The other thing I would mention is LifeLabs in Canada. The margin rate continues to improve. We said by year three, it would be at the company average, and it is definitely heading in that direction, very close to that. And as that margin rate of that business continues to improve, it will help our margin rate as well. Great. Operator, next question. Thank you. Our next question comes from Michael Cherney with Leerink Partners. Your line is open. You may ask your question. Good morning, and thanks for taking the question. Maybe if we can talk about the competitive environment as you see it.
Operator: Remember, with that business, there's no denials, and there's no patient concessions or bad debt. It is definitely a help from a margin/margin rate standpoint as we continue to grow that business north of 20% relative to the portfolio growing 6 to 7%. The other thing I would mention is LifeLabs in Canada. The margin rate continues to improve. We said by year three, it would be at the company average, and it is definitely heading in that direction, very close to that. And as that margin rate of that business continues to improve, it will help our margin rate as well. Great. Operator, next question. Thank you. Our next question comes from Michael Cherney with Leerink Partners. Your line is open. You may ask your question. Good morning, and thanks for taking the question. Maybe if we can talk about the competitive environment as you see it.
Sam Samad: Remember, with that business, there's no denials, and there's no patient concessions or bad debt. It is definitely a help from a margin/margin rate standpoint as we continue to grow that business north of 20% relative to the portfolio growing 6 to 7%. The other thing I would mention is LifeLabs in Canada. The margin rate continues to improve. We said by year three, it would be at the company average, and it is definitely heading in that direction, very close to that. And as that margin rate of that business continues to improve, it will help our margin rate as well.
Speaker #2: Remember , with that business , there's no denials and there's
Speaker #2: concessions or bad debt . It is a it is definitely a help from a EPs margin . Margin rate standpoint . As we continue to grow that business north of 20% relative to the portfolio , growing 6 to 7% .
Speaker #2: The other thing I would mention is Life Labs in Canada , the margin rate We to continues improve . said mentioned three it would be at the company average , and it is definitely heading in that direction , very close to that .
Jim Davis: Great. Operator, next question.
Speaker #2: And the margin rate of that business that continues to improve will help our margin rate as well.
Operator: Thank you. Our next question comes from Michael Cherney with Leerink Partners. Your line is open. You may ask your question.
Speaker #1: Great . Operator next question .
Michael Cherney: Good morning, and thanks for taking the question. Maybe if we can talk about the competitive environment as you see it.
Speaker #3: Thank you . Our next question comes from Michael Cherny with Learning Partners . Your line is open . You may ask your question .
Operator: You talked, obviously, about above expectations organic growth. Some of these are contract-oriented. But as you think about the current health of the market, think about where you sit across the hospital labs and an environment where you continue to have different types of partnerships. Where do you see your biggest competitive strengths are as you kick off in 2026 and 2027, and how much of the expectations for organic growth are, for lack of a better term, share gains? Yeah. Hey, Mike. Look, I think there's absolutely share gains in the organic growth that we saw in 2025, and I think it'll continue into 2026. As I mentioned, getting back into network in those key states with Elevance, that's all share gain in those states. I didn't mention Sentara, but Sentara is a big health system, health plan in the southeast along the Atlantic coast.
Operator: You talked, obviously, about above expectations organic growth. Some of these are contract-oriented. But as you think about the current health of the market, think about where you sit across the hospital labs and an environment where you continue to have different types of partnerships. Where do you see your biggest competitive strengths are as you kick off in 2026 and 2027, and how much of the expectations for organic growth are, for lack of a better term, share gains? Yeah. Hey, Mike. Look, I think there's absolutely share gains in the organic growth that we saw in 2025, and I think it'll continue into 2026. As I mentioned, getting back into network in those key states with Elevance, that's all share gain in those states. I didn't mention Sentara, but Sentara is a big health system, health plan in the southeast along the Atlantic coast.
Operator: You talked, obviously, about above expectations organic growth. Some of these are contract-oriented. But as you think about the current health of the market, think about where you sit across the hospital labs and an environment where you continue to have different types of partnerships. Where do you see your biggest competitive strengths are as you kick off in 2026 and 2027, and how much of the expectations for organic growth are, for lack of a better term, share gains? Yeah. Hey, Mike. Look, I think there's absolutely share gains in the organic growth that we saw in 2025, and I think it'll continue into 2026. As I mentioned, getting back into network in those key states with Elevance, that's all share gain in those states. I didn't mention Sentara, but Sentara is a big health system, health plan in the southeast along the Atlantic coast.
Michael Cherney: You talked, obviously, about above expectations organic growth. Some of these are contract-oriented. But as you think about the current health of the market, think about where you sit across the hospital labs and an environment where you continue to have different types of partnerships. Where do you see your biggest competitive strengths are as you kick off in 2026 and 2027, and how much of the expectations for organic growth are, for lack of a better term, share gains?
Speaker #6: Good morning , and thanks for taking the question . Maybe if we can talk about the . Competitive environment , as you see it , and you talked about above expectations , organic growth , some of these are contract oriented .
Speaker #6: But as you think about the current health of the market , think about where you sit across the hospital labs and environment , have different continue to partnerships types of .
Speaker #6: see your Where do you competitive where you biggest as you strengths are kick off the 26 and 27 , of much the expectations for organic growth are for lack of a better term , share gain ?
Jim Davis: Yeah. Hey, Mike. Look, I think there's absolutely share gains in the organic growth that we saw in 2025, and I think it'll continue into 2026. As I mentioned, getting back into network in those key states with Elevance, that's all share gain in those states. I didn't mention Sentara, but Sentara is a big health system, health plan in the southeast along the Atlantic coast.
Speaker #2: Yeah . Hey , Mike . Look , I think
Speaker #2: absolutely there's in the gains organic growth , you know , that we saw think it'll and how in 2025 . And I into 2026 .
Speaker #2: mentioned I , getting As back into network in those with states key elevons . That's all share gain in states those mention Sentara , .
Operator: We are back in network with them, and that's been a tremendous help. Look, our strengths are simply our national coverage, right? We have over 1,200 sales reps out there positioned with primary care, with all of the various channels. And that really helps when it comes to positioning our autoimmune testing, our brain health testing, our cardiometabolic testing. Having that broad national coverage really, really helps. Now, in terms of everyone wants to make a lot about Quest and our nearest competitor, but I got to tell you what. Quest and our nearest competitor are probably less than 25% of the market, 30% and less than 30% of the market. So I think we're making inroads versus hospital outreach. I think we're making inroads against physician office labs. And perhaps these big health systems are just not as not going after that business as strongly, right?
Operator: We are back in network with them, and that's been a tremendous help. Look, our strengths are simply our national coverage, right? We have over 1,200 sales reps out there positioned with primary care, with all of the various channels. And that really helps when it comes to positioning our autoimmune testing, our brain health testing, our cardiometabolic testing. Having that broad national coverage really, really helps. Now, in terms of everyone wants to make a lot about Quest and our nearest competitor, but I got to tell you what. Quest and our nearest competitor are probably less than 25% of the market, 30% and less than 30% of the market. So I think we're making inroads versus hospital outreach. I think we're making inroads against physician office labs. And perhaps these big health systems are just not as not going after that business as strongly, right?
Operator: We are back in network with them, and that's been a tremendous help. Look, our strengths are simply our national coverage, right? We have over 1,200 sales reps out there positioned with primary care, with all of the various channels. And that really helps when it comes to positioning our autoimmune testing, our brain health testing, our cardiometabolic testing. Having that broad national coverage really, really helps. Now, in terms of everyone wants to make a lot about Quest and our nearest competitor, but I got to tell you what. Quest and our nearest competitor are probably less than 25% of the market, 30% and less than 30% of the market. So I think we're making inroads versus hospital outreach. I think we're making inroads against physician office labs. And perhaps these big health systems are just not as not going after that business as strongly, right?
Jim Davis: We are back in network with them, and that's been a tremendous help. Look, our strengths are simply our national coverage, right? We have over 1,200 sales reps out there positioned with primary care, with all of the various channels. And that really helps when it comes to positioning our autoimmune testing, our brain health testing, our cardiometabolic testing. Having that broad national coverage really, really helps. Now, in terms of everyone wants to make a lot about Quest and our nearest competitor, but I got to tell you what. Quest and our nearest competitor are probably less than 25% of the market, 30% and less than 30% of the market. So I think we're making inroads versus hospital outreach. I think we're making inroads against physician office labs. And perhaps these big health systems are just not as not going after that business as strongly, right?
Speaker #2: but Sentara is a I didn't system . Health plan in big health the along along southeast Atlantic . We the are network back in that's with them .
Speaker #2: a tremendous that's been help . Look our And our our strengths , you know , are simply our national coverage . Right . have over We 1200 sales reps out positioned there in , you know , with care , primary with all of the channels various .
Speaker #2: that really helps when it comes And you know to , , positioning our autoimmune brain testing , our testing , our health testing , cardiometabolic having that national broad coverage really , helps .
Speaker #2: , in really terms of , you know Now , everyone wants to make a , you know , about quest lot competitor . nearest But I got to tell you and our what competitor probably nearest less are than 25% of the market , 30% , less than 30% of the market .
Speaker #2: So I think we're making inroads hospital think we're outreach . I making against office physician inroads labs and perhaps , you know , health these big systems are know , just , you not as you know , not going after that business as strongly .
Operator: They have other things to invest in. They have other priorities, other investments that generate higher returns than laboratory testing. So I think we're capitalizing on those trends. Great. Operator, next question. Thank you. Our next question comes from Kevin Caliendo with UBS. Your line is open. You may ask your question. Hi. Thanks for taking my question. What are you guys seeing in terms of the HIX now that we have further visibility? Is that sort of in line with your original expectations around the potential impact? And just a clarifying question around volumes. I appreciate that you're now including Fresenius and Corwell in this, but if we were to take that out, what would it have been, and what would your organic sort of volumes have been in Q4? Yeah. Sure, Kevin. Let me comment on both, and Jim can add color as well.
Operator: They have other things to invest in. They have other priorities, other investments that generate higher returns than laboratory testing. So I think we're capitalizing on those trends. Great. Operator, next question. Thank you. Our next question comes from Kevin Caliendo with UBS. Your line is open. You may ask your question. Hi. Thanks for taking my question. What are you guys seeing in terms of the HIX now that we have further visibility? Is that sort of in line with your original expectations around the potential impact? And just a clarifying question around volumes. I appreciate that you're now including Fresenius and Corwell in this, but if we were to take that out, what would it have been, and what would your organic sort of volumes have been in Q4? Yeah. Sure, Kevin. Let me comment on both, and Jim can add color as well.
Operator: They have other things to invest in. They have other priorities, other investments that generate higher returns than laboratory testing. So I think we're capitalizing on those trends. Great. Operator, next question. Thank you. Our next question comes from Kevin Caliendo with UBS. Your line is open. You may ask your question. Hi. Thanks for taking my question. What are you guys seeing in terms of the HIX now that we have further visibility? Is that sort of in line with your original expectations around the potential impact? And just a clarifying question around volumes. I appreciate that you're now including Fresenius and Corwell in this, but if we were to take that out, what would it have been, and what would your organic sort of volumes have been in Q4? Yeah. Sure, Kevin. Let me comment on both, and Jim can add color as well.
Jim Davis: They have other things to invest in. They have other priorities, other investments that generate higher returns than laboratory testing. So I think we're capitalizing on those trends. Great. Operator, next question.
Speaker #2: things to Right ? They have other in . They invest other have Other , priorities . you know , investments that generate higher returns .
Operator: Thank you. Our next question comes from Kevin Caliendo with UBS. Your line is open. You may ask your question.
Speaker #2: than laboratory So we're I think on testing . capitalizing And those trends . Great .
Kevin Caliendo: Hi. Thanks for taking my question. What are you guys seeing in terms of the HIX now that we have further visibility? Is that sort of in line with your original expectations around the potential impact? And just a clarifying question around volumes. I appreciate that you're now including Fresenius and Corwell in this, but if we were to take that out, what would it have been, and what would your organic sort of volumes have been in Q4?
Speaker #1: next question .
Speaker #3: next Operator Kevin from Caliendo with open . UBS . question comes your Our Your line is question You may ask
Speaker #7: Thanks for my taking question . What are you guys in terms , now that we hics seeing further of the visibility , is that sort line of in with original expectations impact potential around the ?
Speaker #7: And just a clarifying your question around volumes . I appreciate that you're now Fresenius and Corewell in this , but if take to that what would out , organic and what would your been it have sort volumes been in for ?
Jim Davis: Yeah. Sure, Kevin. Let me comment on both, and Jim can add color as well.
Operator: But first, on the health exchanges, I'll remind you about what we modeled and what our expectations are. We modeled a 30 basis point impact on revenue growth from the exchanges, and that's factored into our guide for the year. So that was our modeling, and that's what our expectation is. Now, in reality, what we've seen in terms of enrollments has actually been better than expected. It's early days to measure utilization as a result of that and what the loss of utilization is off of the enrollments. But I would say we're encouraged by what we saw so far in terms of by the end of the year and also what we saw in January in terms of enrollments. Now, again, we need to see the mix of those enrollments, of potentially patients going to higher deductible plans, bronze plans versus gold plans.
Operator: But first, on the health exchanges, I'll remind you about what we modeled and what our expectations are. We modeled a 30 basis point impact on revenue growth from the exchanges, and that's factored into our guide for the year. So that was our modeling, and that's what our expectation is. Now, in reality, what we've seen in terms of enrollments has actually been better than expected. It's early days to measure utilization as a result of that and what the loss of utilization is off of the enrollments. But I would say we're encouraged by what we saw so far in terms of by the end of the year and also what we saw in January in terms of enrollments. Now, again, we need to see the mix of those enrollments, of potentially patients going to higher deductible plans, bronze plans versus gold plans.
