How strong was Quest's first quarter 2026 growth?

Revenue grew 9.2% to $2.90 billion, with 9.0% organic growth, and requisition volume rose 10.9%. Operating income grew 15.5% and adjusted diluted EPS grew 13.1% to $2.50. Growth was driven mainly by volume rather than pricing, since revenue per requisition declined 1.3%.

Why did Quest raise its 2026 guidance?

Management cited robust first-quarter performance and continued strategic focus. Revenue guidance rose by about $80 million at both ends of the range, and adjusted diluted EPS guidance rose by $0.13 at both the low and high ends. Cash from operations and capital expenditure guidance were left unchanged.

What are the main differences between reported and adjusted EPS?

In Q1 2026, reported diluted EPS of $2.24 was adjusted up to $2.50 mainly by adding back amortization of intangibles ($0.25 per share) and restructuring and integration charges ($0.04), along with other charges and investment losses. These gains were partly offset by an excess tax benefit from stock compensation of $0.11. Investors should weigh amortization, which is a recurring non-cash cost from acquisitions, when assessing earnings quality.

Is there any concern about cash flow or working capital?

Operating cash flow declined 11.6% to $278 million, largely because accounts receivable increased by $180 million compared with $101 million a year earlier. Management still expects approximately $1.75 billion of operating cash flow for the full year, which implies stronger cash conversion in the remaining quarters. Receivables trends should be monitored.

What should investors note about the balance sheet?

Goodwill rose to $9.12 billion and intangible assets to $1.72 billion, reflecting acquisitions, with $38 million of acquisition spending in the quarter. Cash was $393 million, and long-term debt was $5.16 billion. Noncontrolling interests jumped to $300 million from $36 million, which is a significant change that the excerpted filing does not explain.

DGX 8-K: Earnings & Results

01—Abstract

Summary

Summary of the 8-K filed April 21, 2026. Cited figures are marked; the original filing is the authoritative source.

Quest Diagnostics (DGX) reported first quarter 2026 results on April 21, 2026, with net revenues of $2.90 billion^a, up 9.2% year over year, including 9.0% organic growth.

Growth was driven primarily by volume: requisition volume rose 10.9% (10.8% organic), partly offset by a 1.3% decline in revenue per requisition. Operating income rose 15.5% to $399 million^b, and operating margin expanded 80 basis points to 13.8%. Reported diluted EPS was $2.24, up 15.5%, and adjusted diluted EPS was $2.50, up 13.1%.

Adjustments for amortization, restructuring, contingent consideration and ETB were the main drivers of the gap between GAAP and adjusted results. Management raised full-year 2026 guidance. Net revenue is now expected at $11.78 billion to $11.90 billion^c, up 6.8% to 7.8%, compared with the prior $11.70 billion to $11.82 billion.

Reported diluted EPS is now $9.58 to $9.78^d (previously $9.45 to $9.65), and adjusted diluted EPS is $10.63 to $10.83 (previously $10.50 to $10.70). Cash from operations and capital expenditures guidance was unchanged at roughly $1.75 billion and $550 million, respectively. Cash generation in the quarter was softer, with operating cash flow down 11.6% to $278 million, mainly due to a $180 million increase in accounts receivable.

The balance sheet shows goodwill and intangibles increasing from acquisitions, and total debt was roughly $5.66 billion at quarter end, with $38 million spent on business acquisitions in the quarter. Noncontrolling interests rose sharply from $36 million to $300 million, which is notable and was not explained in the excerpted filing. Overall, the quarter was strong on volume, earnings and guidance, with working capital and cash conversion the primary points to monitor.

02—Key points

Key Highlights

Net revenues of $2.90 billion, up 9.2% YoY (9.0% organic); requisition volume up 10.9%, partly offset by a 1.3% decline in revenue per requisition.
Operating income up 15.5% to $399 million; operating margin expanded 80 bps to 13.8% (adjusted margin 15.4%).
Diluted EPS of $2.24 (up 15.5%); adjusted diluted EPS of $2.50 (up 13.1%).
Full-year 2026 revenue guidance raised to $11.78–$11.90 billion (6.8%–7.8% growth) from $11.70–$11.82 billion.
Full-year 2026 EPS guidance raised: reported diluted EPS $9.58–$9.78 and adjusted diluted EPS $10.63–$10.83, each up $0.13 at the midpoint.
Operating cash flow fell 11.6% to $278 million on higher receivables; full-year cash from operations guidance of ~$1.75 billion unchanged.
Noncontrolling interests increased from $36 million to $300 million, a balance sheet change that warrants follow-up in the 10-Q.

03—Questions

Frequently Asked Questions

How strong was Quest's first quarter 2026 growth?
Revenue grew 9.2% to $2.90 billion, with 9.0% organic growth, and requisition volume rose 10.9%. Operating income grew 15.5% and adjusted diluted EPS grew 13.1% to $2.50. Growth was driven mainly by volume rather than pricing, since revenue per requisition declined 1.3%.
Why did Quest raise its 2026 guidance?
Management cited robust first-quarter performance and continued strategic focus. Revenue guidance rose by about $80 million at both ends of the range, and adjusted diluted EPS guidance rose by $0.13 at both the low and high ends. Cash from operations and capital expenditure guidance were left unchanged.
What are the main differences between reported and adjusted EPS?
In Q1 2026, reported diluted EPS of $2.24 was adjusted up to $2.50 mainly by adding back amortization of intangibles ($0.25 per share) and restructuring and integration charges ($0.04), along with other charges and investment losses. These gains were partly offset by an excess tax benefit from stock compensation of $0.11. Investors should weigh amortization, which is a recurring non-cash cost from acquisitions, when assessing earnings quality.
Is there any concern about cash flow or working capital?
Operating cash flow declined 11.6% to $278 million, largely because accounts receivable increased by $180 million compared with $101 million a year earlier. Management still expects approximately $1.75 billion of operating cash flow for the full year, which implies stronger cash conversion in the remaining quarters. Receivables trends should be monitored.
What should investors note about the balance sheet?
Goodwill rose to $9.12 billion and intangible assets to $1.72 billion, reflecting acquisitions, with $38 million of acquisition spending in the quarter. Cash was $393 million, and long-term debt was $5.16 billion. Noncontrolling interests jumped to $300 million from $36 million, which is a significant change that the excerpted filing does not explain.

04—Continue

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