All right, good afternoon, everyone. My name is Matt Sykes, the Life Science Tools and Diagnostic Analyst at Goldman Sachs, and I have the pleasure of welcoming Myriad Genetics to our conference this afternoon. Sam Raha, President and CEO, and Scott Leffler, CFO. Sam, Scott, thanks for joining me. Pleasure to be here. Thanks for having us. Thanks for having us, Matt. Great. Maybe, Sam, if we just start off at a high level. I mean, look, there are challenges across the sector, but I do want to kind of start on a more positive note and kind of see what you're most excited about for 2025. You're obviously in a relatively new seat, so it'd be great to get, one, kind of what are you excited about, what are some of the goals this year, and sort of, given you've been in the seat for a little while, kind of your impressions and things that you might want to accomplish. Yeah, I appreciate the question. If you do not mind, Matt, I am going to answer that question and also maybe take the opportunity to talk about not just the back half of the year, but in the years to come as I assume the role. Part of it is I have been doing a lot of thinking about maybe what is underappreciated about the company. I am going to wrap it all into one. I will start by saying, listen, genuinely, I am as excited today as I was 18 months ago when I joined Myriad from Agilent. Really, the excitement is about the potential to deliver on predictable, sustained, profitable growth. As a starting point, I think we have some foundational points of strength that are both about what is going to happen in 2025 as much about what we are going to be able to leverage going forward. Starting with, we have an established connection with over 50,000 healthcare providers. We're very trusted for high-quality tests that really impact medical management. A big part of how we enable those high-quality tests is through really state-of-the-art lab operations for sample processing. By the way, what we've set up allows us to turn around test results from the best times in the industry, along with a cost basis that gives us industry-best gross margins, around 70%. You put that together with the fact that we are operating in some, I think, really meaningful, attractive markets, both in terms of size, in terms of growth. Oncology, for example, a cornerstone of the company. Think about hereditary cancer, $6 billion market opportunity overall. This is a place where we have an opportunity to continue growing and being a leader in that space. MRD, I'm sure we'll get around talking more about it, but we see a real opportunity to use our differentiated assay, where that differentiation for sensitivity really makes a difference. Getting a little bit more tactical about this year, listen, what gives me a lot of confidence is we know what the challenges are. We are categorically addressing them, be it related to EMR for unaffected cancer, the challenge related to GeneSight and really focusing that on profitability and other things. I'm really excited in the coming months, based on the work that Scott, me, and the rest of the team are doing, to really provide clarity on the go-forward direction. What is Myriad going to be in the coming years? Finally, to answer your question, listen, it's all about relentless focus on execution. That's part of something we can really step up and we are focused on, starting with meeting our numbers consistently, doing what we say we're going to do, including launching products on the timelines that we say that we're going to launch them, taking any distractions away, such as, is there a concern around our level of financial liquidity, whatever that may be. Driving with a sense of urgency in the now while building a really compelling strategy, which we look forward to sharing, is what gives me a lot of confidence and excitement for the future. Awesome. Thank you. Let's start with, let's just go down through some of the challenges you had outlined just to get them out up front. On the EMR integrations, these integrations are critical to the diagnostic industry to drive volume growth and also customer stickiness. They're always a bit of a challenge, though. In recent quarters, you've seen some challenges. Maybe walk us through kind of where you guys are and where have you run into problems in the timeline for potentially kind of flipping those EMR integrations into a tailwind from a bit of a headwind. Yeah, I appreciate the question here, too. I mean, I think that maybe we could be more clear about the specificity here. EMRs are a critical requirement, increasingly so, to really be able to serve healthcare systems and providers. We've actually had some good success. Last year, we did 4,500 EMR integrations, the year before that, 1,500. Just to be clear, as it relates to our oncology customers, our prenatal customers, we're seeing success there. We're starting to see some uplift. It's doing what we hoped it would do. The challenge that we cited as one of the reasons we actually brought down guidance on our Q&A earnings call was related to the unaffected hereditary cancer segment. Specifically here, what's happened is we realized, now shame on us, we could have done better of really understanding this in more detail before we started going live, is that for a lot of our healthcare providers, they've come back and said, listen, we like the integration to the EMR, but for hereditary cancer, for unaffected, meaning those that have a familial reason to be tested but don't have cancer yet, you start with a questionnaire. Traditionally, it's been done in paper. We've also imported that into portals. When we went to the full digital EMR, that part