Operator: But first, on the health exchanges, I'll remind you about what we modeled and what our expectations are. We modeled a 30 basis point impact on revenue growth from the exchanges, and that's factored into our guide for the year. So that was our modeling, and that's what our expectation is. Now, in reality, what we've seen in terms of enrollments has actually been better than expected. It's early days to measure utilization as a result of that and what the loss of utilization is off of the enrollments. But I would say we're encouraged by what we saw so far in terms of by the end of the year and also what we saw in January in terms of enrollments. Now, again, we need to see the mix of those enrollments, of potentially patients going to higher deductible plans, bronze plans versus gold plans.
Jim Davis: But first, on the health exchanges, I'll remind you about what we modeled and what our expectations are. We modeled a 30 basis point impact on revenue growth from the exchanges, and that's factored into our guide for the year. So that was our modeling, and that's what our expectation is. Now, in reality, what we've seen in terms of enrollments has actually been better than expected. It's early days to measure utilization as a result of that and what the loss of utilization is off of the enrollments. But I would say we're encouraged by what we saw so far in terms of by the end of the year and also what we saw in January in terms of enrollments. Now, again, we need to see the mix of those enrollments, of potentially patients going to higher deductible plans, bronze plans versus gold plans.
Speaker #7: Q
Speaker #1: Yeah , Kevin , let me comment . on both and Jim can add color as well , but first , on the health exchanges , I'll about what remind you and what our expectations we are .
Speaker #1: sure .
Speaker #1: We modeled a 30 basis point impact on growth on revenue growth from the exchanges . So and that's factored into our guide for the year .
Speaker #1: So that was our modeling . And that's what our expectation is in reality now what we've seen in terms of enrollments has actually been better than expected .
Speaker #1: early It's days to , you know , measure utilization as a result of that . And what the loss of utilization is off the of enrollments .
Speaker #1: But I would say we're encouraged by what we saw so far in terms the year and also what we saw in January in terms of enrollments .
Speaker #1: Now , again , we need to see the mix of those enrollments of of potentially patients going to higher deductible plans . Bronze versus gold plans plans .
Operator: I mean, there's a lot of moving parts there, and it's very early days to be able to say, "This is really encouraging." But so far, based on the enrollments, we've seen it better than expected. In terms of the, you asked about Fresenius and Corwell. Listen, both of these are. Corwell is all organic growth. It's a co-lab relationship. It's all organic growth. Fresenius is mostly organic growth as well. In terms of, we did talk about the fact that in Q4, where our DIS business grew by roughly close to 8% organically in terms of volumes, the volume growth ex Fresenius and Corwell was just over 4%.
Operator: I mean, there's a lot of moving parts there, and it's very early days to be able to say, "This is really encouraging." But so far, based on the enrollments, we've seen it better than expected. In terms of the, you asked about Fresenius and Corwell. Listen, both of these are. Corwell is all organic growth. It's a co-lab relationship. It's all organic growth. Fresenius is mostly organic growth as well. In terms of, we did talk about the fact that in Q4, where our DIS business grew by roughly close to 8% organically in terms of volumes, the volume growth ex Fresenius and Corwell was just over 4%.
Operator: I mean, there's a lot of moving parts there, and it's very early days to be able to say, "This is really encouraging." But so far, based on the enrollments, we've seen it better than expected. In terms of the, you asked about Fresenius and Corwell. Listen, both of these are. Corwell is all organic growth. It's a co-lab relationship. It's all organic growth. Fresenius is mostly organic growth as well. In terms of, we did talk about the fact that in Q4, where our DIS business grew by roughly close to 8% organically in terms of volumes, the volume growth ex Fresenius and Corwell was just over 4%.
Jim Davis: I mean, there's a lot of moving parts there, and it's very early days to be able to say, "This is really encouraging." But so far, based on the enrollments, we've seen it better than expected. In terms of the, you asked about Fresenius and Corwell. Listen, both of these are. Corwell is all organic growth. It's a co-lab relationship. It's all organic growth. Fresenius is mostly organic growth as well. In terms of, we did talk about the fact that in Q4, where our DIS business grew by roughly close to 8% organically in terms of volumes, the volume growth ex Fresenius and Corwell was just over 4%.
Speaker #1: I mean , there's a lot of moving parts there . And it's very early days to be able to say , you know , this is is this really encouraging .
Speaker #1: But so far , based on the enrollments , we've seen it better than expected . You know , in terms of the you asked about Fresenius and Caldwell .
Speaker #1: Listen , both of these are well is all organic growth . It's a colab relationship . It's all organic growth . Fresenius is mostly organic growth as well .
Speaker #1: You know , in terms of we did talk about the fact that in Q4 , you know , our dis where business grew by roughly close to 8% organically in terms of volumes , the volume growth x Fresenius and Caldwell just was over 4% .
Operator: So basically, from a volume perspective, they had a sizable impact because the nature of the Fresenius business specifically, and to some extent, Corwell, but more so Fresenius, is it's very routine business, very high-volume business that's done on a very regular basis. It's a lower ref per rec business, still very profitable based on the fact that we don't do draws. We don't incur as much cost, but it's a high-volume business. The impact on revenue in Q4 was much less. It was just less than 1%. So our organic revenue growth was 5.6% excluding those two businesses, and it was 6.4% in total. Yeah. Kevin, the other thing I'd point out is, in addition to the 4.1% organic growth when you strip out Fresenius and Corwell, we also had 3% organic ref per rec left. And again, that's coming from price being stable, number one.
Operator: So basically, from a volume perspective, they had a sizable impact because the nature of the Fresenius business specifically, and to some extent, Corwell, but more so Fresenius, is it's very routine business, very high-volume business that's done on a very regular basis. It's a lower ref per rec business, still very profitable based on the fact that we don't do draws. We don't incur as much cost, but it's a high-volume business. The impact on revenue in Q4 was much less. It was just less than 1%. So our organic revenue growth was 5.6% excluding those two businesses, and it was 6.4% in total. Yeah. Kevin, the other thing I'd point out is, in addition to the 4.1% organic growth when you strip out Fresenius and Corwell, we also had 3% organic ref per rec left. And again, that's coming from price being stable, number one.
Operator: So basically, from a volume perspective, they had a sizable impact because the nature of the Fresenius business specifically, and to some extent, Corwell, but more so Fresenius, is it's very routine business, very high-volume business that's done on a very regular basis. It's a lower ref per rec business, still very profitable based on the fact that we don't do draws. We don't incur as much cost, but it's a high-volume business. The impact on revenue in Q4 was much less. It was just less than 1%. So our organic revenue growth was 5.6% excluding those two businesses, and it was 6.4% in total. Yeah. Kevin, the other thing I'd point out is, in addition to the 4.1% organic growth when you strip out Fresenius and Corwell, we also had 3% organic ref per rec left. And again, that's coming from price being stable, number one.
Jim Davis: So basically, from a volume perspective, they had a sizable impact because the nature of the Fresenius business specifically, and to some extent, Corwell, but more so Fresenius, is it's very routine business, very high-volume business that's done on a very regular basis. It's a lower ref per rec business, still very profitable based on the fact that we don't do draws. We don't incur as much cost, but it's a high-volume business. The impact on revenue in Q4 was much less. It was just less than 1%. So our organic revenue growth was 5.6% excluding those two businesses, and it was 6.4% in total.
Speaker #1: basically , from a So volume perspective , you know , a they they had had a sizable impact because the nature of the Fresenius business specifically and to some extent , Caldwell , but more so Fresenius is it's very routine business , very high volume business .
Speaker #1: That's done on a very regular basis . It's a lower per rec business , still very profitable based on the fact that we don't do draws , we don't incur as much cost , but it's a high volume business .
Speaker #1: The impact on revenue in Q4 was much was it less . It was just less than a percent . So our organic revenue growth was 5.6% .
Sam Samad: Yeah. Kevin, the other thing I'd point out is, in addition to the 4.1% organic growth when you strip out Fresenius and Corwell, we also had 3% organic ref per rec left. And again, that's coming from price being stable, number one.
Speaker #1: Excluding those two businesses , and it was 6.4% in total .
Speaker #2: Yeah , Kevin , the other thing I'd point out addition to is in the 4.1% organic growth , out strip when you Fresenius and Corewell , we also had 3% organic rev per rec lift .
Operator: Number two, the continued test per rec increase we're seeing, some of that coming from the mix of our consumer business. So all of that just continues to point to strong organic revenue growth that we're seeing. Operator, next question. Thank you. Our next question comes from Jack Meehan with Nephron Research. Your line is open. You may ask your question. Thank you. Good morning, guys. Jim, wanted to ask you about how you see PAMA playing out this year. So we do have the survey coming up from May through July. I assume, are you ready to participate in that? And do you think this data ultimately is read out later in the year and could inform rates in 2027? Yeah. So first, Jack, we're really thankful that we got a delay for the sixth year in a row.
Operator: Number two, the continued test per rec increase we're seeing, some of that coming from the mix of our consumer business. So all of that just continues to point to strong organic revenue growth that we're seeing. Operator, next question. Thank you. Our next question comes from Jack Meehan with Nephron Research. Your line is open. You may ask your question. Thank you. Good morning, guys. Jim, wanted to ask you about how you see PAMA playing out this year. So we do have the survey coming up from May through July. I assume, are you ready to participate in that? And do you think this data ultimately is read out later in the year and could inform rates in 2027? Yeah. So first, Jack, we're really thankful that we got a delay for the sixth year in a row.
Operator: Number two, the continued test per rec increase we're seeing, some of that coming from the mix of our consumer business. So all of that just continues to point to strong organic revenue growth that we're seeing. Operator, next question. Thank you. Our next question comes from Jack Meehan with Nephron Research. Your line is open. You may ask your question. Thank you. Good morning, guys. Jim, wanted to ask you about how you see PAMA playing out this year. So we do have the survey coming up from May through July. I assume, are you ready to participate in that? And do you think this data ultimately is read out later in the year and could inform rates in 2027? Yeah. So first, Jack, we're really thankful that we got a delay for the sixth year in a row.
Sam Samad: Number two, the continued test per rec increase we're seeing, some of that coming from the mix of our consumer business. So all of that just continues to point to strong organic revenue growth that we're seeing.
Speaker #2: And again , that's coming from price being stable . Number one . Number two , the continued increase we're seeing some of that coming from the mix of our consumer business .
Jim Davis: Operator, next question.
Speaker #2: So all of that , you know , just continues to point to strong organic revenue growth that we're seeing .
Operator: Thank you. Our next question comes from Jack Meehan with Nephron Research. Your line is open. You may ask your question.
Jack Meehan: Thank you. Good morning, guys. Jim, wanted to ask you about how you see PAMA playing out this year. So we do have the survey coming up from May through July. I assume, are you ready to participate in that? And do you think this data ultimately is read out later in the year and could inform rates in 2027?
Speaker #1: next Operator question .
Speaker #3: Thank you . Our question comes from next Jack Meehan with Nephron line is Your open . You may ask your question .
Speaker #8: Thank you . Good morning guys . Jim wanted to ask you how you about see Pama playing out this year . So we do have the survey from May coming through up July or I assume like are you ready to participate in that .
Jim Davis: Yeah. So first, Jack, we're really thankful that we got a delay for the sixth year in a row.
Speaker #8: And do you think data this read out ultimately is later in the could inform year and rates in 2027 ?
Operator: I think that is reflective of the fact that Congress feels that the original methodology was flawed, and it led to excessive cuts, and that's why we got the further delay. As you indicated, they moved the data collection process from 2019 to 2025. And yes, we're absolutely prepared to report. The problem, Jack, is I'm not sure the other 10,000 labs, maybe there'll be a few, are prepared to report. So if we end up with less than 1% of the labs reporting like what happened before, it's just going to lead to inaccurate market-based pricing. So that's why we continue to push the Results Act. And we remain optimistic that the act will get, for lack of a better word, acted on this year. There was a hearing on 8 January with the Energy and Commerce Committee, the Health Subcommittee. Our ACLA president testified at that meeting.
Operator: I think that is reflective of the fact that Congress feels that the original methodology was flawed, and it led to excessive cuts, and that's why we got the further delay. As you indicated, they moved the data collection process from 2019 to 2025. And yes, we're absolutely prepared to report. The problem, Jack, is I'm not sure the other 10,000 labs, maybe there'll be a few, are prepared to report. So if we end up with less than 1% of the labs reporting like what happened before, it's just going to lead to inaccurate market-based pricing. So that's why we continue to push the Results Act. And we remain optimistic that the act will get, for lack of a better word, acted on this year. There was a hearing on 8 January with the Energy and Commerce Committee, the Health Subcommittee. Our ACLA president testified at that meeting.
Operator: I think that is reflective of the fact that Congress feels that the original methodology was flawed, and it led to excessive cuts, and that's why we got the further delay. As you indicated, they moved the data collection process from 2019 to 2025. And yes, we're absolutely prepared to report. The problem, Jack, is I'm not sure the other 10,000 labs, maybe there'll be a few, are prepared to report. So if we end up with less than 1% of the labs reporting like what happened before, it's just going to lead to inaccurate market-based pricing. So that's why we continue to push the Results Act. And we remain optimistic that the act will get, for lack of a better word, acted on this year. There was a hearing on 8 January with the Energy and Commerce Committee, the Health Subcommittee. Our ACLA president testified at that meeting.
