About Quest Diagnostics

Quest Diagnostics Incorporated (Quest Diagnostics) provides diagnostic information services worldwide. Quest Diagnostics works across the healthcare ecosystem to create a healthier world, one life at a time. The company provides diagnostic insights from the results of its laboratory testing to empower people, physicians, and organizations to take action to improve health outcomes. Derived from one of the world's largest databases of de-identifiable clinical lab results, the company's diagnostic insights reveal new avenues to identify and treat disease, inspire healthy behaviors and improve healthcare management. In the right hands and with the right context, its diagnostic insights can inspire actions that transform lives and create a healthier world. The patients the company serves annually comprise approximately one-third of the adult population of the United States, and over a three-year period, it serves approximately one-half of the adult population in the United States. Strategy The company's growth strategy focuses on continually developing solutions to meet the evolving needs of its customers. The key elements of the company's strategy include collaborating with healthcare providers and partners to leverage its broad access; offering an industry-leading menu of testing and other services; leveraging its data assets and services to improve population health and enable value-based care; and continuously improving its quality and efficiency by leveraging the Quest Management System and by embracing innovative technologies, such as automation and artificial intelligence (AI). The company's growth strategy focuses on its primary customer channels - physicians, hospitals, patients and consumers - supported by Advanced Diagnostics (defined below), strategic acquisitions, and continuous quality improvement. Physicians The company serves approximately half the physicians in the United States each year. The company serves virtually all types of physicians from primary care physicians and internists to specialists, including rheumatologists, cardiologists, neurologists, and obstetricians/gynecologists. The company also serves physicians associated with accountable care organizations (ACOs), and Federally Qualified Health Centers (FQHCs). Hospitals The company serves approximately half the hospitals in the United States each year in many ways, including: Serving as a hospital lab's laboratory: In 2023, the company performed testing that hospitals do not perform in their own in-hospital labs. Helping Hospitals Operate their Labs More Efficiently: The company's key Professional Laboratory Services offerings include lab management outsourcing, test menu optimization and spend consolidation, supply chain management and providing, advanced data solutions. Acquiring Outreach Lab Operations from Hospitals: Quest looks for opportunities to acquire assets of outreach lab operations from hospitals whose in-house labs have expanded from supporting in-patients to supporting out-patients and ambulatory patients who see physicians affiliated with the hospital. The company also has joint venture arrangements with leading hospitals and health systems. These joint venture arrangements, which provide diagnostic information services for affiliated hospitals, as well as for unaffiliated clinicians and other local healthcare providers, serve as its principal facilities in their service areas. Typically, the company has either a majority ownership interest in, or day-to-day management responsibilities for, its joint venture relationships. Patients and Consumers The company has taken steps to be recognized as the consumer-friendly provider of choice of diagnostic information services. Patients increasingly expect their healthcare experiences to be consumer-centric, which includes being more transparent, accessible and convenient. Many of the company's 2,000 patient service centers are located inside large retail stores or in convenient retail settings across the United States. The company continues to enhance its operations to improve the patient experience in these locations. The company provides mobile phlebotomy services in many parts of the United States so patients who prefer an in-home blood draw may access services for a fee. The company is also making investments to improve the consumer digital experience, from locating a patient service center to receiving results on its MyQuest patient healthcare portal. The company is also building the patient payment process into the digital customer experience, which not only improves the patient experience, but also helps its patient concession rate and reduces demands on phlebotomists. In response to the growing consumer desire to be more directly involved in and have more control over their health outcomes, the company provides its QuestHealth.com platform to allow health-minded consumers to purchase testing directly from it without first having to make a doctor's appointment. Consumers who want to evaluate their health or monitor certain chronic conditions, such as diabetes or hepatitis, as well as those seeking privacy can use these self-directed options to identify and more frequently monitor health issues than their health plan or other payer may be willing to reimburse. A third-party physician reviews test orders and is available to consult with the consumer via a teleconsult about their test results. The company's QuestHealth offering reflects its belief that by building on the foundation of its strong consumer focus it can capture growing opportunities in consumer-initiated testing and demand for expanded access to basic healthcare services. The company also provides opportunities for companies with telehealth and retail business models to rebrand its testing and utilizes its patient