Almost $20 trillion in revenue—and a record-breaking $1.87 trillion in profits. Introducing the 2025 Fortune 500, the definitive list of the biggest companies in America.

Fortune 500

The 300 companies on this year’s list brought in over $12.6 trillion in revenue for the latest 12 months, with the median revenue figure at $22 billion.

America's Most Innovative Companies

Leaders in all industries rely more than ever on Big Tech—and appreciate the giants that deliver, at scale, without drama.

World's Most Admired Companies

Industries included in the sector are insurance and managed care, medical products and facilities, pharmacy services, and pharmaceutical companies.

Fortune Sector Leaders: Health Care

The Fortune 500, in its 70th year in 2024, ranks the biggest U.S. companies by revenue.

The 200 companies on this list are transforming industries from the inside out.

The 26th edition of the list shows how much esteem Big Tech giants command among other business leaders.

The 300 companies on this list are transforming industries from the inside out.

The Fortune 500, in its 69th year in 2023, ranks the biggest U.S. companies by revenue.

Just as it dominates our economy, Big Tech now dominates Fortune’s annual ranking of corporate reputation.

This year’s Fortune 500 marks the 68th running of the list.

After a year in which humanity leaned more heavily than ever on tech giants, see which companies topped Fortune's ranking of corporate reputation.

This year’s Fortune 500 marks the 67th running of the list.

F500-2021-218-Laboratory Corp. of America

The life sciences company operates one of the largest clinical laboratory networks in the world. As many put off routine medical care during the pandemic, the company saw business decline, but according to its 10-K for 2020, polymerase chain reaction (PCR) testing for COVID more than made up for the losses.

This year's Fortune 500 marks the 66th running of the list.

The medical testing company employs nearly 65,000 people worldwide and conducts clinical research for pharmaceutical companies.

Here are the World's Most Admired Companies for 2019 as ranked in their industries. See who made the list.

This year's Fortune 500 marks the 65th running of the list.

Here are the World's Most Admired Companies for 2018 as ranked in their industries. See who made the list.

This year's Fortune 500 marks the 64th running of the list.

This year's Fortune 500 marks the 63rd running of the list.

This year's Fortune 500 marks the 62nd running of the list.

This year's Fortune 500 marks the 61st running of the list. Wal-Mart claims the top spot again. See who made the list.

Wal-Mart stayed on top as its sales crept closer to half-a-trillion dollars. Apple moved into the top five. And UnitedHealth Group continued its steady climb. 

Sector

Industry

Current All-Star Rank

Previous All-Star Rank

Industry Rank

Previous Industry Rank

Overall Score

Innovation

People Management

Use of Corporate Assets

Social Responsibility

Quality of Management

Financial Soundness

Long-Term Investment Value

Quality of Products/Services

Global Competitiveness

Culture rank

Process rank

Product rank

Years on list

Previous rank

Key Financials (last Fiscal Year)

Revenues ($M)

Profits ($M)

Assets ($M)

Total Stockholder Equity ($M)

Profit Ratios

Profit as % of Revenues

Profits as % of Assets

Profits as % of Stockholder Equity

Earnings Per Share (last Fiscal Year)

Earnings Per Share ($)

EPS % Change (from prior fiscal year)

EPS % Change (5 year annual rate)

EPS % Change (10 year annual rate)

Total Return

Total Return to Investors (last year)

Total Return to Investors (5 year, annualized)

Total Return to Investors (10 year, annualized)

Labcorp provides laboratory services to pharmaceutical and diagnostics companies, health care and health insurance providers, governments, hospitals and health systems, patients and consumers, academic institutions, and retailers. Labcorp operates in over 100 countries and performs more than 600 million tests around the world each year.

Q2 2025

Q1 2025

Q4 2024

Labcorp Holdings (LH): Company Profile, Stock Price, News, Rankings

legacy

Labcorp Holdings

labcorp holdings

Good day and thank you for standing by. Welcome to the Q2 twenty twenty five LabCorp Holdings Earnings Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question and answer session. To ask a question during the session, you will need to press 11 on your telephone.

You will then hear an automated message advising your hand is raised. To withdraw your question, please press 11 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Kristen O'Donnell, Vice President of Investor Relations. Please go ahead.

