Quest Diagnostics 10-Q 2026-03-31
Filed 2026-04-22. 8 sections, 159K characters. Original on sec.gov · Markdown · JSON
Cover and table of contents
| UNITED STATES | ||
| SECURITIES AND EXCHANGE COMMISSION | ||
| WASHINGTON, DC 20549 | ||
FORM 10-Q
(Mark One)
☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended March 31, 2026
Or
☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from to
Commission file number 001-12215
Quest Diagnostics Incorporated
| Delaware | 16-1387862 | ||||||||||||||||
| (State of Incorporation) | (I.R.S. Employer Identification Number) | ||||||||||||||||
| 500 Plaza Drive | |||||||||||||||||
| Secaucus, | NJ | 07094 | |||||||||||||||
| (973) | 520-2700 |
Securities registered pursuant to Section 12(b) of the Act:
| Title of each class | Trading Symbol(s) | Name of each exchange on which registered | ||||||
| Common Stock, $0.01 Par Value | DGX | New York Stock Exchange |
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes ☒ No ☐
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and "emerging growth company" in Rule 12b-2 of the Exchange Act.
| Large accelerated filer | ☒ | Accelerated filer | ☐ | ||||||||
| Non-accelerated filer | ☐ | Smaller reporting company | ☐ | ||||||||
| Emerging growth company | ☐ |
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☒
As of April 15, 2026, there were outstanding 110,696,429 shares of the registrant’s common stock, $.01 par value.
PART I - FINANCIAL INFORMATION
QUEST DIAGNOSTICS INCORPORATED AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
FOR THE THREE MONTHS ENDED MARCH 31, 2026 AND 2025
(unaudited)
(in millions, except per share data)
| Three Months Ended March 31, | |||||||||||||||||||||||
| 2026 | 2025 | ||||||||||||||||||||||
| Net revenues | $ | 2,895 | $ | 2,652 | |||||||||||||||||||
| Operating costs and expenses and other operating income: | |||||||||||||||||||||||
| Cost of services | 1,953 | 1,789 | |||||||||||||||||||||
| Selling, general and administrative | 504 | 476 | |||||||||||||||||||||
| Amortization of intangible assets | 37 | 39 | |||||||||||||||||||||
| Other operating expense, net | 2 | 2 | |||||||||||||||||||||
| Total operating costs and expenses, net | 2,496 | 2,306 | |||||||||||||||||||||
| Operating income | 399 | 346 | |||||||||||||||||||||
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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
Our Company
Diagnostic Information Services
Quest Diagnostics works across the healthcare ecosystem to create a healthier world, one life at a time. Our diagnostic information services ("DIS") business provides diagnostic insights from the results of our 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, our 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, our diagnostic insights can inspire actions that transform lives and create a healthier world. We provide services to a broad range of customers within our primary customer channels - physicians (including those associated with accountable care organizations and Federally Qualified Health Centers), hospitals, and patients and consumers. Our other customers include health plans, employers, emerging retail healthcare providers, government agencies, pharmaceutical companies and other commercial clinical laboratories. We offer broad access to clinical testing through a nationwide network of laboratories, patient service centers, phlebotomists in physician offices, and our connectivity resources, including call centers and mobile phlebotomists, nurses and other health and wellness professionals. Our 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 our tests and test results, and help them best utilize our services to improve outcomes and enhance satisfaction. Our DIS business makes up greater than 95% of our consolidated net revenues.
We assess our revenue performance for our DIS business based upon, among other factors, volume (measured by test requisitions) and revenue per requisition. Each test requisition accompanies patient specimens, indicating the test(s) to be performed and the party to be billed for the test(s). Revenue per requisition is impacted by various factors, including, among other items, the impact of fee schedule changes (i.e., unit price), test mix, payer mix, business mix and the number of tests per requisition. Management uses number of requisitions and revenue per requisition data to assist with assessing the growth and performance of the business, including understanding trends affecting number of requisitions, pricing and test mix. Therefore, we believe that information related to changes in these metrics from period to period are useful information for investors as it allows them to assess the performance of the business.
Diagnostic Solutions
Our diagnostic solutions ("DS") group, which represents the balance of our consolidated net revenues, includes our risk assessment services business, which offers solutions for insurers, and our healthcare information technology businesses, which offer solutions for healthcare providers and payers.
