Aug 13, 2026 earnings call — Waiting on Medicare LCD; commercial coverage progress
Laboratory performed 2,770 EsoGuard tests and recognized $1.5 million in revenue, and secured a Concert laboratory benefit manager coverage policy.
Revenue $0.0B (est $0.0B) · EPS $-0.06 (est $-0.06)
Key quotes
"Obviously, Medicare coverage remains our most important near-term milestone, and we remain confident we will secure a positive draft policy."
"Concert concluded that EsoGuard is medically necessary for patients meeting established screening criteria and that the evidence definitively demonstrates improved health outcomes."
"With regard to the VA, this remains a very large opportunity for us, and the process is progressing very well."
Analyst Q&A 6
How VA affected volume and hiring plans
Q (Alexander Vukasin): He asked how the VA contributed to test volume this quarter and whether SG&A might be accelerated in coming quarters. He also asked for details on the first LBM contract and whether more LBMs could be added before Medicare coverage.
A: They said the VA has not yet contributed meaningfully to test volume but they are engaging centers, working through budgets and contracting, and expect VA contracts to add volume over time. On SG&A they are upgrading commercial staff, adding modest headcount, and preparing to scale; because the test is $2,000 with roughly 90% margin, added OpEx should not raise burn proportionally. They said the first laboratory benefit manager is Concert; its policy called EsoGuard medically necessary, 3 client plans immediately published coverage, and Concert helps discussions with other LBMs.
"The VA has not yet contributed meaningfully to the test volume." — Lishan Aklog (CEO·CHAIR)
Medicare timing, Concert coverage, volume mix
Q (Mark Massaro · BTIG): He asked whether personnel changes at Palmetto GBA could affect Medicare timing and how many plans follow Concert. He also asked if they still target 2,500–3,000 tests and about activity with firefighters and primary care.
A: They said they don't think personnel changes will affect their place in front of Medicare and they feel things are in the late stages as backlog may be loosening. Under Concert there are just under 10 million covered lives across its client plans, 3 plans already adopted coverage and they expect more will follow. They are still targeting 2,500 to 3,000 tests per quarter; they are shifting volume from firefighter events toward primary care, GIs and health systems, and of the 2,800 tests this quarter just under 40% fit the contracted/MVAC category, with government insurance about half and direct contracting the other half; the VA is not yet contributing to volume but purchase orders are forthcoming.
"We feel quite confident that things are in the late stages and that the work that went into getting us this far all the way through the tech meeting and beyond is already sort of built in, baked in." — Lishan Aklog (CEO·CHAIR)
HEOR cost model and sample collection
Q (Michael Matson · Needham): He asked if they could share metrics from their cost-effectiveness HEOR model, like QALYs. He also asked where test samples are being collected — from PCPs, GIs, or test centers.
A: They said they are not ready to disclose the public numbers yet; the HEOR model is sophisticated, includes quality-adjusted years of life among metrics, was built with Dr. Nick Shaheen, and initial results look quite good across most scenarios and will be submitted for publication. On sample collection they said they are shifting volume away from firefighter health fairs toward primary care physicians and gastroenterologists and using their satellite Lucid Test Center model to run testing days at practices; most patients come from primary care but GIs and health systems are important and health-system programs are starting to be active.
"So yes, one of the metrics will be what you mentioned, quality-adjusted years of life, but there's a lot of other details that come out of it." — Lishan Aklog (CEO·CHAIR)
Concert covered lives and claim denials
Q (Anthony Vendetti · Maxim Group): He asked how many covered lives Concert represents and what that implies for patient reach. He also asked whether denials are trending down, what they're doing to reduce denials, and the percent of denials this quarter.
A: They said the total under Concert is about a bit under 10 million covered lives concentrated in the Midwest, which lets them target resources geographically. On denials they said the situation is choppy; they push medical records and evidence in advance and use appeals, but some denials are placeholders like "not medically necessary" or "experimental" despite meeting guidelines; having Concert's coverage helps but there is no clear trend down yet. They reported that of the 2,800 tests, about two-thirds have been adjudicated so far, and of those adjudicated about a third resulted in a payment allowance (the allowance quoted was $1,424 after deductibles and co-pays); of the denied, 18% were experimental/investigational, 22% required prior authorization, and 5% required additional medical records.
"And the total number is about a bit under 10 million covered lives within the client health plans under Concert." — Lishan Aklog (CEO·CHAIR)
Test price and inflation potential
Q (Edward Woo · Ascendant Capital): He asked whether there is any opportunity to raise the $2,000 test reimbursement for inflation.
A: They said they are not pushing to increase the price and are satisfied that $2,000 is fair. They noted their marginal cost of goods is relatively modest and that their focus is on adoption and securing coverage policies.
"You know, our cost of goods or our marginal incremental cost of goods is relatively modest, and our focus is on adoption and on securing a coverage policy." — Lishan Aklog (CEO·CHAIR)
Concierge, hiring, COGS, and cash burn
Q (Kyle Mikson · Canaccord): He asked about concierge medicine or other nontraditional payment paths, what backgrounds to hire sales reps from, COGS savings from automation, and levers to reduce cash burn near term.
A: They said concierge was explored last year with some success but had high conversion hurdles, so it's not a major emphasis; they prefer contracted events, employer contracts, and MVAC focus. For hiring they use a mix — early-career reps, pharma/MedTech backgrounds, and GI diagnostics experience at senior levels — and stressed training (now including AI role play) is the key. On COGS Dennis said the EsoCheck device costs around $60 and lab processing is about $125 per test; lab and device costs should come down marginally with volume and automation. On cash burn they said burn is pretty flat at $11.3 million and they need to keep roughly 2,500 to 3,000 tests to stay relevant; cutting commercial activity would lower burn but hurt adoption, and increasing revenue is the best lever to reduce burn because the $2,000 price and ~90% margin make growth less cash-intensive.
"Yes, just to give you a sense, presently, you know, the EsoCheck device costs around $60, and to process a test through the lab is about $125 or so." — Dennis McGrath (CFO)