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Quest Diagnostics Incorporated (DGX)

Q4 2015 Earnings Call· Thu, Jan 28, 2016

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Transcript

Operator

Operator

Welcome to the Quest Diagnostics Fourth Quarter and Full Year 2015 Conference Call. At this time, at the request of the company, this call is being recorded. The entire content of the call, including the presentation and question-and-answer session that will follow, are the copyrighted property of Quest Diagnostics with all rights reserved. Any redistribution, retransmission, or rebroadcast of this call in any form without the express written consent of Quest Diagnostics is strictly prohibited. Now, I'd like to introduce Dan Haemmerle, Executive Director of Investor Relations for Quest Diagnostics. Go ahead, please.

Dan Haemmerle - Executive Director-Investor Relations

Management

Thank you and good morning. I'm here with Steve Rusckowski, our President and Chief Executive Officer, and Mark Guinan, our Chief Financial Officer. During this call, we may make forward-looking statements and also discuss non-GAAP measures. Actual results may differ materially from those projected. Risks and uncertainties that may affect Quest Diagnostics' future results include, but are not limited to, those described in Quest Diagnostics' 2014 Annual Report on Form 10-K, quarterly reports on Form 10-Q, and current reports on Form 8-K. Our earnings press release is available and the text of our prepared remarks will be available later today in the Investor Relations Quarterly Updates section of our website at www.questdiagnostics.com. A PowerPoint presentation and spreadsheet with our results and supplemental analysis are also available on the website. Now, here's Steve Rusckowski. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Thanks, Dan, and thanks, everyone, for joining today. This morning I'll provide you with highlights of the quarter, share a few comments on industry dynamics and review progress on our five-point strategy. Then Mark will provide more detail on the results and take you through guidance. Well, we continued to make progress on our path forward, delivering a strong year and positioning ourselves very well for 2016. Before turning to the quarter, let me recap our performance for the year. Revenues grew by 2% on an equivalent basis. Adjusted operating income as a percentage of revenues expanded by about 110 basis points, and adjusted EPS, excluding amortization, grew by 6%. In the fourth quarter, revenues were $1.85 billion, growing by 60 basis points on an equivalent basis. Adjusted EPS, excluding amortization, was $1.19, and this represents our seventh consecutive quarter of year-on-year EPS growth. Before I get into our strategy update, I'd like to talk about our…

Dan Haemmerle - Executive Director-Investor Relations

Management

Operator?

Operator

Operator

Thank you. We will now open it up to questions. Our first question is from Ricky Goldwasser of Morgan Stanley. Your line is open. Ricky Goldwasser - Morgan Stanley & Co. LLC: (20:50) ...regarding the underlying assumptions on guidance, obviously you have upped your buyback allocation to over $1 billion. Can you just share with us what's kind of like your assumptions for capital deployment? Are you assuming any buybacks now and if so, kind of, like the magnitude? Mark J. Guinan - Chief Financial Officer & Senior Vice President: Yes. So Ricky, I thank you for the question; good morning. In the EPS guidance, it assumes a flat share count. So at this point, depending as we always talk about, the best value-creation opportunity between M&A and share buybacks, we may end up deploying more towards buybacks. We may end up reducing the share count. But at this point, EPS guidance assumes a flat share count. Ricky Goldwasser - Morgan Stanley & Co. LLC: And the topline assumes some capital deployment? Mark J. Guinan - Chief Financial Officer & Senior Vice President: Right. The topline at this point is built based on some organic growth, including the Barnabas Health deal, and then the only M&A that we have explicitly in there at this point is the Hartford Outreach acquisition. But obviously, we give a range, and so within that range there's various scenarios between organic and inorganic growth. Ricky Goldwasser - Morgan Stanley & Co. LLC: Okay. And can I have just one follow-up? Just when you think about kind of like the early hospital partnerships that you've signed – not this year but the year before and we think about it as case studies – what type of growth are you seeing from these kind of like early partnerships that we can think about as kind of like a framework for the new deals that you've signed recently? Stephen H. Rusckowski - President, Chief Executive Officer & Director: Well, we're building the business, Ricky, so with building any business this is part of our growth strategy, is to focus on these hospital partnerships, and we find the receptivity of hospital systems quite promising. And we've talked about in the past, we now have a number of deals that are already in our revenues in 2015. And we announced Barnabas in the fourth quarter, so that will start to show up in 2016. And again, these are growth rates of our organic revenues that Mark talked about. And then finally, as we have a nice robust funnel, more prospects in 2016. So we believe that this business will continue to build and contribute to our growth prospects for the company going forward. So that's the way we look at it. Ricky Goldwasser - Morgan Stanley & Co. LLC: Okay, thank you. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Okay. Thanks, Ricky.