service centers to provide access. Other Customer Channels The company's other customer channels include health plans, employers, emerging retail healthcare providers, government agencies, pharmaceutical companies and other commercial clinical laboratories. While it principally focuses on the U.S. market, the company serves customers globally and has a growing business that provides advanced reference testing to laboratory providers in other countries. Advanced Diagnostics The company supports the needs of all its customers with a focus on Advanced Diagnostics. Clinical laboratory testing can be characterized as routine, non-routine or advanced. Non-routine tests are tests that may require professional hands-on attention from highly-skilled technical personnel, generally require more sophisticated data analysis, technology, equipment or materials, may be performed less frequently than routine tests and may be reimbursed at higher levels than routine tests. Some non-routine tests are advanced (Advanced Diagnostics). Advanced Diagnostics includes certain procedures in the areas of molecular diagnostics (including next-generation sequencing), oncology, neurology, companion diagnostics and non-invasive pre-natal and other germline genetic testing. The company is a leading provider of Advanced Diagnostics. The company's investments in its Advanced Diagnostics offerings enhance its innovation capabilities and strengthen its service offering, making its Advanced Diagnostics offerings more attractive and accessible to physicians and hospitals. The company is also seeking to apply the capabilities gained by these efforts to support other areas where it can make a meaningful difference in healthcare, including offerings to pharmaceutical companies and consumers. The company provides an array of Advanced Diagnostics offerings across the spectrum, including in high growth areas such as Molecular Genomics and Oncology. The company has a portfolio of oncology tests that includes traditional oncology screening and anatomic pathology, such as cervical cancer and skin cancer screening and diagnosis. The company is also well positioned to take advantage of advances in next generation sequencing to grow its business in cancer and other disease state testing. This includes inherited genetics, newborn screening, and rare disease diagnosis, and solid tumor sequencing, such as to aid treatment selection and monitoring. The company is also particularly focused on the rapidly growing areas of monitoring recurrence and therapy effectiveness. In 2023, the company acquired Haystack Oncology, Inc. (Haystack Oncology) a cancer testing company that has developed a highly sensitive testing technology for detecting minimal-residual disease (MRD) by circulating tumor DNA due to residual or recurring cancer. Circulating tumor DNA (ctDNA) refers to tiny molecules of cancer shed by a solid tumor, such as colorectal or breast cancer, into the blood stream. In 2023, the company also launched its QUEST AD-DETECT test portfolio for assessing Alzheimer's disease risk using blood specimens, as opposed to testing by more costly or invasive methods, such as testing of cerebral spinal fluid by lumbar puncture. Acquisitions and Capital Deployment The company's strategy includes generating growth through value-creating, strategically aligned acquisitions using disciplined investment criteria. The company screens potential acquisitions using guidelines that assess strategic fit and financial considerations, including value creation, return on invested capital and impact on its earnings. In 2023, the company acquired Haystack Oncology, as well as certain assets of the laboratory services business of NewYork-Presbyterian, one of the nation's largest and most comprehensive academic medical centers. The company also completed its acquisition of select assets of Northern Light Laboratory, the outreach laboratory services business of Northern Light Health, a large integrated healthcare system in Maine. Business Operations The company is made up of two businesses: Diagnostic Information Services and Diagnostic Solutions. The company's Diagnostic Information Services business develops and delivers diagnostic information services, providing insights from the results of its laboratory testing to empower people, physicians, and organizations to take action to improve health outcomes. The company Diagnostic Solutions group includes its risk assessment services business, which offers solutions for insurers, and its healthcare IT businesses, which offers solutions for healthcare providers and payers. The company's services primarily are provided under the Quest Diagnostics brand, but it also provides services under other brands, including AmeriPath Dermpath Diagnostics, ExamOne, and Quanum. The company is a leading provider of diagnostic information services in the United States, where it conducts substantially all of its business. The company sees opportunities to bring its experience and expertise in diagnostic information services to markets outside the United States, including leveraging existing facilities to serve new markets. Diagnostic Information Services The company provides information and insights based on an industry-leading menu of routine, non-routine and advanced clinical testing and anatomic pathology testing, and other diagnostic information services. The company has strong testing capabilities, including services for the predisposition, diagnosis, treatment and monitoring of cancers and other diseases, and offers advanced tests in many fields, including endocrinology, immunology, neurology and oncology. Increasingly, the company focuses on providing solutions and insights to its customers, based on the testing that it performs, the data that it gathers and its extensive