We're going to kick it off. I'm Tycho Peterson from the life science team at Jefferies. It's my pleasure to introduce our next company, Quest Diagnostics. We're pleased to have Sam and Shawn with us today. Maybe you kick it off. I was able to sit in on some of the group meetings, and I think one of the things you're talking a little bit about is some of the consumer initiations and applications. Maybe just talk a little bit about how you're thinking about some of these new initiatives, including the WHOOP partnership. Yeah, sure, Tycho. First of all, thanks for having us today and hosting us. The consumer health business that we have is something that we're really excited about. It's about a $2.5 billion market. A while back we said we can get to 10% of this market in terms of adoption, so almost $250 million. We're well on our way to that. That business, which is basically operated as questhealth.com, where a patient can get on our website, order a test, get it fulfilled at a patient service center, get their blood drawn there, and then get a result the next day, is a really convenient offering to patients and one that's out of pocket. They pay for it directly. We're seeing great adoption in that business. On top of that, I think to your point about wearables, we're also seeing now more interest in that wellness, preventive medicine aspect of getting not only all your vitals on a wearable through the app and being able to track your sleep patterns, your health patterns, but also your laboratory testing. We announced recently this partnership with WHOOP, which is a wearables provider that does this band, that not only do you get all your vitals in the app, but you get also your blood testing. It's basically an exclusive partnership with them where laboratory testing is provided by Quest. I think there's a lot more opportunities in that regard in terms of other potential interesting things in that space. I think this focus on wellness is definitely opening up new opportunities for us. You have a partnership with Function Health you've announced as well. Maybe just touch on how that's slightly different. Also, how do you get paid on these? What are the economics? Yeah, so Function Health is, you know, a company that's operating, again, in this wellness space. It's a membership company. Basically, they have, you know, they've got thousands on the waiting list. It's really been very popular recently with members and subscribers, you know, paying a certain fee per year and getting a panel, a very wide panel of testing. Again, we're the exclusive provider of laboratory testing for them. Patients, you know, who sign up for Function Health will get a panel once a year. They'll go and get it fulfilled with us, and they get, you know, a very comprehensive report. Slightly different in that regard. Again, it's out of pocket. It's not through our questhealth.com. It's through Function Health. We perform all the testing for them. The economics, whether it's WHOOP or whether it's Function Health or whether it's any other partner that we deal with, is really a price that's negotiated between us and that company. They will pay us basically depending on the test. It's a price that's negotiated. They'll pay us if they do one test a year, for instance, you know, they'll pay us a certain fee. If it's two tests per year, they'll pay us a higher fee. It's a direct, it's what we call a direct client bill price that's negotiated between us and them. Are margins comparable to your kind of enterprise margins overall? Yeah, very much so. I mean, with those providers or with those other companies, I would say it's comparable to our overall margins. If you're looking at questhealth.com, you know, our direct consumer business, I would say the margins over time will be higher than our average margins because, you know, the testing prices are set by us. There's no limits in terms of reimbursed prices that we have to negotiate with the payers. Also, on top of that, we have, you know, it's all out of pocket. It's all patient paid. It's all, you know, you put in your credit card, and we bill you for that test. There are no denials. There are no patient price concessions, you know, bad debt that we have to chase from certain patients or unable to collect on, you know, if there's co-pays or stuff in our usual business, which is the third-party payer business. Maybe we can shift over to oncology. You announced a partnership with Guardant last week, you know, for a Shield through your network. Talk a little bit about, you know, the opportunity there, how you think about screening longer term. You obviously had the Galleri GRAIL partnership before that. Yeah, I would say we're working with broad-based, you know, many different companies in this space. We have an interest in early cancer screening and screening in general. We're pretty agnostic in terms of partnering with other companies. In cases where we have a gap in our testing until we stand up one of our