Thank you, operator. Good morning, and welcome to LabCorp's second quarter twenty twenty five conference call. As detailed in today's press release, there will be a replay of this conference call available. With me today are Adam Schechter, Chairman and Chief Executive Officer and Julia Wong, Executive Vice President and Chief Financial Officer. This morning in the Investor Relations section of our website at www.labcorp.com, we posted both our press release and an Investor Relations presentation with additional information on our business and operations, which include a reconciliation of the non GAAP financial measures to the most comparable GAAP financial measures, both of which are discussed during today's call.

Please see the Use of Adjusted Measures section in our press release and investor relations presentation for more information regarding our use of non GAAP financial measures. Additionally, we are making forward looking statements. These forward looking statements include, but are not limited to, statements with respect to the estimated 2025 guidance and the related assumptions, the projected impact of various factors on the company's businesses operating and financial results cash flows and or financial condition, including global economic and market conditions future business strategies expected savings benefits and synergies from the Launch Pad initiative and from acquisitions and other strategic transactions and partnerships, the completed holding company reorganization, and opportunities for future growth. Each of the forward looking statements is subject to change based upon various factors, many of which are beyond our control. More information is included in our most recent annual report on Form 10 ks and subsequent quarterly reports on Form 10 Q and in the company's other filings with the SEC.

We have no obligation to provide any updates to these forward looking statements even if our expectations change. Now I'll turn the call over to Adam Schechter.

Thank you, Kristen, and good morning, everyone. We appreciate you joining us today to discuss our second quarter financial results and progress on our strategy. During the quarter, we delivered double digit top line growth and solid margin expansion. Our financial results reflect continued strength of our diagnostic laboratories business and momentum in our biopharma laboratory services business. Enterprise revenue reached $3,500,000,000 representing 10% growth versus last year.

Diagnostics revenue grew 9%, reaching $2,700,000,000 driven equally by organic growth and acquisitions. Margin improved slightly, including the impact from Invitae. And Invitae continues to perform very well and remains on track. BOS delivered strong revenue performance and grew 11% or 8% constant currency to $785,000,000 while margins improved 50 basis points. Central Laboratories grew 8% or 4% constant currency, and Early Development grew 20% or 18% constant currency.

Importantly, the quarterly book to bill was strong at 1.18 with a trailing twelve month of 1.11. Enterprise margin improved 20 basis points and adjusted earnings per share of $4.35 grew 10% year over year. Based upon our performance year to date and our expectations for the second half of the year, we are raising our enterprise guidance. Julie will provide more details on our results and full year 2025 outlook in just a moment. But first, I'll highlight how our strategy is continuing to enable our growth and our leadership in the industry.

First, in our Diagnostics Laboratory segment, one of our objectives is to be the partner of choice for health systems and regional local laboratories. By focusing on these customers, we've expanded our presence in hospitals, we've strengthened customer relationships, and we've broadened patient access in key geographies, which helps improve patient outcomes and also accelerate growth. Through technology solutions such as LabCorp Diagnostic Assistant, we've been able to provide data and analytics and important insights to our customers. Many of these customers are thought leaders in specialty areas, and our collaboration with them mutually benefits our collective scientific expertise. In the quarter, we announced acquisitions and partnerships with several health systems and regional local laboratories, including acquiring key clinical and anatomic pathology assets from InSight Diagnostics in the Pacific Northwest, extending our long term agreement with U Health, the University of Miami Health System, to serve as their preferred laboratory partner.

Progressing our acquisition of select oncology and clinical testing assets from BioReference Health. The transaction is on track to close in the second half of twenty twenty five. And subsequent to quarter end, we announced an agreement to acquire select assets of the outreach business from community health systems across 13 states. CHS is one of the largest health care companies in The United States. Looking ahead, we have a strong deal pipeline, and we look forward to sharing our progress in the coming quarters.

Second, we continue to launch new and innovative tests in our specialty focused areas, including oncology, women's health, neurology, and autoimmune diseases. This focus has helped to accelerate our growth in those categories, as well as across our core testing portfolio, as physicians utilize our broad test menu to meet the comprehensive needs of these patients. We have leading expertise both scientifically and in the marketplace in these areas, which also complements our BLS business. We partner with many pharmaceutical and biotechnology companies as they develop novel therapeutics as well as products which require companion diagnostics. In the second quarter, we made important progress launching innovative tests in specialty areas and introducing new capabilities to our customers.

