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Morgan Stanley 22nd Annual Global Healthcare Conference

Sep 6, 2024

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Hey, everyone. Good morning. I'm Tejas Savant, and I cover the life sciences here at Morgan Stanley. Before we begin, for important disclosures, please see the Morgan Stanley Research Disclosure website at morganstanley.com/research disclosures. And if you have any questions, do reach out to your sales rep. It's my pleasure to host NeoGenomics today, and speaking on behalf of the company, we have CEO Chris Smith, CFO Jeff Sherman, and Warren Stone, who's the Chief Commercial Officer.

Jeff Sherman
CFO, NeoGenomics

Good morning.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Thanks for joining me on the stage, guys.

Jeff Sherman
CFO, NeoGenomics

Yeah.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Appreciate it. Maybe, Chris, just to kick things off, could you just outline, you know, NeoGenomics key accomplishments this year in your view against a decidedly tough macro backdrop? What are you particularly proud of?

Chris Smith
CEO, NeoGenomics

Wow! That's a really good question. We could spend the whole time on that today. So I think if you followed the Neo story, I would say one thing I'm particularly proud of, which started last year and continued this year, is that the company has gone through an amazing amount of transformation.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

And this was a business that was a great franchise, a twenty-year-old company, kind of built the cancer testing market, especially to community hospitals, grew through acquisitions. And a business that was growing fast and making money, went to not growing at all and losing money. And so I'm particularly proud of how well the team has come together and gotten the business back on a very nice growth trajectory.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

growing double digits, taking a business that lost $50 million adjusted EBITDA a couple of years ago to actually making money last year. And just recently, in our recent guidance or our recent quarter, we raised guidance.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

The thing that I would say, the second thing I'm particularly proud of, more and more cancer care is occurring in the community setting.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

So if you think about 85% of cancer patients are treated in the community, and what we've always said is that we want to be able to bring cancer testing to the patient in Paducah, Kentucky, so they can get the same kind of care that you get at Sloan Kettering.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Right.

Chris Smith
CEO, NeoGenomics

I think the team continues to do that, and we see an incredible need for our products.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it. Yeah. Maybe let's start with the clinical side of things. You know, you, you've demonstrated really good ability to improve AUP. I think last quarter was the thirteenth consecutive quarter where AUP went up. As you look to next year, what do you think are the main levers you intend to pull? Is it predominantly that NGS mix, or do you see room from the RCM initiatives as well?

Chris Smith
CEO, NeoGenomics

Yeah, I'll kind of give high level and then maybe let Jeff and Warren kind of chime in there. But look, I think for us, we were under indexed on solid tumor NGS. So without question, as we grow our share in that NGS, it contributes, but also bringing out new products. And so our we've seen a big lift in AUP because we launched key products in Q1 of last year and Q3, but those comparables get tougher in the back half of this year. But we have two major product launches, and maybe Warren can take the two major product launches that we have in the middle of next year. And so I think all those factors, but do you want to kind of talk specifically how-

Jeff Sherman
CFO, NeoGenomics

Yeah. Sure, I think the NGS mix has been a big driver of the AUP improvement-

Chris Smith
CEO, NeoGenomics

Mm-hmm

Jeff Sherman
CFO, NeoGenomics

... this year. We've talked about that.

Chris Smith
CEO, NeoGenomics

Mm-hmm.

Jeff Sherman
CFO, NeoGenomics

As Chris said, there was a pretty big step up in Q1 and even and an even bigger step up in Q2, and an even bigger step up in Q3 of last year. We continue to believe that NGS growth and penetration is going to drive AUP. New products that Warren can talk about will help drive that even more. And then, that's one aspect. That's probably That's driven, you know, roughly 60% of the AUP increase. The other drivers are, the rest of the business, there's mix as well. So if you're still hitting higher value tests in the rest of the business-

Chris Smith
CEO, NeoGenomics

Mm-hmm

Jeff Sherman
CFO, NeoGenomics

... that can drive AUP.

Chris Smith
CEO, NeoGenomics

Mm-hmm.

Jeff Sherman
CFO, NeoGenomics

And then there's the RCM element. The RCM element, the first is price.

Chris Smith
CEO, NeoGenomics

Mm-hmm.

Jeff Sherman
CFO, NeoGenomics

We've been successful in getting price. You know, two-thirds of our clinical business is actually billing hospitals directly-

Chris Smith
CEO, NeoGenomics

Mm-hmm

Jeff Sherman
CFO, NeoGenomics

... and we've been successful in getting price there. Then the remaining third is managed care and Medicare. So managed care, we have pricing opportunities as well, and then just getting paid for the work we're doing. So the biomarker legislation will be a tailwind for us.

Chris Smith
CEO, NeoGenomics

Yeah.

