Testing: Bio Reference Labs (BRLI), Quest Diagnostics Inc. (DGX), Laboratory Corp. of America (LH): Diagnosis Profits
Whether a buy-and-hold investment strategy is a good idea or not, is one of the most hotly debated investing concepts. From our point of view, the best answer as to whether buy and hold is a good strategy or not is that it primarily depends on the specific company or companies being considered. In other words, there are some companies that can and should be bought and held, and conversely, there are companies that should not. And, equally important, you could pay too much for even the best company. Therefore, the principle of valuation is a second component behind implementing a viable buy and hold strategy.
This logically moves us to the question of how do we define exactly what a correct, or good, buy and hold company is? Once again, the answer will be dependent to a great extent on the goals and objectives of the individual investor. For an income investor, the current yield coupled with the company's history of dividend growth would be important considerations. On the other hand, the aggressive growth investor will be most concerned with earnings growth and the price they have to pay to buy that growth. There are many nuances and calibrations between the pure income investor versus the pure growth investor that need be applied in order to correctly answer the question regarding exactly what is a good buy and hold company.
The points we are endeavoring to illustrate are that buy and hold is an excellent strategy if it's properly executed. This means finding companies with the right characteristics to meet your goals and objectives, and then having the discipline and prudence to only invest in them when they make good economic sense. When this is done correctly, then buy and hold is capable of producing appropriate returns at controlled levels of risk. And perhaps the most critical point is that the decision as to whether buy and hold is a smart idea or not is a question of specifics, not generalities. One of our pet peeves is how people attempt to argue the laurels of a buy and hold strategy by providing evidence based on general markets or indices. Frankly, there are always a lot of companies in every indice that should not be bought and held.
Executing a Smart Buy and Hold Strategy for Growth
Since pure growth stocks typically do not pay dividends, the pure growth investor's only real source of return is capital appreciation. Therefore, if your investment objective is growth, we believe there are several critical metrics that should be measured and focused upon. The first would be the rate of change of earnings growth, because capital appreciation will be solely a function of the marketplace capitalizing future earnings. Next, it's important to understand that the price or value you pay to buy the future earnings growth will have a great impact on both the return and the risk you take to generate it. Finally, the consistency or reliability of the company's record of earnings growth will usually correlate to how consistently the marketplace prices the company's stock.
Therefore, when attempting to identify above-average growth stocks we place a very high premium on what we like to call the confidence factor. Our confidence will increase based on the consistency and the duration a respective company's earnings growth achievements. Also, in addition to being consistent, we also seek above-average rates of growth. Our own research indicates that an above-average earnings growth rate of 15% to 20% is both achievable and sustainable for truly above-average businesses. There are some growth stocks that can even grow faster than this, but they are very rare. Furthermore, although the law of large numbers will inevitably take its toll, well-positioned companies in appropriate industries can grow at these high rates for decades. An appropriate industry is one that facilitates the company's ability to grow based on its market opportunity and/or advantages such as patent protection, etc.
Diagnostic Testing and Clinical Laboratories - A Reliable Growth Industry
To forecast future earnings growth with any degree of accuracy, it seems logical to place great emphasis on recognizing major future investment opportunities. One way to identify growth opportunities is through the study and monitoring of demographics. For example, we believe that a great opportunity exists from understanding the economic impact of our population's current bi-modal distribution, namely, the graying of America and the baby boomer generation. Understanding the consumption tendencies of these and other demographic segments allows us to make informed forecasts as to the future health of several industries that will serve these large and growing markets.
Of course, healthcare naturally comes to mind when looking for growth opportunities available from an aging population. On the other hand, healthcare is rapidly becoming politicized and, therefore, seekers of profitable growth need be very discerning. On the other hand, the demographic forces behind healthcare as a growth industry are obvious and undeniable. But as we will soon illustrate, diagnostic testing and diagnostic testing laboratories are a small part of the huge healthcare pie, but this industry has a large influence on the outcomes and utilization of the entire healthcare segment.