We expanded our oncology portfolio with new solutions for cancer detection, diagnosis, and monitoring. Key launches include expansion of our MRD portfolio through Blackport Plasma Detect, a liquid biopsy test that assesses colon cancer recurrence risk, and PDX ileal plasma focus DX, the first and only FDA authorized pan solid tumor liquid biopsy test for targeted treatment guidance. We continue to advance our leading position in Alzheimer's disease and plan to offer FujiRevio's FDA cleared biomarker test that aids in diagnosing the disease in the coming weeks. We also expanded our consumer offerings. We launched several consumer initiated tests through LabCorp on demand, including tests that measure an individual's cortisol and leptin levels.

We also introduced a new and improved Ovia app, providing women with a single platform to support their health journey. We introduced LabCorp's Whole Health Solutions for functional medicine, integrative medicine, and primary care practices. The solution offers specialized test panels and a test menu of more than 1,000 scientifically backed biomarkers for cardiometabolic health, hormones, micronutrients, longevity, and wellness. Finally, our central laboratory business added digital pathology capabilities, including advanced image scanning to preserve critical sample data and AI powered solutions to provide analysis on large data sets instantly. These enhancements complement our existing global anatomic pathology capabilities, our full service tissue based testing, and our companion diagnostic development across cancer, MASH, and other diseases.

And third, we are focused on enhancing customer and employee experiences and leveraging technology to drive ongoing operational and process efficiencies. We're using digital technologies and AI to drive improvements in areas such as Net Promoter Score, our Launchpad initiatives and margins. We expect to see continued benefits as we incorporate technology across our business. To summarize, we delivered very strong results in the quarter and continue to make significant progress on our strategy. We remain committed to delivering sustained value to our customers, our employees and our shareholders.

With that, I'll turn the call over to Julia to discuss our financial results and 2025 outlook in further detail.

Thank you, Adam. As Adam just shared in the opening remarks, we delivered strong underlying performance from both segments in the quarter as we have continued to win in the marketplace and execute against our strategy. The strong quarter, combined with favorable foreign exchange rates, enabled us to raise our full year guidance. Now, let me start with a review of our Q2 financials. Revenue for the quarter was $3,500,000,000 an increase of 9.5% compared to last year, driven by organic growth of 5.4%, the impact from acquisitions of 3.5% and foreign currency translation of 0.6%.

Operating income for the quarter was $395,000,000 or 11.2% of revenue, which is 15.1% on an adjusted basis. During the quarter, we had $69,000,000 of restructuring charges and special items, primarily related to acquisitions and launchpad initiatives. Excluding these items and amortization of $68,000,000 adjusted operating income in the quarter was $532,000,000 or 15.1% of revenue, compared to $480,000,000 or 14.9% of revenue last year. The increase in adjusted operating income was due to organic demand as we leveraged well on our revenue growth. Our Launchpad initiative continues to be on track in the quarter, which offset typical increases in personnel costs.

Despite a 30 basis point headwind from Invitae, adjusted operating margin increased 20 basis points. The adjusted tax rate for the quarter was 23.1, compared to 23% last year. We continue to expect our adjusted tax rate for full year 2025 to be approximately 23%. Net earnings for the quarter were $238,000,000 or $2.84 per diluted share. Adjusted EPS was $4.35 in the quarter, up 10.4% from last year, as we leveraged well our revenue growth.

Operating cash flow was $621,000,000 in the quarter, compared to $561,000,000 a year ago. Capital expenditures totaled $78,000,000 in the quarter. For the full year, we continue to expect capital expenditures to be approximately 3.8% of revenue. Free cash flow for the quarter was $543,000,000 compared to $433,000,000 last year. This $110,000,000 increase in free cash flow was driven by higher earnings and the timing of capital expenditures.