Jeff Sherman
CFO, NeoGenomics

We believe over time, as more states pay or mandating the payment for larger panel tests. So we, we as well as others, have struggled with getting paid for those tests. So. And then just core RCM, just getting paid for the work we're doing, prior authorization, medical necessity, medical records, we have teams focused on all of those. So we actually see a multi-year opportunity to continue to drive AUP, both from a mix perspective and then an operational RCM perspective.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it. Makes sense. You, you've talked about, you know, NGS being as a percent of the clinical services revenue, could reach north of 50% down the road. Everyone wants to know the slope of that curve, right?

Chris Smith
CEO, NeoGenomics

Mm-hmm.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

You know, versus the 25% or so you're at today. What are the main drivers of adoption that you're focused on? And as we think about the next, say, 3 years, are there sort of step function increases that you envision, or is this one of those situations where every year it should go up by, I don't know, maybe like 3% to 4%?

Chris Smith
CEO, NeoGenomics

Right. I think... Look, the two big step ups I think you would see is, number one, the new products.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

So we-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

... we have been very strong on heme, and in heme, obviously Heme NGS, but we were well behind on solid tumor. We launched one product last year. We'll launch a very large tumor panel in 2025. And then the other big one is we're not in liquid today at all-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Right

Chris Smith
CEO, NeoGenomics

... liquid biopsy. And so those two new products will lift that significantly. And I think the second one is really our field expansion. And maybe, Warren, I'll throw that off to you and talk a little bit about what you're thinking about from the field and how we're doing it, and why that would be another step.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

... step up, yeah.

Warren Stone
Chief Commercial Officer, NeoGenomics

Maybe go back to new products first. So, because that's a key part of the strategy, obviously, and in the first quarter next year, we'll launch a pan-cancer liquid biopsy test, 500 genes. We're calling it PanTrace, the liquid biopsy.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

Five hundred genes in the first quarter, and I think that's important because today we only have IVFL, which is a lung liquid biopsy, so it gives us obviously greater utility, and as guidelines are changing around concurrent testing, first in lung, but probably gonna broaden from there, I think it's important that we have access to that technology as well, and that's a nice add to our portfolio. The second area is this larger whole genome sequencing panel that we're gonna bring out second quarter. That's attractive because it gives us access into the academic community-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Warren Stone
Chief Commercial Officer, NeoGenomics

... and in the academic hospitals, which is an area where we haven't necessarily focused on, and certainly a strong growth opportunity. In addition to the value of that test into the academic space, also the downstream data benefits of that that we can obviously then plow into our informatics business will be attractive too. So certainly, product is key. Over the last couple of years, we've expanded our commercial team extensively. We did an expansion in January of this year, and we've communicated the fact that we're gonna expand again, effective January of this year again. And the primary purpose of the expansions is broadening our focus from where we've traditionally been strong, which has been community hospital-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Warren Stone
Chief Commercial Officer, NeoGenomics

...and it, broadening our focus to community oncology. And what we've learned through the process of accessing community oncology over the last year is that, frequency, there's a higher frequency need. The business is more fickle, it's not as sticky as what we see in the hospital, so we need to increase the frequency of our visits to ensure the stickiness of our product. So the investment into additional resources will allow us to get a broader reach, get some of those commun- more community oncology practices-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Warren Stone
Chief Commercial Officer, NeoGenomics

... that are more rural, but also increase the frequency and the combination of our broad portfolio, the new portfolio, and the additional commercial resources is, I think, the key elements that are gonna drive the growth from where we are right now, or the ratio from roughly 30% to the 50% that you were talking about.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it. Fair enough. Maybe, you know, talking about sort of your leadership position within Heme, can you speak a bit to how you're leveraging that there to expand into new accounts within the community setting, and also using that to drive further adoption of the rest of your NGS portfolio?

Warren Stone
Chief Commercial Officer, NeoGenomics

Yeah. So again, I think it's a similar strategy in terms of hospitals versus community oncology, but as you say, we consider ourselves market leader within the Heme space, and obviously, what's interesting with the Heme space, it's sort of a different set of competitors that we're up against.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

When we think about Heme, we think more towards larger reference labs-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Warren Stone
Chief Commercial Officer, NeoGenomics

... than we do towards some of the onco-techs. What that actually does, because a lot of the Heme Cancers are treated within the hospital, it creates this very strong position within hospitals. It actually allows us to sort of become the oncology provider of services within these hospitals. Once you integrate it in there, and you've got interfaces, et cetera, it becomes very, very sticky business. We leverage our commercial strategy of protect, expand, and acquire very much around using that position within the hospitals to expand our portfolio, both within the Heme, but also expanding into the solid tumor.