tests, we're happy to partner. We're happy to end license. We're happy to acquire. We look at different ways of partnering with different companies or standing up our own testing. In the example that you provided, which is in the case of the Shield, which Guardant just announced on their recent Investor Day, essentially, companies are recognizing the scale that Quest Diagnostics offers and the solutions that we offer. They are going to be partnering with us for us to be promoting the Shield test to some of the primary care physicians that our commercial team calls on. We will basically get a promotion fee. We will get what we call an access fee when we essentially stand up the test with new physician practices and put it on our test list. We will also be compensated through a blood draw fee when patients present at one of our patient service centers and they get their blood drawn for the test. We have similar partnerships with GRAIL for their Galleri test in the pan-cancer screening space. As I said, we continue to have interest in the screening phase and eventually in the screening space. Eventually, we might stand up an early cancer colorectal screening test ourselves. We have a partnership right now with a company called Universal DX, which is based in Spain, that we intend to, at some point down the road, potentially launch a colorectal screening test with. Anything you can say on how far down that path you are with Universal? It's still early. We're doing clinical trial testing on their tests right now, but it's still a ways off before it makes it to market. There's still some time. I think you've noted screening and MRD have kind of different appeal to you. Talk a little bit about how your MRD strategy differs. Yeah, I mean, MRD, we wanted to be directly in and acquire a test in the MRD space for two reasons. One is, first and foremost, you know, it's a really attractive market with tons of growth potential. It's a market that we estimate today is about $1 billion in size. We think, not just us, but independent estimates, you know, sell-side estimates estimate that that market could be $5+ billion in five years, maybe even more. We got into this MRD space because of the potential, given the market growth, but also given the fact that we have, you know, natural synergies in that space. We have a pathology business. We call on oncologists. We've got a billion-dollar-plus existing cancer business. We've got 2,000 patient service centers that collect blood from patients and do testing or at least process, you know, requisitions and send tests to our labs. That was the appeal of MRD. The other reason is we saw this asset, Haystack Oncology, that has a great test. This started with research that they were doing in Germany. It's a company that was based in Baltimore. We decided that, you know, given the profile of that test and given the appeal of the MRD market, this was a tremendous opportunity for us to get into this space. Maybe just talk a little bit about the regulatory, sorry, the payer reimbursement pathway. You've got the two PLA codes. You're obviously working on Medicare reimbursement. Just talk a little bit about milestones we can track. Yeah, absolutely. I mean, we see this path to, you know, we've already commercialized Haystack, but we see this path to growth resting on three, what I call it, essentially a three-legged stool. One is commercial, and we've already ramped up commercial kind of promotion for this asset, for this test. The other one is evidence generation, and we're, you know, getting much more active on the evidence generation front, both for colorectal and other types of cancer. The third, which you're asking about, is reimbursement. We're on the path to reimbursement now, and I'll talk a little bit about that. Right now, we're kind of in this case-by-case reimbursement through the MACs, the Medicare contractors, where every case we essentially have to submit a claim and get reimbursement. It's still not ideal in terms of the speed of reimbursement. Here's how things will work going forward. First of all, we applied for PLA codes from CMS. We received two PLA codes in June, one for baseline, which is when you first perform kind of the sequencing and doing, you know, a bespoke assay on the certain type of tumor for a patient, and then one for the monitoring, which is the ongoing blood-based testing. We've received those PLA codes. We expect to have a price attached to those PLA codes by the end of the year, I would say close to somewhere around Thanksgiving. We really expect that by early 2026, as early as January, to start getting reimbursement from Medicare. More than 50% of the patients that present for MRD, having done a cancer surgery, are, you know, in the Medicare age. That's where most of the patients are. In terms of Medicare Advantage, we're doing a technical assessment or a technology assessment for the purpose of getting reimbursed by Medicare Advantage. The test received a breakthrough