broke. They came back and said, we're just going to wait. This is too much of a workaround, or we have too much manual steps to actually do this in a non-integrated way. The good news is we know that. We've identified it. We're working on our fixed in place. In the coming quarters, is working with Epic to actually have an integrated MyGeneHistory, which is our version of this survey. There's a couple of other workflow elements, too, related to sample collection kits and some other things. What I want to leave you with is we understand the specifics. We're working on them, and we are confident that we're going to be able to address them. Over time, as we head into the last part of this year and then go into next year, this is going to turn into a good guy for us. Maybe. You want to? Yeah. Scott? Go ahead, Scott. I think that captured really well some of the technical challenges and the opportunity to flip that headwind into a tailwind. The other element where I think there's a lot of opportunity that we have a more clear line of sight to is around just the focus of the commercial organization and allowing our sellers to sell. One of the nuances to our commercial organization is that historically, they've been a very high-touch commercial team, not just in terms of selling, but also in terms of providing support for the providers that they call on. In the EMR ramp-up situation, they are being distracted from the art of selling to have to focus more and more on the support during that ramp-up period. We are staffing more aggressively now some of the technical/commercial support folks that are able to provide dedicated support to providers that are kind of mid-ramp-up on EMR, which then gives our commercial organization the freedom to focus on the selling side where they had had some distractions previously. Got it. Maybe shifting over to GeneSight, it seems like there's kind of two pieces of this. There's obviously the UnitedHealthcare coverage decision, as well as the impact that we saw from Q1 from the reallocation of commercial resources. Maybe starting with the UnitedHealthcare coverage decision, can you kind of give us an update on the additional evidence you're generating and any conversations you're having with UnitedHealthcare around reversing that decision or any progress that's being made on that? Yeah, I mean, first of all, we're on plan. I mean, I think what we've said publicly in the past is that our plan to submit new pieces of data to UnitedHealthcare for their consideration, we're on track for that. We'll be doing that this summer. We have an ongoing set of dialogue with them. I want to be just very clear, though, Matt, from our perspective and what's factored into our projections, our numbers, is not a change or a reversal of their policy decision. So there's nothing that we've heard or seen that would give us any encouragement or reason that it could change. Not saying that it couldn't, but just to be clear to set expectations related to that. The other part of the challenge that we had, particularly in Q1, I think we made the right decisions understanding the nature of the financial impact from the UnitedHealthcare policy decision. We reduced some of our selling staff. We redirected some of our marketing spend and so forth. The right things to do, but tactically, within the quarter, the timing of that, the reassignment of territories and all that, that had an effect. We feel like we're in a good place. Very importantly, we are focused on predictable, profitable growth. It has changed from before what we were thinking would have been high single-digit growth now to low to mid-single-digit growth. That business is doing what we expect it to do at this point. Got it. Maybe one other element just to emphasize on the GeneSight side is that when the UnitedHealthcare development was first publicized, there was a lot of concerned inquiry from investors that were concerned that there might be some kind of a spillover in terms of loss coverage for other payers across the landscape. We are really pleased that so far now, here we are, over six months later, we have not lost a single, not a single other instance of coverage loss. In fact, we are accumulating an increasing list of new coverage wins so far this year, including on the commercial side. Unfortunately, none of them carry the same dollar weight that UnitedHealthcare does, but it is very encouraging to see these multiple instances accumulating. It is just a reminder that UnitedHealthcare may be big, but they are still just one opinion. There are more and more opinions that are more favorable working in our direction. Got it. Maybe sticking to commercial strategy, you also talked about adding additional commercial intensity behind Prolaris. Maybe talk more about the strategy there and when we might start seeing the benefits of that increased commercial intensity and resource allocation. Yeah. I mean, I think we're already starting to see some positive traction. Coming into the year, we did a number of things, specifically around prostate cancer and Prolaris. We added some new staff. We added a new sales manager. We also trained our sales team with new messaging and supported by KOLs who could provide a broader, different perspective that Simon Level 1 criteria isn't the end-all, be-all. We're seeing the combination of that, along with now that we have announced the partnership with PATHOMIQ, which will give us the AI component to complement our molecular assay for Prolaris, we're seeing a little bit of change in the marketplace. There's a perception that we're going to be here. I think our competitor had done a really nice job of saying, hey, is