Jim Davis: I think that is reflective of the fact that Congress feels that the original methodology was flawed, and it led to excessive cuts, and that's why we got the further delay. As you indicated, they moved the data collection process from 2019 to 2025. And yes, we're absolutely prepared to report. The problem, Jack, is I'm not sure the other 10,000 labs, maybe there'll be a few, are prepared to report. So if we end up with less than 1% of the labs reporting like what happened before, it's just going to lead to inaccurate market-based pricing. So that's why we continue to push the Results Act. And we remain optimistic that the act will get, for lack of a better word, acted on this year. There was a hearing on 8 January with the Energy and Commerce Committee, the Health Subcommittee. Our ACLA president testified at that meeting.
Speaker #2: So first , Jack Yeah . really , we're that thankful got a delay for the sixth year in a row . think And I is that reflective of the fact that Congress feels that the original methodology was flawed , and it led to excessive cuts .
Speaker #2: And that's got the delay further As you indicated . data moved the , they process collection from 2019 to 2025 . And yes , we're absolutely prepared to report the problem , Jack , is I'm not the sure other 10,000 labs , maybe there'll be a prepared to few are report .
Speaker #2: So if we end up with less than 1% of the labs reporting, like what happened before, it's just going to lead to inaccurate, base-to-market pricing.
Speaker #2: So why we that's continue to push the results . Act . And we remain optimistic that the act will get , for lack of a better word , acted on this year .
Speaker #2: There was a hearing on January 8th with the Energy and Commerce Committee, the Health Subcommittee, and our ACLA president meeting. There, it was testified that there are over 65 co-sponsors of the bill.
Operator: There's over 65 co-sponsors of the bill. As you know, under the Results Act, that leads to a different type of data collection process, one that uses a third-party database. There's many third-party databases out there. The one we've recommended represents a sample of over 80% of the adjudicated laboratory recs. We think that's going to be a much better indicator of what the market price will be. When you mix in the roughly 9,800 labs that failed to report the last time, and those are labs that are primarily hospital outreach labs, physician office labs, other smaller independent labs, when you mix all that data into the two largest national labs, we think it is good news for the calculations related to the absolute market rate of the testing that is out there today.
Operator: There's over 65 co-sponsors of the bill. As you know, under the Results Act, that leads to a different type of data collection process, one that uses a third-party database. There's many third-party databases out there. The one we've recommended represents a sample of over 80% of the adjudicated laboratory recs. We think that's going to be a much better indicator of what the market price will be. When you mix in the roughly 9,800 labs that failed to report the last time, and those are labs that are primarily hospital outreach labs, physician office labs, other smaller independent labs, when you mix all that data into the two largest national labs, we think it is good news for the calculations related to the absolute market rate of the testing that is out there today.
Operator: There's over 65 co-sponsors of the bill. As you know, under the Results Act, that leads to a different type of data collection process, one that uses a third-party database. There's many third-party databases out there. The one we've recommended represents a sample of over 80% of the adjudicated laboratory recs. We think that's going to be a much better indicator of what the market price will be. When you mix in the roughly 9,800 labs that failed to report the last time, and those are labs that are primarily hospital outreach labs, physician office labs, other smaller independent labs, when you mix all that data into the two largest national labs, we think it is good news for the calculations related to the absolute market rate of the testing that is out there today.
Jim Davis: There's over 65 co-sponsors of the bill. As you know, under the Results Act, that leads to a different type of data collection process, one that uses a third-party database. There's many third-party databases out there. The one we've recommended represents a sample of over 80% of the adjudicated laboratory recs. We think that's going to be a much better indicator of what the market price will be. When you mix in the roughly 9,800 labs that failed to report the last time, and those are labs that are primarily hospital outreach labs, physician office labs, other smaller independent labs, when you mix all that data into the two largest national labs, we think it is good news for the calculations related to the absolute market rate of the testing that is out there today.
Speaker #2: And as you know , under the Act Results , that leads to a type of different data collection process , one that uses a third party database .
Speaker #2: There's many third party out there . databases The one we've recommended represents a sample of over 80% of the adjudicated laboratory RECs , and we think that's going to be a much better indicator of what the market price will be .
Speaker #2: And when you mix in , you know , the roughly 9800 labs that failed to report the last time . And those are labs that are primarily hospital outreach labs , physician office labs , other smaller , independent labs .
Speaker #2: When you mix all that data into the two largest national labs , we think it is good news for for the calculations . You know , related to to the absolute market rate of the testing that is So we're out there today .
Operator: So we're optimistic, but we're going to keep pushing it hard in the first six months of this year and hopefully get it done before the fall. Great. Operator, next question. Thank you. Our next question comes from Aaron Wright with Morgan Stanley. Your line is open. You may ask your question. Great. Sorry for the issue earlier, but can we dig into some of the consumer testing dynamics in the environment that you're seeing? You've launched several new partnerships, new initiatives, HIMSS, Oura, Function Health. Can you speak to some of the sustainability of growth across this segment, the margin profile? Are you seeing anything new or different in terms of consumer utilization trends across this segment? And how should we think about what's embedded in guidance in 2026 on this front? Thanks. Yeah. So thanks, Aaron. We remain very optimistic about this.
Operator: So we're optimistic, but we're going to keep pushing it hard in the first six months of this year and hopefully get it done before the fall. Great. Operator, next question. Thank you. Our next question comes from Aaron Wright with Morgan Stanley. Your line is open. You may ask your question. Great. Sorry for the issue earlier, but can we dig into some of the consumer testing dynamics in the environment that you're seeing? You've launched several new partnerships, new initiatives, HIMSS, Oura, Function Health. Can you speak to some of the sustainability of growth across this segment, the margin profile? Are you seeing anything new or different in terms of consumer utilization trends across this segment? And how should we think about what's embedded in guidance in 2026 on this front? Thanks. Yeah. So thanks, Aaron. We remain very optimistic about this.
Operator: So we're optimistic, but we're going to keep pushing it hard in the first six months of this year and hopefully get it done before the fall. Great. Operator, next question. Thank you. Our next question comes from Aaron Wright with Morgan Stanley. Your line is open. You may ask your question. Great. Sorry for the issue earlier, but can we dig into some of the consumer testing dynamics in the environment that you're seeing? You've launched several new partnerships, new initiatives, HIMSS, Oura, Function Health. Can you speak to some of the sustainability of growth across this segment, the margin profile? Are you seeing anything new or different in terms of consumer utilization trends across this segment? And how should we think about what's embedded in guidance in 2026 on this front? Thanks. Yeah. So thanks, Aaron. We remain very optimistic about this.
Jim Davis: So we're optimistic, but we're going to keep pushing it hard in the first six months of this year and hopefully get it done before the fall. Great. Operator, next question.
Speaker #2: optimistic , pushing it but we're going keep hard in to the first . You know , six months of this year and hopefully get it done before the fall .
Operator: Thank you. Our next question comes from
Operator: Aaron Wright with Morgan Stanley. Your line is open. You may ask your question.
Erin Wright: Great. Sorry for the issue earlier, but can we dig into some of the consumer testing dynamics in the environment that you're seeing? You've launched several new partnerships, new initiatives, HIMSS, Oura, Function Health. Can you speak to some of the sustainability of growth across this segment, the margin profile? Are you seeing anything new or different in terms of consumer utilization trends across this segment? And how should we think about what's embedded in guidance in 2026 on this front? Thanks. Yeah. So thanks, Aaron. We remain very optimistic about this.
Speaker #1: Gray Operator, next question.
Speaker #3: Thank you . Our next question comes from Erin Wright with Morgan Stanley . Your line is open . You may ask your question .
Speaker #9: for Great . Sorry the issue earlier , but can we dig into some of the consumer testing dynamics in the environment that you're seeing ?
Speaker #9: You've launched several new partnerships , new initiatives , hymns or a function health like what can you speak to some of the sustainability of growth across the segment .
Speaker #9: You know , the margin profile ? Are you seeing anything new or different in terms of consumer utilization trends across this segment , should we think and how about what what's embedded in guidance in 2026 on on this front ?
Speaker #9: Thanks .
Operator: This is all about consumers who are interested in their own health. They're interested in prevention. And as you know, prevention is not about waiting for symptoms. Prevention is doing something before diagnosis, doing something before symptoms set in. Let me start with the wearable companies. I think this notion of linking your biometrics with your biomarkers so that you understand the influence of those biometrics, whether it's sleep, nutrition, movement, heart rate variability, pulse, you can create these correlations between those biometrics and your biomarkers, ultimately giving feedback to the consumer on what they need to do in order to improve their biomarkers. And I think these wearable companies are really onto it. And we're seeing nice lift from it. It's still very early with both those companies, but we're seeing nice lift.
Operator: This is all about consumers who are interested in their own health. They're interested in prevention. And as you know, prevention is not about waiting for symptoms. Prevention is doing something before diagnosis, doing something before symptoms set in. Let me start with the wearable companies. I think this notion of linking your biometrics with your biomarkers so that you understand the influence of those biometrics, whether it's sleep, nutrition, movement, heart rate variability, pulse, you can create these correlations between those biometrics and your biomarkers, ultimately giving feedback to the consumer on what they need to do in order to improve their biomarkers. And I think these wearable companies are really onto it. And we're seeing nice lift from it. It's still very early with both those companies, but we're seeing nice lift.
Operator: This is all about consumers who are interested in their own health. They're interested in prevention. And as you know, prevention is not about waiting for symptoms. Prevention is doing something before diagnosis, doing something before symptoms set in. Let me start with the wearable companies. I think this notion of linking your biometrics with your biomarkers so that you understand the influence of those biometrics, whether it's sleep, nutrition, movement, heart rate variability, pulse, you can create these correlations between those biometrics and your biomarkers, ultimately giving feedback to the consumer on what they need to do in order to improve their biomarkers. And I think these wearable companies are really onto it. And we're seeing nice lift from it. It's still very early with both those companies, but we're seeing nice lift.
Jim Davis: This is all about consumers who are interested in their own health. They're interested in prevention. And as you know, prevention is not about waiting for symptoms. Prevention is doing something before diagnosis, doing something before symptoms set in. Let me start with the wearable companies. I think this notion of linking your biometrics with your biomarkers so that you understand the influence of those biometrics, whether it's sleep, nutrition, movement, heart rate variability, pulse, you can create these correlations between those biometrics and your biomarkers, ultimately giving feedback to the consumer on what they need to do in order to improve their biomarkers. And I think these wearable companies are really onto it. And we're seeing nice lift from it. It's still very early with both those companies, but we're seeing nice lift.
Speaker #2: Yeah . So thanks , Erin . We've remained very optimistic about this . You know , this is all about who consumers are interested in health , they're interested in their own prevention .
Speaker #2: And as you know , prevention is not about waiting for symptoms . Prevention is some doing things before diagnosis , doing before something symptoms set in .
Speaker #2: Let me start with the wearable companies . I think this notion of linking your biometrics with your biomarkers . So that you understand the influence of those biometrics , whether it's sleep , nutrition , movement , heart rate variability , pulse , you can create these correlations between those biometrics and your biomarkers , ultimately giving feedback to the consumer on what they need to do in order to improve their biomarkers .
Speaker #2: And I think these wearable companies are really onto it . And we're seeing , you know , nice lift from it's very early still companies , with both those but we're nice lift seeing .
Operator: I think some of our value-added resellers that are providing, let's just say, other value-added medical guidance to the laboratory testing that we do for them. I think it's serving the need, honestly, that consumers can't get or aren't getting from their physicians. Many of the tests on these panels won't be covered by normal health plans under normal conditions, under normal general health and wellness testing. And yet, these same tests are covered if the patient is sick. So again, people are worried about prevention, not waiting till they get sick to get these types of tests. So look, we're looking at the renewal rate of these companies. Many of these value-added resellers are subscription-based, and we look at the renewal rates, and we're positive about what we're seeing.
Operator: I think some of our value-added resellers that are providing, let's just say, other value-added medical guidance to the laboratory testing that we do for them. I think it's serving the need, honestly, that consumers can't get or aren't getting from their physicians. Many of the tests on these panels won't be covered by normal health plans under normal conditions, under normal general health and wellness testing. And yet, these same tests are covered if the patient is sick. So again, people are worried about prevention, not waiting till they get sick to get these types of tests. So look, we're looking at the renewal rate of these companies. Many of these value-added resellers are subscription-based, and we look at the renewal rates, and we're positive about what we're seeing.
Operator: I think some of our value-added resellers that are providing, let's just say, other value-added medical guidance to the laboratory testing that we do for them. I think it's serving the need, honestly, that consumers can't get or aren't getting from their physicians. Many of the tests on these panels won't be covered by normal health plans under normal conditions, under normal general health and wellness testing. And yet, these same tests are covered if the patient is sick. So again, people are worried about prevention, not waiting till they get sick to get these types of tests. So look, we're looking at the renewal rate of these companies. Many of these value-added resellers are subscription-based, and we look at the renewal rates, and we're positive about what we're seeing.
Jim Davis: I think some of our value-added resellers that are providing, let's just say, other value-added medical guidance to the laboratory testing that we do for them. I think it's serving the need, honestly, that consumers can't get or aren't getting from their physicians. Many of the tests on these panels won't be covered by normal health plans under normal conditions, under normal general health and wellness testing. And yet, these same tests are covered if the patient is sick. So again, people are worried about prevention, not waiting till they get sick to get these types of tests. So look, we're looking at the renewal rate of these companies. Many of these value-added resellers are subscription-based, and we look at the renewal rates, and we're positive about what we're seeing.
Speaker #2: of our I think some value added resellers are that providing . Let's other just say value added medical guidance to the laboratory testing that we do I them .
Speaker #2: think it's it's serving the need , honestly , that consumers can't get or aren't getting from their physicians . You know , many of the tests on these panels won't be by covered normal health under normal conditions .
Speaker #2: Under normal , you know , normal general health and wellness testing . And yet these same tests are covered . If the patient is sick .