designation from the FDA recently. We think that's going to help the case for reimbursement as well. I think we're making all, taking all the steps that we need to take, and we really expect reimbursement both from Medicare and Medicare Advantage by January 2026. Should we think about pricing similar to Signatera, the leading test in the market? I think that's a good proxy, is equivalent pricing to what's out there right now. How should we think about timelines for commercial payers? Yeah, that's still a ways off. I think that's sort of the next phase, but I would probably say there's still some work to do before that happens, which is coverage by the third-party plans. Again, as I said, more than 50% are Medicare type of reimbursement. That's the important part right now is to get Medicare and Medicare Advantage. I think you're tripling your sales force, getting to kind of high 30s, 40 folks by the end of the year. Is that the right number in the long run? Your largest competitor has 150 reps. Yeah, I mean, for us, we've got, as you said, we're going to have roughly 40 by the end of the year or just shy of 40 dedicated Haystack reps. All they do is they call on Haystack. We're going to have roughly half of our oncology health system general commercial sales force focus on Haystack. 50% of their time is going to be Haystack. Between those two, I think we're going to have about close to 60 FTEs focused on Haystack. We're not going to be at 150. That's not what we're aiming for. I think with the focus that we will offer with the FTEs that we have, with the evidence generation that we're looking to undertake, the broad reach that Quest has within the oncology space, and with the very, very attractive profile of the test with its low limits of detection, which we think are best in class right now, we're confident that we can succeed. How about, you know, for evidence generation beyond colorectal? How do we think about additional indications? Yeah, I mean, we're focusing on a number of, you know, cancer indications. I think head and neck, breast, there's other types, you know, eventually lung as well. All of those, we're going to be working, partnering with academic medical centers, oncology thought leaders, different thought leaders in the space to come up with more evidence on that front. More to come. I guess just rounding it out on oncology, and then we'll hit on Alzheimer's. How do you think about multicancer, you know, that opportunity set both in terms of partnering and going at it on your own? Yeah, I mean, I'd say right now our focus is in terms of standing up our own test is, I would say, early cancer screening with colorectal or with, you know, specific types of cancer. When it comes to pan-cancer, you know, we're happy to partner right now as we are with GRAIL, but no specific focus to stand up our own test today. Do you think that market goes pan-cancer or will be narrower panels? How do you think about how broad you'll go? Hard to say right now. I mean, listen, GRAIL has a really good test. You know, Galleri has very, in my opinion, attractive sensitivity and specificity. The reimbursement path is going to be challenging. I think the more immediate appealing path for us is specific types of cancer. Maybe just shifting over to Alzheimer's, you know, blood-based testing growing, I think high double digits. You've talked about that doubling year over year. Just talk about adoption barriers. How confident are you that, you know, blood becomes a leading modality for treatment determination? Yeah, I mean, listen, it's growing really fast and it's, you know, the uptake has been exceeding our expectations in terms of blood-based testing for early onset dementia and Alzheimer's. I think, you know, obviously the catalyst for some of that has been the availability of therapies. When you, as either a patient or a provider, know that there's an option to slow down the progression of the disease, if you're somebody that's either presenting with symptoms or you have high risk factors, you know, getting them on an early screening blood-based test, which is way less expensive than imaging, than a PET scan, way less invasive than CSF, I think is really appealing, has a very strong appeal and a lot of promise. We're seeing the uptake really rise fast. The AD- Detect portfolio includes different tests with different analytes. We have one test that measures amyloid beta 42/ 40, and the higher the ratio, the lower the odds that you have, or the lower the risk that you have early onset dementia. There's p-tau 217, 181. The reimbursement is attractive because the reimbursement is measured per analyte. It's over $120 per analyte, and if you get covered, if you get a test that basically looks at three analytes, you can get a test that's being reimbursed at over $350. In terms of barriers, I'd say right now, it's not right now the guideline to say based on a blood-based test, you're going to put a patient on therapy. Usually, a lot of