During the quarter, the company invested $25,000,000 in acquisitions and partnerships, paid out $60,000,000 in dividends and repurchased $200,000,000 of stock. At quarter end, we had $647,000,000 in cash, while total debt was $5,600,000,000 Our debt leverage as of quarter end was 2.5x gross debt to trailing twelve months adjusted EBITDA, at the low end of our targeted leverage range of 2.5x to 3x. Now, I will review our segment performance, beginning with Diagnostics Laboratories. Revenue for the quarter was US2.7 billion dollars a increase of 8.9% compared to last year, with organic growth of 4.5% and acquisitions of 4.5%, partially offset by foreign currency translation of 0.1%. Total volume increased 4.9% compared to last year, with organic volume contributing 3.4%, as we continued to execute our strategy and drive strong demand.

Acquisitions contributed 1.5%. Price mix increased 4% versus last year due to organic growth of 1.1% and acquisitions of 3%, partially offset by foreign currency translation of 0.1%. Organic price mix was up due to less, as we benefited from an increase in tax per accession and net management agreements. Diagnostics adjusted operating income for the quarter was $483,000,000 or 17.6% of revenue, compared to $442,000,000 or 17.5% of revenue last year. Adjusted operating margin was up 10 basis points.

We continue to be pleased with the progress we are making in Invati, which we will annualize next quarter. InVeyTay remains on track to achieve 10% revenue growth and to be slightly accretive for full year 2025. Excluding the impact of InVeyTay, margins would have been up approximately 50 basis points. Now, I will review the segment performance of Biopharma Laboratory Services, or BLS. Revenue for the quarter was $785,000,000 an increase of 11% compared to last year, due to an increase in organic revenue of 7.8% and foreign currency translation of 3.2%.

In constant currency, Central Lab's revenue was up approximately 4%, while Early Development was up approximately 18%. The growth in early development was primarily driven by a relatively easy compare to prior year, as well as timing of study starts. We still expect both businesses to grow in the mid single digits on a constant currency basis for the full year, with early developments facing more challenging year over year comparisons, particularly in the fourth quarter. BLS adjusted operating income for the quarter was $123,000,000 or 15.7% of revenue, compared to $107,000,000 or 15.2% of revenue last year. Adjusted operating income and margin increased, primarily driven by organic demand and operating efficiencies.

We ended the quarter with a backlog of $8,700,000,000 and we expect approximately 2,700,000,000 of this backlog to convert into revenue over the next twelve months. Our segment quarterly book to bill was strong at 1.18, bringing the trailing twelve month book to bill to 1.11. The strength was driven by several large Star Day awards in Central Labs. Now I will discuss our updated 2025 full year guidance, which assumes foreign exchange rates effective as of 06/30/2025, for the remainder of the year. The enterprise guidance also includes the impact from currently anticipated capital allocation, utilizing free cash flow for acquisitions, share repurchases and dividends.

Our guidance has taken into account various scenarios as the macro and regulatory landscape continues to evolve. We are raising guidance for enterprise revenue, adjusted EPS and free cash flow, primarily driven by currency as well as the underlying strength of our businesses. We raised the 2025 enterprise revenue guidance by 70 basis points at the midpoint, and narrowed the growth range to 7.5% to 8.6% when compared to 2024. Diagnostics continues to execute well in the marketplace. We raised Diagnostics revenue guidance by 40 basis points at the midpoint, and narrowed the growth range to 7% to 8%.

In BLS, we increased the midpoint by two eighty basis points due to the favorable impact of foreign currency, and narrowed the growth range to 6.1% to 7.5. We continue to expect full year enterprise margins to increase, with margins improving in both Diagnostics and DLS in 2025 versus 2024. For Diagnostics, we expect margin expansion in the second half of the year versus prior year. For BLS, we expect margins to be stronger in second half than first half, albeit overlapping a stronger prior year comparison. Our guidance range for adjusted EPS is $16.05 to $16.5 with an implied growth rate at the midpoint of 12%.