Operator

Operator

Our next question is from Jack Meehan from Barclays. Your line is open. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Hey, Jack. Mark J. Guinan - Chief Financial Officer & Senior Vice President: Good morning, Jack.

Mitchell Petersen - Barclays Capital, Inc.

Analyst

Hey, thanks. This is actually Mitchell Petersen calling in for Jack this morning. Last quarter, I know you guys talked about utilization levels and how they are little bit weaker in 3Q, but trending positively. I was wondering if you could call out the trends you've been seeing on utilization per customer throughout the quarter. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Yeah, sure. We've talked about it in the past. We do this test where we take a look at our known accounts that are our accounts; we have about 1,000. We look at year-on-year comparison. We did that in Q3 and we said that volumes picked up at the end of the quarter. And we've done that again in Q4, and what we'll say at this time is when we look at that it's feeling like Q4 was stable with the prior year. No notable change in that and that's the best insight we have around utilization in the market that we serve.

Mitchell Petersen - Barclays Capital, Inc.

Analyst

Great. Thanks. And then just one more quick one. So obviously, PAMA coming out and then the margin impacts from the esoteric mix shifts. Are there any other noticeable pricing trends that you're seeing in the market? Stephen H. Rusckowski - President, Chief Executive Officer & Director: Mark, you want to...? Mark J. Guinan - Chief Financial Officer & Senior Vice President: No trends per se. I mean, obviously, there's mix we talk about, and that includes test mix; it also includes payer mix. So we have mentioned previously that we have seen some growth in our Medicaid volumes, probably most likely in response to the Affordable Care Act, but also a reduction in our uninsured mix as well. So, some of that was more pronounced several quarters ago. I wouldn't say recently any other thing of note. And as I shared at the Investor Day, we expected 2016 to be more like – and then 2017 as well – to be more like 2014. You've seen the results for the past year. You can see that there was some pricing pressure. It was fairly tame, certainly compared to several years ago. And even with PAMA, we're still confident that through 2017, there's not going to be anything noteworthy, and as we said, it should be consistent with the last couple years.

Mitchell Petersen - Barclays Capital, Inc.

Analyst

Great. Thank you.

Operator

Operator

Thank you. Our next question is from Lisa Gill from JPMorgan. Your line is open.

Lisa Christine Gill - JPMorgan Securities LLC

Analyst

Thank you. Mark J. Guinan - Chief Financial Officer & Senior Vice President: Hey, Lisa. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Good morning.

Lisa Christine Gill - JPMorgan Securities LLC

Analyst

Good morning. I was wondering if you could maybe just give us an update. You talked a little bit about the Quintiles' JV Q2. But Mark, can you tell us what you have built into the guidance for 2016 for that? And then maybe, Steve, if you can spend a minute, have you been successful in signing some new deals under the new relationship? Stephen H. Rusckowski - President, Chief Executive Officer & Director: Sure. Mark J. Guinan - Chief Financial Officer & Senior Vice President: Yeah, sure. So Lisa, to answer your question directly, I'm sure you recognize, nothing on the revenue line since we can't consolidate. On the earnings line, certainly as we discussed, we expected to deliver some significant synergies this year in 2016, and I have that built into our guidance. We don't break that out specifically. It's not large enough or substantive enough to provide specific detail. But that is considered, and we are pleased and looking forward to having more earnings in 2016 than we did in 2015 from clinical trials, and then also having more than we think we would've had had we kept that business as standalone Quest. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Great. And Lisa, to your point about the business prospects, actually I was down there earlier this week with Quintiles' management team. As you know, we started this joint venture Q2 Solutions in the second half. We're very pleased with the integration that's gone on so far. We've built a nice management team. We now have a good integration plan. We feel good about the cadence. And in parallel with the integration, we feel good about the prospects that we're seeing in our funnel and the business that we've retained. We're not going to comment specifically any new business, but we're encouraged about the beginning of the joint venture and the working relationships between both companies – and between both of us, ourselves and Quintiles – we'll give you more color as it evolves, but so far so good.