Speaker #2: So again , people , you know are worried about prevention , not waiting till they get sick to to to get these types of tests .
Speaker #2: So you know , look we we're looking at the rate of renewal these companies . You know many of these value added resellers are are subscription based .
Operator: The last thing I'd leave you with is our own QuestHealth.com channel is on a $100 million; it's a $100 million run rate business right now. And we continue to see nice uptick there. And it's not just in the wellness panels that we offer on QuestHealth.com, but there's a lot of what I call episodic testing that occurs. This could be allergy testing, tick testing. This could be diabetics who just want to check their A1C. It's a lot of STD testing. So our own channel continues to grow very nicely, and we certainly look at the repeat business of our own consumers and are happy with that. Maybe I'll add a couple of comments, Aaron, just on the financial side.
Operator: The last thing I'd leave you with is our own QuestHealth.com channel is on a $100 million; it's a $100 million run rate business right now. And we continue to see nice uptick there. And it's not just in the wellness panels that we offer on QuestHealth.com, but there's a lot of what I call episodic testing that occurs. This could be allergy testing, tick testing. This could be diabetics who just want to check their A1C. It's a lot of STD testing. So our own channel continues to grow very nicely, and we certainly look at the repeat business of our own consumers and are happy with that. Maybe I'll add a couple of comments, Aaron, just on the financial side.
Operator: The last thing I'd leave you with is our own QuestHealth.com channel is on a $100 million; it's a $100 million run rate business right now. And we continue to see nice uptick there. And it's not just in the wellness panels that we offer on QuestHealth.com, but there's a lot of what I call episodic testing that occurs. This could be allergy testing, tick testing. This could be diabetics who just want to check their A1C. It's a lot of STD testing. So our own channel continues to grow very nicely, and we certainly look at the repeat business of our own consumers and are happy with that. Maybe I'll add a couple of comments, Aaron, just on the financial side.
Jim Davis: The last thing I'd leave you with is our own QuestHealth.com channel is on a $100 million; it's a $100 million run rate business right now. And we continue to see nice uptick there. And it's not just in the wellness panels that we offer on QuestHealth.com, but there's a lot of what I call episodic testing that occurs. This could be allergy testing, tick testing. This could be diabetics who just want to check their A1C. It's a lot of STD testing. So our own channel continues to grow very nicely, and we certainly look at the repeat business of our own consumers and are happy with that.
Speaker #2: And we look at the renewal rates and we're positive about what we're seeing . The last thing I'll leave you with is our own quest Health.com .
Speaker #2: Channel know , , you is on $100 million , business right $100 million run rate now we . And continue uptick nice to see there .
Speaker #2: And it's not just in the wellness panels that we offer on quest Health.com , lot of but there's a what I call episodic testing that occurs .
Speaker #2: could be This testing , allergy tick testing . This could be diabetics who just want to check their a-1c . It's a lot of STD testing .
Speaker #2: So that our own channel to grow continues very nicely . And we certainly look at the repeat business of our consumers and are happy with that .
Sam Samad: Maybe I'll add a couple of comments, Aaron, just on the financial side.
Operator: So with regards to the direct consumer that Jim just mentioned, the QuestHealth.com, we've talked about that business growing somewhere in the 35% range over the course of the year. And that's, in fact, where it ended, is approximately 35% for the full year 2025. So that business is really doing very well. And then if I think about the direct consumer, but also the partnerships that we have, and the partnerships are wearables and other wellness companies, etc., we've got a vibrant ecosystem there that we're supporting and that we are the engine for. The margin rates on those businesses, both direct and the other collaborations that we have, is an attractive margin rate above our corporate average because basically, it's simple. It's all cash pay. We don't have patient concessions. We don't have denials. So that business is an attractive margin profile. You asked about guidance for 2026.
Operator: So with regards to the direct consumer that Jim just mentioned, the QuestHealth.com, we've talked about that business growing somewhere in the 35% range over the course of the year. And that's, in fact, where it ended, is approximately 35% for the full year 2025. So that business is really doing very well. And then if I think about the direct consumer, but also the partnerships that we have, and the partnerships are wearables and other wellness companies, etc., we've got a vibrant ecosystem there that we're supporting and that we are the engine for. The margin rates on those businesses, both direct and the other collaborations that we have, is an attractive margin rate above our corporate average because basically, it's simple. It's all cash pay. We don't have patient concessions. We don't have denials. So that business is an attractive margin profile. You asked about guidance for 2026.
Operator: So with regards to the direct consumer that Jim just mentioned, the QuestHealth.com, we've talked about that business growing somewhere in the 35% range over the course of the year. And that's, in fact, where it ended, is approximately 35% for the full year 2025. So that business is really doing very well. And then if I think about the direct consumer, but also the partnerships that we have, and the partnerships are wearables and other wellness companies, etc., we've got a vibrant ecosystem there that we're supporting and that we are the engine for. The margin rates on those businesses, both direct and the other collaborations that we have, is an attractive margin rate above our corporate average because basically, it's simple. It's all cash pay. We don't have patient concessions. We don't have denials. So that business is an attractive margin profile. You asked about guidance for 2026.
Sam Samad: So with regards to the direct consumer that Jim just mentioned, the QuestHealth.com, we've talked about that business growing somewhere in the 35% range over the course of the year. And that's, in fact, where it ended, is approximately 35% for the full year 2025. So that business is really doing very well. And then if I think about the direct consumer, but also the partnerships that we have, and the partnerships are wearables and other wellness companies, etc., we've got a vibrant ecosystem there that we're supporting and that we are the engine for. The margin rates on those businesses, both direct and the other collaborations that we have, is an attractive margin rate above our corporate average because basically, it's simple. It's all cash pay. We don't have patient concessions. We don't have denials. So that business is an attractive margin profile. You asked about guidance for 2026.
Speaker #1: Maybe I'll add a couple of comments . Aaron , just on the financial side , so , you know , with regards to the direct consumer that Jim just mentioned , the quest Health.com , you know , we've talked about that business growing somewhere in the 35% the course range over of the year , and that's in fact where it ended is approximately 35% for the full year , 25 .
Speaker #1: So that business is really doing very well . And then if I think about the direct consumer , but also the partnerships that we have and the partnerships are other wellness companies , etc.
Speaker #1: , we've got a vibrant there that ecosystem we're supporting and that we are the engine for , you know , the margin rates on those , on those businesses , both direct and the other collaborations that we have is an attractive margin rate above our corporate average because basically it's simple .
Speaker #1: We it's all cash pay . It's we don't have patient concessions . We don't have denials . So that that business is an attractive margin profile .
Operator: I mean, not going to give you a specific number, but all I'll say is that greater than 20% growth in terms of a CAGR over the long term, we still feel very confident about in terms of consumer and these other high-growth businesses that we called out during Investor Day. The expectation this year is that we're going to continue to sign up new partners as well and collaborations because we are powering a whole ecosystem here. Great. Operator, next question. Thank you. Our next question comes from Michael Ryskin with Bank of America. Your line is open. You may ask your question. Hey. Thanks for the question, guys. I want to go back to Corewell and Fresenius' contribution in 2026, just given that it's organic and not sort of traditional M&A basket. But I also want to focus on margin opportunity and the ramp there over time.
Operator: I mean, not going to give you a specific number, but all I'll say is that greater than 20% growth in terms of a CAGR over the long term, we still feel very confident about in terms of consumer and these other high-growth businesses that we called out during Investor Day. The expectation this year is that we're going to continue to sign up new partners as well and collaborations because we are powering a whole ecosystem here. Great. Operator, next question. Thank you. Our next question comes from Michael Ryskin with Bank of America. Your line is open. You may ask your question. Hey. Thanks for the question, guys. I want to go back to Corewell and Fresenius' contribution in 2026, just given that it's organic and not sort of traditional M&A basket. But I also want to focus on margin opportunity and the ramp there over time.
Operator: I mean, not going to give you a specific number, but all I'll say is that greater than 20% growth in terms of a CAGR over the long term, we still feel very confident about in terms of consumer and these other high-growth businesses that we called out during Investor Day. The expectation this year is that we're going to continue to sign up new partners as well and collaborations because we are powering a whole ecosystem here. Great. Operator, next question. Thank you. Our next question comes from Michael Ryskin with Bank of America. Your line is open. You may ask your question. Hey. Thanks for the question, guys. I want to go back to Corewell and Fresenius' contribution in 2026, just given that it's organic and not sort of traditional M&A basket. But I also want to focus on margin opportunity and the ramp there over time.
Sam Samad: I mean, not going to give you a specific number, but all I'll say is that greater than 20% growth in terms of a CAGR over the long term, we still feel very confident about in terms of consumer and these other high-growth businesses that we called out during Investor Day. The expectation this year is that we're going to continue to sign up new partners as well and collaborations because we are powering a whole ecosystem here.
Speaker #1: You asked about guidance for 26 . I mean , going to give you a specific number , but you know , all I'll say is that that greater than 20% growth in terms of a CAGR over the long term , we still feel very confident about in terms of consumer and these other high growth businesses that we called out during Investor Day .
Speaker #1: And , you know , the expectation this year is that we're going to continue to sign up new partners as well . And collaborations because , we you know , are powering a whole ecosystem .
Operator: Great. Operator, next question.
Jim Davis: Thank you. Our next question comes from Michael Ryskin with Bank of America. Your line is open. You may ask your question.
Speaker #10: Here .
Michael Cherney: Hey. Thanks for the question, guys. I want to go back to Corewell and Fresenius' contribution in 2026, just given that it's organic and not sort of traditional M&A basket. But I also want to focus on margin opportunity and the ramp there over time.
Speaker #1: Operator next question .
Speaker #3: Thank you. Our next question comes from Michael Riskin with Bank of America. Michael, your line is open. You may ask your question.
Speaker #11: Hey , thanks for thanks for the question , guys . back I want to go to Corwell . And for seniors contribution in 26 .
Speaker #11: Hey , thanks for thanks for the question , guys . back I want to go to Corwell . And for seniors contribution in You know , just given that it's it's organic and that's sort of like traditional M&A basket .
Operator: I think you talked about sort of dilutive margins and price in 2026 and improving over time. Could you just walk us through the ramp and what gets you there and just sort of give us a sense for the time frame for both of those businesses, just going beyond this year? Thanks. Yeah. I think it's pretty straightforward, Michael. On Corwell, we said it's a $250-ish million book of business for us in 2026. And we said in total, and we said that that would start out at low single-digit margin rate. As we get into 2027, we expect that to be in the low teens. Fresenius, the margin rate will continue to improve through the end of the year. And by the end of the year, we expect that book of business to be at or slightly above the company operating margin rate average. Great. Okay.
Operator: I think you talked about sort of dilutive margins and price in 2026 and improving over time. Could you just walk us through the ramp and what gets you there and just sort of give us a sense for the time frame for both of those businesses, just going beyond this year? Thanks. Yeah. I think it's pretty straightforward, Michael. On Corwell, we said it's a $250-ish million book of business for us in 2026. And we said in total, and we said that that would start out at low single-digit margin rate. As we get into 2027, we expect that to be in the low teens. Fresenius, the margin rate will continue to improve through the end of the year. And by the end of the year, we expect that book of business to be at or slightly above the company operating margin rate average. Great. Okay.
Operator: I think you talked about sort of dilutive margins and price in 2026 and improving over time. Could you just walk us through the ramp and what gets you there and just sort of give us a sense for the time frame for both of those businesses, just going beyond this year? Thanks. Yeah. I think it's pretty straightforward, Michael. On Corwell, we said it's a $250-ish million book of business for us in 2026. And we said in total, and we said that that would start out at low single-digit margin rate. As we get into 2027, we expect that to be in the low teens. Fresenius, the margin rate will continue to improve through the end of the year. And by the end of the year, we expect that book of business to be at or slightly above the company operating margin rate average. Great. Okay.
Michael Cherney: I think you talked about sort of dilutive margins and price in 2026 and improving over time. Could you just walk us through the ramp and what gets you there and just sort of give us a sense for the time frame for both of those businesses, just going beyond this year?Thanks.
Jim Davis: Yeah. I think it's pretty straightforward, Michael. On Corwell, we said it's a $250-ish million book of business for us in 2026. And we said in total, and we said that that would start out at low single-digit margin rate. As we get into 2027, we expect that to be in the low teens. Fresenius, the margin rate will continue to improve through the end of the year. And by the end of the year, we expect that book of business to be at or slightly above the company operating margin rate average.
Speaker #11: But I also want to focus on margin opportunity . And the there over ramp time . I think you talked about sort of you know , dilute of the margins and price in 2026 .
Speaker #11: And improving over time. Could you just walk us through the ramp and what gets you there, and just sort of give us a sense for the time frame for both of those businesses?
Speaker #11: Just , you know , going this year . Thanks .
Speaker #2: Yeah , I think it's it's pretty straightforward . Michael , on Corwell , we said it's a 250 ish million dollar book of business for us in 2026 .
Speaker #2: And we said in total said and we that that would , start out know , you at single low digit margin rate as we get into 2027 , we expect that to be in the low teens for seniors .
Speaker #2: Will the margin rate will continue to improve through the end of the year . And by the end of the year , we expect that book of business to be at slightly above or the company operating margin rate , average .
Michael Cherney: Great. Okay.
Operator: Operator, next question. Go ahead. Go ahead, Michael. Go ahead. Sorry, just real quick. When we think about the moving pieces to the margins in 2026, you talked about margins will grow this year, but it sounds like it's a little bit less than we would have expected in prior years. Is that the biggest swing factor, or is there something else that we're keeping in mind for margins this year? I think the Corwell one is the biggest swing factor, Michael, because of the fact that it's a $250 million incremental business at low single-digit margins. So that is definitely a swing factor. Fresenius, as Jim mentioned, I mean, think about it as kind of a somewhat similar profile to a physician outreach acquisition where it starts out below the margin average. We've got integration costs. We've got some setup costs.