Myriad even really, really interested in long-term prostate cancer? We've been able to see that. Listen, we know that while we're on track for, and I can tell you more about that, launching our paired test, if you will, it'll be a single test, including the AI capability at the end of this year. We're already seeing the fact that we are holding steady. Our volumes are steady. It's not a decline. We're not continuing to lose a lot of share in that space. I mean, Scott, would you add anything to that one? No. That was great. Maybe let's drill down into PATHOMIQ technology and what that does and what are sort of some of the key features that clinicians might see from that partnership and that sort of increased capabilities. Yeah. Just a little bit on the background. What PATHOMIQ is, what they've done, based on deep expertise in prostate cancer, a lot of relationships, a lot of clinical data around prostate cancer, they've developed an algorithm, which is really based on looking at a H&E stain slide and then using the morphology of that to be able to make predictions on the stage or the advancement of cancer, starting with prostate cancer. By the way, this is an opportunity for us then to leverage this in breast and other cancer types as well. The first test that'll be coming to market at the end of this year, at least as early access, will be where when a provider orders this combined test, if you will, it's actually from a single tissue sample where part of it will go for the molecular test as it's done today. The other part will be put onto slides and stained and imaged using the algorithm. What they will get back is a single report. The report will essentially be enhanced. The opportunity with the PATHOMIQ piece is to have even more precision on, this is at the time of biopsy, which is about 800,000 patients a year, to determine the level of risk, low, medium, high, with a higher level of confidence ratio. That is what it does immediately. In future, in 2026, we will be bringing to market tests for post-radical prostatectomy or post-radiation, which, by the way, is a complete blue ocean for us. That is not where we engage today. That has been all Decipher and VeraSight. We are excited about that opportunity. For those tests, it will actually be a comprehensive singular readout altogether. That's taking us a little while to do, even though you're getting the benefit. It'll be an even more integrated report, if you will. Got it. Scott, just on the updated guidance in the first quarter, it included a moderated OpEx spending number. While you're going to keep strategic investments intact, maybe talk a little bit more about where you're finding those savings and if there are more structural cost takeouts or costs that may have to be added back once you kind of return back to growth. Sure. I guess I would start out by saying that the most important part of our OpEx strategy now is to make sure that we're able to fund the investments that we deem to be most critical in terms of long-term strategic growth. When you think about things like in the short and medium term, like EMR and so on, like we discussed a few minutes ago, or over the longer term, MRD and PATHOMIQ and things like that, we absolutely intend to prioritize that from an OpEx investment standpoint. What it gives us the opportunity to do then is to go back. We obviously have a very large OpEx base to work with and look at discretionary spend in other parts of the organization in order to deprioritize in those areas to fund the ones that we know are more important and more strategic over the longer term. Got it. You have talked about in terms of the strategic investments, EMR integrations, commercial focus on Prolaris, which you already addressed. Are there any other investments you kind of see as key to catalyzing growth, either for you or Sam? I mean, I think that three things that I would give you on that, Matt. One is I think we have an opportunity to continue really strengthening and building on our commercial capabilities. I think market reach and being able to get to more providers and more healthcare systems is an opportunity for us. I think that so long as the business case holds, that with the addition of every individual, we'll get a return. I think that that's something we're very seriously looking at. Another very important part of our journey going forward at Myriad is recognizing not everything has to be fully developed and commercialized by Myriad, that there will be opportunities in the market that we'll be able to better address through a partnership, either be it because they bring a component, be it from the science or the development of a product to something else that would complement us and allow us to go to market quicker. Investments in those partnerships to really make those successful, PATHOMIQ being the first example of that, is another area. Without a doubt, where you said MRD. Let me say MRD again. That is such an important driver, I think, of what will really help accelerate our growth. Got it. And just kind of getting at more of the initiatives on the commercial side, what are you kind of doing to implement to get increased productivity at the existing sales force? I mean, you talked about how there's a lot of one-to-one interaction, personal interaction with sales. I mean, we keep hearing about digital initiatives and things like that. Maybe talk a little bit about how you're looking to enhance the productivity of the sales force. Yeah. There is, again, multiple fronts to what we're doing. One is it starts with how do you direct your sales team to be efficient and effective. That means doing the work in the background