David P. King
Analyst · Bank of America
Thank you, Brad. We are pleased with our fourth quarter results. During the quarter, we grew volume 5% on organic volume by approximately 2% and we continue to execute well on our key growth initiatives. Although our nominal revenue per requisition was down 2.6% year-over-year, managed care revenue per requisition increased year-over-year and was flat versus last quarter. The drag on year-over-year revenue per requisition was due to government reimbursement reductions, molecular pathology payment issues and test mix. We repurchased $251.6 million of our shares, demonstrating our commitment to our stated capital allocation objective to return capital to shareholders. We are also pleased with our full year 2013 results, particularly when we take into account the significant government payment reductions and the unexpected reimbursement issues related to new molecular pathology codes that we faced through the year. As a reminder, our reported results for the year were negatively impacted by Medicare payment reductions and molecular pathology payment issues that lowered revenue by approximately $100 million and adjusted EPS, excluding amortization, by $0.68. Finally, during 2013, we repurchased approximately $1 billion of our stock representing 10.4 million shares. I would now like to update our progress on each aspect of our five-pillar strategy. The first pillar of our strategy is that we deploy capital to investments that enhance our business and return capital to shareholders. I have just reviewed our share repurchase activity during the fourth quarter and the year. Our share repurchase to date brings us closer to our target leverage ratio of 2.5x debt to EBITDA. In addition, our acquisition pipeline remains attractive and we believe that components of health care reform will drive consolidation in our industry. Thus, acquisition should provide an attractive way to expand our test menu and geographic footprint for the next several years. We will maintain a disciplined approach to valuation as we look for the best strategic opportunities. The second pillar of our strategy is to enhance our IT capabilities to improve the physician and patient experience. We continue to enhance our Beacon analytics platform for managing practice and population health data as we add new clients and plans to the platform. This platform helps clients unify the multiple components of population health management, providing primary care physicians with complete access to their patients' health care picture, rules for monitoring gaps and care and reporting that addresses more than 600 quality measures. Beacon Analytics helps providers reduce expenses, improve outcomes and enhance patient satisfaction. The robust rules engine is highly-customizable and provides compliance with meaningful use requirements, as well as ACO, Joint Commission on accreditation of health care organizations, and physician quality reporting system reporting requirements. These industry-leading data-driven services position LabCorp as a trusted partner to health care stakeholders, providing knowledge to optimize decision-making, improve health outcomes and reduce treatment costs. We also continue to improve our tools to assist physicians and patients in understanding test results and optimizing decision-making. We introduced a new report format for Pap results, which provides a result history chart and improves clarity of results delivery. In addition, we now have more than 400,000 registrations on our patient portal and this figure continues to grow every day. Looking ahead, we will expand the conditions covered by our comprehensive clinical reports that integrate and track test results for at-risk patients. We will continue help customers analyze their population health and clinical practice data with new tools for hospitals, physician practices and ACOs, supplemented with insights derived from our extensive patient database. We are working with clients to use our data to benchmark ordering patterns and to determine preclinical markers in specific diseases. Insights gained from these efforts help payors and physicians better manage health care expenses and patient outcomes. The third pillar of our strategy is to continue to improve efficiency to offer the most compelling value in laboratory services. The second installation of our Propel robot is underway at our major laboratory in Tampa. Propel has begun to drive expense reductions, increase throughput and accuracy and enhance specimen management at our Burlington lab. We continue to consolidate facilities into our new Phoenix campus and we are now processing more than 23,000 specimens per day at this state-of-the-art facility. We have continued the installation of our new automated chemistry platform and upgrades have now been completed in our Burlington, Phoenix, San Diego and Seattle labs. Our Raritan, New Jersey lab will be converted later this quarter. These instruments, enabled by advanced software systems, are expected to increase testing throughput and reduce labor and supply expenses. Finally, as part of our ongoing commitment to efficiency, we have begun a comprehensive enterprise-wide review of our cost structure. The fourth pillar of our strategy is to continue scientific innovation at reasonable and appropriate pricing. We introduced new tests and collaborate with leading companies and academic institutions to provide our physicians and patients with the most scientifically-advanced testing in our industry. We launched 152 new tests in 2013, many of which we expect to drive growth in our genomic and oncology testing businesses. This reflects our commitment to offer products and services on the cutting-edge of science, as well as our strategy to develop real revenue growth opportunities. One such growth opportunity relates to our recent entry into the sizable bracket testing market, which is composed of a suite of test for the assessment of breast cancer risk that the payor community values and reimburses. Our bracket test menu now includes a comprehensive panel of BRCA 1 and 2 complete gene sequence analysis and deletion duplication testing, targeted analysis test for other family members once a mutation is identified and a panel for mutations prevalent among the Ashkenazi Jewish population. Our BRCA testing capabilities and services give physicians and patients powerful tools to better comprehend and predict breast cancer risk. In combination with our care coordination pre-authorization service, LabCorp offers an end-to-end program that includes compliance with insurance requirements, comprehensive testing and expert interpretation from our license directors and a team of 122 Board-certified genetic counselors and 9 medical geneticists. We expanded our next-generation sequencing test menu by launching our first multi-gene oncology panel. The intelligent assay provides an assessment of targetable mutations with a panel profile of 50 cancer genes known to be involved in the development, progression and treatment of cancers. IntelliGEN will be useful tool to multiple clinical settings, including when guideline-recommended biomarker evaluations yield no targeted therapeutic option, when relapse or disease progression occurs or when a tumor is poorly differentiated and have a uncertain origin. We continue to expand our oncology offerings to enhance our women's health initiatives. We recently lost the Prosigna Breast Cancer Prognostic Gene Signature Assay, an FDA-cleared assay developed by NanoString Technologies, Inc. This test enters a large existing market and is routinely by the payor community. Studies showed that Prosigna is able to better categorize high-risk patients, providing more prognostic clarity than other predictive breast cancer assays. The fifth pillar of our strategy is the development of knowledge services. LabCorp recently performed a comprehensive retrospective study involving over 55,000 patients comparing the treatment of patients enrolled in our innovative chronic kidney disease management program with those patients diagnosed with CKD who were not in the program. The study showed that patients who were enrolled in LabCorp's CKD program showed an approximate 10 percentage points increase in compliance with guideline-recommended testing, meaning that their physicians were more closely monitoring their disease state and progression. The study concluded that the use of a laboratory-based point-of-care CKD clinical decision support program is associated with increased compliance with guideline-recommended disease monitoring, particularly among primary care physicians. LabCorp leads the industry in the development of decision-support tools for kidney stones, CKD and coagulation, as well as for cardiovascular risk assessment. These tools are an important differentiator and we will continue to develop them and integrate them into the fifth pillar of our strategy. We have also begun work with United Healthcare to implement BeaconLBS across its physician and patient base in Florida. We remain on schedule to launch the program in the latter half of 2014 and we are excited about the valuable services that BeaconLBS will provide physicians, patients and payors. Health care reform is upon us and delivery systems continues to change. The critical components of success will be quality, efficiency, scale and a central role in improving patient outcomes. LabCorp is uniquely-positioned to achieve these goals in the years to come. Now, Steve Anderson will review anticipated questions and our specific answers to those questions.