First Quarter Highlights
| Three Months Ended March 31, | ||||||||||||||
| 2026 | 2025 | |||||||||||||
| (dollars in millions, except per share data) | ||||||||||||||
| Net revenues | $2,895 | $2,652 | ||||||||||||
| DIS revenues | $2,832 | $2,589 | ||||||||||||
| Revenue per requisition change | (1.3)% | 0.3% | ||||||||||||
| Requisition volume change | 10.9% | 12.4% | ||||||||||||
| Organic requisition volume change | 10.8% | (0.9)% | ||||||||||||
| DS revenues | $63 | $63 | ||||||||||||
| Operating income | $399 | $346 | ||||||||||||
| Net income attributable to Quest Diagnostics | $252 | $220 | ||||||||||||
| Diluted earnings per share | $2.24 | $1.94 | ||||||||||||
| Net cash provided by operating activities | $278 | $314 | ||||||||||||
| Capital expenditures | $114 | $117 |
For further discussion of the year-over-year changes for the three months ended March 31, 2026 compared to the three months ended March 31, 2025, see "Results of Operations" below.
Venture with Corewell Health
During August 2025, we and Corewell Health signed a definitive agreement to form a new entity which will perform laboratory testing in the state of Michigan via a new laboratory facility. The parties completed the transaction during January 2026. In connection with the transaction, Corewell Health contributed a laboratory business over which we obtained a controlling financial interest. Under the terms of the transaction, the parties are continuing to serve providers and patients in Michigan from their existing patient service centers (which are operated by the newly formed entity) and their existing laboratories until a new laboratory is operational during 2027. Equity ownership of the newly formed entity is shared 51% by us and 49% by Corewell Health and we are consolidating the entity in our consolidated financial statements. The business is included in our DIS segment.
For further details see Note 5 to the interim unaudited consolidated financial statements.
Invigorate Program
We are engaged in a multi-year program called Invigorate, which includes structured plans to drive savings and improve productivity across the value chain, including in such areas as patient services, logistics and laboratory operations, revenue services, information technology and procurement. The Invigorate program aims to deliver 3% annual cost savings and productivity improvements to partially offset pressures from the current inflationary environment, including labor and benefit cost increases and reimbursement pressures. We are leveraging automation and artificial intelligence to improve productivity and also improve quality across our entire value chain, not just in the laboratory. Other areas of focus include reducing denials and patient concessions, enhancing the digital experience, and selecting and retaining talent.
For the three months ended March 31, 2026, we incurred $7 million of pre-tax charges in connection with restructuring and integration activities, principally including employee separation costs, with the remainder including integration costs. Most of the charges will result in cash expenditures. Additional restructuring and integration charges may be incurred in future periods, including as we identify additional opportunities to achieve further savings and productivity improvements.
Critical Accounting Policies
There have been no significant changes to our critical accounting policies from those disclosed in our 2025 Annual Report on Form 10-K**.**
Impact of New Accounting Standards
The adoption of new accounting standards, if any, is discussed in Note 2 to the interim unaudited consolidated financial statements.
The impact of recent accounting pronouncements not yet effective on our consolidated financial statements, if any, is also discussed in Note 2 to the interim unaudited consolidated financial statements.
Results of Operations
The following tables set forth certain results of operations data for the periods presented:
| Three Months Ended March 31, | |||||||||||||||||||||||||||||||||||||||||||||||
| 2026 | 2025 | $ Change | % Change | ||||||||||||||||||||||||||||||||||||||||||||
| (dollars in millions, except per share amounts) | |||||||||||||||||||||||||||||||||||||||||||||||
| Net revenues: | |||||||||||||||||||||||||||||||||||||||||||||||
| DIS business | $ | 2,832 | $ | 2,589 | $ | 243 | 9.4 | % | |||||||||||||||||||||||||||||||||||||||
| DS businesses | 63 | 63 | — | 0.8 | |||||||||||||||||||||||||||||||||||||||||||
| Total net revenues | $ | 2,895 | $ | 2,652 | $ | 243 | 9.2 | % | |||||||||||||||||||||||||||||||||||||||
| Operating costs and expenses and other operating income: | |||||||||||||||||||||||||||||||||||||||||||||||
| Cost of services | $ | 1,953 | $ | 1,789 | $ | 164 | 9.2 | % | |||||||||||||||||||||||||||||||||||||||
| Selling, general and administrative | 504 | 476 | 28 | 6.0 | |||||||||||||||||||||||||||||||||||||||||||
| Amortization of intangible assets | 37 | 39 | (2) | (3.9) | |||||||||||||||||||||||||||||||||||||||||||