What we find attractive there is, as more and more hospitals are acquiring outreach community centers, we're actually able to use this hospital leverage to also drive growth within these community settings with regards to Heme and solid tumor. Second aspect, if you think about the more independent community oncology practices, there is a need for Heme.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

You know, we offer a service today to many community, independent community oncology practices and have a good standing. We're well regarded, and we're leveraging that position again to expand into solid tumor, particularly as more and more of the products we're bringing out are relevant to the community oncology setting. The products that we launched in late Q1 last year, near comprehensive solid tumor, the DNA, RNA lung, those were really, really relevant for the community setting, and we've leveraged our position from a Heme point of view to pull those through.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it. Warren, maybe this one's for you as well. Talk to us about just how much further investing in the commercial team you need to do, and I think, Chris, you flagged about, you know, using AI tools for increasing the sales force effectiveness. Talk to us about, you know, where you are on that journey, and how much more you can do there.

Chris Smith
CEO, NeoGenomics

Yeah. You wanna take it?

Warren Stone
Chief Commercial Officer, NeoGenomics

So I think, again, we've had a significant amount of investment in our commercial team, and even with this expansion that we're gonna do in January, we indicated that it was gonna be roughly a 35% increase in-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Warren Stone
Chief Commercial Officer, NeoGenomics

... in size. If we look at the community oncology market per se, which is still the bigger market for solid tumor, we're still underrepresented relative to a number of our peers.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

I think within this sort of long-range plan, I think there's definitely expectations that we will further invest, especially as these new products start to mature and we get back on the market in terms of MRD in the future.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

but an additional strategy that it's not just about how many people you have, it's how effective your people are out there, and that's where using tools and AI to help target and increase effectiveness is gonna be a critical part of that strategy.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it.

Chris Smith
CEO, NeoGenomics

Yeah, I think one of the big misnomers, I think, in this business as we came in, is just how ineffective the sales channel-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm

Chris Smith
CEO, NeoGenomics

... were.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

You know, we use a Gartner index, and we've talked a lot about this, and to manage the effectiveness. Best in class would be in the high 50s, 60%, and I think this industry was in the low teens, high teens, low 20s. A lot of our strategy has been to bring in those tools that frees up minutia and takes time that has been, you know, taken away from in front of the customer selling and taking those off our sales force. That has been a big, big lift to our-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

to our sales force effectiveness.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it.

Chris Smith
CEO, NeoGenomics

Using AI to do that has helped us. Yeah.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Fair enough. One on the non-molecular side of things, what's the status there on just the price degradation to anticipate going forward? And could we see you rationalize the offering there as you focus more heavily on NGS, or does the importance of being a truly sort of comprehensive one-stop shop outweigh the benefit, particularly in the community setting?

Chris Smith
CEO, NeoGenomics

Yeah, look, I mean, I think we would love every category or modality that we're in to grow 20%

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

So NGS, we have growing

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Right

Chris Smith
CEO, NeoGenomics

North of 20%. I would say things like Cyto, FISH, Flow, we have those growing 2%-4%..

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Right.

Chris Smith
CEO, NeoGenomics

And so our mantra is that we need to grow those faster than markets. So if market's at two to four, let's grow them faster. But I think that our sweet spot is the ability to offer that end-to-end comprehensive. I think that's what makes us differentiated. I think the big reference labs really don't have the service levels, or I'd say the depth in oncology, that we have, and I think these onco-techs are offering five to 10 products.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm, mm-hmm.

Chris Smith
CEO, NeoGenomics

And so one of the things that I've always loved is that all our competitors on solid tumor, their customers are buying something from us, so it gives us a door open. So, look, I think, you know, you have to accept, I think, those things that are the ability to provide your customer all the solutions, if you're gonna be kind of the end-to-end comprehensive cancer testing company. And that's what we believe that we are, and we think there's a huge opportunity for a company to lead the way there.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it.

Jeff Sherman
CFO, NeoGenomics

Yeah, again, I would add to that. So again, with two-thirds of the business being billed directly to hospitals and us getting price increases there, we may see degradation in a small percentage from a Medicare, 1% or 2%.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Jeff Sherman
CFO, NeoGenomics

But the overall, even for those lower value tests, the overall AUP is still gonna be going up, we believe.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it. Got it.

Warren Stone
Chief Commercial Officer, NeoGenomics

Maybe adding one of this additional element there in terms of the importance of breadth of portfolio. When we look at the requisitions that come in on a day-to-day basis, you know, only 22%-24% of those requisitions are for a single test.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm.

Warren Stone
Chief Commercial Officer, NeoGenomics

The other sort of 74%-78% of those requisitions are for multiple different tests within our portfolio.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it.

Warren Stone
Chief Commercial Officer, NeoGenomics

A big, big part of the strategy for us is sort of the, what we call Concurrent Testing.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

Trying to get as many tests-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Warren Stone
Chief Commercial Officer, NeoGenomics

as possible on a single sample.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it. I want to switch to PanTrace, which-

Warren Stone
Chief Commercial Officer, NeoGenomics

Mm-hmm

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

which you mentioned, Warren, just now.

Chris Smith
CEO, NeoGenomics

I love that you already know the brand name.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Yeah.