medical, information and connectivity assets. The company offers services, solutions and insights based on a full range of tests, information assets and other capabilities strengthens its market offering, market position and reputation. The company offers broad access to clinical testing through a nationwide network of laboratories, including advanced laboratories as well as rapid response laboratories (smaller facilities where it can quickly perform an abbreviated menu of routine tests for customers that require rapid turnaround times). The company operates 24 hours a day, 365 days a year. The company's nationwide network also includes patient service centers, phlebotomists in physician offices, and its connectivity resources, including call centers and mobile phlebotomists, nurses and other health and wellness professionals. The company's large in-house staff of medical and scientific experts, including medical directors, scientific directors, genetic counselors and board-certified geneticists, provide medical and scientific consultation to healthcare providers and patients regarding its tests and test results, and help them best utilize its services to improve outcomes and enhance satisfaction. The company also provides testing (including anatomic pathology) services and medical director services at hospital laboratories. The company is a leading provider of diagnostic information services for infectious disease, such as tuberculosis (e.g., T.SPOT.TB and Quantiferon offerings) and tick-borne disease (e.g., Accutix offering). The company strives to be the first to provide diagnostic solutions for emerging infectious diseases (e.g., its offerings for mpox virus). The company has comprehensive offerings in drug monitoring and toxicology, in neurology diagnostics, in advanced cardiovascular diagnostic information services (e.g., its CARDIO IQ and Cleveland HeartLab offerings through its Cardiometabolic Center of Excellence), and in cancer diagnostics. The company also provides workplace drug testing services, testing urine, hair, and oral fluid specimens, and is certified by the U.S. Department of Health and Human Services (HHS) to perform drug testing using electronic custody and control forms for federally-mandated, safety-sensitive workers. The company offers a wide range of employer population health services, including biometric screenings, flu shots and related preventative services that leverage clinical data to improve population health outcomes and reduce healthcare spend. The company's solutions enable employers to leverage screening insights to identify chronic disease risks, guide employees to needed in-network care, and improve employee health with intervention services. The company's offerings include connecting participants to the right care at the right time, such as a program designed to prevent diabetes and other chronic conditions, a program that enables participants to engage with a board-certified physician about their results and be guided to the right next action based on those results, a health coaching program to help individuals adopt healthier behaviors to improve health outcomes and a program to facilitate virtual telehealth access to clinical services for participants and adult dependents, with emphasis on reducing risks related to preventable chronic diseases. These services are sold directly to employers, through resellers and health plan partners. The company offers health IT solutions, including its products and national healthcare provider network, to help healthcare organizations and clinicians empower better health by leveraging the power of its significant information assets, including many years of test result data, and its technology prowess, including its history of providing leading IT for diagnostic information services. The company's portfolio of offerings is designed to address analytic, clinical and financial needs. The solutions help healthcare organizations and clinicians analyze and put in context data, and enables them to connect across the healthcare system and engage with their stakeholders. The company offers population health solutions to clinicians, health plans, and hospitals. The company's services build on the power of its information assets and data capabilities and helps its customers deliver better care to their patient populations by identifying gaps in care in a population, providing clinical solutions to close the gaps and fostering consumer engagement with a solution. For example, Quest Lab Stewardship employs machine learning to help clinicians optimize medically-appropriate laboratory test utilization. The company's extended care services (e.g., home collection kits for lab testing) help deliver better care to patient populations by identifying and filling gaps in care for patient populations and by enabling delivery of the most effective healthcare to the right populations and individuals. These services leverage the power of the company's assets (e.g., its extensive clinical data and data analytics services) and capabilities (e.g., call centers, patient service centers, mobile workforce) and focus on extending the reach of clinician offices beyond their traditional four walls to assess the health of their populations, and doing so when it is convenient for consumers. Once gaps are identified, the company engages patients in its retail sites, in home or by telephone, including through its call centers and its mobile capabilities, including highly trained healthcare professionals. In 2022, the company enhanced its extended care offering by acquiring Pack Health, LLC (Pack Health), which offers patient engagement services that help individuals adopt healthier behaviors to improve outcomes. The company offers services to pharmaceutical companies, including clinical trials testing, and