Operator: Operator, next question. Go ahead. Go ahead, Michael. Go ahead. Sorry, just real quick. When we think about the moving pieces to the margins in 2026, you talked about margins will grow this year, but it sounds like it's a little bit less than we would have expected in prior years. Is that the biggest swing factor, or is there something else that we're keeping in mind for margins this year? I think the Corwell one is the biggest swing factor, Michael, because of the fact that it's a $250 million incremental business at low single-digit margins. So that is definitely a swing factor. Fresenius, as Jim mentioned, I mean, think about it as kind of a somewhat similar profile to a physician outreach acquisition where it starts out below the margin average. We've got integration costs. We've got some setup costs.
Operator: Operator, next question. Go ahead. Go ahead, Michael. Go ahead. Sorry, just real quick. When we think about the moving pieces to the margins in 2026, you talked about margins will grow this year, but it sounds like it's a little bit less than we would have expected in prior years. Is that the biggest swing factor, or is there something else that we're keeping in mind for margins this year? I think the Corwell one is the biggest swing factor, Michael, because of the fact that it's a $250 million incremental business at low single-digit margins. So that is definitely a swing factor. Fresenius, as Jim mentioned, I mean, think about it as kind of a somewhat similar profile to a physician outreach acquisition where it starts out below the margin average. We've got integration costs. We've got some setup costs.
Michael Cherney: Operator, next question. Go ahead. Go ahead, Michael. Go ahead. Sorry, just real quick. When we think about the moving pieces to the margins in 2026, you talked about margins will grow this year, but it sounds like it's a little bit less than we would have expected in prior years. Is that the biggest swing factor, or is there something else that we're keeping in mind for margins this year?
Speaker #11: Okay .
Speaker #10: Good .
Speaker #11: And and is that .
Speaker #10: The next question Go ahead ?
Speaker #10: go Go ahead . ahead .
Speaker #11: real quick . Just Is that Sorry . when we think about the moving pieces to the margins in 2026 , you talked about , you margins will grow .
Sam Samad: I think the Corwell one is the biggest swing factor, Michael, because of the fact that it's a $250 million incremental business at low single-digit margins. So that is definitely a swing factor. Fresenius, as Jim mentioned, I mean, think about it as kind of a somewhat similar profile to a physician outreach acquisition where it starts out below the margin average. We've got integration costs. We've got some setup costs.
Speaker #11: This year . But you know it sounds like it's a little bit less than we would have expected in prior years . Is that the biggest swing factor or is there something else that we're keeping in mind for margins .
Speaker #10: This year, I think that I... I think.
Speaker #1: The Corwell one is the biggest swing factor . Michael , because of the fact that it's a 250 million incremental business at low single digit margins .
Speaker #1: that is definitely a swing factor So for mentioned . Jim I mean , seniors . As think about it as , somewhat kind of a similar similar profile to a physician outreach acquisition where it starts out below the margin average .
Operator: And then over time, maybe it takes longer than a typical physician outreach acquisition. But over time, it improves. And by the end of the year, I think we'll be at the average. The only other thing I'd point to, which I mentioned earlier when I answered Patrick's question, is Nova expenses and the fact that we have an incremental $0.25 of Nova expenses in 2026. But we still have healthy operating margin rate expansion impacted to some extent by the Corwell growth. But Corwell will ramp over time to improve the normal lab margin rates. Operator, next question. Thank you. Our next question comes from Tycho Peterson with Jefferies. Your line is open. You may ask your question. Hey. Thanks. A couple on oncology. So hey, Haystack. You've got the MolDX reimbursement decision effective 1 January.
Operator: And then over time, maybe it takes longer than a typical physician outreach acquisition. But over time, it improves. And by the end of the year, I think we'll be at the average. The only other thing I'd point to, which I mentioned earlier when I answered Patrick's question, is Nova expenses and the fact that we have an incremental $0.25 of Nova expenses in 2026. But we still have healthy operating margin rate expansion impacted to some extent by the Corwell growth. But Corwell will ramp over time to improve the normal lab margin rates. Operator, next question. Thank you. Our next question comes from Tycho Peterson with Jefferies. Your line is open. You may ask your question. Hey. Thanks. A couple on oncology. So hey, Haystack. You've got the MolDX reimbursement decision effective 1 January.
Operator: And then over time, maybe it takes longer than a typical physician outreach acquisition. But over time, it improves. And by the end of the year, I think we'll be at the average. The only other thing I'd point to, which I mentioned earlier when I answered Patrick's question, is Nova expenses and the fact that we have an incremental $0.25 of Nova expenses in 2026. But we still have healthy operating margin rate expansion impacted to some extent by the Corwell growth. But Corwell will ramp over time to improve the normal lab margin rates. Operator, next question. Thank you. Our next question comes from Tycho Peterson with Jefferies. Your line is open. You may ask your question. Hey. Thanks. A couple on oncology. So hey, Haystack. You've got the MolDX reimbursement decision effective 1 January.
Sam Samad: And then over time, maybe it takes longer than a typical physician outreach acquisition. But over time, it improves. And by the end of the year, I think we'll be at the average. The only other thing I'd point to, which I mentioned earlier when I answered Patrick's question, is Nova expenses and the fact that we have an incremental $0.25 of Nova expenses in 2026. But we still have healthy operating margin rate expansion impacted to some extent by the Corwell growth. But Corwell will ramp over time to improve the normal lab margin rates.
Speaker #1: You know , we've got integration costs , we've got some setup costs . And then over time maybe takes us longer than a typical physician outreach acquisition .
Speaker #1: But over time it improves . And by the end of the year , I think we'll be at the the average , the only other thing I'd point to , which I mentioned earlier , when I answered Patrick's question , is Nova expenses and the fact that we have an incremental $0.25 of Nova expenses in 26 , but , you know , we still have a healthy operating margin rate expansion impacted to some extent by the core , well , growth .
Jim Davis: Operator, next question.
Speaker #1: But Corwell will will ramp over time to improve the normal Colab margin rates .
Operator: Thank you. Our next question comes from Tycho Peterson with Jefferies. Your line is open. You may ask your question.
Speaker #10: Operator next question .
Tycho Peterson: Hey. Thanks. A couple on oncology. So hey, Haystack. You've got the MolDX reimbursement decision effective 1 January.
Speaker #3: Thank you . Our next question comes from Tycho Peterson with Jefferies . Your line is open . You may ask your question .
Operator: Maybe just touch on the path to getting commercial coverage, Medicare Advantage, some of the next steps we should be thinking about on the back of MolDX. And then on the flow cytometry-based MRD test, I'm just curious how you think about the value proposition there. Obviously, more of that market is moving towards sequencing-based tests. And then just lastly, are you baking anything in for your multi-cancer risk stratification test launching this year? And what about the partnerships with Guardant and GRAIL? Thanks. Yeah. So there's a lot there, Tycho. Look, with respect to Haystack reimbursement, Novitas is the MAC that we submit to. And it did receive a PLA code. It received reimbursement. We continue to adjudicate through Novitas and are successful there. With respect to Medicare Advantage, we're still waiting on the MolDX tech assessment.
Operator: Maybe just touch on the path to getting commercial coverage, Medicare Advantage, some of the next steps we should be thinking about on the back of MolDX. And then on the flow cytometry-based MRD test, I'm just curious how you think about the value proposition there. Obviously, more of that market is moving towards sequencing-based tests. And then just lastly, are you baking anything in for your multi-cancer risk stratification test launching this year? And what about the partnerships with Guardant and GRAIL? Thanks. Yeah. So there's a lot there, Tycho. Look, with respect to Haystack reimbursement, Novitas is the MAC that we submit to. And it did receive a PLA code. It received reimbursement. We continue to adjudicate through Novitas and are successful there. With respect to Medicare Advantage, we're still waiting on the MolDX tech assessment.
Operator: Maybe just touch on the path to getting commercial coverage, Medicare Advantage, some of the next steps we should be thinking about on the back of MolDX. And then on the flow cytometry-based MRD test, I'm just curious how you think about the value proposition there. Obviously, more of that market is moving towards sequencing-based tests. And then just lastly, are you baking anything in for your multi-cancer risk stratification test launching this year? And what about the partnerships with Guardant and GRAIL? Thanks. Yeah. So there's a lot there, Tycho. Look, with respect to Haystack reimbursement, Novitas is the MAC that we submit to. And it did receive a PLA code. It received reimbursement. We continue to adjudicate through Novitas and are successful there. With respect to Medicare Advantage, we're still waiting on the MolDX tech assessment.
Tycho Peterson: Maybe just touch on the path to getting commercial coverage, Medicare Advantage, some of the next steps we should be thinking about on the back of MolDX. And then on the flow cytometry-based MRD test, I'm just curious how you think about the value proposition there. Obviously, more of that market is moving towards sequencing-based tests. And then just lastly, are you baking anything in for your multi-cancer risk stratification test launching this year? And what about the partnerships with Guardant and GRAIL? Thanks.
Speaker #10: Hey , thanks .
Speaker #12: A couple on oncology . So , haystack , you've got the decision reimbursement effective January 1st . just touch Maybe on the path to getting commercial coverage .
Speaker #12: Medicare next the steps . We should Advantage , some of be thinking about . You know , on the back of mold . And then on the flow cytometry based MRD test .
Speaker #12: I'm just curious how you think about the value proposition there . You know , obviously , more of that market is moving towards sequencing based tests .
Speaker #12: And then just lastly , are you baking anything in for your multi-cancer risk stratification test ? Launching this year ? And and what about the partnerships with Garden and Grail ?
Jim Davis: Yeah. So there's a lot there, Tycho. Look, with respect to Haystack reimbursement, Novitas is the MAC that we submit to. And it did receive a PLA code. It received reimbursement. We continue to adjudicate through Novitas and are successful there. With respect to Medicare Advantage, we're still waiting on the MolDX tech assessment.
Speaker #12: Thanks .
Speaker #2: Yeah . So there's a lot there Tycho . Look with respect to haystack reimbursement , Novitas is the Mac that we submit to .
Speaker #2: And it did . Reed receive a PLA code . It received reimbursement . We continue to adjudicate through Novitas and are successful . There with respect to Medicare Advantage .
Operator: Once that tech assessment is complete, we will be well-positioned with the Medicare Advantage plans. And then look, we're having ongoing discussions with all the major payers in terms of commercial reimbursement. In some cases, we get paid. In other cases, you don't. And we appeal them all. We have doctors write letters around medical necessity. And we continue to make progress on that. Look, the Flow MRD is an ultra-sensitive flow test that has incredibly good sensitivity, specificity. And we think it is very, very competitive with next-gen sequencing-based tests. We're very confident of that. We'll continue to do studies to show that. The value proposition is really around speed. So as you know, patients with myeloma, that disease moves very, very quickly. Speed is of the essence. And we can get an answer back within three days. It's also a significantly lower-cost test.
Operator: Once that tech assessment is complete, we will be well-positioned with the Medicare Advantage plans. And then look, we're having ongoing discussions with all the major payers in terms of commercial reimbursement. In some cases, we get paid. In other cases, you don't. And we appeal them all. We have doctors write letters around medical necessity. And we continue to make progress on that. Look, the Flow MRD is an ultra-sensitive flow test that has incredibly good sensitivity, specificity. And we think it is very, very competitive with next-gen sequencing-based tests. We're very confident of that. We'll continue to do studies to show that. The value proposition is really around speed. So as you know, patients with myeloma, that disease moves very, very quickly. Speed is of the essence. And we can get an answer back within three days. It's also a significantly lower-cost test.
Operator: Once that tech assessment is complete, we will be well-positioned with the Medicare Advantage plans. And then look, we're having ongoing discussions with all the major payers in terms of commercial reimbursement. In some cases, we get paid. In other cases, you don't. And we appeal them all. We have doctors write letters around medical necessity. And we continue to make progress on that. Look, the Flow MRD is an ultra-sensitive flow test that has incredibly good sensitivity, specificity. And we think it is very, very competitive with next-gen sequencing-based tests. We're very confident of that. We'll continue to do studies to show that. The value proposition is really around speed. So as you know, patients with myeloma, that disease moves very, very quickly. Speed is of the essence. And we can get an answer back within three days. It's also a significantly lower-cost test.
Jim Davis: Once that tech assessment is complete, we will be well-positioned with the Medicare Advantage plans. And then look, we're having ongoing discussions with all the major payers in terms of commercial reimbursement. In some cases, we get paid. In other cases, you don't. And we appeal them all. We have doctors write letters around medical necessity. And we continue to make progress on that. Look, the Flow MRD is an ultra-sensitive flow test that has incredibly good sensitivity, specificity. And we think it is very, very competitive with next-gen sequencing-based tests. We're very confident of that. We'll continue to do studies to show that. The value proposition is really around speed. So as you know, patients with myeloma, that disease moves very, very quickly. Speed is of the essence. And we can get an answer back within three days. It's also a significantly lower-cost test.
Speaker #2: We're still waiting on the moldy tech assessment . Once that tech assessment is complete , the first we well will be positioned with the Medicare Advantage plans and then , you know , look , we're having ongoing discussions with all the major payers in terms of commercial reimbursement .
Speaker #2: In some cases , we get paid . In other cases , you don't . In some , you know , we feel them all .
Speaker #2: We have doctors write letters around medical necessity and we continue to make progress on that . Look , the flow MRD is is an ultra sensitive flow test that has incredibly good sensitivity , specificity , and we think it is very , very competitive with , you know , with next gen sequencing based tests .
