Thanks, everyone, for joining us. I'm Patrick Donnelly, the tools and diagnostics analyst here at Citi. Happy to have Sam Samad and Shawn Bevec from Quest here with us. Thanks for coming down, guys. Sam, maybe to start, we were just chatting about it a little bit. Just the utilization backdrop, you know, is something we hear a lot of questions about. I know you guys get questions as well. It's remained quite elevated. I think everyone thought it was a COVID phenomenon. And then the farther away we get, and it hanging in at these elevated levels, it doesn't seem all that connected. But maybe just give us a rundown on the utilization, what you're seeing, and the expectations for this to remain elevated, at least relative to historical levels. Yeah, sure. And first of all, thanks for having us, Patrick. Great to be here. So yeah, utilization has been strong now, for some time coming out of COVID. You know, at first, I think we were a little bit more guarded in terms of thinking, is it catch-up utilization? Is it people that have just deferred testing all during COVID? Is it a temporary thing? And are we gonna see it start to come down to kind of pre-COVID levels? It's been pretty resilient. And I think there are a number of factors that are feeding into that. So I don't think it's one thing. There isn't a sort of a silver bullet here. You know, number one is access. We've gotten access in with at least one payer where we had, you know, four states that we didn't have access before that we got access to this year. So that's helping in terms of driving more access in more parts of the country. We had access, exclusive access with another payer also in the east. So that's helped as well, but I think more fundamentally, it's other things that deal with kind of the health of the population and where testing is going. So, you know, chronic illness continues to be on the increase, unfortunately, for all of us, but I think that's where screening comes in. You know, you've got now screening with really a so what in terms of what you can do about certain conditions. For instance, you know, early onset dementia, we've got AD Detect where you can do blood-based screening and potentially, you know, look at the overall risk of a patient and whether you need to consider therapy after you reflex the imaging. You've got, you know, oncology, early screening. You've got, you know, cardiometabolic risk and cardiovascular risk and screening for that. I think you're also seeing consumer, sort of this whole consumer segment really continue to grow and gain traction as well as patients take more ownership of their overall health, and they really wanna understand their health better. So we're seeing this whole aspect of wellness and consumer growth, whether it's through our direct channel of questhealth.com or whether it's through some of the partnerships that we're doing as well with other providers that are really gaining traction. So I think you put all these together, really driving to higher than, I would say, traditional utilization, which is really benefiting us. Yeah. Yeah. And we can touch on a few of those. I mean, you just mentioned the consumer one there at the end. Can you just talk about that consumer channel? I know you guys have the partnerships with WHOOP, Oura, at least indirect partnerships, you know, how that's tracking. How are those structured too in terms of just marketing the tests, requisition volume contribution? Maybe we could just run down that piece. Yeah. I mean, first of all, it's a, it's a really exciting part of our business. So we talked about consumer a while back when we relaunched our consumer efforts in the direct space. And we said this business can be about $250 million in terms of revenue, at some point down the road. And, you know, in 2021, we re-established or kind of re-energized our growth into consumer, established this questhealth.com. And, you know, this business is growing really nicely. It's growing about 35% every quarter, year over year. And, you know, approaching now $100 million in terms of top line. So that's the direct questhealth.com where we offer Quest tests online. And you, as a consumer, as a patient, can order the test. You can go to one of our patient service centers, get the blood draw done, get your result as early as a day. So great, great opportunity for people. It's usually paid out of pocket. Now, we have also these collaborations with providers and partners that are really gaining traction as well. And we're very excited about partnering with some key companies there. Function Health is one of them, which, again, they have a membership subscription model that they offer to their patients. And we are the engine behind that. So the patient basically subscribes to Function Health, and they get referred to testing in one of our, again, one of our PSCs. And we perform the testing. And Function then will provide a very comprehensive report to the patient or the consumer. Same with WHOOP and Oura that we announced, not too far back where, you know, you have basically the wearable, you have the app. And now, as part of the app, you can order testing. You know, with WHOOP, for instance, you can order