Lisa Christine Gill - JPMorgan Securities LLC

Analyst

Is there any way to quantify any of that? The size of the funnel or – I know that you said it's bigger than what you thought previously on your own. But just as we think about that as being a future opportunity for your business, is it something that could be a key driver over time? Or you just think this is something that's a smaller, incremental driver to your business? Mark J. Guinan - Chief Financial Officer & Senior Vice President: I just want to refresh everyone's memory. It was 2% of our overall revenues. What we shared at that point was that its operating margin was fairly representative of the overall enterprise, so nothing materially higher or lower. So therefore, you can kind of frame about what the contribution was, and we expect significantly larger growth on that than we could have done ourselves, but still off a 2% base. So, we're pleased with it and certainly every couple pennies is nice to have, but it's not going to be a game-changer overall. But as Steve said, relative to the expectations going into the partnership, we're very pleased with the first six months and looking forward to 2016. Stephen H. Rusckowski - President, Chief Executive Officer & Director: And since we don't consolidate revenues, we're going to see it back in our earnings growth. And a lot of that earnings growth will come from the cost synergies that's implied in – or a portion of it's implied in our guidance.

Lisa Christine Gill - JPMorgan Securities LLC

Analyst

Okay, that's helpful. Thank you. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Okay. Thanks.

Operator

Operator

Thank you. Our next question is from Brian Tanquilut from Jefferies. Your line is open. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Good morning Brian.

Jason Michael Plagman - Jefferies LLC

Analyst

Hey, guys. This is Jason Plagman on for Brian. Morning. A question on the Barnabas partnership and the hospital management segment in general. How should we think about the margin profile for that segment, both over the next year or two and then how you're thinking about it longer term? Stephen H. Rusckowski - President, Chief Executive Officer & Director: Well, the way we look at this is we believe the market is continuing to look for partnerships. I said this in my opening comments. Hospitals are looking for partners like us to help them with their lab strategy. A piece of this is helping them run their hospital business, but also think about how we could partner with them in their more sophisticated testing – what we refer to as reference work. And so, then when we engage with clients or customers like Barnabas, we expect that we're going to start working with them and we're going to start to – continue to build their book of business with us. As far as margins, what we'll say is this. We're driving growth in this company and we're driving better ROIC. And included in our guidance around growth and included in our guidance around earnings growth, we do expect that our build of our professional lab services business will be accretive to our plan going forward. Mark J. Guinan - Chief Financial Officer & Senior Vice President: And I'll just add that – I have shared in the past – these professional laboratory services agreement come with a couple of different components, as Steve just laid out. Certainly the reference piece, those margins would be similar to our other reference business relationships. And then, in some of these cases there is partnership involving Outreach as well. On the PLS piece…

Jason Michael Plagman - Jefferies LLC

Analyst

Great. Thanks for the insight. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Thanks.

Operator

Operator

Thank you. Our next question is from A.J. Rice from UBS. Your line is open. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Hey, A.J.