| Other operating expense, net | 2 | 2 | — | NM | |||||||||||||||||||||||||||||||||||||||||||
| Total operating costs and expenses, net | $ | 2,496 | $ | 2,306 | $ | 190 | 8.2 | % | |||||||||||||||||||||||||||||||||||||||
| Operating income | $ | 399 | $ | 346 | $ | 53 | 15.5 | % | |||||||||||||||||||||||||||||||||||||||
| Other income (expense): | |||||||||||||||||||||||||||||||||||||||||||||||
| Interest expense, net | $ | (63) | $ | (67) | $ | 4 | (6.0) | % | |||||||||||||||||||||||||||||||||||||||
| Other expense, net | (2) | (3) | 1 | NM | |||||||||||||||||||||||||||||||||||||||||||
| Total non-operating expense, net | $ | (65) | $ | (70) | $ | 5 | NM | ||||||||||||||||||||||||||||||||||||||||
| Income tax expense | $ | (74) | $ | (59) | $ | (15) | 24.5 | % | |||||||||||||||||||||||||||||||||||||||
| Effective income tax rate | 22.2 | % | 21.5 | % | |||||||||||||||||||||||||||||||||||||||||||
| 0 | |||||||||||||||||||||||||||||||||||||||||||||||
| Equity in earnings of equity method investees, net of taxes | $ | 4 | $ | 18 | $ | (14) | (77.5) | % | |||||||||||||||||||||||||||||||||||||||
| Net income attributable to Quest Diagnostics | $ | 252 | $ | 220 | $ | 32 | 14.4 | % | |||||||||||||||||||||||||||||||||||||||
| Diluted earnings per common share attributable to Quest Diagnostics' common stockholders | $ | 2.24 | $ | 1.94 | $ | 0.30 | 15.5 | % | |||||||||||||||||||||||||||||||||||||||
| NM - Not Meaningful | |||||||||||||||||||||||||||||||||||||||||||||||
The following table sets forth certain results of operations data as a percentage of net revenues for the periods presented:
| Three Months Ended March 31, | |||||||||||||||||||||||
| 2026 | 2025 | ||||||||||||||||||||||
| Net revenues: | |||||||||||||||||||||||
| DIS business | 97.8 | % | 97.6 | % | |||||||||||||||||||
| DS businesses | 2.2 | 2.4 | |||||||||||||||||||||
| Total net revenues | 100.0 | % | 100.0 | % | |||||||||||||||||||
| Operating costs and expenses and other operating income: | |||||||||||||||||||||||
| Cost of services | 67.4 | % | 67.5 | % | |||||||||||||||||||
| Selling, general and administrative | 17.4 | 17.9 | |||||||||||||||||||||
| Amortization of intangible assets | 1.3 | 1.5 | |||||||||||||||||||||
| Other operating expense, net | 0.1 | 0.1 | |||||||||||||||||||||
| Total operating costs and expenses, net | 86.2 | % | 87.0 | % | |||||||||||||||||||
| Operating income | 13.8 | % | 13.0 | % | |||||||||||||||||||
Operating Results
Results for the three months ended March 31, 2026 were affected by certain items that on a net basis decreased diluted earnings per share by $0.26 as follows:
-
pre-tax amortization expense of $37 million, recorded in amortization of intangible assets, or $0.25 per diluted share;
-
pre-tax charges of $7 million, principally recorded in equity in earnings of equity method investees, net of taxes, or $0.05 per diluted share, representing the losses associated with changes in the carrying value of our strategic investments;
-
pre-tax charges of $7 million ($1 million recorded in cost of services and $6 million recorded in selling, general and administrative expenses), or $0.04 per diluted share, primarily associated with workforce reductions and integration costs incurred in connection with further restructuring and integrating our business; and
-
pre-tax charges of $4 million, principally recorded in other operating expense, net, or $0.03 per diluted share, primarily representing a loss associated with the increase in the fair value of the contingent consideration accrual associated with previous acquisitions; partially offset by
-
$12 million of excess tax benefits associated with stock-based compensation arrangements, recorded in income tax expense, or $0.11 per diluted share.
Results for the three months ended March 31, 2025 were affected by certain items that on a net basis decreased diluted earnings per share by $0.27 as follows:
-
pre-tax amortization expense of $39 million recorded in amortization of intangible assets, or $0.26 per diluted share;
-
pre-tax charges of $19 million ($6 million recorded in cost of services and $13 million recorded in selling, general and administrative expenses), or $0.13 per diluted share, primarily associated with workforce reductions and integration costs incurred in connection with further restructuring and integrating our business; and
-
pre-tax charges of $2 million, recorded in other operating expense, net, or $0.02 per diluted share, primarily representing a loss associated with the increase in the fair value of the contingent consideration accrual associated with previous acquisitions; partially offset by
-
pre-tax gains of $8 million, recorded in equity in earnings of equity method investees, net of taxes, or $0.06 per diluted share, principally consisting of a non-recurring gain related to a lease; and
-
$9 million of excess tax benefits associated with stock-based compensation arrangements, recorded in income tax expense, or $0.08 per diluted share.