a test which is 65 analytes. You pay a certain fee. You get the test done at Quest. And we provide, and WHOOP actually provides you that report within their app. So think of it, Patrick, as we are the engine behind this. We're the exclusive testing provider for these companies. Hims & Hers was also one that was announced recently. They do all the marketing. You know, they basically deal with all the consumer aspects with getting paid by the consumer. And we basically get paid by the providers themselves or these partners that offer this, either the wearables or the membership. Yep. Okay. And then in the advanced diagnostics piece, you obviously have the wellness testing, the specialty testing pieces. You know, how are those tracking? What's the right way to think about, you know, just that contribution to overall revs as well? Yeah. There are really five areas of advanced diagnostics testing that we consider as the high growth areas of our business. And they are really all growing in the double digits. So when you think about contribution, these are offering a positive disproportionate contribution and really helping in terms of driving, again, higher utilization to the question that you asked at the beginning. So those five key areas are cardiometabolic, autoimmune, women's health, brain health, and oncology. And so within each of those clinical franchises, there are these high growth tests that are really driving. And they're now close to about $1 billion in terms of contribution. And as I said, growing in the low double digits in terms of contribution. So, you know, really, really an important part of our business helping with our overall mix 'cause these are also usually higher value tests as well. Yep. Okay, and then maybe the test per rec. You know, I know we talk about that a good amount. You know, where is that in terms of number of tests per rec growth year to date? Where are we on that front? And then that's another one, again, I think people look at the durability and it's held at a pretty high number for a few years here. Is that just a permanent shift now where you guys feel pretty comfortable on that? Yeah. It's. I think it's structural. And I think it's resilient. And it's got, you know, definitely some runway to it. Back to your question about where it was, where it is today, I mean, if you go back to pre-COVID, a typical requisition we would see is about 3.8, 3.9 tests per rec. Today, fast forward, you know, five, six years, we're somewhere in the 4.3, 4.4. So an average requisition now has almost half a test more. Now, to the average person, you hear that, you go, "Okay, that's what's the big deal? Yeah. For us, it is a big deal actually in terms of margin because, you know, you're performing a half a test more on each requisition. You know, other than some reagent additional cost, you've got a lot of your fixed cost already covered. So it's actually a pretty good margin lift for us. And, you know, some of that is driven by some of the things that I talked about with regards to consumer and some of the partnerships that we have where you have some really rich panels that are being done with multiple tests to get an overall kaleidoscope of a patient's health. So the work that we do with Function, for instance, and, you know, even in the, sometimes in the Quest Health space. But it's also driven by advanced diagnostics. And, you know, some of the additional work that now physicians are basically ordering for patients. Mm-hmm. First, because there are therapies to certain disease states or to certain conditions that they, there's a so what again. And second, because, you know, it's, I mean, with chronic illness, aging population, I think physicians are really more focused on underlying health and ordering more testing than they were before. Yep. Okay. And, I guess when you put that all together, both the test per rec and then the volume side, how are you guys thinking about this sequentially? Obviously, gave the 4Q guide, 3Q to 4Q. You have LifeLabs. I think that flips organic this quarter. So maybe just kind of give us the bridge on the revenue side for 4Q in terms of how that built up. Yeah. I mean, I'll give you a little bit of the seasonality first. I mean. Yeah. You know, always we expect that 4Q is a slight dip from, or it's a dip from 3Q. Mm-hmm. I mean, usually in terms of typical seasonality, the second quarter is our highest quarter of the year in terms of just, you know, the strength of that quarter. Third Q is a slight dip from that. Fourth Q is usually a below 3Q. And then first quarter is usually our weakest quarter of the year. And no surprise. I mean, 4Q, you've got the holidays. Right. First quarter, you've got, you know, usually bad weather and, you know, coming out of also the holidays and maybe more sluggish testing. Mm-hmm. But, you know, so that typical seasonality usually holds. Now, for the full year, we are expecting organic revenue growth to be in the 4.5%-5%. Year to date, our organic revenue growth at 4.8%. Mm-hmm. So, you know, this has been a strong year for us in terms of utilization. You know, we'll give guidance for 2026 when the time comes. But, you know, suffice it to say, I think