A.J. Rice - UBS Securities LLC

Analyst

Hi, thanks. Just initially, I'm trying – this is sort of a bigger-picture question. So the revenue guidance looks for 1.5% to 2.5% growth, and I'm just trying to think through the puts and takes and how they relate to the underlying assumptions. Obviously, you've got the headwind of the half year, so the revenues that were contributed in the Quintiles JV. Alternatively, you're anniversarying at this point some lost or exited contracts that sort of impaired growth last year, as well as you've got the St. Barnabas deal ramping up. So I'm trying to get to what do you really think the underlying trends are in terms of pricing, volume, and sort of an apples-to-apples revenue comparison? Any comments on that would be helpful. Mark J. Guinan - Chief Financial Officer & Senior Vice President: Sure. First off, A.J. – and thank you for the question – the 1.5% to 2.5% is on what we call an equivalent basis. So that does not include the headwinds from clinical trials. So this is excluding that. So the businesses that we continue to have or will be adding, such as the Hartford acquisition or new partnerships like Barnabas, are included in that. But that excludes the impact of the $85 million in the first half. So as we look at it, we talked about the price; and we expect price in 2016 to have some modest headwinds. And then mix, obviously, we didn't get to that specifically, but we wouldn't expect a materially different trend than what you saw through 2015. So we continue to grow our esoteric business; so we mentioned 5% growth in Q4. We continue to focus on our most profitable business opportunities. We have cleaned up our portfolio, which certainly you're seeing some of that benefit in terms of our customers. And as we engage with new customers, we're very focused on making sure that we get the value that we deliver through our pricing. So that's really the overall commentary. I would say the 1.5% to 2.5% is a combination of organic growth and we've had five straight quarters of revenue. We mentioned we had some volume, organic growth in this quarter, and an improving trend throughout 2016.

A.J. Rice - UBS Securities LLC

Analyst

Okay, that's great. And then, maybe just following up on Steve's comment around the LDT question and the FDA. It seems like there's two dynamics going on. The Congress is sort of working with the industry to try to come up with some parameters around what might happen there, and then you occasionally have these salvos out of the FDA suggesting that they may move ahead with guidance around it. Can you give us any flavor? I mean, is there any dialogue with the FDA? Do you get any sense of whether they're going to stand down and let Congress move forward, or are they – do you have any sense of what they're doing? Stephen H. Rusckowski - President, Chief Executive Officer & Director: Yes. So, thanks, A.J. First of all, as you know, our position as an industry is the FDA does not have statutory authority to regulate laboratories. We're in the business of medicine and applying a device (35:00) regulation to our industry doesn't make sense. And it's duplicative with what we already have with CLIA. So that remains our position. Now with all that said, as an industry we also believe that the legislative action or process is the best solution to this and we're encouraged with what's been proposed from Congress as a good start. So we're engaging with Congress on their proposed legislation. We're doing this with other stakeholders. And as far as the FDA involvement in this, I trust Congress and their team, and also with the work in our trade association. We have engaged with the FDA as well to see if we can come up with a reasonable solution of what they are trying to accomplish, while at the same time address the issues we're concerned about. So we are working. We think the legislative action is the best action for us, and that would be much better than the current guidance that we've seen so far from the FDA.

A.J. Rice - UBS Securities LLC

Analyst

Okay. Thanks a lot. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Thanks.

Operator

Operator

Thank you. Our next question is from Nick Jansen from Raymond James. Your line is open. Nicholas M. Jansen - Raymond James & Associates, Inc.: Hi, nice job on the quarter with the organic volumes, but a couple questions. First on the SG&A trend, it did look like your SG&A dollars grew faster on maybe an equivalent basis. Maybe it's probably because last year's number wasn't restated. But just want to get a better sense of what you're viewing as core SG&A growth, and how we should be thinking about 2016 in context of the accelerating benefit from Invigorate 2.0. Mark J. Guinan - Chief Financial Officer & Senior Vice President: Yes, thanks, Nick. I'm sure as you can appreciate SG&A will bounce around quarter to quarter, depending on the timing of certain investments and other things that impact that overall expense. There is certainly not a trend to be read from that. You can see for the year we drove not only improvement in gross margin but leverage of our SG&A. You would expect we need to continue that in order to drive the leverage that we're implying for our guidance in 2016, and certainly the leverage we were implying through the outlook that I provided at the Investor Day in 2014. So, some of Invigorate is on the cost of sales line; some of it is on the SG&A line and you should not expect us to deleverage our SG&A going forward. Nicholas M. Jansen - Raymond James & Associates, Inc.: Okay. and then secondly, I think you mentioned a bad debt benefit in the quarter. Just wanted to know if you could potentially quantify that and think about what drove the improvement from that benefit. Thanks. Mark J. Guinan - Chief Financial Officer & Senior Vice President: Yes. So what I would say is the bad debt continues to be fairly stable. Mix, as we mentioned, mix is going against us: as we get a larger proportion of our revenues from patients, the bad debt rate on that is significantly, on an order of magnitude, higher than it is from the payers, whether it's commercial payers or the government. So that's something we have to offset. And through some of the good Invigorate work we've been doing, we've held that at bay and held it pretty stable. So that's what I would say is, without that one-time benefit, you should have expected to see some stability in our bad debt.