Net Revenues
Net revenues for the three months ended March 31, 2026 increased by 9.2% compared to the prior year period principally driven by organic revenue growth of 9.0%.
DIS revenues for the three months ended March 31, 2026 increased by 9.4% compared to the prior year period.
For the three months ended March 31, 2026:
-
The increase in DIS revenues compared to the prior year period was principally driven by the organic growth of 9.2%.
-
DIS volume increased by 10.9% compared to the prior year period principally driven by organic growth of 10.8%, of which approximately 7% was due to both our new relationship with Corewell Health to provide Collaborative Lab Solutions and increasing our laboratory testing at dialysis clinics owned by Fresenius Medical Care in the United States. Excluding the Corewell Health and Fresenius Medical Care related testing, organic volume increased 3.8% compared to the prior year period.
-
Revenue per requisition decreased by 1.3% compared to the prior year period primarily driven by the business mix associated with our new relationships with Corewell Health and Fresenius Medical Care, which include a greater proportion of routine tests than most of our clinical testing. Excluding the Corewell Health and Fresenius Medical Care business mix impacts, revenue per requisition increased by approximately 2.5% primarily driven by an increase in the number of tests per requisition and favorable test mix.
DS revenues for the three months ended March 31, 2026 were principally consistent with the prior year period.
Cost of Services
Cost of services consists principally of costs for obtaining, transporting and testing specimens as well as facility costs used for the delivery of our services.
For the three months ended March 31, 2026, cost of services increased by $164 million compared to the prior year period. The increase was primarily driven by higher compensation costs and, to a lesser extent, higher supplies expense, partially offset by cost savings and productivity improvements from our Invigorate program.
Selling, General and Administrative Expenses ("SG&A")
SG&A consist principally of the costs associated with our sales and marketing efforts, billing operations, credit loss expense and general management and administrative support as well as administrative facility costs.
For the three months ended March 31, 2026, SG&A increased by $28 million compared to the prior period. The increase was primarily driven by higher compensation costs.
The changes in the value of our deferred compensation obligations is largely offset by changes in the value of the associated investments, which are recorded in other expense, net. For further details regarding our deferred compensation plans, see Note 17 to the audited consolidated financial statements included in our 2025 Annual Report on Form 10-K.
Amortization Expense
For the three months ended March 31, 2026, amortization expense was principally consistent with the prior year period.
Other Operating Expense, Net
Other operating expense, net includes miscellaneous income and expense items and other charges related to operating activities.
For both the three months ended March 31, 2026 and 2025, other operating expense, net primarily represents losses associated with the increase in the fair value of the contingent consideration accrual associated with previous acquisitions.
Interest Expense, Net
For the three months ended March 31, 2026, interest expense, net decreased by $4 million compared to the prior year period primarily due to the repayment in full of the outstanding indebtedness under our $600 million of 3.50% senior notes, which matured on March 30, 2025.
Other Expense, Net
Other expense, net represents miscellaneous income and expense items related to non-operating activities, such as gains and losses associated with investments and other non-operating assets.
For both the three months ended March 31, 2026 and 2025, other expense, net included $2 million of losses associated with investments in our deferred compensation plans.
Income Tax Expense
Income tax expense for the three months ended March 31, 2026 and 2025 was $74 million and $59 million, respectively.
The effective income tax rate for the three months ended March 31, 2026 and 2025 was 22.2% and 21.5%, respectively. The effective income tax rate benefited from $12 million and $9 million of excess tax benefits associated with stock-based compensation arrangements for the three months ended March 31, 2026 and 2025, respectively.
Equity in Earnings of Equity Method Investees, Net of Taxes
Equity in earnings of equity method investees, net of taxes, decreased by $14 million for the three months ended March 31, 2026, compared to the prior year period, primarily due to the three months ended March 31, 2025 including an $8 million non-recurring gain related to a lease and the three months ended March 31, 2026 including $7 million of losses associated with changes in the carrying value of our strategic investments.
