Started a small position in Lab Corp. - LH
Ross,
Been thinking about LH - I love the industry. Question though, why LH over Quest?
jwfm,
The short answer is management at LH is better than DGX. Quest and LH both grow through acquisition but Quest has proven again and again to destroy value when they acquire. Quest seems to take 1-2 years to fully digest a new lab (they have nothing to show for a couple big acquisitions) where LH does the same in 1-2 quarters. I think both companies are in a fantastic business. Together, they have the same kind of moat UPS, MSFT, or even KO possess. Long term, I think North American demographics and universal health care are going to provide a nice tail wind for both companies.
Ross,
Not that I think you are wrong, but I always look for the possible mistake in my thinking before investing. So let me go all Charlie Munger on you for a moment. What if a company like Opko Health actually manages to come up with a diagnostic test that can be done in your doctor's office (something they are working on) based on a simple blood test? What about the impact of government payment reductions? LH stated that this cost them over $100 million in 2013 alone?
Looking forward to your comments as the idea does look interesting.....
cheers
Zorro
Zorro,
I'll hit the government reductions first. The Midcare/caid acutually increased reimbursement 1% last year. LH lost money on routine standard tests that were moved onto the governments "not approved list". To give an analogy; there where 10 types of tests approved and reimbursed at $100 in 2012. In 2013, doctors ordered the same tests, LH performed the testing and sent the bill to the government. The government, in turn, decided in Q4 of 13 that 2 of the 10 tests were no longer covered and rather than reimbursing LH sent bills to individuals on medicare. (LH will have very limited success collecting these debts) The remaining 8 tests were reimbursed at $101 each.
Management stated that they will simply abandon these tests billed to medicare in the future and stated that this is a temporary problem. Once doctors start getting sued when patients suffer because they are unable to get routine and best practice testing reimbursed; the government will change course. Until then, LH will not be giving any more free testing.
HR 4015 passed the house on the 14th of March (this was not expected). This allows Medicare to reimburse doctors and labs at a rate greater than sustainable growth rate (SGR) in the future; meaning LH should actually pick up revenue growth from the government abandoning SGR @ 1% per year to something closer to YoY cost of care inflation - roughly 4%.
Regarding being Charlie Mungered on the moat. I tend to think of moats as being sustainable if they can be expanded while under siege. The testing business is a technology arms race at its heart and technology always gets more and more complex as it matures. Opko Health may design a great real time test that replaces an offering by LH, but what about LH's 500 other offerings, or the new relatively complex genomics testing they are rolling out? Everyone expects new technology to replace existing technology, but in most cases, there is room for both. I.E. laptops and smartphones, SSD and HDD, credit cards and mobile payment. We are taking a pretty big leap to assign risk to a technology that a company may develop that may be an acceptable replacement for a current product that may be adopted by the medical community at large.
I learned my lesson with inverting investments too much and tearing down moats based on new technology. A few years ago, I could have bought WDC at $23 but I didn't because I was convinced SSD would replace WDC's HDDs. Looking back on it, I missed out on a 400% gain and a position in a consistently growing company with a sustainable competitive advantage as part of the data storage duopoly.