have expertise in developing laboratory tests for the U.S. Food and Drug Administration (FDA) submission as companion diagnostics and laboratory developed tests (LDTs) for complementary diagnostics, and offer an array of assets and services to support the development of companion diagnostics, including its robust data set and patient services network. The company also offers Quest Clinical Trials Connect to help accelerate clinical trials (and thus the speed of drugs to market) through better patient recruitment, involvement and management, and improved physician outreach. The company also offers Pack Health's patient engagement services to its pharma clients. Diagnostic Solutions The company's risk assessment service, ExamOne is the largest provider of risk assessment services to the life insurance industry in North America and comprises underwriting support services, including data gathering, paramedical examinations and clinical laboratory testing and analytics, designed to assist life insurance companies objectively to evaluate the mortality risks of applicants. Most specimen collections and paramedical examinations are performed by the company's network of paramedical examiners at the applicant's home or workplace, but they also are offered at hundreds of its patient service centers and many additional locations. ExamOne also offers other national specimen collection and health data solutions that provide fast and accurate insights for clinical research and diagnostics programs, as well as academic studies. The company also offers its award-winning Quanum Enterprise Content Solutions for hospitals, to connect data to decision-making and help clinicians advance clinical and operational strategies. Healthcare organizations use Quanum Enterprise Content Solutions at approximately 745 sites in North America. Customer Channels The company provides diagnostic information services to a broad range of customers within its primary customer channels of physicians, hospitals, and patients and consumers. In many cases, the individual that orders the company's services is not responsible for paying for these services. Increasingly, patients are bearing greater responsibility for some portion of the payment for the services it provides to them, even if a third party is primarily responsible for payment. In addition, consumers are more frequently requesting and paying for tests themselves. The company provides a summary of its different customer channels. Health Plans, Government Agencies and Other Payers Most of the services the company performs are paid for by commercial payers, including large national health plans, managed care organizations and other health insurance providers, regional and local health plans and government payers, which includes Medicare and Medicaid. These customers typically reimburse the company as a contracted (or out-of-network) provider for services rendered to their members. In certain locations, health plans may delegate to Independent Physician Associations (IPAs) or other alternative delivery systems (e.g., physician organizations, ACOs, patient-centered medical homes) the ability to negotiate for diagnostic information services on behalf of certain members. Under capitated payment arrangements, the company provides services at a predetermined monthly reimbursement rate for each covered member, generally regardless of the number or cost of services provided by it. The company also provides services on a fee-for-service basis to federal, state and local governmental agencies. Historically, most Medicare and Medicaid beneficiaries were covered under the traditional Medicare and Medicaid programs administered by the federal government. The company also provides additional services to and in conjunction with government agencies across the United States. For example, in 2023, the company formed a novel collaboration with the CDC to research the disease burden of hepatitis C virus in the United States based on its laboratory testing. Sales and Marketing The company's Diagnostic Information Services business has a unified commercial organization focused on the sale of most of its services. It coordinates closely with the company's clinical franchises and marketing organization. The commercial organization is centrally led, and is organized regionally, in conjunction with its operations organization, to focus on local customer needs and to ensure aligned delivery for the company's customers. The company's commercial organization employs leading processes and tools and strong management discipline. The company provides industry-leading training and development, focus on opportunities with hospitals and specialty physicians, and foster a customer-focused, performance-driven culture. The company also maintains distinct sales and marketing organizations for its offerings in Diagnostic Solutions and its employer testing services. Regulations The company is subject to laws and regulations regarding protecting the security and privacy of certain healthcare and personal information, including the federal Health Insurance Portability and Accountability Act and the regulations thereunder, which establish a complex regulatory framework, including requirements for safeguarding protected health information; and comprehensive federal standards regarding the uses and disclosures of protected health information; state laws (e.g., California) and similar laws in other states; and laws outside the U.S., including the European Union's General Data Protection Regulation and similar laws in other jurisdictions. Competition The company's largest commercial clinical laboratory competitor is Laboratory Corporation of America Holdings, Inc. History Quest Diagnostics Incorporated was founded in 1967. The company was incorporated in Delaware in 1990.