Quantitative and Qualitative Disclosures About Market Risk
We address our exposure to market risks, principally the risk of changes in interest rates, through a controlled program of risk management that includes the use of derivative financial instruments. We do not hold or issue derivative financial instruments for speculative purposes. We seek to mitigate the variability in cash outflows that result from changes in interest rates by maintaining a balanced mix of fixed-rate and variable-rate debt obligations. In order to achieve this objective, we have historically entered into interest rate swap agreements. Interest rate swap agreements involve the periodic exchange of payments without the exchange of underlying principal or notional amounts. Net settlements are recognized as an adjustment to interest expense, net. We believe that our exposures to foreign exchange impacts and changes in commodity prices are not material to our consolidated results of operations, financial position or cash flows.
As of March 31, 2026 and December 31, 2025, the fair value of our debt was estimated at approximately $5.6 billion and $5.7 billion, respectively, principally using quoted prices in active markets and yields for the same or similar types of borrowings, taking into account the underlying terms of the debt instruments. As of March 31, 2026 and December 31, 2025, the estimated fair value was more than (less than) the carrying value of the debt by $(15) million and $59 million, respectively. A hypothetical 10% increase in interest rates (representing 48 basis points and 44 basis points as of March 31, 2026 and December 31, 2025, respectively) would potentially reduce the estimated fair value of our debt by approximately $136 million and $135 million as of March 31, 2026 and December 31, 2025, respectively.
Borrowings under our secured receivables credit facility and our senior unsecured revolving credit facility are subject to variable interest rates. Interest on our secured receivables credit facility is based on either commercial paper rates for highly-rated issuers or the adjusted Term Secured Overnight Financing Rate ("Term SOFR"), plus a spread. Interest on our senior unsecured revolving credit facility is based on certain published rates plus an applicable margin based on changes in our public debt ratings. As such, our borrowing cost under this credit arrangement is subject to fluctuations in interest rates and changes in our public debt ratings. As of March 31, 2026, the borrowing rates under these debt instruments were: for our secured receivables credit facility, commercial paper rates for highly-rated issuers or the adjusted Term SOFR, plus a spread of 0.80%; and for our senior unsecured revolving credit facility, the adjusted Term SOFR, plus 1.00%. As of March 31, 2026, there were no borrowings outstanding under both the secured receivables credit facility and the senior unsecured revolving credit facility.
The notional amount of fixed-to-variable interest rate swaps outstanding as of both March 31, 2026 and December 31, 2025 was $1.8 billion. The aggregate net fair value of the fixed-to-variable interest rate swaps was $1 million and $14 million, in a net asset (liability) position, as of March 31, 2026 and December 31, 2025, respectively.
Based on our net exposure to interest rate changes, a hypothetical 10% change to the variable rate component of our variable-rate indebtedness would not materially change our annual interest expense. A hypothetical 10% change in the SOFR curve (representing a 38 basis points change in the weighted average yield) would potentially change the fair value of our fixed- to-variable interest rate swaps by $44 million.
For further details regarding our outstanding debt, see Note 13 to the audited consolidated financial statements included in our 2025 Annual Report on Form 10-K. For details regarding our financial instruments and hedging activities, see Note 7 to the interim unaudited consolidated financial statements and Note 15 to the audited consolidated financial statements included in our 2025 Annual Report on Form 10-K.
Risk Associated with Investment Portfolio
Our investment portfolio primarily includes equity investments comprised mostly of strategic holdings in companies concentrated in the life sciences and healthcare industries. Equity investments (except those accounted for under the equity method of accounting or those that result in consolidation of the investee) with readily determinable fair values are measured at fair value in our consolidated balance sheet with changes in fair value recorded in current earnings in our consolidated statement of operations. Equity investments that do not have readily determinable fair values (which consist of investments in preferred and common shares of private companies) are measured at cost minus impairment, if any, plus or minus changes resulting from observable price changes.
We regularly evaluate equity investments that do not have readily determinable fair values to determine if there are any indicators that the investments are impaired. The carrying value of our equity investments that do not have readily determinable fair values was $47 million as of March 31, 2026. In conjunction with the preparation of our March 31, 2026 financial statements, we considered whether the carrying values of our investments were impaired and concluded that no such impairment existed.
We do not hedge our equity price risk. The impact of an adverse movement in equity prices on our holdings in privately held companies cannot be easily quantified as our ability to realize returns on investments depends on, among other things, the enterprises’ ability to raise additional capital or derive cash inflows from continuing operations or through liquidity events such as initial public offerings, mergers or private sales.