Chris Smith
CEO, NeoGenomics

We haven't even launched it. Love that!

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

What differentiates PanTrace from the other, you know, liquid biopsy CGP tests on the market? Is, you know, what you just said about, you know, the portfolio approach and being a one-stop shop, enough of a hook to get physicians to try you and switch eventually, you know, their liquid biopsy needs over to you?

Warren Stone
Chief Commercial Officer, NeoGenomics

Yeah, that's a great question. I think it, it's, there's no one thing, to be frank. It is, it's a combination of multiple aspects. We believe the product, the PanTrace liquid biopsy, being a 500-plus gene panel that we're gonna bring to market, is a very competitive.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Warren Stone
Chief Commercial Officer, NeoGenomics

... product in terms of its limited detection, the number of genes, et cetera. We're not on the market yet, but we believe, based on the runs that we've been doing, in preparation for validation, et cetera, it's gonna be a very competitive turnaround time. Something that's critically important, especially if you're thinking about running concurrent or you're using liquid to get an initial indication. So it's a combination of a very competitive test, a fast turnaround time, and the fact that we were able to offer the solid tumor, if you're thinking about that from a concurrent perspective, or any other test that you may-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Warren Stone
Chief Commercial Officer, NeoGenomics

... actually need within that setting. So it's a combination. It's not one thing.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it

Warren Stone
Chief Commercial Officer, NeoGenomics

... um.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

What's the degree of concurrent testing that you see today, you know, between... Well, I guess a bit of an unfair question because you're, you're not really live in liquid yet, but, but eventually, what do you expect to see, in terms of the overlap between tissue plus liquid? And then, what about sort of RNA testing in addition to tissue? 'Cause both of those seem to be increasingly ordered together.

Warren Stone
Chief Commercial Officer, NeoGenomics

So, I think, yeah, we don't have a lot of experience yet today because it's not something we have.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Yeah.

Warren Stone
Chief Commercial Officer, NeoGenomics

I mean, one of the areas that we do think about is, is how many times do we get a QNS TMP when we run a solid sample? Because that would be an obvious opportunity now for us to drive that to liquid.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

I mean, we have those as a ratio, and we continue to look to improve the quality or the effectiveness of our solid tumor panel. But I mean, that is in the range of sort of the high teens at this particular point.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

So there's initial proxy for us.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Warren Stone
Chief Commercial Officer, NeoGenomics

... to say, "Okay, we could get as much as high teens in terms of concurrent testing, because we're receiving a QNS TNP.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

But that's more of a reflex than a concurrent.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Right.

Warren Stone
Chief Commercial Officer, NeoGenomics

So it could be more than that, but I think I'm speculating if I were to provide any more detail.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Right.

Chris Smith
CEO, NeoGenomics

And very different than you doing RNA, DNA separate-

Warren Stone
Chief Commercial Officer, NeoGenomics

Definitely, yeah.

Chris Smith
CEO, NeoGenomics

If that's what your question is.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Oh, it was both, really.

Chris Smith
CEO, NeoGenomics

Yeah.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

I mean, it was tissue plus liquid, and, tissue DNA plus tissue RNA.

Chris Smith
CEO, NeoGenomics

Yeah.

Warren Stone
Chief Commercial Officer, NeoGenomics

Yeah. It's a question that's come up often today, actually.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Yeah.

Warren Stone
Chief Commercial Officer, NeoGenomics

It's probably something we need to dig into. I mean, we obviously have RNA plus standalone panels, where people are looking for fusions and those types of things. And, certainly not something that we've factored into our business case, but so we've got a fair amount of air time today, so something we're gonna look at.

Chris Smith
CEO, NeoGenomics

Yeah. Look, I think at the end of the day, our belief is we're gonna provide the best care possible-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

... and we're gonna run our business to do that. We're not gonna run our business to gain a little bit better initial pricing strategies, especially if it's flying close to the flames.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

I think there's been some discussion about, can you bill for both? Do you not bill for both? Look, I think at the end of the day, I think our view has always been that you're gonna take the high road, and we're gonna follow the guidelines that are, that are in place, and I think that's serving us well.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it.

Chris Smith
CEO, NeoGenomics

Maybe a way,

Warren Stone
Chief Commercial Officer, NeoGenomics

The medical necessity question-

Chris Smith
CEO, NeoGenomics

Yeah

Warren Stone
Chief Commercial Officer, NeoGenomics

is one that we continue to need to ask.

Chris Smith
CEO, NeoGenomics

I think-

Warren Stone
Chief Commercial Officer, NeoGenomics

If there's a medical necessity, we'll drive for that.

Chris Smith
CEO, NeoGenomics

Right.

Warren Stone
Chief Commercial Officer, NeoGenomics

But again, we have that within our portfolio, so this is really, that's the question: What's the medical necessity here?