Three Growth Stocks in a Well Defined Growth Industry
Modern medicine has come a long way from the days of the home visit from the family doctor with his little black bag of medical supplies. In modern times, the proper diagnosis and treatment regimens have become far more efficient and applicable thanks to the results from tests performed in the clinical laboratory. The ability to pinpoint the exact presence or absence of disease provides the data needed to prescribe the most effective treatment. This not only supports better patient outcomes, but also reduces costs from providing unnecessary or improper treatment therapies.
In summary, laboratory tests play an important role in the detection, diagnosis, and treatment of many diseases. But most importantly, it's cost effective and supportive of better patient outcomes and results. There are many healthcare experts and professionals that would agree that the practice of modern medicine would be impossible without the tests performed in the clinical laboratory. From an investor's point of view, these facts support an attractive growth industry to examine further. This article will look at three leading companies in the important diagnostic testing industry.
About Bio-Reference Laboratories, Inc.
"BRLI is a clinical testing laboratory offering testing, information and related services to physician offices, clinics, hospitals, employers and governmental units. We believe that we are the fourth largest full-service laboratory in the United States and the largest independent regional laboratory in the Northeastern market. BRLI offers a comprehensive list of laboratory testing services utilized by healthcare providers in the detection, diagnosis, evaluation, monitoring and treatment of diseases. BRLI primarily focuses on esoteric testing, molecular diagnostics, anatomical pathology, women's health and correctional health care."
The following slide taken from the company's investor presentation provides an excellent summary of Bio-Reference Laboratories' business model that includes important niches. We especially like the opportunities from their genetics business Gene Dx. We believe that designer medicine based on DNA sequencing represents a major long-term growth opportunity. Since being acquired by Bio-Reference Laboratories in 2006, this specialized genetic laboratory has already grown over six-fold. With that said, we see growth potential over their entire spectrum of Bio-Reference Laboratories' clinical laboratories.
Bio-Reference Laboratories, Inc. (BRLI): A History of Consistent Strong Earnings
The following plotting of earnings per share growth (the orange line) since calendar year 2002 speaks volumes to the strength of this small but powerfully growing business. Of the three companies we will highlight, Bio-Reference Laboratories (BRLI) is the smallest but also the fastest-growing of the three. A quick glance of their historical earnings growth shows remarkable degree of consistent above-average growth averaging almost 25% per annum.
When we introduce monthly closing stock prices to the equation we discover that stock price has closely tracked earnings per share growth over the years. However, although healthcare reform has apparently driven their stock price to historically low valuations it has thus far had very little effect on operating earnings growth. We would argue that this price drop is therefore unwarranted based on the idea that testing companies such as Bio-Reference Laboratories (BRLI) are part of the solution to out-of-control healthcare costs, not part of the problem.
The historical performance for this strong growth company has provided shareholders a rate of return far in excess of the S&P 500. (As we were preparing this article for submission, Bio-Reference Laboratories reported an extremely strong first-quarter earnings report that has sent shares soaring find the link here.
This next graph is drawn from the calendar year 2007 to current illustrates that recent earnings growth has remained extremely strong even considering the hangover from the recent recession coupled with threats of healthcare reform. Consequently, we believe the current stock valuation represents an uncommon opportunity to buy strong growth at a very attractive price.
The following Estimated Earnings and Return Calculator show that five analysts covering this company expects future growth of 16% per annum. Frankly, we believe those estimates are understated and that the recently reported first quarter results backup our view.
About Quest Diagnostics (DGX)
"Quest Diagnostics is the world's leading provider of diagnostic testing, information and services that patients and doctors need to make better healthcare decisions. The company offers the broadest access to diagnostic testing services through its network of laboratories and patient service centers, and provides interpretive consultation through its extensive medical and scientific staff. Quest Diagnostics is a pioneer in developing innovative diagnostic tests and advanced healthcare information technology solutions that help improve patient care."
The following slide from Quest Diagnostics' investor presentation highlights the capabilities and opportunities of this the largest provider of diagnostic testing information and services. We believe this company is very well-positioned for future above-average long-term growth, and is the only company in this group of three that pays a dividend.