Liquidity and Capital Resources
| Three Months Ended March 31, | |||||||||||||||||
| 2026 | 2025 | Change | |||||||||||||||
| (dollars in millions) | |||||||||||||||||
| Net cash provided by operating activities | $ | 278 | $ | 314 | $ | (36) | |||||||||||
| Net cash used in investing activities | (152) | (115) | (37) | ||||||||||||||
| Net cash used in financing activities | (152) | (561) | 409 | ||||||||||||||
| Effect of exchange rate changes on cash and cash equivalents and restricted cash | (1) | 1 | (2) | ||||||||||||||
| Net change in cash and cash equivalents and restricted cash | $ | (27) | $ | (361) | $ | 334 |
Cash and Cash Equivalents
Cash and cash equivalents consist of cash and highly-liquid short-term investments with original maturities, at the time of acquisition, of three months or less. Cash and cash equivalents as of March 31, 2026 totaled $393 million, compared to $420 million as of December 31, 2025.
As of March 31, 2026, approximately 21% of our $393 million of consolidated cash and cash equivalents were held outside of the United States.
Cash Flows from Operating Activities
Net cash provided by operating activities for the three months ended March 31, 2026 and 2025 was $278 million and $314 million, respectively. The $36 million decrease in net cash provided by operating activities for the three months ended March 31, 2026, compared to the prior year period, was primarily a result of the timing of operating receipts and disbursements and higher bonus payments in the current period versus a year ago, partially offset by increased operating income.
Days sales outstanding, a measure of billing and collection efficiency, was 48 days as of March 31, 2026, 48 days as of December 31, 2025 and 47 days as of March 31, 2025.
Cash Flows from Investing Activities
Net cash used in investing activities for the three months ended March 31, 2026 and 2025 was $152 million and $115 million, respectively. This $37 million increase in net cash used in investing activities for the three months ended March 31, 2026, compared to the prior year period, was primarily a result of increased cash used for business acquisitions.
Cash Flows from Financing Activities
Net cash used in financing activities for the three months ended March 31, 2026 and 2025 was $152 million and $561 million, respectively. This $409 million decrease in net cash used in financing activities for the three months ended March 31, 2026, compared to the prior year period, was primarily a result of the prior year period including the repayment in full of the outstanding indebtedness under our $600 million of 3.50% senior notes (which matured on March 30, 2025) using a combination of cash on hand and $215 million of borrowings under our secured receivables credit facility.
During the three months ended March 31, 2026, there were no borrowings or repayments under our secured receivables credit facility. During the three months ended March 31, 2026, there were no borrowings or repayments under our senior unsecured revolving credit facility. During the three months ended March 31, 2025, we borrowed $215 million under our secured receivables credit facility, none of which was repaid prior to March 31, 2025. During the three months ended March 31, 2025, there were no borrowings or repayments under our senior unsecured revolving credit facility.
Dividend Program
During the first quarter of 2026, our Board of Directors declared a quarterly cash dividend of $0.86 per common share. During each of the four quarters of 2025, our Board of Directors declared a quarterly cash dividend of $0.80 per common share.
Share Repurchase Program
In February 2026, our Board of Directors authorized us to repurchase an additional $1 billion of our common stock. As of March 31, 2026, $1.4 billion remained available under our share repurchase authorization. The share repurchase authorization has no set expiration or termination date.
Share Repurchases
For both the three months ended March 31, 2026 and March 31, 2025, we repurchased no shares of our common stock.
Contractual Obligations
A description of the terms of our indebtedness and related debt service requirements is contained in Note 13 to the audited consolidated financial statements included in our 2025 Annual Report on Form 10-K.
A discussion of our lease obligations is contained in Note 14 to the audited consolidated financial statements included in our 2025 Annual Report on Form 10-K.
A discussion of our noncancellable commitments to purchase products or services is contained in Note 18 to the audited consolidated financial statements included in our 2025 Annual Report on Form 10-K.
Equity Method Investees
Our equity method investees primarily consist of a diagnostic information services joint venture and an investment in a fund that purchases strategic holdings in private companies in the healthcare industry. Such investees are accounted for under the equity method of accounting. Our investment in equity method investees is less than 5% of our consolidated total assets. Our proportionate share of income before income taxes associated with our equity method investees is less than 5% of our consolidated income before income taxes and equity in earnings of equity method investees. We have no material unconditional obligations or guarantees to, or in support of, our equity method investees and their operations.
In conjunction with the preparation of our March 31, 2026 financial statements, we considered whether the carrying values of our equity method investments were impaired and concluded that no such impairment existed.
Requirements and Capital Resources
We estimate that we will invest approximately $550 million during 2026 for capital expenditures, to support and grow our existing operations, principally related to investments in laboratory equipment and facilities, including laboratory automations and information technology to support our diagnostic offerings.
We have $500 million of 3.45% senior notes due June 1, 2026.