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it. Fair enough. Quickly on the MolDX process on PanTrace, where do things stand?

Warren Stone
Chief Commercial Officer, NeoGenomics

So, right now, we are starting to work towards validation of the test at this particular point. Once we've done that, we're gonna start doing various studies-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Warren Stone
Chief Commercial Officer, NeoGenomics

... which will be required, obviously, to submit to MolDX.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

If I look at timelines within the first quarter-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Yeah

Warren Stone
Chief Commercial Officer, NeoGenomics

Our intention is to submit to MolDX in the first quarter reimbursement.

Chris Smith
CEO, NeoGenomics

So we've already started enrollment in one of our big, the big trial. We have not running those tests yet, but we've already engaged our investigators in starting to run enrollment. So I think that we'll be pretty early on from the time we go to market as to when we're going into MolDX on that, which I think is gonna be-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it.

Chris Smith
CEO, NeoGenomics

Yeah.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Maybe on just the launch of a bunch of these new tests that you have in the hopper, how are you thinking about the impact to margins when they initially launch and scale up? Will you be sort of gating volumes ahead of broad reimbursement, or do you think there's some merit in building mind share so that once the reimbursement comes, you're already live and people are aware of the offering?

Chris Smith
CEO, NeoGenomics

Look, I think it's a combination of both. I mean, I think you definitely want to have physicians, your early adopters, get the product early, and we'll do things like a controlled market release to-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

... to be able to do that. That being said, it has not been our custom policy to give away hundreds of thousands of tests, and so we try to move very quickly on the reimbursement side.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

I think fortunately for both of those tests, there's pretty established reimbursement.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Yeah

Chris Smith
CEO, NeoGenomics

In the marketplace that we think that we can follow, and that's why I think starting these MolDX clinical trials early on helps. In addition, while a lot of these new tests are very focused on the community oncology-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

... over 60%, about two-thirds of our business today is in hospitals, and none of that goes through third-party payers.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Sure.

Chris Smith
CEO, NeoGenomics

It's direct bill to the hospital.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Right.

Chris Smith
CEO, NeoGenomics

So we think that a lion's share of these products will start there.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it.

Chris Smith
CEO, NeoGenomics

We'll continue to grow other things, so I think it'll be very different than if we were just doing all through third-party payers.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it.

Chris Smith
CEO, NeoGenomics

So I think we'll get payment coming out of the gate.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Jeff, one for you, and just, you know, you've done a bunch of restructuring activities in advanced diagnostics, and you now expect to return to year-over-year growth. What gives you confidence in that outlook, you know, in the remainder of this year and into twenty-five? Pharma customers still seem to be grappling with budget constraints and reprioritizing pipelines. There's some sort of renewed IRA and patent cliff concerns that some of the preclinical CROs have been talking about as well in June and July. So just talk to us about that.

Jeff Sherman
CFO, NeoGenomics

Yeah, I'll start, and then I'll ask probably Warren to add in as well. So coming out of Q1, we said expect Q2 and Q3 to be in a similar range as Q1-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Jeff Sherman
CFO, NeoGenomics

... for a revenue perspective.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Jeff Sherman
CFO, NeoGenomics

You know, keep in mind, some of this was self-selection, where we decided to exit some unprofitable contracts as well.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Yeah.

Jeff Sherman
CFO, NeoGenomics

So even though our revenue is going down, our actual adjusted gross margin was actually increasing from a dollar perspective, and our margin performance has gone up, you know, 400-plus basis points in the second quarter. So I think what we set out to do, you know, what was happening, we said we expected growth to start occurring, you know, kind of recurring in Q4 and starting in the next year.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Jeff Sherman
CFO, NeoGenomics

Really, I would say a lot of that is the work Warren and his team is doing, you know, to drive that, and I'll let Warren kind of expand on that.

Warren Stone
Chief Commercial Officer, NeoGenomics

Yes. Thanks, Jeff. So I think a couple of things, and I took over this business in April of this year, and I must say, it feels a bit like going home because I've been responsible for a similar business in the past, and really excited about the opportunity. I mean, 19 of the top 20 pharma companies have oncology as their number one focus from an R&D perspective.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

So, you know, it's an attractive market. There's no question about it. And as we look to our sort of competency and capability, I feel that maybe we hadn't structured our business effectively to serve the needs of our pharma customers as well as we could potentially. And so we're thinking about this two ways. We're adjusting the business model. We're adjusting our deployment strategy.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

All of those things are sort of in flight, and will fully go live in January.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

But we've already started to tactically put a number of those elements in place. And what's really good is we. It is a long sales cycle, but we can measure the opportunities within Salesforce, and not only the volume. I think what we're looking at very closely is the quality of those opportunities, and not quality as are they gonna close, more about what's the value and the profitability of those opportunities. And leading indicator points to very attractive opportunity pipeline. We are seeing a good conversion into statement of work, if I look at sort of Q2 developments and what we're seeing through Q3.