As compared to our prior guidance, we have narrowed the range and raised the midpoint by approximately $0.23 benefiting from both currency and strengthening our underlying businesses. Our free cash flow guidance range is $1,125,000,000 to $1,275,000,000 We raised the midpoint by $25,000,000 versus prior guidance, and due to normal seasonality, we expect to generate the majority of free cash flow in the second half of the year. In closing, we continue to be encouraged by the strong performance across both business segments this quarter. The results reflect the effective execution of our strategy, the resilience of our operations and the dedication of our teams across the organization. As we look ahead, we remain confident in our ability to deliver sustainable growth and long term value for our shareholders. Operator, we will now take questions. Thank

And our first question comes from Michael Cherny of Leerink Partners. Congrats

on a nice quarter. Maybe if I could just dive in a little bit on the volume dynamics and mix. I mean, seems like everything is fairly broad based, Adam. Is there anywhere that you think you're pushing harder relative to customer base, payer mix, test type that can be more of, call it, an offensive approach to growth? I'm just trying to parse through what exactly is going on in terms of driving the stability of growth this year, given that I know there's a number of potential moving pieces on the regulatory side that has been a big question for volumes for next year and beyond.

So if we can parse those two pieces together, that'd be great.

Yep, will do. And first of all, we appreciate the congratulations. It was a very strong quarter and we saw the strength across both the diagnostics and the BLS business, which gives us a lot of momentum for the second half of the year as we go into next year. Specific to your question on diagnostics, the revenue was $2,700,000,000 about 10% growth. But I think that the important thing is to look at the volume and where the growth came from.

So about half of the 9% growth came from organic growth and about the other half, 4.5% came from acquisitions. So then I looked separately at what was volume. Overall volume was up about 5% and then price mix was up 4%. And then I take it to organic volume. If you look at organic volume, it was up about 3.5%.

And I think that shows the strength of the underlying growth that we have. Historically, that growth was 1% to 2%. So I do think we're seeing some accelerated growth. I think the accelerated growth is coming from several areas. One is the hospital regional local laboratory deals that we're doing are serving us well.

It expands access in the hospitals and the surrounding geographies, but I think when you win those hospital deals, the access in those geographies works to your benefit and you actually gain share. The second thing is the focus on our specialty products in the areas of oncology, neurology, autoimmune disease, and neurology. Those areas are growing three to four times faster than the overall diagnostic market. And by focusing on those areas, you not only do well in those areas, but typically those patients have more severe disease. And with more severe disease, physicians typically look for more tests in order to understand the diseases.

So therefore the routine tests that we do actually grow faster when you have a focus on the specialty areas. And I think those two things are helping us accelerate our growth faster than you would expect, which gives me a lot of gives us a lot of momentum going into 2026.

Thank you. Our next question comes from Ann Hynes of Mizuho. Your line is open.

Good morning. Good morning, and thank you. I just want to ask about the legislative and regulatory outlook. Obviously, there's a lot of changes coming over the next few years. Maybe how we should think about PAMA going into 2026?

Do you think the risk has increased of those cuts coming back? And just on the legislative front, as time goes by, it probably seems clear that the ACA subsidies are not being extended. How do you think, those enhanced subsidies have positively impacted your business? And how should we view the risk in 2026? And just on the Medicaid side, could you remind us what LabCorp's Medicaid exposure and how changes to enrollment over the next few years could impact you? Thanks.

Yeah, so let me start overall with how I think about the momentum we're going into the year next year with. And I think that the strength that you see in the quarter is going to serve us well. As I look at the legislative changes and you look at One Beautiful Bill, you look at PAMA and so forth, I look at them individually. So let me start with PAMA. PAMA, we're continuing to work with ACLA, the trade organization, to try to get legislation approved that actually would be more apt to what they were trying to achieve with PAMA in the first place.

And we're going to continue to work on a legislative solution. If that doesn't happen, we'll continue to seek ways to see if it can be delayed again so that we can get appropriate legislation approved, of which we have very strong support for both Democrats and Republicans. If the delay doesn't occur, then we could also work to see, is there a way to ensure that the appropriate data is available to help calculate PAMA in a way which it was intended to be calculated, meaning that you need more data than just some of the laboratories. You need a lot of the hospital laboratories to get all the data you need. All three of those things are things that we'll be working on as we go through this year.

In my base case, I've always said, assume PAMA comes next year. And I've said that for the last probably five years now. And we build our base case that it's coming because we don't know if any of these other strategies will actually occur. If PAMA does come next year, it will be about a $100,000,000 impact, top and bottom line, of which we've worked hard to offset as much of that as we possibly could through things like Launchpad and even going further than what we've done with Launchpad. Separate and distinct from that, when I think about other legislation, I would say in broad terms we see some tailwinds and we see some headwinds.