Speaker #2: We're very confident of that . We'll continue to do studies to show that the value proposition is really around speed . So , as you know , patients with myeloma , you know , disease very quickly .
Speaker #2: moves very , that Speed is of the essence . And answer back within three days . It's also a significantly lower cost test .
Operator: So from a reimbursement standpoint, it'll offer payers a choice. It'll offer physicians and patients a choice to have a test that is highly comparable with a next-gen sequencing test. And again, a turnaround time that is very, very short, 3 days, not weeks, and with, again, ultra-good sensitivity specificity. In terms of the multi-cancer early detection test, yes, we have a partnership with GRAIL. We will do the blood draws for GRAIL. We've listed it in our test compendium. And GRAIL obviously pays us to do those draws and handle the logistics for them. And then we did announce a partnership to draw for the Guardant colon cancer-based blood screening test. And that will be underway later in the Q1. Yeah. And from a guidance perspective, Tycho, the partnerships with GRAIL and Guardant are reflected in our guide.
Operator: So from a reimbursement standpoint, it'll offer payers a choice. It'll offer physicians and patients a choice to have a test that is highly comparable with a next-gen sequencing test. And again, a turnaround time that is very, very short, 3 days, not weeks, and with, again, ultra-good sensitivity specificity. In terms of the multi-cancer early detection test, yes, we have a partnership with GRAIL. We will do the blood draws for GRAIL. We've listed it in our test compendium. And GRAIL obviously pays us to do those draws and handle the logistics for them. And then we did announce a partnership to draw for the Guardant colon cancer-based blood screening test. And that will be underway later in the Q1. Yeah. And from a guidance perspective, Tycho, the partnerships with GRAIL and Guardant are reflected in our guide.
Operator: So from a reimbursement standpoint, it'll offer payers a choice. It'll offer physicians and patients a choice to have a test that is highly comparable with a next-gen sequencing test. And again, a turnaround time that is very, very short, 3 days, not weeks, and with, again, ultra-good sensitivity specificity. In terms of the multi-cancer early detection test, yes, we have a partnership with GRAIL. We will do the blood draws for GRAIL. We've listed it in our test compendium. And GRAIL obviously pays us to do those draws and handle the logistics for them. And then we did announce a partnership to draw for the Guardant colon cancer-based blood screening test. And that will be underway later in the Q1. Yeah. And from a guidance perspective, Tycho, the partnerships with GRAIL and Guardant are reflected in our guide.
Jim Davis: So from a reimbursement standpoint, it'll offer payers a choice. It'll offer physicians and patients a choice to have a test that is highly comparable with a next-gen sequencing test. And again, a turnaround time that is very, very short, 3 days, not weeks, and with, again, ultra-good sensitivity specificity. In terms of the multi-cancer early detection test, yes, we have a partnership with GRAIL. We will do the blood draws for GRAIL. We've listed it in our test compendium. And GRAIL obviously pays us to do those draws and handle the logistics for them. And then we did announce a partnership to draw for the Guardant colon cancer-based blood screening test. And that will be underway later in the Q1.
Speaker #2: So from a reimbursement standpoint , it will offer payers a choice . It will offer physicians and patients a choice have to a test that is highly comparable with the next gen sequencing test , and again , a turnaround time that is very , very short .
Speaker #2: Three days , not weeks . And with again , ultra , ultra , you know , good sensitivity , specificity in terms of the multi-cancer early detection test .
Speaker #2: Yes , we have a partnership with Grail . We we will do the blood draws for Grail . We've listed it in our test compendium .
Speaker #2: And Grail . Obviously pays us to do those draws and handle the logistics for them . And then we did announce a partnership to draw for the guardant Colon cancer based blood screening test .
Sam Samad: Yeah. And from a guidance perspective, Tycho, the partnerships with GRAIL and Guardant are reflected in our guide.
Speaker #2: And that will underway be later in the first quarter .
Speaker #1: Yeah . And from a guidance perspective , Tyco , you know , the partnerships with Grail and Gardens are reflected in our guide .
Operator: Their modest contribution in terms of as a percentage of the total. The risk stratification test is, again, very modest. It doesn't launch until later in the year. But we are excited about that launch. Great. Operator, next question. Thank you. Our next question comes from Andrew Brackman with William Blair. Your line is open. You may ask your question. Yeah. Hi, guys. Good morning. Thanks for taking the question here. So Jim, maybe a big picture question for you sort of related to the opportunity for Quest in sort of monetizing the data that you generate. You obviously generate quite a bit of it.
Operator: Their modest contribution in terms of as a percentage of the total. The risk stratification test is, again, very modest. It doesn't launch until later in the year. But we are excited about that launch. Great. Operator, next question. Thank you. Our next question comes from Andrew Brackman with William Blair. Your line is open. You may ask your question. Yeah. Hi, guys. Good morning. Thanks for taking the question here. So Jim, maybe a big picture question for you sort of related to the opportunity for Quest in sort of monetizing the data that you generate. You obviously generate quite a bit of it.
Operator: Their modest contribution in terms of as a percentage of the total. The risk stratification test is, again, very modest. It doesn't launch until later in the year. But we are excited about that launch. Great. Operator, next question. Thank you. Our next question comes from Andrew Brackman with William Blair. Your line is open. You may ask your question. Yeah. Hi, guys. Good morning. Thanks for taking the question here. So Jim, maybe a big picture question for you sort of related to the opportunity for Quest in sort of monetizing the data that you generate. You obviously generate quite a bit of it.
Sam Samad: Their modest contribution in terms of as a percentage of the total. The risk stratification test is, again, very modest. It doesn't launch until later in the year. But we are excited about that launch.
Speaker #1: they're modest contribution in terms of as a percentage of the total . There is the risk stratification test is , you again , very know , modest .
Jim Davis: Great. Operator, next question.
Operator: Thank you. Our next question comes from Andrew Brackman with William Blair. Your line is open. You may ask your question.
Speaker #1: It doesn't launch until later in the year, but we are excited about that launch.
Speaker #10: Great. Operator, next question.
Andrew Brackman: Yeah. Hi, guys. Good morning. Thanks for taking the question here. So Jim, maybe a big picture question for you sort of related to the opportunity for Quest in sort of monetizing the data that you generate. You obviously generate quite a bit of it.
Speaker #3: Thank you . Our next question comes from Andrew Brackman with William Blair . Your line is open . You may ask your question .
Speaker #13: Yeah . Hi , guys . Good morning . Thanks for taking the question . Question here . So , Jim , maybe a big picture question for you , sort of related to the opportunity for for quest in sort of monetizing the data that you generate , you know , you're obviously generate quite a bit of that .
Operator: So as you sort of think potentially about monetizing some of this longer term or maybe even partnering with some of these AI companies to further unlock that value, sort of what are the things that you're putting in place today to maybe sort of going after that opportunity? Thanks. Yeah. The data business has been a nice business for Quest. It's growing double digits. It has been growing double digits for the last several years. There's multiple customers when we think about who are the customers for that data. Number one, the pharmaceutical industry, whether it's targeting clinical trials, targeting patients with certain conditions, type 2 diabetes, you name the condition, pharma turns to us to look for patient cohorts. We give patients, when they're getting a blood draw, the option to make their names available for clinical trials. And that has been very successful as well.
Operator: So as you sort of think potentially about monetizing some of this longer term or maybe even partnering with some of these AI companies to further unlock that value, sort of what are the things that you're putting in place today to maybe sort of going after that opportunity? Thanks. Yeah. The data business has been a nice business for Quest. It's growing double digits. It has been growing double digits for the last several years. There's multiple customers when we think about who are the customers for that data. Number one, the pharmaceutical industry, whether it's targeting clinical trials, targeting patients with certain conditions, type 2 diabetes, you name the condition, pharma turns to us to look for patient cohorts. We give patients, when they're getting a blood draw, the option to make their names available for clinical trials. And that has been very successful as well.
Operator: So as you sort of think potentially about monetizing some of this longer term or maybe even partnering with some of these AI companies to further unlock that value, sort of what are the things that you're putting in place today to maybe sort of going after that opportunity? Thanks. Yeah. The data business has been a nice business for Quest. It's growing double digits. It has been growing double digits for the last several years. There's multiple customers when we think about who are the customers for that data. Number one, the pharmaceutical industry, whether it's targeting clinical trials, targeting patients with certain conditions, type 2 diabetes, you name the condition, pharma turns to us to look for patient cohorts. We give patients, when they're getting a blood draw, the option to make their names available for clinical trials. And that has been very successful as well.
Andrew Brackman: So as you sort of think potentially about monetizing some of this longer term or maybe even partnering with some of these AI companies to further unlock that value, sort of what are the things that you're putting in place today to maybe sort of going after that opportunity? Thanks.
Speaker #13: So as you sort of think potentially about monetizing some of this longer term or maybe even partnering with some of these AI companies to further unlock that value , sort of what are the things that you're putting in place today to maybe sort of going after that opportunity ?
Jim Davis: Yeah. The data business has been a nice business for Quest. It's growing double digits. It has been growing double digits for the last several years. There's multiple customers when we think about who are the customers for that data. Number one, the pharmaceutical industry, whether it's targeting clinical trials, targeting patients with certain conditions, type 2 diabetes, you name the condition, pharma turns to us to look for patient cohorts. We give patients, when they're getting a blood draw, the option to make their names available for clinical trials. And that has been very successful as well.
Speaker #13: Thanks .
Speaker #2: You know , Yeah . the data business is has been a nice business for quest . It's growing , you know , double digits .
Speaker #2: has been It growing double digits for the last several years . know , You there's multiple customers when we think about who are the customers for that data .
Speaker #2: Number one , the pharmaceutical industry , whether it's targeting trials clinical , targeting with patients certain conditions , you know , type two diabetes , you name the condition , pharma turns to us to look for patient cohorts .
Speaker #2: We give patients when they're getting a blood draw . The option to make their names available for clinical trials . And that has been very successful as well .
Operator: The payers tend to be a very good customer of this data. As an example, you know that people switch from Medicare Advantage plan to Medicare Advantage plan. If a patient switches from plan A to plan B, plan B will come to us and ask us for previous lab data, lab history of that patient so they can quickly understand what chronic conditions and other issues that that patient may be dealing with. And then I would say the public health agencies are also. There's certain tests that we certain results that we have to provide public health agencies, including the CDC. But very often, these public health agencies come to us and want to understand viral conditions, STD outbreaks, and things like that. And we highlight to them.
Operator: The payers tend to be a very good customer of this data. As an example, you know that people switch from Medicare Advantage plan to Medicare Advantage plan. If a patient switches from plan A to plan B, plan B will come to us and ask us for previous lab data, lab history of that patient so they can quickly understand what chronic conditions and other issues that that patient may be dealing with. And then I would say the public health agencies are also. There's certain tests that we certain results that we have to provide public health agencies, including the CDC. But very often, these public health agencies come to us and want to understand viral conditions, STD outbreaks, and things like that. And we highlight to them.
Operator: The payers tend to be a very good customer of this data. As an example, you know that people switch from Medicare Advantage plan to Medicare Advantage plan. If a patient switches from plan A to plan B, plan B will come to us and ask us for previous lab data, lab history of that patient so they can quickly understand what chronic conditions and other issues that that patient may be dealing with. And then I would say the public health agencies are also. There's certain tests that we certain results that we have to provide public health agencies, including the CDC. But very often, these public health agencies come to us and want to understand viral conditions, STD outbreaks, and things like that. And we highlight to them.
Jim Davis: The payers tend to be a very good customer of this data. As an example, you know that people switch from Medicare Advantage plan to Medicare Advantage plan. If a patient switches from plan A to plan B, plan B will come to us and ask us for previous lab data, lab history of that patient so they can quickly understand what chronic conditions and other issues that that patient may be dealing with. And then I would say the public health agencies are also. There's certain tests that we certain results that we have to provide public health agencies, including the CDC. But very often, these public health agencies come to us and want to understand viral conditions, STD outbreaks, and things like that. And we highlight to them.
Speaker #2: The payers tend to a be very good customer of this data . As an example , you know that people switch from Medicare Advantage plan to Medicare Advantage plan .
Speaker #2: switches patient a If from plan A to plan B , plan B come to us and will ask us for previous data lab lab history of that patient .
Speaker #2: So they can quickly understand chronic other conditions and issues that that what patient may be dealing with I would . And then say the public health are also agencies you know , there's certain we tests that certain results that we have provide to public health agencies , including the CDC , very but often these public health agencies come to us and want to understand know , , you viral conditions , STD things like that .
Operator: I will say we've got partnerships with several different AI-based companies that we are working with to better use the data to provide health insights and other population health insights to all the constituencies that I mentioned above. Great. Operator, next question. Thank you. Our next question comes from Elizabeth Anderson with Evercore ISI. Your line is open. You may ask your question. Hey, guys. Good morning. Thanks for the question. I just had two quick modeling questions. One, and I apologize if I missed it, but can you just highlight the Elevance and Sentara reinclusion in their networks and sort of the impacts you think that that will put through in 2026 volumes? And then in response to Luke's question, I understand that core volumes are continuing to be strong.
Operator: I will say we've got partnerships with several different AI-based companies that we are working with to better use the data to provide health insights and other population health insights to all the constituencies that I mentioned above. Great. Operator, next question. Thank you. Our next question comes from Elizabeth Anderson with Evercore ISI. Your line is open. You may ask your question. Hey, guys. Good morning. Thanks for the question. I just had two quick modeling questions. One, and I apologize if I missed it, but can you just highlight the Elevance and Sentara reinclusion in their networks and sort of the impacts you think that that will put through in 2026 volumes? And then in response to Luke's question, I understand that core volumes are continuing to be strong.