In February 2025, we committed to a multi-year project ("Project Nova") to modernize our "Order-to-Cash" business processes including related information technology infrastructure and underlying enabling technologies. We expect to deliver value throughout the implementation of Project Nova, as it unlocks a variety of streamlined operational benefits, reduced technology-related operating costs, accelerated revenue opportunities and improvements to the customer and patient experience. See our 2025 Annual Report on Form 10-K for further details.
As of March 31, 2026, we had $1.3 billion of borrowing capacity available under our existing credit facilities, including $518 million available under our secured receivables credit facility and $750 million available under our senior unsecured revolving credit facility. There were no borrowings outstanding under the secured receivables credit facility and no borrowings outstanding under the senior unsecured revolving credit facility as of March 31, 2026. In support of our risk management program, $82 million in letters of credit under the secured receivables credit facility were outstanding as of March 31, 2026.
Our secured receivables credit facility is subject to customary affirmative and negative covenants, and certain financial covenants with respect to the receivables that comprise the borrowing base and secure the borrowings under the facility. Our senior unsecured revolving credit facility is also subject to certain financial covenants and limitations on indebtedness. As of March 31, 2026, we were in compliance with all such applicable financial covenants.
We believe that our cash and cash equivalents and cash from operations, together with our borrowing capacity under our credit facilities, will provide sufficient financial flexibility to fund seasonal and other working capital requirements, capital expenditures, debt service requirements and other obligations, cash dividends on common shares, share repurchases and additional growth opportunities, including acquisitions, for the foreseeable future. However, should it become necessary, we believe that our credit profile should provide us with access to additional financing in order to fund normal business operations, make interest payments, fund additional growth opportunities, including acquisitions, and satisfy upcoming debt maturities.
Forward-Looking Statements
Some statements and disclosures in this document are forward-looking statements. Forward-looking statements include all statements that do not relate solely to historical or current facts and can be identified by the use of words such as “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “plan”, "aim", or “continue.” These forward-looking statements are based on our current plans and expectations and are subject to a number of risks and uncertainties that could cause our plans and expectations, including actual results, to differ materially from the forward-looking statements. Risks and uncertainties that may affect our future results include, but are not limited to, uncertain and volatile economic conditions, adverse results from pending or future government investigations, lawsuits or private actions, the competitive environment, the complexity of billing, reimbursement and revenue recognition for clinical laboratory testing, changes in government policies, including related to trade, and regulations, changing relationships with customers, payers, suppliers and strategic partners, acquisitions and other factors discussed in our most recently filed Annual Report on Form 10-K and subsequently filed Quarterly Reports on Form 10-Q and Current Reports on Form 8-K, including those discussed in the “Business,” “Risk Factors,” “Cautionary Factors that May Affect Future Results” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” sections of those reports.
Item 3. Quantitative and Qualitative Disclosures About Market Risk
See Item 2. "Management's Discussion and Analysis of Financial Condition and Results of Operations."
Item 4. Controls and Procedures
Management, including our Chief Executive Officer and our Chief Financial Officer, has evaluated the effectiveness of our disclosure controls and procedures (as defined under Rules 13a-15(e) and 15d-15(e) of the Securities Exchange Act of 1934, as amended). Based upon that evaluation, our Chief Executive Officer and our Chief Financial Officer concluded that our disclosure controls and procedures were effective as of the end of the period covered by this quarterly report.
During the first quarter of 2026, there were no changes in our internal control over financial reporting (as defined in Rule 13a-15(f) under the Securities Exchange Act of 1934, as amended) that materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
PART II - OTHER INFORMATION
Item 1. Legal Proceedings
See Note 10 to the interim unaudited consolidated financial statements for information regarding the status of legal proceedings involving the Company.
Item 1A. Risk Factors
Item 1A. of our Annual Report on Form 10-K for the year ended December 31, 2025 includes a discussion of our risk factors. There have been no material changes in the risk factors described in that report.
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
The table below sets forth the information with respect to purchases made by or on behalf of the Company of its common stock during the first quarter of 2026.