providers, what they'll do is they'll default. If they get a positive test, they'll default to imaging and then put a patient on therapy. If you're doing broad-based screening, it does save a lot of money. Also, it's way easier to just do screening based on a blood-based test. If the answer is negative, then you as a patient can rest assured that maybe you don't have Alzheimer's or you don't have early onset. If the test is positive, then you'll default to an imaging test. We'd like to see the guidelines continue to evolve where you can reflex from a blood-based test directly to therapy. We're not quite there yet. Can you talk to the strategy of having AD- Detect and then the Fuji rebio partnership that you signed? How does that work having two different tests? I mean, the AD- Detect, again, with different types of AD- Detect depending on the analytes, is an LDT. That's the test that's widely used. The other test that we stood up with as a partnership is an FDA-approved test. In cases where you need an FDA-approved test, that's the option that we could provide. Really, the main test that we're focused on is the LDT test. Long term, do you get a sense that imaging is still going to be, you know, a big part of the market? How do you think about that evolving? I mean, hard to tell. I think it's going to be a while before imaging is not the go-to when you have a positive test. I think that's still the guideline right now. I think physicians still feel that that's probably the better option is to go to imaging. Over time, as I said earlier, we hope that, given the high sensitivity, the reliability, and the high predictive power of some of these blood-based tests, we hope that that's going to be sufficient to go to therapy from that. Maybe we could just shift to the base business then. Utilization, you've seen accelerating organic growth. You've kind of said we're beyond that post-COVID catch-up testing dynamic. Maybe just talk about the structural shift you're seeing in underlying utilization. Yeah, I mean, utilization has been stronger than expected over the last number of quarters. I think coming out of COVID, early 2023 or so, we thought that there's some catch-up demand, catch-up utilization. If I was in a room like this and I asked, you know, for a show of hands as to who had done a physical in the last two years, I would probably have gotten just maybe in the single digits or low single digits of hands saying they have. A lot of people had not done because they had basically just, you know, during the course of COVID, maybe had not done their physicals or not kept current on their testing. I think we're past that now. I think most people have, you know, gotten the catch-up care they need, having, you know, maybe left that behind during COVID. I think what we're seeing is structural. We're seeing more structural demand and more structurally higher utilization. Now, you know, we're not talking like 2 or 3 percentage points higher, but, you know, I do think we are seeing structurally higher utilization. Now, what's driving that? Number one for us, and I don't want to, you know, gloss over this, but we are seeing a share shift that we are capturing in the market. We've done a lot of acquisitions in the physician outreach space, buying up these, you know, physician affiliated physician businesses that hospitals have and move them to Quest. As opposed to these hospitals that have affiliated physicians getting the patients from these physicians doing their testing in their hospital labs, what we're seeing is with the acquisition of these businesses is now we're doing the testing for them. That's caused a higher utilization and definitely is a positive, you know, share shift for us. Other things, I mean, in addition to the usual stuff like a sicker aging population, we're not getting any healthier. That's driving utilization. I do think, you know, evolution of guidelines is favoring more testing, you know, favoring more advanced diagnostics testing. We are seeing, you know, more non-routine advanced diagnostics testing. Listen, we talked about, you know, at length just now about AD- Detect and some of the blood-based screening. This focus on early screening, whether it's cancer, whether it's, you know, Alzheimer's, early screening is also driving more testing in general. Things that weren't available 2, 3 years ago. Therapies, availability of therapies definitely driving more testing. You put all those together, we are seeing a step up in utilization. You talked about M&A being kind of part of the market share shift. Talk a little bit about, you know, that opportunity set going forward. Do you see this pace continuing or multiples changing? How do you think about M&A? I do see it continuing. I mean, we've called out in our long-term projections that we would expect to continue to drive 1%- 2% of top line growth from M&A. That equates to a deployment every year of about $500 million of capital. Could we do more? Absolutely. If the