we're seeing some very strong utilization and organic revenue growth. Yep. And, and then maybe just the margin side as well. You have some Project Nova expenses. We'll get into Project Nova in a little bit. I think it's, like you called out, the employee costs, on the healthcare side. What's the right way to think about maybe the exit rate on margins? And then I know that's always a debate, you know, is this the right number to jump off of into 2026? But maybe we could talk 4Q and then, you know, maybe the right build-up point. Yeah. There's always noise in the margin rates. I mean, first of all, let me emphasize this year, our operating margin rate is growing from last year. So we're seeing expansion of our operating margin rate. And in fact, if I take you back to our investor day comments back in March of this year, we said that we expect operating margin rates to grow between 75 and 150 basis points over the next three years. Mm-hmm. So, between 25 and 27, we still stand behind that long-term guidance. In terms of, you know, the noise between Q3 and Q4, in Q3, our operating margin rate was 16.3%. I think we had about a 50 basis points negative impact from employee healthcare costs. A lot of that was also a catch-up over the course of the year, you know, based on claims data and based on information that we get around exact claims. You know, we make the adjustment to really reflect the true cost of employee healthcare costs. And some of that was a catch-up in Q3. I wouldn't expect that to necessarily repeat in Q4, but we did say that in Q4, we do have some Nova costs. Mm-hmm. That maybe we didn't have to the same extent in Q3. You know, we signed the agreement with Epic earlier. Right. We were a bit delayed in terms of when we signed the agreement. So some of those costs got pushed out a bit into Q4. The bottom line, Patrick, when you put all that together, you know, what we, what we said, and I think we called that out on our earnings call, is that typically in the pre-COVID seasonality, we usually see somewhere between a 50-100 basis points margin rate, negative, let's just say, or reduction between Q3 to Q4. So I think that's, that's still in the same ballpark in terms of margin rate, you know, progression from Q3 to Q4. Okay. And then, yeah, maybe we can touch on Nova and then would love to flow it to 2026. But I guess with Nova, maybe just talk about where those initial investments are going. Is there a magnitude we should think about in terms of, you know, 4Q relative to the initial expectations? And then, you know, maybe when some of the benefits start to show up, we could touch on as well. Yeah. I mean, just in terms of overall magnitude of cost around Nova. And by the way, Nova is not all costs. Nova. Yes. As you said, there's a lot of benefits that we see for that project that are gonna be, frankly, potentially transformative for our business in terms of how we do things and, you know, how we manage order to cash. But, in terms of the overall cost, it's somewhere between $250-$310 million of one-time costs for Nova. Mm-hmm. 40% of that is gonna be operating expenses. 60% roughly is capital expenses. That's the overall cost of the project over the next six to seven years. So that's not. Mm-hmm. Next year, in terms of, you know, going back to sort of your points around where the costs go, etc., what's gonna first be impacted. So this is gonna be a staged implementation across really our entire lab footprint. Mm-hmm. We're gonna start with our esoteric, what we call our esoteric labs, which is where we perform our advanced diagnostic testing, 'cause that's where we need to start in terms of changing the lab information systems and transforming that experience for our lab operations. Then we'll move into our regional labs. It's not gonna be, hey, flip the switch, everything starts together. It's gonna be, as I said, staged. You know, we'll turn on one lab after another and we'll start going through our whole footprint. We're gonna transform the patient experience in certain cases in terms of, you know, how they get their results. We're gonna introduce AI into that, also implementation as well. In terms of 2025, Patrick, you know, we said at the beginning of the year that we're gonna spend roughly $20 million on Nova this year. We're not gonna spend $20 million. We're spending less than that, because, as I said, we were delayed in terms of starting this relationship. But we'll, there will be spend in Q4 that I mentioned earlier. You know, we'll guide in 2026, in early 2026 in terms of what that investment looks like for 2026. But, you know, the 75-150 basis points for the three years in terms of operating margin expansion that I mentioned, that includes in it, you know, the Nova sort of implementation. Okay? So we still feel confident that we can increase our operating margin rate with all of the costs that we're undertaking for Nova. Because Nova, to your last question, in 2027, we expect to start to see benefits from it, benefits in terms of a lot of productivity, reducing denials, improving patient, customer onboarding. There's a lot of things that we think will improve productivity and cost. Okay. No, that's helpful. And