Dan Haemmerle - Executive Director-Investor Relations

Management

Operator?

Operator

Operator

Thank you. Our next question is from Bill Quirk from Piper Jaffray. Your line is open. William R. Quirk - Piper Jaffray & Co (Broker): Great. Thanks and good morning, everybody. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Hey Bill. Good morning. William R. Quirk - Piper Jaffray & Co (Broker): I guess going back to FDA as well as PAMA, Steve, what are you guys thinking in terms of the final documents coming out? I guess we've been hearing probably 1Q for PAMA and 2Q for FDA. I'm just curious if those are consistent with your expectations. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Yes. So first of all, let me start with PAMA. So, we've been engaged with CMS on this all last year, once we received their draft document. Two things, as I said in my introductory comments, we believe they did not get it right as far as the applicable labs; it needs to include hospitals. We've been quite clear on that and we've got a lot of support now from American Medical Association, American Hospital Association, and Congress to help us with that. So we've made that loud and clear. And then second is the timing. We think the ability for us to get the final guidance out this year, for us to submit the data, and then also for them to go through that data to refresh the clinical lab fee schedule by 2017 is a very, very tight timetable, as you can imagine. So those are the two big issues that we've highlighted. We're hopeful that we'll see something in the first half of 2016. They never commit to what the date is, but we're hopeful that we'll see something after they've digested everything we've provided to…

Operator

Operator

Thank you. Our next question is from Isaac Ro from Goldman Sachs. Your line is open. Joel Harrison Kaufman - Goldman Sachs & Co.: Hi, guys. Thanks. It's actually Joel in for Isaac. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Hi, Joel. Joel Harrison Kaufman - Goldman Sachs & Co.: You guys touched a little bit on the companion diagnostics market in the prepared remarks. Could you maybe help us think about how you intend to win share in that market? It appears that market's increasingly becoming a more commoditized end market? Stephen H. Rusckowski - President, Chief Executive Officer & Director: Yes, sure. It's a promising market. If you go back and look at our platforms for growth, companion diagnostics, and sometimes it's connected with precision medicine. It is an important part of our growth strategy. Several things – one is that we continue to work with the market-leading research organizations. About two years ago, we announced a relationship with Memorial Sloan-Kettering; we're actually taking their research and we are now marketing a product we call OncoVantage, with 34 actionable genes. And we're actually going to expand that panel this year as well with their help. So this is right in the middle of precision medicine, and clearly, we're providing the companion diagnostics associated with that. Second is, we're engaging with pharma. We announced the work this past quarter that we were doing. I talked about in my introductory remarks our recent announcement around melanoma. We continue to be highly engaged with all the pharma companies that have many companion diagnostics associated with their development funnels. So we're very well positioned in that regard. We do work now closely with Quintiles of getting an even better view in the marketplace and better access point for a…

Operator

Operator

Thank you. Our next question is from Elizabeth Blake from Bank of America Merrill Lynch. Your line is open.