But if you look at it all together and you look at all the different scenarios, for our business we think it's manageable. First of all, if you look at lab testing, it's a very small fraction of US healthcare spend. But it's an essential tool and it's used in almost every healthcare decision. So people realize the importance of laboratory testing. If you think about the legislation, I think it's going be hard in some of our customers like hospitals.

And it could have hospitals work with us faster and want to do even more deals with us in terms of outreach business and also running hospital laboratories. In addition to that, if you look at the healthcare exchange and expiration of the tax credits, there could be a negative impact and we've measured that to be as high as 30 basis points. If you look at Medicaid, I don't think anything is going to really happen until 2028. And the key is going to be, do people find insurance through other ways, through states or spouses that might have insurance? To me, the key is if people have insurance, we find ways to be successful.

When there's a very large group of people that could become uninsured, that's where we get concerned. I don't think that's likely. I don't think it's very likely in The United States that you'll have a very big group of people automatically become uninsured in a specific period of time. So net net, boiling it all down, Pam and put aside, we'll do everything we can to either change the legislation, delay or offset as much as we can. The other legislative things are manageable when you look at the impact net net.

The only thing I would add is we do not expect the one big beautiful bill to have a material impact on our overall effective tax rate. We continue to expect our tax rate to be approximately 23% for full year 2025 and beyond.

Thank you. Our next question comes from Kevin Caliendo of UBS. Your line is open.

Good morning. Congrats. Really, really impressive performance, Kevin. Can I ask about the community health deal a little bit? We didn't get a lot of details from you around it.

I understand it's not gonna close till April, and so the impact this year isn't great. But from an absolute size perspective, a $195,000,000 is meaningful. Is this deal expected to be accretive, in on the first twelve months? Flat? Can you talk a little bit about maybe the mix of the business or the profitability of that?

Does it need to be repriced? Yeah. As much detail as you can provide, because, obviously, it's gonna be somewhat interesting piece of the bridge when we think about 2026.

Yeah, absolutely. The first thing I'd say is that if you recall, we actually increased the range that we thought that inorganic growth would happen. It used to be 1% to 2%, now we say 1.5% to 2.5%. A lot of that is incorporated because of the hospital deals that we're doing, of which this is one. If I look at the deal and the hospital deals, our bar is high.

We want them to be accretive in the first year, return our cost of capital in a couple years, and be something that we know how to do and integrate with a good partner we can work with. And I would say CHS deal, it meets all those criteria. Obviously, it's going depend on how fast we can close and so forth to see what the impact will be, but we're going to try to work with them to close as quickly as we possibly can. As you said, we paid $195,000,000 of cash And I think it's going to prove to be another really good hospital deal for us. It's the outreach business, which is typically the higher margin business.

It's the hospital laboratory where we run those laboratories that you have the lower margin, albeit a high return on cost of capital business. So this is outreach, which actually is better for margins.

Thank you. Our next question comes from Patrick Donnelly of Citi. Your line is open.

Hey, good morning. Thanks for taking the questions. Maybe one on the BLS segment, nice performance there, nice to see the bookings pick up as well. Can you just talk about what you saw in the quarter, I guess, Central Lab and then particularly the early development business, looked like it picked up a little bit of momentum as the quarter went. You obviously heard from the CRO group this week quite positive in terms of some of those prints.

So are you did you see improvement as the quarter went? Can you just talk about some of those customer conversations? I know if we rewind three or six months, there's a lot of concern about this business. It seems like it's turning the corner a bit, so we'd love to pull the curtain back a little bit there and what you saw as the quarter went and then again, expectations going forward just given the bookings. Thank you.

Sure. So I'll start off with BLS revenue was 11% increase year over year. It was 8% if you look at it in constant currency. And we had good growth for both businesses. We had 8% or 4% constant currency for our central labs and 20 or 18 for ED.