| ISSUER PURCHASES OF EQUITY SECURITIES | ||||||||||||||||||||||||||||||||
| Period | Total Number of Shares Purchased | Average Price Paid per Share | Total Number of Shares Purchased as Part of Publicly Announced Plans or Programs | Approximate Dollar Value of Shares that May Yet Be Purchased Under the Plans or Programs (in thousands) | ||||||||||||||||||||||||||||
| January 1, 2026 – January 31, 2026 | ||||||||||||||||||||||||||||||||
| Share Repurchase Program (A) | — | $ | — | — | $ | 433,481 | ||||||||||||||||||||||||||
| Employee Transactions (B) | 119 | $ | 175.70 | N/A | N/A | |||||||||||||||||||||||||||
| February 1, 2026 - February 28, 2026 | ||||||||||||||||||||||||||||||||
| Share Repurchase Program (A) | — | $ | — | — | $ | 1,433,481 | ||||||||||||||||||||||||||
| Employee Transactions (B) | 61,028 | $ | 208.34 | N/A | N/A | |||||||||||||||||||||||||||
| March 1, 2026 – March 31, 2026 | ||||||||||||||||||||||||||||||||
| Share Repurchase Program (A) | — | $ | — | — | $ | 1,433,481 | ||||||||||||||||||||||||||
| Employee Transactions (B) | 119,493 | $ | 204.86 | N/A | N/A | |||||||||||||||||||||||||||
| Total | ||||||||||||||||||||||||||||||||
| Share Repurchase Program (A) | — | $ | — | — | $ | 1,433,481 | ||||||||||||||||||||||||||
| Employee Transactions (B) | 180,640 | $ | 206.02 | N/A | N/A |
(A)In February 2026, our Board of Directors increased the size of our share repurchase program by $1 billion. Since the share repurchase program’s inception in May 2003, our Board of Directors has authorized $14 billion of share repurchases of our common stock through March 31, 2026. The share repurchase authorization has no set expiration or termination date.
(B)Includes: (1) shares delivered or attested to in satisfaction of the exercise price and/or tax withholding obligations by holders of stock options (granted under the Company’s Amended and Restated Employee Long-Term Incentive Plan) who exercised options; and (2) shares withheld (under the terms of grants under the Amended and Restated Employee Long-Term Incentive Plan) to offset tax withholding obligations that occur upon the delivery of outstanding common shares underlying restricted stock units and performance share units.
Item 5. Other Information
a.None
b.None
c.Rule 10b5-1 and Non-Rule 10b5-1 Trading Arrangements by Our Directors and Officers
During the quarterly period covered by this report, our directors and officers (as defined in Rule 16a-1(f) of the Securities Exchange Act of 1934, as amended) adopted, terminated or modified the Rule 10b5-1 trading arrangements (as defined in Item 408 of Regulation S-K) set forth in the table below. No non-Rule 10b5-1 trading arrangements were adopted, modified or terminated by any director or officer during the quarterly period covered by this report.
| Name | Title | Type of Trading Arrangement | Security | Action | Date of Action | Duration of Trading Arrangement | Aggregate Number of Securities Covered | ||||||||||||||||
| Karthik Kuppusamy | SVP, Clinical Solutions | Rule 10b5-1 plan to sell | Common Stock | Adoption | February 26, 2026 | February 26, 2026 to February 26, 2027* | Up to 8,147* |
- Includes shares of common stock to be released from stock options.
Item 6. Exhibits
Exhibits:
| 10.1 | Form of Quest Diagnostics Incorporated 2026 Equity Award Agreement | |||||||
| 22 | Subsidiary Guarantors of Securities | |||||||
| 31.1 | Rule 13a-14(a) Certification of Chief Executive Officer | |||||||
| 31.2 | Rule 13a-14(a) Certification of Chief Financial Officer | |||||||
| 32.1 | Section 1350 Certification of Chief Executive Officer | |||||||
| 32.2 | Section 1350 Certification of Chief Financial Officer | |||||||
| 101.INS | Inline XBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document | |||||||
| 101.SCH | Inline XBRL Taxonomy Extension Schema Document - dgx-20260331.xsd | |||||||
| 101.CAL | Inline XBRL Taxonomy Extension Calculation Linkbase Document - dgx-20260331_cal.xml | |||||||
| 101.DEF | Inline XBRL Taxonomy Extension Definition Linkbase Document - dgx-20260331_def.xml | |||||||
| 101.LAB | Inline XBRL Taxonomy Extension Label Linkbase Document - dgx-20260331_lab.xml | |||||||
| 101.PRE | Inline XBRL Taxonomy Extension Presentation Linkbase Document - dgx-20260331_pre.xml | |||||||
| 104 | Cover Page Interactive Data File (formatted in Inline XBRL and contained in Exhibit 101) | |||||||
Signatures
Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.
April 22, 2026
Quest Diagnostics Incorporated
| By | /s/ James E. Davis | ||||
| James E. Davis | |||||
| Chairman, Chief Executive Officer | |||||
| and President | |||||
| By | /s/ Sam A. Samad | ||||
| Sam A. Samad | |||||
| Executive Vice President and | |||||
| Chief Financial Officer |