Elizabeth Mary Blake - Bank of America Merrill Lynch

Analyst

Hi, good morning and thanks for taking my question. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Hey, Elizabeth,

Elizabeth Mary Blake - Bank of America Merrill Lynch

Analyst

Hi. You touched on your Data Diagnostics partnership with Inovalon that you launched in the quarter. Could you provide some color around your plans for reimbursement there? I mean, have you been in discussions with health plans? I guess, how would you characterize the interest you're getting from a payer perspective? Stephen H. Rusckowski - President, Chief Executive Officer & Director: We said in our comments that we're quite encouraged. We're offering a lot of value. Typically, the payment is through payers or the risk-taking organization, so it could be an ACO; those people that are managing the population and have the financial incentive to provide this information to the physicians that are treating and managing patients' lives. So, in that regard, we've been off and running since the fourth quarter. Momentum is building. We've worked through the integration. The nice part about this is we're providing this capability in the normal workflow of a physician. We have tremendous, tremendous capabilities at the desktop of a physician with our order entry results reporting system which we call Care360. And so when they're in the order entry system, if in fact they want the visibility to this information that we're getting from Inovalon, they can easily access that information. And the payment model is back to, again, typically the risk-taking entity whoever that might be, the payer or in the case of an entity that's taking risk like an ACO. So, we're working both physicians' awareness of this capability along with payer awareness of this. And we're very encouraged about the prospects.

Elizabeth Mary Blake - Bank of America Merrill Lynch

Analyst

Okay, great. Thank you very much.

Operator

Operator

Thank you. Our next question is from Donald Hooker from KeyBanc. Your line is open.

Donald H. Hooker - KeyBanc Capital Markets, Inc.

Analyst

Great, good morning. So my question will be simple because it's a follow-up on the last question. So, I'm also interested in this Data Diagnostics relationship you have with Inovalon and appreciate the color. And looking ahead, how long do you think – if you were to guess – in terms of how long do you think this relationship would take to ramp to sort of a mature level, I guess, over to a point where, I guess, theoretically it could potentially start impacting and showing up in numbers? I guess, in other words, how long are the sales cycles? Stephen H. Rusckowski - President, Chief Executive Officer & Director: Yes. Well, first of all, we started in the fourth quarter. We announced this deal in October. We've already signed some business; I mentioned that in our remarks that we signed some business. We're starting to – we'll start to see some flow in the first quarter and it will continue to build just like building any business. So it's implied in our guidance. We do expect some growth from this business in 2016 and that business will grow into the future.

Donald H. Hooker - KeyBanc Capital Markets, Inc.

Analyst

And then, what is your dedicated sales force to this product? Stephen H. Rusckowski - President, Chief Executive Officer & Director: Well, as you can imagine, you're selling to payers. So we have a hospital – excuse me – we have a health system team that calls on and manages our health insurance relationships. So, there's a portion of the sale that happens there. Second, is we have a health systems sales organization that calls on integrated delivery systems, and as I mentioned, some of those integrated delivery systems are taking risk and have ACOs, so we call there. Third, is we're equipping our physician sales force that goes in and talks to primary care physicians and all physicians, including our specialist physician sales forces. And so, we're training our sales force there and we have over 1,200 people in our sales organization. And this is complementary to what Inovalon already does in calling on the health insurance organizations as well.

Donald H. Hooker - KeyBanc Capital Markets, Inc.

Analyst

Got you, Thank you. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Thanks.

Operator

Operator

Thank you. Our next question is from Bill Bonello from Craig-Hallum. Your line is open. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Hey good morning, Bill.

William Bishop Bonello - Craig-Hallum Capital Group LLC

Analyst

Good morning. I just have a couple of questions about the guidance. So, Mark, you talked about that you felt after puts and takes and adjustments, you were pretty much in line with your long-term guidance range for what you delivered in 2015. If I look at the 2016 EPS guidance, at the middle of the range it's sort of 7%, which I think is still below your long-term EPS guidance range. So I'm just trying to reconcile why that would be and when you might expect to be in that 8% to 10% range? And then I have a follow-up. Mark J. Guinan - Chief Financial Officer & Senior Vice President: Yes, thanks, Bill. So, I appreciate the question. Obviously, we're going to provide guidance that we think is prudent and deliverable. We have provided a range. That range certainly includes some numbers that would put us into that 8% to 10%. I want to refresh people's memory that the 8% to 10% was a compound annual growth rate over three years, so it was not a commitment to do that every single year. And also in my prepared remarks, I reminded people that at that point we were obviously looking at a 2014 number that was a nickel lower than we actually delivered in 2014. And I certainly did not anticipate a reduction in our amortization, which was really driven by the fact that we did not have as much significant M&A activity in 2015. So, we feel in terms of what we committed to that we're on track. We're not behind. Certainly, depending on where we end 2016 within that guidance, we'll either be a little bit slightly below the CAGR or right in the CAGR. So really, what we want to do is provide guidance that we feel is prudent and deliverable, and as we progress through the year, obviously, we'll see where we might end up within that range. But we certainly don't think the guidance implies, given the framing I shared on 2015, that we're materially off of that 8% to 10%.