But let me break that apart for you and then I want to talk about the book to bill. If you look at the ED, it was a relatively easy compare to the prior year, which accelerated the growth. If you look at fourth quarter of this year, it's gonna be a much more difficult compare for ED than the second quarter was. The other thing is when studies start, you tend to get a bolus of payment at the start of the study. We had some additional study starts in the quarter.

But putting all that aside, ED is back to growth and we expect it to grow for the full year in the mid single digits, which is a good place for us to be. And if you look at ED, what I look at is our number of RFPs that come in which remain consistent. I look at our win rate which remains consistent. And the thing that I look at most carefully now is whether the trials start on time. And that's something we're going to continue to look at very closely.

But when I look at the second quarter, the win rate, the RFPs and the timing of studies looked good. If I look at central laboratory, that's where I focus a lot on book to bill. If you look at the whole business, BLS, the book to bill was very strong and it was a 1.1. If you look at the trailing twelve month book to bill, which is a very good place to be. I've always said you have to be above one.

We're at 1.1. That was driven by a couple of large trials that we won in the central laboratories. The good thing about large trials are they give you fuel for a longer period of time. So I feel really good about the book to bill that we posted and I think it gives us momentum when you think about the central laboratory business moving into the future. Great, thank you.

Thank you. And our next question comes from Lisa Gill of JP Morgan. Your line is open.

Good morning, Adam and Julia. Thank you for taking my question. Adam, can you maybe just discuss anything on the horizon around managed care contracting? Do you have any large contracts that are up for renewal going into 2026? Any changes around how you're contracting with managed care?

Yes, so as I look at our managed care contracts, they typically vary length anywhere from three years to five years. So each year we're renewing maybe 20%, 25% of our contracts. We continue to see unit price relatively flat, which is a good place to be. I'm confident that we've got the renewals that we need for this year and I feel good those are secured. They're reasonable terms and reasonable rates.

They're supportive of our near long term guidance. And as I look into the future, I feel confident that we have very good relationships. And one of the things that helps is the hospital deals that you do actually causes the rates to go down for the payers. And I think the more hospital deals we do, the more we're able to talk to payers about the benefit that we're providing to them above and beyond just talking about the cost of our individual tests. I think that has served us well in those discussions, but I feel very good about our position.

And our next question comes from Jack Meehan of Nephron Research. Your line is open.

Good morning, Adam. Good morning, Julia. So we're almost at the one year anniversary of the Invitae deal. Wanted to hear just how you feel like revenue is tracking there, how competitive dynamics are in the market and then finally, confidence in getting the business profitable.

So I am very confident in our position with VTech. The integration is going extremely well. Confident in the revenue growth of 10% yearly and I'm also confident in it being slightly accretive for the full year. The team is doing a great job. We've improved the customer experience.

The customers are excited. So everything's right on track, and I feel very good about where we are in the position. It's a great add to the offerings that we had for both women's health and specialty areas. And our sales reps are excited to have it as part of us, but also the physicians are excited that we now have that offering as part of LabCorp.

Hi, Jack. Maybe I can provide some additional color as it relates to margin overall inclusive of Invati. Once again, we are very encouraged by our strong performance in the second quarter, whereby we grew top line by almost double digit with 20 basis points of margin expansion despite a 30 basis point headwind from Inviti. This enterprise margin expansion in the quarter was actually supported by the improvements in both business segments. Given the first half results, we actually expect to drive margin expansion in the second half at a level that will enable us to deliver full year margin ratio growth, once again supported by both segments.

So when you think about the cadence for Diagnostics, we tend to see the margins being the highest in the second quarter and then sequentially moderating in Q3 versus Q2 and then Q4 versus Q3. For the BLS segment, we also expect margins to be up in the second half versus prior year. However, not necessarily at the pace that we saw in Q1 or Q2, considering we had a significant margin progression throughout last year. So overall, I would say that as an organization, we are highly focused on continuing to deliver strong top line growth while driving margin expansion through operating efficiencies. Thank you.

And our next question comes from Elizabeth Anderson of Evercore ISI. Your line is open.

Good morning. Thanks so much for the question and congrats. I was wondering if you could maybe expand a little bit more on your BLS commentary, if you have any comments on sort of biotech versus pharma or sort of pockets of strength that you're seeing in general, though, obviously, with the book to bill, I imagine it's decently widespread. And then two, I was wondering if you can just remind us as we think about the impact of FX on the business, I think we called it out you guys called it out obviously very cleanly on the revenue line, but just sort of remind us as we go down the P and L, how we think about the change in FX on the EPS line? Thank you very much.