then again, obviously one of the big variables as we look ahead into next year is PAMA, right? I mean, you had the, I guess, the one-month delay. You have PAMA versus results. Maybe just give us your breakdown of how you're thinking about, does the one-month delay change anything? Were you surprised by, you know, there were obviously some numbers thrown around inside that one month. What does this mean for the probability of PAMA, and as we sit here today in December? So, I mean, it is approaching. Yeah. I was encouraged by the month delay as we were, we all were, because it does, you know, validate that this is still top of mind for, you know, both sides of the house, for the administration, that this is an important, you know, potential, sort of reform piece on the agenda, and the fact that it was delayed by 30 days gives us some confidence that there could be on the cards a potential delay for all of next year. I would not, you know, say there's a really high probability that that happens. But I do think this gives us confidence that more likely than not, we could see a delay of PAMA again next year. So maybe more than a 50% probability. I'm also, you know, still somewhat optimistic that we could see the Results Act passing, you know, so permanent reform for PAMA. Now, you know, less confident of that than a PAMA delay because I think it requires more work for that to go through, but, you know, we also see both sides of the house and we saw more than 40 congresspeople actually do support, you know, the passing of the Results Act and that have put their support behind it, so that gives us confidence that there's some momentum there. Yeah. Now, again, I think it's probably more likely that we see a PAMA delay than that. But so we remain optimistic that we can, you know, we can avoid a PAMA cut next year. Okay. And again, in a hypothetical, obviously you guys have laid out the $100 million potential impact if it does come back. What's the right way to think about if it does show up, the potential offsets, how quickly, how nimble you can be in terms of maybe the cost side, how much of that hundred would actually flow through? I'm sure obviously you guys are prepared for the worst, hope for the best. But. Yeah. You know, what's the view as to what you could offset if the $100 million comes through? Yeah. So, you know, we have been doing this contingency planning for a while because, as you said, we're not gonna just sit there and hope that this doesn't happen and then have to scramble that if this does happen. You know, we run our business in a very disciplined, rigorous way. We have a lot of operational rigor in our labs. So I wouldn't say that there's low-hanging fruit in terms of our cost base that we're just gonna be able to take out this huge amount of cost. But we will offset a portion of the PAMA impact. It's not gonna be the majority of the impact. It's not gonna be 50% of the impact. If it's $100 million, it's gonna be less than that. But we will offset some portion of the impact. Mm-hmm. How we're gonna do it, we're gonna focus on a few things. We'll focus on, you know, first of all, some of our support functions that are non-customer-facing, non-patient-facing, not frontline, and look to find efficiencies there. Can we find efficiencies through AI to potentially not have to backfill certain roles, keep positions open, and potentially reallocate certain positions from maybe transactional functions to more, you know, strategic functions and be able to find efficiencies that way? Could we look at some of our investments? We always have some portion, not a big portion, but a portion that's discretionary investments. Mm-hmm. Could we potentially delay some of those? You know, Nova is not all non-discretionary. There is a discretionary pacing part to it that we can potentially also manage through, you know, some of the slowing down of the pacing of spend. So. Mm-hmm. There's that portion as well. So, you know, you put all that together and that's contingency work that we're doing right now just to be prepared. Yep. Okay. That's helpful. And then maybe staying on the policy side, you have the One Big Beautiful Bill, and then the ACA subsidies as well. Can you just talk through the impacts from those, the potential expiration of the ACA subsidies, what that could mean to you? I think you've broken out some numbers before, but it would be helpful just to run through those as well. Yeah. Yeah. You know, I mean, you've got the Medicaid cuts, right, that potentially could happen, although we don't see those really impacting our business until maybe late 2027, early 2028. I think the healthcare exchange subsidies, if they were not to get extended or in some other framework that got established where they would be preserved, you know, I see that as potentially a 30 basis point impact to our volumes and revenue next year. Mm-hmm. Am I concerned about it? Not really. I think it's, you know, we've got some good tailwinds on utilization. But it would be an impact, right? That's about 30 basis points. I think by 2028, we've sized it to be somewhere close to 50-60 basis points. The majority of that being from the healthcare exchanges. Mm-hmm. With