with our sales support team, sales ops team, to really understand the profile of a customer and where they should be spending their time. Putting that into Salesforce, that's our CRM that we use to really help them be even more focused on every moment of time, where should they be spending time. That's one thing. Another very important thing we've been doing is really helping train our sales team to be more effective in selling. For example, a very big part of our future is in being able to serve the fuller cancer care continuum. Educating our sales organization to be effective in not only selling hereditary cancer, but the molecular profiling tests, be it our comprehensive genomic profiling test, Precise Tumor, HRD with MyChoice, all the way to preparation for MRD. That is another thing. The third very tactical thing I would give you is compensation scheme, commission scheme makes a difference. Volume growth is important, but doing it in a way that incents focus on the places where we are likely to get paid to drive profitability along with growth is a third piece to that. Got it. Yeah. Okay. I mean, and let's shift to MRD. You presented some data at ASCO. Maybe talk a little bit about the progress you're seeing with Precise MRD and also confirm kind of that we still should be thinking about a launch in the first half of 2026. Yeah. It has been an exciting, eventful period related to Precise MRD starting at AACR. We had a collaborator from MD Anderson share some data related to renal cancer. What that showed was clinical validity, the ability for our MRD test to, and this was a retrospective, so you have a lot of time points of data already there, our ability to detect what would be several months ahead of conventional radiology conventions being able to detect. I think the buzz most recently is around ASCO. Just a couple of weeks ago, we had both a collaborator at MSK on breast cancer and then at the National Cancer Center Hospital East from Japan, a major collaborator working with us on a study called Monster, which is going to include more than 1,200 patients. This was the first readout on over 100 patients. This was across eight plus cancer types. When it showed, and this is a prospective study with longitudinal, by the way, this is the set of collaborators that did a lot of the landmark initial work with Natera and Signatera. Also, they picked us because of the sensitivity of our assay. What they were able to show in the data, which has given a lot of buzz, is that for a number of cancers in this more than, I said eight, but it's really more than a dozen cancers that are part of this trial set, they were able to show that for low-shedding tumors, including breast, ovarian, prostate, the sensitivity of our assay allowed the detection of cancers several months before the conventional means and with more than 95% confidence in being able to detect that accurately. Once again, the message from that is for certain cancers, and this is not colorectal and lung, but we're talking about breast, prostate, ovarian, it makes a difference. That's where our detection capability is really going to be important in medical practice. Just given the ultra-sensitive approach you have, how is that informing your strategy of which indications to pursue first? I mean, you kind of just gave a hint of it, but I mean, you had this great slide at your investor day that showed sort of the low-shedding cancers and the number of sites that you could actually identify. It showed that the whole genome and your ultra-sensitive approach was really differentiated with those specific cancers. Is that going to inform how you go to market in terms of the indications? 100%, Matt. It is not coincidence, right? We believe that what will allow us, even being a late entrant into MRD, to have success and have traction in the market, is a combination of, one, our technology, that sensitivity applied to those cancers where it matters. Without it, you cannot detect. Again, I have just stated those: breast, prostate, ovarian, renal, and others. Two, those are the cancer places where we have established franchises, if you will. We have relationships with not only oncologists, with surgeons, the broader network of nurses and the cancer care continuum, if you will. What we've found both through secondary research, primary research, reaffirmed again this past couple of weeks at ASCO is when you think about how cancer care happens, particularly for advanced stage cancers, you have often the need for these molecular tumor boards who come together, multidisciplinary doctors really trying to determine based on as much information they have, what is the best course of treatment for a patient. One of the things that really facilitates, makes them more effective is to have a combined test report. Our ability to combine information where it's relevant, hereditary cancer, together with therapy selection with MRD for these cancers where we have a place, a reputation, and our sensitivity matters, that's the play. That's why we believe even though we're a little late to the market, we're going to be able to have traction. Got it. Sam, shifting more towards sort of longer term, you mentioned on the first quarter call that you feel confident in the high single to low double-digit LRP growth. What do you see as sort of the main drivers of that growth and how long could it take to get there? Yeah. Listen, I mean, I know we shared a slide and a perspective at the October investor day, but I just give it to you fresh this way. As a baseline, when we look at hereditary cancer, and this is across, once again, unaffected and affected in totality, that's a market segment