conditions favor us doing more in the sense that there's attractive M&A that meets our criteria. Our criteria are simple. We look for EPS accretive M&A by year one, and we look for a return on invested capital of 10% by year three. If we find opportunities that meet those criteria, we'll do even more. The baseline assumption is 1% - 2% revenue growth from M&A over the long term. We are definitely seeing those opportunities and a healthy pipeline. Our main focus is these hospital outreach acquisitions. That's our number one priority because they're easy to integrate. They generate a 35% - 40% contribution margin after a few months of integration. They're very profitable. Our number two priority is independent labs. We did a large independent lab acquisition last year, which was in Canada. We bought the biggest lab in Canada called LifeLabs. We'll do more of that in the U.S., not necessarily broad international expansion, but we'll continue to do those independent lab acquisitions, whether it's in the U.S. or any other opportunities that we find that are appealing. Any other acquisitions that are capability building, although those are fewer and further between, and again, they need to meet our criteria. I think, Tycho, the one last thing I'd say about it is in terms of the availability of those targets, hospitals are under a lot of pressure. As you know, I don't need to tell you this, whether it's Medicaid challenges, whether it's reimbursement challenges, whether it's coming out of COVID and labor availability and specialized labor access, wage inflation. They need our help. More and more, they are deprioritizing the less strategic parts of their business, hence labs, and focusing more on the more strategic parts like procedures, cardiovascular clinic, or cath lab, other things that really make them more money. We are the beneficiary of that because they tend to look at us as either a lab insourcing provider or an acquirer of some of their outreach books of business. Since you mentioned it, how would you score the LifeLabs acquisition? It's been growing mid-single digit. I think you just changed the reporting structure there. Talk to that and also the margin levers for that business going forward. It's going really well. Just very briefly to kind of, again, remind you of why we did that acquisition. Really large independent lab in Canada. It's the number one player in the markets that, you know, in the provinces that it plays in, Ontario, British Columbia, Saskatchewan, which is a smaller market. Very stable payer. The provincial governments are the main payers. We usually see low single-digit price increases when we renew those contracts with the payers. An aging population of the G7 countries, I think Canada is one of the faster growing and also aging populations. Really good appeal economically and really good scale for that lab in Canada. It's been doing really well. It's exceeding the expectations that we have in the deal model when we first acquired it. We said it's going to be at our margin levels at some point over the next few years. I think it's exceeding those expectations. One last thing I'll say about it is another part which is really appealing about LifeLabs is the potential for growth initiatives that are not funded by the government, but really patient-funded or patient-paid. Physician-initiated testing that the patient directly pays for, other growth initiatives in Canada that the government needs because they need somebody else to start footing the bill, so to speak. The governments, as all governments are, are strapped for cash. We're seeing good progress on those growth initiatives as well. I think there's a potential to also grow other smaller things into bigger opportunities down the road. Okay, I made it this far without asking about PAMA, but I'm going to ask about PAMA. You've now got the recently submitted Results Act. Maybe just talk about your opinion on the likelihood of a cut next year. It's a perennial overhang, obviously, and different paths for how CBO scoring might shake out. Yeah, so, you know, PAMA, just a reminder for everyone, it's kind of what's the law right now, which is this Protecting Access to Medicare Act, which was based on 2017 data that, frankly, was flawed data because it was only data representative of one part of the sample population, which was the independent labs. When that data was compiled, the health systems never even submitted pricing data. Since then, it's been delayed five years in a row. 2021 all the way to this year, PAMA has been delayed every year. There's an expectation that, you know, it could be delayed again next year. That's a possibility. If it doesn't, then PAMA is back in effect starting in 2026. We have, to your point, submitted this with the help of ACLA, which is the industry body, proposed this Results Act legislation. If this goes through, and we can talk a little bit about what are the odds of it going through, but if this goes through, it