Medicaid being really a small piece of it. Mm-hmm. It's almost like 10-15 basis points of that being from Medicaid. You know, I think, I mean, on the healthcare exchanges, Patrick, I, I don't wanna minimize the impact on the average consumer because, yes, some people will be impacted by that. But I think there's been also some data that's shown that, the people that have benefited from the subsidies that were established, the latest round of subsidies that might get taken away, were less, lower consumers of healthcare. And so, you know, less of a impact on utilization by eliminating those subsidies as you would otherwise see in the overall population. Mm-hmm. Okay. And I guess you put those together, you know, if PAMA comes back, gonna get a lot of ifs. If we see kind of the ACA impact, is there still? You mentioned the 75-100 basis points of margin over the course of a few years. Do margins still, are they, is there room for them to still expand and or be flat in that environment? Or if those things go against you, is it a little more challenging? If PAMA were to come back, you know, I still feel positive that we can expand margins. But that's why we gave the range, right? Yeah. The 75 to 150. I think we'd be definitely on the low end of the range. Sure. Yeah. Yep. Okay. And then maybe just bouncing around, Haystack, you know, obviously, an important one here for you guys, big attractive market. Where are we in terms of that rollout expectations? You know, we can get into, you know, the expenses and the dilution a little bit. But just in terms of the market opportunity, how do you see yourself set up? Obviously, some competitors out there already building, again, what appears to be a very large underpenetrated market. How are you thinking about your guys' approach to MRD with Haystack? Yeah. I think you've captured it well. I mean, large underpenetrated market or, you know, currently really one key player in that market, but more entrants coming in, including us. You know, I think that market over the next five years could be fivefold what it is today. And that's not, you know, Sam's estimates. That's, I think, independent estimates that say it could be a $5-$10 billion market over the next five plus years. I do think we have a great test and, and really proud of the test. You know, it's got the lowest limits of detection out there. It's a really highly sensitive test that, that offers a huge, huge lifesaving value to patients. We have made some really good progress, you know, Patrick, on a number of fronts. You know, we did an early launch last year, had some learnings from that, signed up a lot of physicians and cancer centers. We did the launch earlier this year, and we've been increasing our commercial presence behind the test as we've worked on reimbursement. So, you know, we were very paced and staged in our kind of growth and our, you know, progress here and momentum because we wanted to get reimbursement. We applied for PLA codes, Medicare PLA codes earlier. We just got, basically a reimbursement level attached to those PLA codes for a baseline test at $3,900 and monitoring at $800. And those will go into effect on the 1st of January in 2026. So we'll get Medicare, start to get Medicare reimbursement. Mm-hmm. We are working on a technical assessment with MolDX for Medicare Advantage reimbursement as well, as I said, we took our commercial presence from 12 reps and we're gonna be closer to 35-40 reps by the end of the year. So more feet on the street to drive the adoption of this really important test. And then finally, on the evidence generation front, we've got about two dozen trials right now going on with evidence generation across not just colorectal. Mm-hmm. For MRD, but also other indications for cancer. So, it's been a very thoughtful staged launch and we continue to make really good progress. Yep. And maybe, you know, you mentioned the Early Access program, you know, ran a bunch of tests and had some great partners there. What were some learnings from that? What's the feedback been to you guys in terms of this test, comparing it, you know, obviously to your point, there's one large player out there, several others. What's been the feedback from the early users on the test experience for you guys? Yeah. I mean, some of the feedback, I mean, first, some really positive feedback and, you know, cases where the low limits of detection have really played a key part in terms of uncovering positive cases where, you know, they had negative cases before. And, you know, I'm not talking about many cases. I'm talking about a handful of cases that, you know, physicians were really surprised with Haystack's ability to detect circulating tumor DNA. So really important for patients. We did get some feedback around, you know, the overall workflow, the manual nature of the workflow, and the fact that we needed to implement, you know, a solution called Epic Aura with oncologists to manage the whole workflow and the EMR in the physician office. And that's something that we're investing in right now. You know, got more and more experience also with reimbursement and, you know, what it's gonna take to get reimbursement. And so that's