So we're starting to see early indications of the changes that we've made from a pharma perspective to bear fruit, which ultimately we will really benefit from in 2025 and beyond because of the sales cycle nature.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it.

Jeff Sherman
CFO, NeoGenomics

We have also built a... You know, Warren did a great job of building a kind of a commercial infrastructure-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Jeff Sherman
CFO, NeoGenomics

... and sales enablement. You know, so we've made investments there as well that we'll also be able to leverage on the pharma side of the business more.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Right. Got it.

Warren Stone
Chief Commercial Officer, NeoGenomics

lot of added points.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Chris, switching to MRD, everyone agrees that it's a great market to be in, lots of exciting development there on the payer front as well, you know, sooner than, you know, a lot of folks had expected. How do you think about, you know, Neo's right to win in MRD, right? I mean, it's a complicated market in terms of, you know, all the litigation that's going on, but even beyond that, there seems to be an emphasis placed by oncologists on lots of publications. And especially as more and more tests launch into the market, you know, that becomes a bigger differentiator. So just talk to us about, you know, the journey there for you over the next few years.

Chris Smith
CEO, NeoGenomics

Yeah. So look, if you believe that we're going to kind of want to own the end-to-end comprehensive testing, then you have to be in MRD. As I think we all know MRD is probably going to end up being the biggest-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

-market. I look at it a lot, probably the way NGS was ten or fifteen years ago, and so we definitely want to be there. As you know, we invested early.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

I would say we were one of the first movers to invest in a company called Inivata.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

Subsequently, we bought that company, and I would say the team did a fantastic job of developing and bringing a product to market. So RaDaR-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

was called one

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

-or first generation-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

RaDaR. And in doing all that, when you talk about the clinical trials, we started pathways on multiple indications, as far as clinical trials to get MolDX coverage.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

and to provide, you know, kind of, a validation. I think the one thing that's nice about this industry is I do think there's a sense of clinical trials drives adoption, but it's not a clinical trial specific to the test. So if you think about NGS, you don't see that a lot today on a specific NGS test. It's about the category, and there's a lot to be said that A equals B and B equals C, so A must equal C when it comes to clinical-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

but except for with MolDX.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

So look, we've continued all those trials, as you know. Subsequently, with that product released to the market, we moved into litigation-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

and it went under a PI, where we cannot sell or promote that product, but we were able to continue those trials. So all those trials and all those-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

Indications have continued, and look, for us, we believe that it's important, and you talk about the right to win, we believe that we need to have the right to win there, and I think that we're pursuing really kind of three paths that we've talked about. One is the litigation, which-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

-is going down its path. I'd say the second one, which to me is probably the most exciting, is. Look, we have an incredible brain trust in MRD technology going back several years, and when you think about MRD, the piece that is kind of adjoined right now is that front end, which is really around the DNA sequencing. But for us, our secret sauce has always been the bioinformatics, and that's where our IP is, and our ability to develop a another pathway to do that front end has gone incredibly well.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

And so look, we, you know, we've gone through early on version two, we've gone through feasibility, and we'll probably have a product that's available for the market in 2025, and then we'll move on to our third generation. So there's a lot going on-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

in that middle category. And then I'd say, look, the third one for us, it's around... We don't think it'll be just tumor-informed. We think it'll be tumor-naïve, and I think the ability to insource and license other technologies, 'cause one of our greatest strengths is this distribution channel that Warren has talked about, this, especially in the hospital setting, but more and more in the community, and our ability to bring new products and put them through there. So I think we're going down all three of those paths simultaneously. We don't think it's just one way.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it. Fair enough.

Chris Smith
CEO, NeoGenomics

Yeah.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

So Chris, you know, on the sort of future versions of RaDaR, where do things stand in terms of, you know, development timelines? When can we expect to see perhaps some more lead data?

Chris Smith
CEO, NeoGenomics

More... I'm sorry,

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Just more data on the-

Chris Smith
CEO, NeoGenomics

Yeah, yeah

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

new versions of RaDaR.

Chris Smith
CEO, NeoGenomics

So look, I think that you'll start to see. So, you know, we have colorectal that has been in trial. I think, you know, we've talked about lung. We've talked obviously head and neck.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm. Mm-hmm.

Chris Smith
CEO, NeoGenomics

I think you'll start to see data that'll come out, but as we bring out those new versions, we'll start new trials.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Okay.

Chris Smith
CEO, NeoGenomics

So I think you'll see those come, and, and really, that next one is that version two, which will happen next year.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it.

Chris Smith
CEO, NeoGenomics

So we'll start trials with that as well.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it. Speaking of IP, I mean, you know, TwinStrand has had, you know, some success asserting their duplex sequencing IP against companies in the space using, you know, cell-free DNA-based liquid biopsy tests. Is this something you're keeping an eye on?