Yes, Elizabeth, I'll talk about BLS, I'll ask Julia to talk a little bit about the impact of FX. If you look at BLS, we saw strength in both businesses in the quarter and we expect both businesses to grow for the full year in the mid single digits. If I look at CLS, CLS is heavily skewed towards larger pharma later stage trials, phase three trials. And there we had a couple of big wins. I feel good about that.

I think under all circumstances, pharma is going to continue to support their phase three pipelines and that's a strength for us. As I look at our early development, that is mostly smaller biotechnology companies and we saw a good number of RFPs and win rate there, but that's something we're going to watch very closely to ensure that the funding environment remains favorable, to ensure that they get the information they need to start studies on time as they move forward. So that one, I think we have to watch more closely than the CLS where I feel more confident based upon the later stage trials in the larger companies. With all that said, ED is back to growth. It's important to note that the fourth quarter is going be a very tough compare versus fourth quarter of last year.

But if you look at the full year, we expect it to grow in the mid single digits.

Hi, Elizabeth. Let me comment a bit on the FX impact. We clearly are operating in a very dynamic FX environment. If you step back and look at the composition of our businesses, obviously, the Diagnostics side accounts for over 75% of our revenue, but it's primarily based in The United States. And the BLS side of the business is where we're more global in our footprint and therefore having FX exposure.

The currencies that we have meaningful exposure to for BLS include Swiss franc and the British pound. If you just look at the Q2 enterprise revenue growth of 9.5% year over year, it did include a favorable currency impact of 60 basis points due to BLS. And then when you move to look at the full year guide, which is provided at the midpoint, the enterprise revenue guide at 70 basis points, and we are expecting a FX impact based on the rate at the end of Q2 in that magnitude.

Thank you. And our next question comes from Andrew Brackmann of William Blair. Your line is open.

Hi, Adam. Hi, Julia. Hi, Kristen. Thanks for taking the questions. Maybe just on pricing, I think you called out organic pricing up in the quarter.

Can you maybe just peel that back a bit for us just in terms of the key drivers there? And then I guess how should we think about that trending forward, especially as the mix continues to shift towards those specialty tests? Thanks.

Okay, so if you look at pricing, I look at a few things. I look at our test per accession and our test per accession continues to show growth. I think that that's occurring. If you go historically, I said that I thought that that was a post COVID acceleration because people didn't get diagnosed during COVID. I actually think it's more than that.

I think that there's an aging population. I think there's more severity of disease. So I think people are actually doing more tests for accession. We also include in that lab management. The second thing I think that's helping to drive that is the specialty growth.

So we are seeing asymptotic continuing increase in our specialty testing vis a vis the routine testing, and I think that also helps with price per accession.

The only thing I would also complement is from a unit price perspective, we continue to see it as relatively flat. And therefore, when you think about the price mix impact, it's really been benefiting from the impact of MERS. And as I've already shared, the key contributors once again are the gradual yet consistent growth in passive procession as well as that management agreement.

And our next question comes from Tycho Peterson of Jefferies. Your line is open.

Hey, good morning. Congrats on the quarter. So just want to probe on some of the new content launches, starting with Alzheimer's. Curious how you're sizing the opportunity for pTau217 beta amyloid and any market development that needs to happen there? And then the follow-up is on MRD, with PlasmaDetect, how has early adoption been?

Any synergies you can point to with PGD extra therapy selection? And how do you think about kind of broader menu build out for MRD? Thanks.

Yeah, absolutely. I think that's a very important question as you think about specialty and where we're going. The first thing I'd say though, Tycho, is that when I think about the specialty testing, I don't think about the individual test alone. Because the patient that gets that test is also going to get a whole host of other tests. So if you have somebody that's going to get an MRD test, they're probably going to get CBCs, WBCs, ALTs, ALTs, and a whole host of other things to see and measure their organs as well as their minimal residual disease.

Labcorp Holdings (LH) Q2 2025 Earnings Call Transcript

Company Participants