why we went through the reimbursement channel with the MAC and now with, you know, getting to the PLA code level. So I think there's been some good learnings that have, you know, we've done. We've paced in a very, as I said earlier, methodical way. Yep. And in terms of driving, you know, that next leg of adoption, is it the reimbursement side where, you know, these doctors wanna see the test get paid and then they'll start kind of running more volumes? What's the feedback you hear in terms of, you know, driving the next big step up on the ramp and the potential revenue? Yeah. I mean, reimbursement is a part of it. I think you also have to be very disciplined in terms of your operational rigor. Mm-hmm. Something that I would argue we do better than anyone. I think you have to, I mean, listen, commercial, you know, focus and commercial sort of just drive is gonna really matter here in this space as well is making sure that you educate physicians on the nature of this test. Mm-hmm. The last piece I would say is evidence generation. I mean, that's gonna be critical. You know, the more evidence you can generate, the more you can provide data to some of these oncologists, the more you're gonna get adoption. But today, Patrick, I mean, we've got, you know, almost, I'd say probably still about more than half of oncologists out there have never tried MRD. Mm-hmm. And so they, there's still a tremendous opportunity to expand in that market as well 'cause these are, you know, oncologists that have never tried it. It's not like they've tried some other test out there. Yep. And in terms of, you know, the dilution, you know, I think it ended up being—is it $0.35-$0.40 this year? You know, I think the hope was it improved maybe as the year went and obviously, again, maybe the revenue got pushed out a little bit. How do you think about the progression? Is it purely tied to, you know, when the revenue starts to ramp, the dilution just eases and it's that simple? Is there a revenue number where it's once we hit this run rate, it's break even? Maybe just kind of frame up the P&L tied to Haystack. Yeah. I mean, you know, dilution this year is gonna be roughly on pace with what it was last year. Mm-hmm. As I said, you know, we've made, we've been very careful to manage dilution, but at the same time to not shortchange the test in terms of, you know, the potential for more adoption. Mm-hmm. So we've increased commercial presence. We've built this workflow and this Epic Aura system that's gonna help us in terms of managing the workflow. I think next year, you know, we're still gonna expect it to be dilutive. It's gonna be potentially less dilution than what we have this year. You're right. You know, there is a certain level of volume that you have to get to before you can break even on this test. And our goal is that by the end of next year, that we would get to break even in terms of not for the full year, but at some point towards the end of next year that we break even on this test. But we also have to be mindful of the fact that we need to, you know, continue to drive adoption and not shortchange the investment on it. Mm-hmm. You know, some of it relates to clinical trials as well and evidence generation that we do. Yep. But, you know, I mean, you and I both know about sort of the sequencing. Mm-hmm. Cost environment. And what, what you do know as well is that until you have a certain level of volumes, you can't really bring down the cost of testing sufficiently 'cause you need scale, you need volumes. And that's something that will happen as you get more and more volumes. You can fill these sequencers. Mm-hmm. You're gonna get better gross margin and you're gonna get better profitability as well. Yep. Okay. And maybe last one on Haystack, just on the indications to your point, you mentioned, you know, getting out beyond colorectal. Any timelines around that? And then how important are guidelines like NCCN and, and those types and, you know, how, how close are those in, in terms of being on your radar? Yeah. I think, you know, no specific timelines on the other indications. I mean, we are focusing first on colorectal. Mm-hmm. As I said, we're working on a number of trials around, you know, colorectal and other indications down the road. We're focused on breast. We're focused on head and neck. We're focused on the use of MRD and immunotherapy. We're focused on. So there's a number of indications that I think we will, you know, prove out Haystack's use in. With regards to NCCN, they are important. I mean, but I think that work is, you know, being done by the number of players in the space, not just us. You know, the more there are evidence-based data that support the use of MRD and, you know, post-resection cancer therapy, I think the more there's a likelihood that this gets added to the guidelines under NCCN. And I think it's important. It'll take a while. Mm-hmm. Yep. Okay. And then you guys also have some cancer screening partnerships. I mean, the Guardant one came out a few months ago. I guess how do you balance partnerships with external cancer screening companies, developing your own tests in-house potentially in the future if you get into the