Chris Smith
CEO, NeoGenomics

Yeah, look, I think, more and more in this space, IP becomes significantly more important. And I think also this whole thing about potentially, are you moving from lab-developed tests? What-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

regulations will the FDA

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

have? I think Neo was probably, if you go back to the original way Neo was developed, it was lab-developed tests.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

And probably not a lot of time was spent on IP or innovation. I would say that that's pivoted a lot under our leadership. I think, you know, the team that's focusing on IP is doing a great job, I think, getting looking at freedom to operate before we get into the development and then starting to patent our own things. So, look, I think more and more IP becomes important. But I think that's just a maturing of an industry that happens.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it. Fair enough. Want to switch gears a little bit to, you know, the digital transformation that's underway. Talk to us about, you know, any improvement you've seen in account stickiness or perhaps even integration with customer EMRs?

Chris Smith
CEO, NeoGenomics

Yeah, I think that's a really great one for you to take 'cause we see a significant difference through interfacing and the impact it's making. So you want to talk a little bit about that?

Warren Stone
Chief Commercial Officer, NeoGenomics

Yeah. I think as an organization, we're going through a pretty large digital transformation. I think we've spoken about the fact that we're changing out our LIMS system, and that process is in flight, and the first phase of that process will conclude at the end of this year, which is really around, I'd say, replacing the existing LIMS system with the existing capability.

Chris Smith
CEO, NeoGenomics

Really like eight LIMS systems, eight different-

Warren Stone
Chief Commercial Officer, NeoGenomics

Eight LIMS systems-

Chris Smith
CEO, NeoGenomics

Yeah

Warren Stone
Chief Commercial Officer, NeoGenomics

...into one with existing capability. The phase two, which will start in January, is really around, okay, now building on additional functionality that we can leverage. So that's the one aspect that we're doing. The second aspect in terms of digital transformation is our sort of we call it NeoLink. That's how most of our physicians actually order our tests through us if they're not interfacing.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

I'll get to that part of your question in a moment. We're in the process of replacing NeoLink with a new portal solution, which is gonna offer significantly greater benefits-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Warren Stone
Chief Commercial Officer, NeoGenomics

... and capability and even self-serve capability in there.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

Will ultimately also become an app-based solution as well.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm.

Warren Stone
Chief Commercial Officer, NeoGenomics

So that's the second part of the digital transformation. The third aspect, which is critically important, particularly with the fact that we do a lot of business in the hospital settings, is the interfaces. And we're on track this year to probably interface towards about 250-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Warren Stone
Chief Commercial Officer, NeoGenomics

... different sites in twenty twenty four, and it's continuously our strategy to do so because of, certainly when you have the bi-directional interfaces, it significantly simplifies that workflow in terms of receiving the test, providing the results, the results representing directly within the EMR.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Warren Stone
Chief Commercial Officer, NeoGenomics

And then also, obviously, the opportunity to use genomics modules for data interpretation and those types of things. So we're working. That's a key focus for us because, as Chris says, we monitor this sort of the growth trajectory before and after the establishment of these, and we see a very attractive uplift. It also helps with the stickiness as well, which is a critical factor.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it.

Warren Stone
Chief Commercial Officer, NeoGenomics

There's multiple factors that would... or drivers that we've got as we go through this digital transformation.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it. Chris, talk to us about your, your internal data lake. What proportion of it is multimodal data that's, you know, matched with patient outcomes versus just test results? And, and how are you thinking about, you know, monetizing your data lake beyond working with pharma customers as a clinical trial vendor?

Chris Smith
CEO, NeoGenomics

Yeah, look, I would say that we've kinda, like Warren talked about the transformation that he made in pharma in April, we're kinda going through that process in informatics as well, and-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

... look, I think for us, data, and informatics has been kind of a by-product of our testing. So-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm. Mm-hmm.

Chris Smith
CEO, NeoGenomics

Excuse me. So I think different than some of the other players on the market, we believe that our strength and our core competency is the testing.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

We kinda get the data, I think, for free. I think what's changed in that is that we see a big opportunity because of the sheer amount of data that we have. Going forward, as we add these bigger panels.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

... we're gonna get significantly more data. But then I think it's about building it as a business, and how do you aggregate the data, or how do you pull it together from a data science perspective, and then be able to go and sell that to the pharma partners? At this point, we've done very little-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it

Chris Smith
CEO, NeoGenomics

... as far as going, whether it's to payers or CROs. We see that as an opportunity, I think, as more and more emerges, and I think as the market looks more and more for that.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it.

Chris Smith
CEO, NeoGenomics

Yeah.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Fair enough. Jeff, a couple of quick ones for you to wrap it up on the guide and the outlook. Second half of this year, you know, how do you think about the upside drivers there? What are you baking in for a biopharma uptick in the fourth quarter, and new product contributions?