William Bishop Bonello - Craig-Hallum Capital Group LLC

Analyst

Okay. And then just as a follow-up to that, wouldn't it be logical to think that the growth comp – assuming PAMA doesn't get postponed – that the growth comp would actually be a little bit more difficult in 2017 than it is in 2016? Or are there things about either this year or next year that would offset that Medicare cut? Mark J. Guinan - Chief Financial Officer & Senior Vice President: Yes, so Bill, I talked about three levers that would enable us to grow earnings significantly faster than revenue. One of them was the synergies that would be continued to be delivered to their kind of steady-state from acquisitions we had done early in 2014. So you would imagine that probably a lot of that has been delivered. The second piece has been our Invigorate, and it being large enough to offset price and wage inflation, and deliver some margin expansion. And then the third element is the leverage we get from organic growth. And so, we committed to improving our relative performance. As Steve talked about, minus 4% in 2013, then minus 2% in 2014, and then some revenue growth the last five quarters. And certainly, since there's not as much M&A in our guidance this year as there was in the 2% we got last year, which benefited from some carryover on Solstas, we're implying continued strengthening of our organic performance. And as you know, organic volume growth has a high drop-through, and as we get closer and closer to market rates, which we had committed we would do through the three-year timeframe, that's going to also enable us to lever our P&L. So you should expect accelerating organic growth, which will be a driver, and then continued to progress to get to the $1.3 billion of Invigorate, which will also accelerate our earnings leverage.

William Bishop Bonello - Craig-Hallum Capital Group LLC

Analyst

That's really helpful. And then, just one last thing. Is there any way you can tell us what clinical trials contributed to operating income in Q4 of last year on an annualized basis? Just so we have an apples-to-apples comp on the operating income as well as the revenue? Mark J. Guinan - Chief Financial Officer & Senior Vice President: We never broke it down by quarter, Bill. So the best I'm willing to do, which I've said in the past, is that it was about 2% of our revenue and its margin was comparable. So, you can kind of frame what that would've contributed in Q4.

William Bishop Bonello - Craig-Hallum Capital Group LLC

Analyst

Okay. Thank you so much.

Operator

Operator

Thank you. Our next question is from Amanda Murphy from William Blair. Your line is open. Amanda L. Murphy - William Blair & Co. LLC: Hi, good morning, guys. I just had a follow-up actually to one of the points you just made in terms of volume growth. So, what is, would you say, is the market growth at this point? I'm just curious what you're seeing in terms of just base utilization. Obviously, there's been some discussion around the ACA and what impact that has had. So, just curious if you can provide more detail on utilization rates this year and then going into next year as well? Stephen H. Rusckowski - President, Chief Executive Officer & Director: Yes, well, I'll start and then I'm sure Mark will add something to it. First of all, we continue to build our own market model. In 2014 when we had our Investor Day, we ran our model with a number of assumptions. And we say that the independent laboratory market's going to grow about 2% to 3% in value; and 2% to 3% in value has, as you know, a lot of moving parts. We also made some assumptions about the ACA impact. We've always assumed that as we have more insured lives in the United States that that would be net positive for this industry, net positive for us. But we all know that has been muted. There's some question about what will happen in 2016 around some of those lives. And then also, we assume in that, our advancement of technology. We're continuing to roll out new innovation to the marketplace, which helps with the growth rate assumptions and that was implied in the 2%, 3%. The aging population, for instance, Hepatitis C is a good opportunity for us,…

Dan Haemmerle - Executive Director-Investor Relations

Management

Yes, sure. Amanda, we've seen growth in a number of different categories but certainly saw during the course of the year growth in our BRCA testing; in our non-invasive prenatal testing solution; within infectious disease with HCV and HIV. So, seeing growth in a number of different areas. Stephen H. Rusckowski - President, Chief Executive Officer & Director: So we feel good about that $1.8 billion business growing 5% and we think the prospects continue to be good going forward. Amanda L. Murphy - William Blair & Co. LLC: Got it. Thanks very much. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Thanks.