screening world? What's the right way to think about just, just how you think about that screening environment and the partnership side versus the internal? Yeah. I mean, this applies to screening, but it also applies to our approach in general to how we sort of build the menu, right, and build the menu across our thousands of tests. We look at, I, I would say three areas. Number one, organic investment and developing tests organically through our own R&D. AD Detect is a great example of that where this test was developed in-house and it's, you know, it's paying dividends for us. Then another area is really either in licensing or acquisition. We in-license certain tests from key providers and key companies that we partner with, and we've acquired other tests. Haystack is a really good example of that. And I think the third area is, you know, where we don't have a test either that's organically developed or in-licensed or acquired. It's, you know, partnerships where we'll partner with certain other companies to basically provide a service for them and get paid for that service, but really enable, you know, the growth of that test in the market. So the partnership with Guardant is one example of that where we're partnering with them on their colorectal screening assay, where, you know, we get compensated for signing up physicians for promotion work that we do. We have the test on our menu. We get paid for the draws that we do in our patient service center. So today we don't have a colorectal cancer screening assay. That doesn't mean that we won't have one down the road. We're actually partnering with a company called Universal DX on a colorectal early cancer screening. Okay. But until such time happens as we launch that, you know, we're partnering with Guardant. We partner with Grail as well. Mm-hmm. And we also do an important service for them. We sign up physicians and we have them on our menu and we do blood draws for them. So. Yep. You know, we have these because we don't have an MC, a multi-cancer early detection test right now. Yep. And I guess in terms of, you know, the Haystack acquisition itself, it was a bit of a one-off for you guys in terms of buying, you know, pre-revenue dilutive asset. You know, you guys have been very consistent in buying up, you know, outreach labs, hospital labs. Should we expect that to be a one-off? Is there still an appetite for those types of deals? Obviously, since then, you've done a bunch of good kind of volume acquisition. Maybe we can talk both the pipeline on the reference lab hospital side. And then again, is there an appetite to do other one-off tests or should we think about kind of those core deals? Yeah. I mean, I will start with what are our kind of key criteria, financial criteria for deals 'cause I'm usually the guy that's like pounding on the table going, do they meet those criteria? Mm-hmm. Number one, it's to exceed 10% ROIC by year three. And number two, those are not like either/or, they're and. Number two is to be EPS accretive in year one. Mm-hmm. So the majority of the deals that we do, Patrick, have to meet those two criteria. The Haystack didn't because it's a pre-revenue, you know, key strategic test that we thought has a pretty incredible potential market. But the majority of the deals that we do are gonna fit into those two criteria. Now, you know, again, it has to have like that Haystack profile for us to, you know, really deviate from those two criteria. But I would say in terms of the pipeline, to your question, the majority are gonna fall into this outreach, physician book of business acquisitions that are, you know, most, if not all, will fit those two criteria. Mm-hmm. You'll have some that are more independent lab driven, you know, where we think there's an opportunity to acquire an independent lab. And then, you know, the capability building acquisitions that sometimes are less obvious are ones that we look at much more carefully and much more selectively. But again, with the lens of they have to meet those two criteria unless there's like a really. Mm-hmm. Market-driven reason. Yep. And how is the pipeline today in terms of, you know, the acquisition side? You know, has the PAMA threat brought people back to the table? Is that irrelevant in terms of the deal discussions? How is the pipeline looking? The pipeline is good and healthy. I mean, I think with a lot of emphasis on the physician outreach books of business, you know, that we buy from hospitals. Mm-hmm. From health systems. I don't think PAMA has made a huge difference, frankly. I think it's, and I don't think even like the, legislative changes and the one big beautiful bill have made a big difference yet. But I do think with an eye towards potential challenges for the community-based health systems, other health systems down the road because of Medicaid cuts, that actually might drive more, you know, more hospitals to consider selling those outreach books of business to us as well. When you think about the tail on that opportunity, or at least what's, you know, what's available in terms of opportunities in that space, there's still tons of health systems where we think we can partner, acquire those books