Operator: I will say we've got partnerships with several different AI-based companies that we are working with to better use the data to provide health insights and other population health insights to all the constituencies that I mentioned above. Great. Operator, next question. Thank you. Our next question comes from Elizabeth Anderson with Evercore ISI. Your line is open. You may ask your question. Hey, guys. Good morning. Thanks for the question. I just had two quick modeling questions. One, and I apologize if I missed it, but can you just highlight the Elevance and Sentara reinclusion in their networks and sort of the impacts you think that that will put through in 2026 volumes? And then in response to Luke's question, I understand that core volumes are continuing to be strong.
Jim Davis: I will say we've got partnerships with several different AI-based companies that we are working with to better use the data to provide health insights and other population health insights to all the constituencies that I mentioned above.
Speaker #2: outbreaks and and And we to them , I will highlight say we've got partnerships with several different AI based companies that we are working to , with know , you better use data to provide the health insights and other population health insights to all the constituencies that I above mentioned constituents .
Jim Davis: Great. Operator, next question.
Operator: Thank you. Our next question comes from Elizabeth Anderson with Evercore ISI. Your line is open. You may ask your question.
Speaker #10: Great . Operator question .
Speaker #10: next
Elizabeth Anderson: Hey, guys. Good morning. Thanks for the question. I just had two quick modeling questions. One, and I apologize if I missed it, but can you just highlight the Elevance and Sentara reinclusion in their networks and sort of the impacts you think that that will put through in 2026 volumes? And then in response to Luke's question, I understand that core volumes are continuing to be strong.
Speaker #3: question comes from Elizabeth Thank you . Next Anderson with Evercore ISI . Your line is open . You may ask your question .
Speaker #14: Good morning . Thanks for guys . the question . I just two quick had modeling questions , apologize if I but can one , and I missed it , you just the elephant stara and you know Re-inclusion in their networks and sort of the impacts to you that will think that put in 2026 volumes .
Operator: I just didn't quite understand whether you were calling out that there was any weather impact from the cold weather and storms in January? So I just want to make sure I have that down exactly. Thank you. Yeah. So again, on Elevance, we mentioned in 2025, we got back in network in the states of Nevada, Colorado. We were partially in network in Georgia, but we were not in network with all of their plans, so back in Georgia and Virginia. And let's just say it's a three-year ramp from our current share position with other health plans to get to that same level with Elevance in those states. So we're now in year two. So we expect continued share gains with that. Sentara, as you know, is a health system in Virginia. And it has its own health plan.
Operator: I just didn't quite understand whether you were calling out that there was any weather impact from the cold weather and storms in January? So I just want to make sure I have that down exactly. Thank you. Yeah. So again, on Elevance, we mentioned in 2025, we got back in network in the states of Nevada, Colorado. We were partially in network in Georgia, but we were not in network with all of their plans, so back in Georgia and Virginia. And let's just say it's a three-year ramp from our current share position with other health plans to get to that same level with Elevance in those states. So we're now in year two. So we expect continued share gains with that. Sentara, as you know, is a health system in Virginia. And it has its own health plan.
Operator: I just didn't quite understand whether you were calling out that there was any weather impact from the cold weather and storms in January? So I just want to make sure I have that down exactly. Thank you. Yeah. So again, on Elevance, we mentioned in 2025, we got back in network in the states of Nevada, Colorado. We were partially in network in Georgia, but we were not in network with all of their plans, so back in Georgia and Virginia. And let's just say it's a three-year ramp from our current share position with other health plans to get to that same level with Elevance in those states. So we're now in year two. So we expect continued share gains with that. Sentara, as you know, is a health system in Virginia. And it has its own health plan.
Elizabeth Anderson: I just didn't quite understand whether you were calling out that there was any weather impact from the cold weather and storms in January? So I just want to make sure I have that down exactly. Thank you. Yeah. So again, on Elevance, we mentioned in 2025, we got back in network in the states of Nevada, Colorado. We were partially in network in Georgia, but we were not in network with all of their plans, so back in Georgia and Virginia. And let's just say it's a three-year ramp from our current share position with other health plans to get to that same level with Elevance in those states. So we're now in year two. So we expect continued share gains with that. Sentara, as you know, is a health system in Virginia. And it has its own health plan.
Speaker #14: through And then in Luke's response to question , I understand that core volumes are continuing to be strong . I just didn't quite understand whether you were calling out that there was any weather impact the the , the cold from weather and storms in January .
Speaker #14: So I just want to make sure I have that down—exactly. Thank you.
Speaker #2: Yeah . So again , on elephants , we mentioned in 2025 , we got back in network in the states of , Colorado were Nevada partially in network in Georgia , .
Speaker #2: but we were not We in network with all of their plans . So back in Georgia and Virginia and , you know , let's just say it's a ramp three year our current share position health with plans other to get to that same level with in those states .
Speaker #2: So we're now in year two, so we expect gains with continued share there. Sentara, as you know, is a health system in Virginia.
Operator: And we're the only one in their network on their health plan side. So we'll continue to get share gains in Virginia. And the health plan actually goes even further south. So the health plan extends beyond just the Virginia border. So we're excited about that as well. With regards to weather, Elizabeth, so what we said is the weather impact was significant in January, but it's embedded in our guide for the year. So as we think about the year itself and the seasonality, as I mentioned earlier, we expect the seasonality to be similar to what we saw last year, even with this weather impact that we saw in January, which was actually worse than January of last year, which in itself was pretty bad. But we had some pretty bad storms across the country in the second half of January.
Operator: And we're the only one in their network on their health plan side. So we'll continue to get share gains in Virginia. And the health plan actually goes even further south. So the health plan extends beyond just the Virginia border. So we're excited about that as well. With regards to weather, Elizabeth, so what we said is the weather impact was significant in January, but it's embedded in our guide for the year. So as we think about the year itself and the seasonality, as I mentioned earlier, we expect the seasonality to be similar to what we saw last year, even with this weather impact that we saw in January, which was actually worse than January of last year, which in itself was pretty bad. But we had some pretty bad storms across the country in the second half of January.
Operator: And we're the only one in their network on their health plan side. So we'll continue to get share gains in Virginia. And the health plan actually goes even further south. So the health plan extends beyond just the Virginia border. So we're excited about that as well. With regards to weather, Elizabeth, so what we said is the weather impact was significant in January, but it's embedded in our guide for the year. So as we think about the year itself and the seasonality, as I mentioned earlier, we expect the seasonality to be similar to what we saw last year, even with this weather impact that we saw in January, which was actually worse than January of last year, which in itself was pretty bad. But we had some pretty bad storms across the country in the second half of January.
Elizabeth Anderson: And we're the only one in their network on their health plan side. So we'll continue to get share gains in Virginia. And the health plan actually goes even further south. So the health plan extends beyond just the Virginia border. So we're excited about that as well.
Speaker #2: And it has its own health plan . And we're the only one in their network on their health plan side . So we'll continue to get share gains in Virginia and the health plan actually goes even further south .
Sam Samad: With regards to weather, Elizabeth, so what we said is the weather impact was significant in January, but it's embedded in our guide for the year. So as we think about the year itself and the seasonality, as I mentioned earlier, we expect the seasonality to be similar to what we saw last year, even with this weather impact that we saw in January, which was actually worse than January of last year, which in itself was pretty bad. But we had some pretty bad storms across the country in the second half of January.
Speaker #2: health plan So the extends beyond just the Virginia border . So we're excited about that as well .
Speaker #1: With regards to whether, Elizabeth, so what we said is the weather impact, you know, was significant in January, but it's embedded in our guide for the year.
Speaker #1: So , you know , as we think about the year itself and the seasonality , as I mentioned earlier , we the expect seasonality to be similar to what we last year saw .
Speaker #1: Even with this weather impact that in we saw was actually January , which worse than January of last year , which in itself was pretty bad .
Operator: We do expect some recovery in the next two months or the next month and a half remaining in the quarter. And we've seen the underlying utilization has been very strong. So we're encouraged by that. Operator, next question. Thank you. Our next question comes from Pito Chickering with Deutsche Bank. Your line is open. You may ask your question. Hey, guys. You've got Benjamin Shaver on for Pito. Thanks for taking the question. Just a quick one on 2026 guidance. How should we think about the price per rec versus requisition growth assumptions as it pertains to that? And also within the pricing assumption, how does the test per rec versus unit pricing play out? Thanks. Yeah. So we're not going to provide the specific guidance around revenue per requisition. We usually don't. We provide revenue assumptions in terms of the guide.
Operator: We do expect some recovery in the next two months or the next month and a half remaining in the quarter. And we've seen the underlying utilization has been very strong. So we're encouraged by that. Operator, next question. Thank you. Our next question comes from Pito Chickering with Deutsche Bank. Your line is open. You may ask your question. Hey, guys. You've got Benjamin Shaver on for Pito. Thanks for taking the question. Just a quick one on 2026 guidance. How should we think about the price per rec versus requisition growth assumptions as it pertains to that? And also within the pricing assumption, how does the test per rec versus unit pricing play out? Thanks. Yeah. So we're not going to provide the specific guidance around revenue per requisition. We usually don't. We provide revenue assumptions in terms of the guide.
Operator: We do expect some recovery in the next two months or the next month and a half remaining in the quarter. And we've seen the underlying utilization has been very strong. So we're encouraged by that. Operator, next question. Thank you. Our next question comes from Pito Chickering with Deutsche Bank. Your line is open. You may ask your question. Hey, guys. You've got Benjamin Shaver on for Pito. Thanks for taking the question. Just a quick one on 2026 guidance. How should we think about the price per rec versus requisition growth assumptions as it pertains to that? And also within the pricing assumption, how does the test per rec versus unit pricing play out? Thanks. Yeah. So we're not going to provide the specific guidance around revenue per requisition. We usually don't. We provide revenue assumptions in terms of the guide.
Sam Samad: We do expect some recovery in the next two months or the next month and a half remaining in the quarter. And we've seen the underlying utilization has been very strong. So we're encouraged by that.
Speaker #1: So but we had some pretty bad storms across the country in the second half of January . We do expect some recovery in the next two months or the next month and a half remaining in the quarter , and , you know , we've seen the underlying utilization has been very strong .
Operator: Operator, next question. Thank you. Our next question comes from Pito Chickering with Deutsche Bank. Your line is open. You may ask your question.
Speaker #1: So we're encouraged by that .
Benjamin Shaver: Hey, guys. You've got Benjamin Shaver on for Pito. Thanks for taking the question. Just a quick one on 2026 guidance. How should we think about the price per rec versus requisition growth assumptions as it pertains to that? And also within the pricing assumption, how does the test per rec versus unit pricing play out? Thanks.
Speaker #10: Operator next question .
Speaker #3: Thank you . Next question comes from Pito Chickering with Deutsche Bank . Your line is open . You may ask your question .
Speaker #15: guys , you've Hey , got Benjamin shaven for Pito . Thanks for taking the question . Just a quick one . On 26 guidance .
Speaker #15: How should we think about the price per rec versus requisition growth assumptions as it as it pertains to that and also within the pricing assumption , how does the test correct versus unit pricing play Thanks ?
Jim Davis: Yeah. So we're not going to provide the specific guidance around revenue per requisition. We usually don't. We provide revenue assumptions in terms of the guide.
Speaker #15: .
Speaker #1: Yeah . we're So
Speaker #1: provide the specific guidance around , revenue per requisition . We usually don't . We provide revenue assumptions in terms of the guide on a qualitative basis .
Operator: On a qualitative basis, I will tell you, I mean, the impact that we talked about with regards to the high-volume impact from Fresenius at a lower revenue per rec, still very profitable business, but that will impact revenue per rec as a total in 2026. If you look at it more from an organic or sorry, not organic, but just excluding those two businesses, Corwell and Fresenius, I think the rec per rec assumptions would be consistent with what we've been seeing. But those two businesses, Corwell and Fresenius, will impact and mostly Fresenius, will impact rec per rec negatively, as we saw in Q4. In terms of the other factors within revenue per requisition, I think the key thing that you should factor in is the fact that we continue to see tests per rec improve. We saw that across all of 2025.
Operator: On a qualitative basis, I will tell you, I mean, the impact that we talked about with regards to the high-volume impact from Fresenius at a lower revenue per rec, still very profitable business, but that will impact revenue per rec as a total in 2026. If you look at it more from an organic or sorry, not organic, but just excluding those two businesses, Corwell and Fresenius, I think the rec per rec assumptions would be consistent with what we've been seeing. But those two businesses, Corwell and Fresenius, will impact and mostly Fresenius, will impact rec per rec negatively, as we saw in Q4. In terms of the other factors within revenue per requisition, I think the key thing that you should factor in is the fact that we continue to see tests per rec improve. We saw that across all of 2025.
Operator: On a qualitative basis, I will tell you, I mean, the impact that we talked about with regards to the high-volume impact from Fresenius at a lower revenue per rec, still very profitable business, but that will impact revenue per rec as a total in 2026. If you look at it more from an organic or sorry, not organic, but just excluding those two businesses, Corwell and Fresenius, I think the rec per rec assumptions would be consistent with what we've been seeing. But those two businesses, Corwell and Fresenius, will impact and mostly Fresenius, will impact rec per rec negatively, as we saw in Q4. In terms of the other factors within revenue per requisition, I think the key thing that you should factor in is the fact that we continue to see tests per rec improve. We saw that across all of 2025.