Jeff Sherman
CFO, NeoGenomics

Yeah, so I would say always with new products, you're gonna have a ramp.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Jeff Sherman
CFO, NeoGenomics

So I would expect, like our Rapid AML product that's coming out-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Jeff Sherman
CFO, NeoGenomics

... will be an incremental driver.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Jeff Sherman
CFO, NeoGenomics

It won't be as significant as a new product.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Jeff Sherman
CFO, NeoGenomics

... introduction, you know, coming in. On the pharma side, you know, we expect to see growth starting again in Q4. So there'll be some uptick there.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Jeff Sherman
CFO, NeoGenomics

But the main drivers will be clinical volume. We've talked about, you know, some potential new customer relationships that are gonna help drive Q4 as well. So I think just kind of the core business continuing to grow, you know, some new customer wins will be some of the bigger drivers for the Q4 revenue growth that we're expecting. And we always thought Q4 was gonna be... It was gonna be more weighted. The second half growth was gonna be much more weighted to Q4.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Jeff Sherman
CFO, NeoGenomics

... versus Q3, just 'cause we had a really strong Q3 last year, and we have some new things coming on to help drive Q4 this year.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it. And then Chris, one for you on just the margin outlook, right? You've bumped your sort of long-term growth targets, ex MRD as well, so as we think about the margin expansion opportunity, what are the biggest levers? Is it all essentially a function of mix shift with a little bit more from efficiency initiatives?

Chris Smith
CEO, NeoGenomics

I think you definitely. Look, I think one is, as NGS becomes a bigger portion-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Yep

Chris Smith
CEO, NeoGenomics

... of our business, you definitely get, you know, a significant lift. So I think things, whether it's pricing, mix, I think market share conversion. I think we still see a lot of runway, though, in driving operating efficiencies. We're still this is a very labor-intensive-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

... business, and I think that's a pretty new area for us. So we've kind of talked publicly that we would love to drive one hundred and fifty to two hundred basis points a year of gross margin improvement, and I think that significantly drops through 'cause this business has inherent leverage. And so I think, you know, Jeff has talked about us getting to the mid-teens, you know, for Adjusted EBITDA profitability by late 2026, 2027. I think we're still-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

... feeling on track with that so I think just to do that, you gotta get that gross margin up above 50 and starting to move into the mid-50s in the outlying years, and I think we still feel really good about that.

Jeff Sherman
CFO, NeoGenomics

So the mix is gonna be a driver of that, but also RCM pricing.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it.

Jeff Sherman
CFO, NeoGenomics

You know,

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Jeff Sherman
CFO, NeoGenomics

... that's, you know, 100%-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Volume

Jeff Sherman
CFO, NeoGenomics

... basically, drop through to the bottom line.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Got it

Jeff Sherman
CFO, NeoGenomics

... you know, when we get RCM. And then, you know, we do think, just inherent operating leverage, when we get incremental volume, we have excess capacity today-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Jeff Sherman
CFO, NeoGenomics

... you know, in our labs.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Jeff Sherman
CFO, NeoGenomics

The only linear cost we have is supplies. We get operating leverage just with volume growth, both on our labor and our physical plant. We've got a lot of excess capacity to drive incremental volume over the next several years, given our current footprint, where our footprint will be by the end of this year.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Perfect. Ten seconds, Chris.

Chris Smith
CEO, NeoGenomics

Okay.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Strategic, you know, acquisitions, I mean, you've talked about that a little bit of late.

Chris Smith
CEO, NeoGenomics

Yeah.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Where's your head at, and what do you see in the pipeline?

Chris Smith
CEO, NeoGenomics

Look, I think the first thing for us as we came through this transformation, kinda back to the original question, was, look, get the house in order.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Yeah.

Chris Smith
CEO, NeoGenomics

I think we've done that. So I think that we believe that we really do have a right to win and a right to play. So I definitely think we're interested in doing things that accelerate the growth of the business.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm.

Chris Smith
CEO, NeoGenomics

That being said, I think there are things that are probably more tuck-ins-

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Mm-hmm

Chris Smith
CEO, NeoGenomics

... or more in licensing of technologies, but that become accretive pretty quick. So I don't think... Look, it's not our current vision to go out and do something that's big and transformative, but it is our you know, desire to, to start from a business development, to start to bring in some other things that we think our customers need and impact our patients, but that are also accretive. Yeah.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Fair enough.

Chris Smith
CEO, NeoGenomics

Right.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Great place to leave it at. So thank you so much, guys, for joining us.

Chris Smith
CEO, NeoGenomics

Thank you, Tejas

Jeff Sherman
CFO, NeoGenomics

Thank you.

Tejas Savant
Executive Director and Senior Healthcare Equity Analyst, Morgan Stanley

Appreciate it.

Chris Smith
CEO, NeoGenomics

Thank you.

Warren Stone
Chief Commercial Officer, NeoGenomics

Oh, we get-

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