of business. So I think the pipeline is pretty robust. Yep. Okay. And maybe just kind of putting it all together in terms of some of the growth drivers, utilization, you know, we didn't talk a ton about pricing, but, you know, pricing seems like it's still on your side, which is nice. I guess when you looked at 2026, it sounded like, you know, your earlier comment, Sam, was, you know, this momentum should continue. I mean, any variables to call out as we think about the growth side, obviously the LRPs, I think that mid-single digit type top-line growth sounds like you're confident, but any variables to call out as we think about next year? No, I mean, I'm confident because we've got good momentum in our business and some good tailwinds. And so maybe to, you know, describe or point out some of the tailwinds and headwinds, Patrick. So on the tailwinds, listen, we talked about it a lot, but utilization continues to be a tailwind. And I think there's some structural elements to that that will continue to drive growth and, you know, healthy above pre-COVID growth. Mm-hmm. I think the consumer momentum that we're making is really encouraging, right? Mm-hmm. Whether it's our direct business, questhealth.com, or it's the partnerships that we have with other providers that, you know, the partnerships and collaborations that we have that offer these tests to their consumer base, and we are the engine behind that. Mm-hmm. I think that's a real positive. I think our advanced diagnostics menu and those high-growth areas that I talked about, that's a real positive. I think, you know, just the general sort of emphasis on early screening, whether it's early onset dementia, whether it's cancer, whether it's cardiometabolic, genetic risk, all of these things I think is, is a key tailwind as well. Mm-hmm. Another tailwind, you know, that maybe to get a little bit more specific and more transactional, but, you know, next year we do have two portions of our business that are driving some healthy growth on the top line. One is our collaboration with Corewell. Mm-hmm. On the co-lab side, which is basically a professional lab services side where they outsource their lab operations to where we run their lab operations. Mm-hmm. Okay? Across eventually it'll be 20-plus hospitals that we run their lab operations. That next year is about a $200 million contribution to our top line in terms of growth. Mm-hmm. That's a pretty healthy number. Yep. Now, margin rate on that business next year is gonna be pretty low. It's in the low single digits, but that grows over time. Mm-hmm. As you know, with all of our PLS relationships. Yep. Usually we start out in a low single-digit margin rate, and then as we build that business, it gets to somewhere in the, you know, 10%-12% range. Mm-hmm. But that's a tailwind on the top line. Mm-hmm. Margin rate, not so much. Then we have the Fresenius business. Yep. That we talked about this year where we acquired their book of business of external clinics that they serviced and also where they send their kind of a reference relationship where they send their, you know, Fresenius clinic work to us. And we do water testing in addition to clinical testing. That's almost a $100 million top-line lift as well. It starts out at lower than average margins, but it builds over time. Mm-hmm. So those are two important tailwinds as well. On the headwind side, you know, I mean, I talked about Nova. Mm-hmm. That'll be, you know, we'll ramp investment in Nova. So, you know, from a profitability standpoint, it's an impact of profitability. I think you have, obviously, PAMA is a potential headwind, but hopefully we can set that aside, you know. Mm-hmm. Come January and know that it's gonna be delayed. But for now, it's still a potential headwind. And, you know, I mean, I think then there's like the usual market-based or, you know, sort of economic-based factors like inflation, for instance. Mm-hmm. We're always, you know, keeping close eye on inflation, wage-based inflation. But I also think we have a lot of good momentum on our programs like Invigorate to help offset some of those headwinds like inflation, for instance, and cost of labor. Yep. And maybe last one, just a minute left here, just on the pricing side, any change in tone from, from the conversations with payers? I mean, things are obviously getting tight on the, on the payer side. So just curious if your, your discussions, I know they, they roll in terms of when each one comes up, but any, any change in tone there on the payer side? Not really. Not materially. I mean, it's with the payers. It's all about the partnership, and it's all about the value that we bring to them. And, you know, the value that we bring to them is that we do a great service at a very lower cost. Mm-hmm. Lower cost than they would reimburse to hospital labs and health systems, so it's all about the redirection and the ability to save them important, you know, dollars by redirecting some of that work to our own labs. Mm-hmm. I think that the tenor and tone of these conversations is still very positive. Yep. Okay. All right, Sam, Shawn, thank you guys so much. Appreciate you being here. Thank you. Thank you, Patrick.