that's growing mid-single digit to, according to some reports, high single digits. We are the leaders in this space and we have every right to grow at that rate. We are investing in programs such as breast cancer risk assessment, other things to activate the still less than 15% penetrated $4.5 billion part of that, right? One, I'll start with the foundation of that segment growing for us mid-single digits to high single digit growth. If you stay within cancer, molecular profiling, which is the combination for us of Prolaris, HRD, comprehensive genomic profiling for therapy selection, not only what we have today, this is a three- to five-year view with the things that we intend to add through partnership other. That is an area that we believe we can grow high single digit to low double digit, even growing with the market. When you look at MRD, clearly we are going to start from zero, but that is going to be without a, we have high confidence it should grow double digits even for staying with markets, right? The question is how much high double digits. You put that together then with prenatal. In our prenatal franchise, we've already seen based on the launch of a new NIPS assay, which allows earlier at eight-week gestational age, that assay having traction, FirstGene, which we as a combined carrier screening NIPS assay we recently launched. Based on all this, even if the market is growing mid-single digit, we see a path to going at least that as we have for the last several quarters. Now GeneSight, right? Now GeneSight, that's the part where it's changed and that was a core narrative of being able to grow with conviction at double digit. Now that GeneSight, we've adjusted that from high single digit, low double digit, what it was down to low to mid-single digit. You put that all together in the math and we have conviction of our ability to grow high single digit. Over time, we'll see if we can put forward the case and if it makes sense for anything beyond that, but the confidence in high single digit is there. Got it. And then Scott, just shifting over to ASPs for a minute. You had some headwind from GeneSight and prior period collection stepped down in Q1, but if you look at the elsewhere in the portfolio, you had actually pretty strong ASP performance. How are you thinking about the pricing outlook for the remainder of the year if you put all those things kind of in the blender? Yeah. We remain very encouraged. As I know you recall, throughout all of last year, we were very vocal about what we saw as kind of a maturing and increasingly favorable ASP landscape, perhaps partly influenced by the maturation in the competitive landscape around us as well. Across our product portfolio, outside of the one kind of unique instance of the UnitedHealthcare coverage of GeneSight, we were really encouraged with the favorable progress throughout 2024. That momentum carried into 2025. As we talked about on our last earnings call, we continue to see strength and stability in the underlying organic rates across the rest of the portfolio, again, outside of UnitedHealthcare coverage of GeneSight. There is still ample opportunity in terms of no pays that we continue to go after and hopefully create some forward progress that can help towards that high single digit to low double digit revenue trajectory that Sam was talking about. Got it. Just on a cost per test, which we have not kind of discussed in a while, but maybe update us on the potential for improvement on a cost per test basis now that you have, I believe, largely completed a lot of your lab of the future integrations. Yeah. As Sam mentioned, I think at the very beginning of the discussion, industry leading 70% growth margin. Our starting point is a pretty strong one. You can see the operating leverage that we have as a business, just if nothing else, from that growth margin profile. There is more operating leverage to be had. As we continue to advance and grow from a volume standpoint, we expect that to be accretive to the margin profile for those products. To your point, we have not yet really seen the benefits of the lab of the future transformation. You're talking about an overall program over a multi-year cycle that was almost $100 million in total investment that's largely complete now. It really is more in the next couple of years that we expect to realize the P&L benefits and operating benefits of that, which includes an increasing emphasis on automation and optimized workflows and so on. It creates, if nothing else, a margin cushion for us and margin upside opportunity within those product lines. Obviously, as we bring new products in that are part of the pipeline that are going to be such an exciting part of our revenue base in the years to come, during the initial ramp up, new products are typically going to be more dilutive to the margin profile. That increasing margin accretion from the core legacy product categories will position us well for an overall strong margin profile. You've kind of guided to expecting to hold around 69% at the midpoint of guidance for this year on gross margin. You talked a little bit about some of the upside leverage to that gross margin. In the near term, is it safe to say you feel pretty confident about being able to protect the margins where they are today, just given the slower growth that you're experiencing this year? Yeah. Overall, certainly in terms of kind of the underlying health of the portfolio and operating efficiency, we feel really good about the performance and the execution. There is a certain amount of variability in our margin profile that comes from how you are performing from an ASP standpoint because