Operator

Operator

Thank you. Our last question is from Michael Cherny from Evercore ISI. Your line is open. Michael Cherny - International Strategy & Investment Group LLC: Good morning, guys. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Hey, Michael. Michael Cherny - International Strategy & Investment Group LLC: So I actually want to dig a little bit more into Amanda's question. You gave us a nice breakdown in a follow-up related to the way you look at the market here, low single digits growth in terms of the market. Obviously, it's been a while for a number of factors since you guys have been able to deliver that growth on an underlying basis. As we think about both this year as well as the next few – and I know there are moving pieces, so this is a bit of a loaded question. But is thinking about sub-1% organic volume growth or 1%-ish, or somewhere in that range, the new normal that we should think about relative to your business? And if it is or whatever that number is, what does that mean in terms of the incremental drop-down that you would expect relative to historical levels on the volume side? Mark J. Guinan - Chief Financial Officer & Senior Vice President: Yes, so obviously we're not going to project our volume beyond this year, Michael. I'm sure you can appreciate that. What we did commit to was getting back to market levels of revenue growth and also then gaining share at some point. But in the three-year timeframe through 2017, we felt it was incumbent upon us to get back to market-level growth and that's what we're certainly striving to do. I think, as everyone recognizes, we talk about utilization in a market that's really a bunch of…

Dan Haemmerle - Executive Director-Investor Relations

Management

And Michael, just to follow-up on that a little bit. Keep in mind, we talk about revenue a lot because what shows up as volume versus growth in our esoteric business sometimes falls into the mix category. So revenue per requisition, this year we felt some pressure but we were able to offset that for the last several quarters, more than offset that with favorable test mix that's coming through the gene-based and esoteric. So, I think Steve also mentioned that we're seeing more tests on requisitions as well, so the requisition volume counts don't necessarily get the credit, but you see the credit overall in the revenue line for some of that benefit and some of that strategy. Michael Cherny - International Strategy & Investment Group LLC: No, I appreciate that, guys. If I could squeeze in one more quick one, any updated thoughts related to some of the technological developments, or maybe lack thereof, related to some of the point-of-care testing and particularly some of the microfluidics-linked point-of-care testing? Obviously, there's been a lot of news around a certain upstart that seems to have hit a bit of a wall. So anything related to how that market is evolving; if you see any other technologies that at some point make sense to be suppliers, particularly into the patient service centers? Stephen H. Rusckowski - President, Chief Executive Officer & Director: Yeah, so thanks, Mike, for your question. First of all, point-of-care diagnostics has been around for decades. I've been around for decades, invested in it, and know the market well. Where it has been successful is where there has been a good value proposition that has delivered something to the marketplace. So, chronic disease management, diabetes, it's done well. If you look at critical care in hospitals, if…

Operator

Operator

Thank you. At this time we have no further questions. Stephen H. Rusckowski - President, Chief Executive Officer & Director: Great. Well, thanks, everyone, for all the questions and thanks for joining us on the call today. Just to conclude we had another solid quarter and finished the year strong. We appreciate your support, and have a great day. Take care.

Operator

Operator

Thank you for participating in the Quest Diagnostics fourth-quarter 2015 conference call. A transcript of prepared remarks on this call will be posted later today on Quest Diagnostics' website at www.questdiagnostics.com. A replay of the call may be accessed online at www.questdiagnostics.com/investor, or by phone at 888-568-0748 for domestic callers, or 203-369-3927 for international callers. Telephone replays will be available from 10:30 a.m. Eastern Time today until midnight Eastern Time on February 27, 2016. Goodbye.