basically freezes the pricing, you know, that's in place today for the next three years. There would be no other price changes until at least 2029. There would be another data collection process that gets done by a, you know, third- party. That's an independent third- party. There's a company that's been proposed called FAIR Health. That would be a much more representative data set that's collected that represents all of the pricing from the, you know, from the different providers, not just the independent labs. When that 2029 pricing, you know, change takes effect, it could either be a price increase for us or it could be a price decrease depending on the data. If it's a price decrease, the Results Act caps the price reduction to no more than 5%. We think it's a very positive potential legislation. You need both sides of the house. There is bipartisan support, by the way. Bipartisan, I mean, both sides of the house have said PAMA is flawed. Something needs to change. It's the will and the, you know, the actual execution are two different things. I mean, I know we have challenges right now in Congress. Can we get something passed? That's the big question. It needs to be passed as part of a broader legislation. It's not going to happen just as one specific act. That's where we are. The odds, you know, hard to tell, honestly, Tycho. I can't handicap it right now. I think there's a chance that it gets delayed one more year, that meaning PAMA. There's a chance it comes back. There's a chance that the Results Act passes. It's a bit of a tough, you know, a tough one. It's not going to be easy to get the Results Act to pass. CBO scoring, we don't have CBO scoring of, you know, the Results Act yet. I think that's a next step, which is the CBO has to score what is the benefit or cost of a PAMA delay. What's the benefit or cost of the Results Act passing. We're awaiting that. Maybe just in the closing minute and a half here, if you could just touch on pricing, revenue per, you know, requisition continues to move in the right direction. Just talk a little bit about how you're thinking about the pricing environment. Yeah, that's another part of our business that's really been a positive catalyst, I think. It's the revenue per requisition, which is driven by, you know, three or four key things that drive it. Number one, tests per req. If you look back to pre-COVID, the number of tests per req were somewhere in the high 3s, 3.8, 3.9. Today, the number of tests per req that we're seeing, so every requisition that a physician orders is now somewhere in the 4.2, 4.3. Almost a half a test more, which goes back to your question about utilization. What are the things driving it? Part of it is the availability of more tests, etc., which is creating a more dense req. Number two is payer mix. We're seeing more mix of Medicare business, Medicare Advantage business. Medicare is our highest reimbursement. It's our highest price test. As we see more Medicare business driven by aging population, etc., it's helping our payer mix as well. Number three is test mix. We're seeing more advanced diagnostics, high growth tests that are more high-value tests that are also helping in terms of revenue growth. Number four is pricing. Pricing pre-pandemic, setting aside PAMA, from the third-party payers, we were seeing usually a price erosion every year. Now our pricing has stabilized. We've been able to work on value-based incentives with the payers, which are helping to stabilize our pricing. I think we're definitely seeing a benefit in terms of more price stability with the third-party payers as well. Maybe I know we're at time. One last one before we wrap, just that Medicaid risk with a big beautiful bill. I know that's, you know, a little bit further out, but it's 8% of revenues. How do you think about that? Yeah, it's 8% of revenue. First of all, we don't think there'll be a material impact anywhere in the next two years, number one. I think these cuts will probably start to show up in 2028 and beyond. What's been estimated is that 10% of Medicaid participants could eventually lose coverage, but that's over the next 10 years. There's a glide path. The impact's not that material for us, frankly, Tycho. We've estimated if the exchange subsidies don't renew and if Medicaid cuts take place as we see them today in the one big beautiful bill, that by 2028, it could be an impact of about 50 to 60 basis points on our revenue. In three years, frankly, it's a manageable impact. The last time there were Medicaid cuts, which was in the redetermination coming out of COVID, 25 million people lost Medicaid coverage, but actually, we didn't see an impact on utilization. There are some people that actually can opt for employer coverage, etc. There are other means for getting coverage. Not too concerned about it. I would minimize it. It's a big issue, but not too concerned about it for Quest specifically. Great. We got to wrap. Thanks, Sam. Thank you. Thanks, Shawn. All right.