Jim Davis: On a qualitative basis, I will tell you, I mean, the impact that we talked about with regards to the high-volume impact from Fresenius at a lower revenue per rec, still very profitable business, but that will impact revenue per rec as a total in 2026. If you look at it more from an organic or sorry, not organic, but just excluding those two businesses, Corwell and Fresenius, I think the rec per rec assumptions would be consistent with what we've been seeing. But those two businesses, Corwell and Fresenius, will impact and mostly Fresenius, will impact rec per rec negatively, as we saw in Q4. In terms of the other factors within revenue per requisition, I think the key thing that you should factor in is the fact that we continue to see tests per rec improve. We saw that across all of 2025.
Speaker #1: I will tell you I mean the impact that we talked about with regards to the you know , high volume impact from lower Fresenius at a revenue per Rec still very profitable business , know , that but you will impact revenue per Rec as a total in 2026 .
Speaker #1: If you look at it more from an organic or sorry , not organic , but just excluding those two businesses , Corwell and Fresenius , I think the reference assumptions would be consistent with what we've been seeing , but you know , those two businesses , Corwell and for seniors , will impact and mostly Fresenius will impact refer rec negatively , as we saw in Q4 .
Speaker #1: You know, in terms of the other factors within revenue per requisition, I think the key thing that you should factor in is the fact that we continue to see tests per rec improve.
Operator: That improvement is driven by a number of factors, whether it's the advanced diagnostics, more options for early screening, both cancer and other disease states, guidelines evolving, and physicians really gravitating towards more testing. So all of those continue to play out. And we're still encouraged by definitely based on what we saw in Q4 in terms of continued growth tests per rec and what we expect to see in 2026. Operator, next question. Thank you. Our next question comes from Jian Park with Baird. Your line is open. You may ask your question. Hi. Can you hear me? Yes. Go ahead. Hi. Thanks for taking my question. Can you quantify the impact from setting up Fresenius and Corewell and maybe break out the Project Nova cost in Q4?
Operator: That improvement is driven by a number of factors, whether it's the advanced diagnostics, more options for early screening, both cancer and other disease states, guidelines evolving, and physicians really gravitating towards more testing. So all of those continue to play out. And we're still encouraged by definitely based on what we saw in Q4 in terms of continued growth tests per rec and what we expect to see in 2026. Operator, next question. Thank you. Our next question comes from Jian Park with Baird. Your line is open. You may ask your question. Hi. Can you hear me? Yes. Go ahead. Hi. Thanks for taking my question. Can you quantify the impact from setting up Fresenius and Corewell and maybe break out the Project Nova cost in Q4?
Operator: That improvement is driven by a number of factors, whether it's the advanced diagnostics, more options for early screening, both cancer and other disease states, guidelines evolving, and physicians really gravitating towards more testing. So all of those continue to play out. And we're still encouraged by definitely based on what we saw in Q4 in terms of continued growth tests per rec and what we expect to see in 2026. Operator, next question. Thank you. Our next question comes from Jian Park with Baird. Your line is open. You may ask your question. Hi. Can you hear me? Yes. Go ahead. Hi. Thanks for taking my question. Can you quantify the impact from setting up Fresenius and Corewell and maybe break out the Project Nova cost in Q4?
Jim Davis: That improvement is driven by a number of factors, whether it's the advanced diagnostics, more options for early screening, both cancer and other disease states, guidelines evolving, and physicians really gravitating towards more testing. So all of those continue to play out. And we're still encouraged by definitely based on what we saw in Q4 in terms of continued growth tests per rec and what we expect to see in 2026.
Speaker #1: We saw across all that of and that 2025 , is you know , improvement driven by a number of factors , it's the whether advanced diagnostics , more options for early screening , both cancer and other disease states .
Speaker #1: You know , guidelines evolving and physicians really gravitating towards more testing . all of So those continue to play out . And encouraged we're still by definitely based on what we saw in Q4 , in terms of continued growth in test per Rec and what we expect to see in 2026 .
Operator: Operator, next question. Thank you. Our next question comes from Jian Park with Baird. Your line is open. You may ask your question.
Speaker #10: Operator next question .
Operator: Hi. Can you hear me? Yes. Go ahead. Hi. Thanks for taking my question. Can you quantify the impact from setting up Fresenius and Corewell and maybe break out the Project Nova cost in Q4?
Speaker #3: Thank you . And this question comes from Eugene Park with Your line is open . Baird . You may ask a question .
Speaker #16: Hi . Can you hear me ?
Speaker #10: Yes . Hi .
Speaker #10: Go ahead .
Speaker #16: Thanks my question . Can for taking you quantify the impact from setting up for in seniors Cornwall and maybe break out the Nova cost in for Q project ?
Operator: And if you can elaborate more on how much setup, if there is any left to do, and if you can provide more color on 1Q '26 on potential impacts. Yeah. So I think I heard most of your question. And if I didn't catch all of it, please correct me. But in terms of 4Q, I mean, without quantifying the exact impact because we don't want to get into quantifying every single quarter, the impact of Nova and also Fresenius, Corwell, all I would say is there was a significant impact from the setup expenses of Fresenius and Corwell because we're standing up these businesses. There's integration costs. There's a lot of costs that you incur when you initially set up these new partnerships, both a collab partnership and, in the case of Fresenius, a new partnership across dialysis testing.
Operator: And if you can elaborate more on how much setup, if there is any left to do, and if you can provide more color on 1Q '26 on potential impacts. Yeah. So I think I heard most of your question. And if I didn't catch all of it, please correct me. But in terms of 4Q, I mean, without quantifying the exact impact because we don't want to get into quantifying every single quarter, the impact of Nova and also Fresenius, Corwell, all I would say is there was a significant impact from the setup expenses of Fresenius and Corwell because we're standing up these businesses. There's integration costs. There's a lot of costs that you incur when you initially set up these new partnerships, both a collab partnership and, in the case of Fresenius, a new partnership across dialysis testing.
Operator: And if you can elaborate more on how much setup, if there is any left to do, and if you can provide more color on 1Q '26 on potential impacts. Yeah. So I think I heard most of your question. And if I didn't catch all of it, please correct me. But in terms of 4Q, I mean, without quantifying the exact impact because we don't want to get into quantifying every single quarter, the impact of Nova and also Fresenius, Corwell, all I would say is there was a significant impact from the setup expenses of Fresenius and Corwell because we're standing up these businesses. There's integration costs. There's a lot of costs that you incur when you initially set up these new partnerships, both a collab partnership and, in the case of Fresenius, a new partnership across dialysis testing.
Operator: And if you can elaborate more on how much setup, if there is any left to do, and if you can provide more color on 1Q '26 on potential impacts. Yeah. So I think I heard most of your question. And if I didn't catch all of it, please correct me. But in terms of 4Q, I mean, without quantifying the exact impact because we don't want to get into quantifying every single quarter, the impact of Nova and also Fresenius, Corwell, all I would say is there was a significant impact from the setup expenses of Fresenius and Corwell because we're standing up these businesses. There's integration costs. There's a lot of costs that you incur when you initially set up these new partnerships, both a collab partnership and, in the case of Fresenius, a new partnership across dialysis testing.
Speaker #16: and if you can elaborate more on how if much set up is if there any left to do and if you can more color on one Q26 provide on potential impacts .
Speaker #10: Yeah .
Speaker #1: I think I So heard most of your question . And if I didn't catch all of it , please correct me . But , you know , in terms of for Q , I mean , without quantifying the exact impact , because we don't want to get into quantifying every single quarter , the impact of Nova and also Fresenius Cornwall , all I would say is there was a significant impact from the setup expenses of Fresenius and Cornwall because we're standing up these businesses , there's integration costs , know , you there's there's lot of there's a costs that you incur when you initially set up these new partnerships , both a partnership and in the case of Fresenius , a new partnership across dialysis testing .
Operator: And then Nova, we had also expenses in Q4. We had previously called out the fact that with the delayed signing of the contract with Epic, we had some expenses that got pushed out in Q4. And that's, in fact, what played out in the quarter. As you think about next year in terms of specifically Nova, we called out roughly $0.25 impact from Nova expenses in sorry, when I say next year, I mean 2026. So when you think about 2026, the impact is roughly $0.25. The way I think about it is fairly even in terms of quarterly impact across the quarters, maybe slightly more in the first half and the second half, but not materially different. So I think you can model it fairly equally across the quarters. Okay. Operator, thank you. And I'd like to thank everyone again for joining the call today.
Operator: And then Nova, we had also expenses in Q4. We had previously called out the fact that with the delayed signing of the contract with Epic, we had some expenses that got pushed out in Q4. And that's, in fact, what played out in the quarter. As you think about next year in terms of specifically Nova, we called out roughly $0.25 impact from Nova expenses in sorry, when I say next year, I mean 2026. So when you think about 2026, the impact is roughly $0.25. The way I think about it is fairly even in terms of quarterly impact across the quarters, maybe slightly more in the first half and the second half, but not materially different. So I think you can model it fairly equally across the quarters. Okay. Operator, thank you. And I'd like to thank everyone again for joining the call today.
Operator: And then Nova, we had also expenses in Q4. We had previously called out the fact that with the delayed signing of the contract with Epic, we had some expenses that got pushed out in Q4. And that's, in fact, what played out in the quarter. As you think about next year in terms of specifically Nova, we called out roughly $0.25 impact from Nova expenses in sorry, when I say next year, I mean 2026. So when you think about 2026, the impact is roughly $0.25. The way I think about it is fairly even in terms of quarterly impact across the quarters, maybe slightly more in the first half and the second half, but not materially different. So I think you can model it fairly equally across the quarters. Okay. Operator, thank you. And I'd like to thank everyone again for joining the call today.
Operator: And then Nova, we had also expenses in Q4. We had previously called out the fact that with the delayed signing of the contract with Epic, we had some expenses that got pushed out in Q4. And that's, in fact, what played out in the quarter. As you think about next year in terms of specifically Nova, we called out roughly $0.25 impact from Nova expenses in sorry, when I say next year, I mean 2026. So when you think about 2026, the impact is roughly $0.25. The way I think about it is fairly even in terms of quarterly impact across the quarters, maybe slightly more in the first half and the second half, but not materially different. So I think you can model it fairly equally across the quarters. Okay. Operator, thank you. And I'd like to thank everyone again for joining the call today.
Speaker #1: And then, Nova, we had also expenses in Q4. We had previously the fact that was called out with the delay of the signing contract with Epic. We had some expenses that got pushed out into Q4.
Speaker #1: in And that's fact what in the played out quarter . You know , as you think about next year in terms of Nova called out , you know , we specifically roughly 25 cent impact from Nova expenses in 20 .
Speaker #1: Sorry . When I say next year , I mean 26 . So when you think about 26 , the impact is roughly $0.25 .
Speaker #1: You know , the way I think about it is fairly even in terms of quarterly , you know , impact across the quarters , maybe slightly more in the first half than the second half , but not not materially different .
Speaker #1: So , you know , I think you can model it fairly equally across the quarters .
Operator: We certainly appreciate your continued support. Have a great day and stay healthy. Thank you for participating in Quest Diagnostics' fourth quarter and year-end 2025 conference call. A transcript of prepared remarks on this call will be posted later today on Quest Diagnostics' website at www.questdiagnostics.com. A replay of the call may be accessed online at www.questdiagnostics.com/investor or by phone at 866-388-5361 for domestic callers or 203-369-0416 for international callers. Telephone replays will be available from approximately 10:30AM Eastern Time on 10 February 2026, until midnight Eastern Time, 24 February 2026. Goodbye.
Operator: We certainly appreciate your continued support. Have a great day and stay healthy. Thank you for participating in Quest Diagnostics' fourth quarter and year-end 2025 conference call. A transcript of prepared remarks on this call will be posted later today on Quest Diagnostics' website at www.questdiagnostics.com. A replay of the call may be accessed online at www.questdiagnostics.com/investor or by phone at 866-388-5361 for domestic callers or 203-369-0416 for international callers. Telephone replays will be available from approximately 10:30AM Eastern Time on 10 February 2026, until midnight Eastern Time, 24 February 2026. Goodbye.
Operator: We certainly appreciate your continued support. Have a great day and stay healthy. Thank you for participating in Quest Diagnostics' fourth quarter and year-end 2025 conference call. A transcript of prepared remarks on this call will be posted later today on Quest Diagnostics' website at www.questdiagnostics.com. A replay of the call may be accessed online at www.questdiagnostics.com/investor or by phone at 866-388-5361 for domestic callers or 203-369-0416 for international callers. Telephone replays will be available from approximately 10:30AM Eastern Time on 10 February 2026, until midnight Eastern Time, 24 February 2026. Goodbye.
Operator: We certainly appreciate your continued support. Have a great day and stay healthy. Thank you for participating in Quest Diagnostics' fourth quarter and year-end 2025 conference call. A transcript of prepared remarks on this call will be posted later today on Quest Diagnostics' website at www.questdiagnostics.com. A replay of the call may be accessed online at www.questdiagnostics.com/investor or by phone at 866-388-5361 for domestic callers or 203-369-0416 for international callers. Telephone replays will be available from approximately 10:30AM Eastern Time on 10 February 2026, until midnight Eastern Time, 24 February 2026. Goodbye.
Speaker #17: Was it okay ?
Speaker #2: Operator . Thank you . And I'd like to thank everyone again for joining the call today . We certainly appreciate your continued support .
Speaker #2: Have a great day and stay healthy.
Speaker #3: for Thank you participating in Quest fourth Quarter and Year end 2025 Conference Call . A transcript of Prepared , prepared remarks on this call will later today be on posted QUEST DIAGNOSTICS INC at .
Speaker #3: A replay of the call may be accessed online at QUEST DIAGNOSTICS INC . Or by phone at (866) 388-5361 . For domestic callers , or (203) 369-0416 for international callers .
Speaker #3: Telephone replays will be available from approximately 10:30 a.m. Eastern Time on February 10th , 2026 until midnight Eastern Time , February 24th , 2026 .