as your ASP moves up and down, then that really is moving at a 100% contribution margin. That can create in the shorter term some amount of variability, again, both upside or downside. That is not reflective of any kind of sustained change in the operating environment. We feel great about the overall outlook for margin profile and just the overall efficiency and execution of the team. Got it. Any questions from the audience at this point? Sure. Mic's coming. Basic, non-technical question. MRD testing, is that just a recurrence test or can that be used as ultimately be a screening for something for people that haven't yet been diagnosed with? It's a great question. I mean, first of all, there are a number of indications for MRD. Along with recurrence, I think an exciting opportunity is also for therapy de-escalation to even determine if going through a particular course of treatment will help or not, okay? To answer your question directly, what we found in the realm of science is that that same sensitivity that you use to detect the recurrence of cancer at a very early stage could potentially be used for other things, including potentially even in the selection of therapy like comprehensive genomic profiling is done. Some companies have also thought about the fundamental MRD assays being very similar to what could be used much earlier on in screening like MSET. That's not necessarily an area that we're interested in, but I'm just answering your question. The other question I have, again, non-technical, is when UnitedHealthcare says we do not want to pay for it, the investor says, the benefits are not obvious then or they are subject to debate. The company's been around for a long time now. Why have you not built a more comprehensive database to clearly demonstrate the utility of these hereditary tests? Yeah, it's a great question. Just to distinguish, whereas we have, I think, a very comprehensive set of clinical utility, clinical value, dossier, and supporting facts for all of our other tests, it has proven to be uniquely difficult for mental health. That is actually not based on hereditary. It's actually based on the body's ability to metabolize. It's a pharmacogenomic test. And though there are a number of papers related to clinical evidence, the most difficult aspect that we've had or anyone in this space, Myriad or otherwise, that we've been the clear leaders in mental health is the value, the health economic value of being able to reduce the time to selecting the right medication for a patient by three to six months versus, we're going to get there, but it's, okay, so what? You saved three months. We've just not been able to sufficiently compel UnitedHealthcare on that point. Just the last comment though, if there's compelling utility or obviousness to the rest of the portfolio, you kind of have to really share that with your investors because these tests are not going to go away if the clinicians truly believe in them. The only risk is other tests or competitive pricing dynamics, but where the stock is priced today suggests that there's more risk through the portfolio and less opportunity. I couldn't agree with you more and thank you for being here and pointing that out. I mean, that is what gives me a lot of conviction that given a series of things that have happened starting in November with UnitedHealthcare, in many ways, we have been devalued to the point of not even being one times or multiple of our revenue. As I said, these are attractive markets. We have leading positions in many of them. These are tests that are established and being reimbursed. They are growing markets where we have the right to win and grow on. You're absolutely right. We need to. Do you share the clinical benefits with your investors as to the economics behind these, why there's not going to be a commoditization on the reimbursement side and ongoing clinical utility cost benefit? Again, I used to be an investor in the company when Peter Meldrum ran, so this is years ago. I'm not that familiar right now. The risk was always you're a risk tool. It's always kind of vague as to the benefit. It was never clear and compelling what the values are. Now you have much more data. We do. We are well beyond just the hereditary risk part. I appreciate the input. Just as we kind of close here, you've got a couple of launches coming out. FirstGene, myRisk, expanded panel. One I want to talk about that showed some really good traction in Q1 was the Prequel, early gestational age. Has that kind of performance continued in the second quarter? Should we expect that to be a driver in the back half? Maybe talk a little bit about that test and sort of the differentiation that you have given that gestational age. Yeah. The key differentiation here is we are able to detect with high level of accuracy at the eight-week time point rather than 10 or 11 weeks as conventional in the market. That is important because eight weeks is the natural time point where a mother comes back to get a battery of tests, other clinical tests and blood draws anyway. That makes a difference. We found it to be not only of interest to providers, it has also opened doors for us to get back in and have something unique to talk about for new customers. Yeah, in short, Matt, it has seen good traction and interest. We think that will be one important part. Now we are going to have FirstGene, so we are going to have a series of opportunities to go in and have new conversations. The performance of the tests are undisputably among the best in the market. Awesome. We're out of time, unfortunately. Sam, Scott, thank you very much. Appreciate it. Appreciate it. Thank you, Matt.