Quest Diagnostics

Quest is based in Secaucus, New Jersey. It operates patient service centers, including sites inside retail pharmacies and clinics, and it performs routine, advanced, and employer-screening tests.

When a health plan designates Quest as the in-network lab, physicians' electronic orders and patient draw habits follow that designation. Labcorp wins the same kind of contract in other plans, so the national market is a series of exclusive or preferred relationships rather than a patient walking in off the street.

Hospital reference work and health-system joint ventures extend Quest into communities where it does not own the hospital. Those deals decide where send-out tests go for years, because the interface to the medical record is expensive to rebuild.

Preferred-lab clauses in insurer contracts are Quest's and Labcorp's primary competitive instrument.

Retail draw sites make the preferred lab convenient, which reinforces the contract.

Health-system joint ventures lock outreach volume that independent regional labs used to contest.

A patient with a standing lab order is directed to the in-network draw site printed on the requisition.

Employers buying workforce screening pick one national lab and send all sites there.