A quick glance at their earnings record since 2002 shows that the company did experience very moderate earnings pressure just prior to the recession, but during the recession and after the recession earnings have held up reasonably well.
When you bring monthly closing stock prices into the equation, we once again discover the importance of earnings. The correlation between price and earnings is very clear, and the impact of a slowing growth rate is also revealed as stock prices have fallen to historically low valuations.
However, even with historical valuations at their lowest levels, Quest Diagnostics (DGX) was still able to dramatically outperform the S&P 500 since calendar year 2002. On the other hand, it's important to notice that the recent slowdown in earnings growth has caused them to freeze their dividend since calendar year 2007 at $.40 a share. But even more importantly, note that Quest announced a 70% increase in the dividend to $.17 per share, and further announced that they are no longer looking to make large or even midsized acquisitions. Instead, the board expressed a desire to focus on improving the businesses that they've already acquired. Therefore, the board also stated that they plan to return most of their cash flow to shareholders through a combination of dividends and share repurchase.
The following earnings, price and dividend graph on Quest Diagnostics (DGX) since calendar year 2007 shows that stock price has reacted appropriately to their slowing earnings growth. On the other hand, perhaps the markets have been overly negative and, therefore, their share price is currently available at a better value than it has been in years.
The consensuses of 22 analysts reporting to Capital IQ expect earnings growth to resume to double-digit rates from calendar year 2013 and beyond. Therefore, if this were to happen, Quest offers shareholders the opportunity for double-digit returns, including dividends, over the next several years.
About Laboratory Corporation of America (LH)
"Laboratory Corporation of America® Holdings, an S&P 500 company, is a pioneer in commercializing new diagnostic technologies and the first in its industry to embrace genomic testing. With annual revenues of $5.5 billion in 2011, over 31,000 employees worldwide, and more than 220,000 clients, LabCorp offers more than 4,000 tests ranging from routine blood analyses to reproductive genetics to companion diagnostics. LabCorp furthers its scientific expertise and innovative clinical testing technology through its specialized labs and the LabCorp Specialty Testing Group: The Center for Molecular Biology and Pathology, National Genetics Institute, ViroMed Laboratories, Inc., The Center for Esoteric Testing, Litholink Corporation, Integrated Genetics, Integrated Oncology, DIANON Systems, Inc., Monogram Biosciences, Inc., Colorado Coagulation, and Endocrine Sciences. LabCorp conducts clinical trials testing through its Esoterix Clinical Trials Services division. LabCorp clients include physicians, government agencies, managed care organizations, hospitals, clinical labs, and pharmaceutical companies."
The following slide taken from Laboratory Corporation of America's (LH) investor presentation provides a great summary of both the long-term opportunity for healthcare in general, and the relevance and importance that laboratory testing offers investors. We feel that the most important point this slide provides is that the cost of laboratory testing relative to the overall healthcare spend is small, but at the same time its importance to the industry is huge. Consequently, we believe that diagnostic testing will play an important role in the long-term future of our healthcare needs.
The following plotting of earnings per share growth since calendar year 2002 shows that Laboratory Corp. of America (LH) has produced a very consistent record of earnings growth exceeding 15% per annum. As previously stated, investors seeking long-term growth are looking for companies that are capable of producing exactly this kind of earnings record, but they are rare. It is precisely this type of consistent earnings growth that supports a buy and hold candidate.
When monthly closing stock prices are added to the equation, we once again discover a very high long-term correlation between the direction and velocity of earnings and the movement of stock price. Although there will always be short-term volatility of stock price movements, inevitably the price will follow the profits.
When reviewing the long-term operating performance of Laboratory Corp. of America (LH) we discover that it's only the overvaluation that existed in calendar year 2002 that caused shareholder returns to be less than earnings justified. On the other hand, even overvaluation did not keep this consistent grower from generating a rate of return that was significantly greater than an equal investment in the S&P 500.
When we look at Laboratory Corp. of America over the shorter time frame, 2006 to current, we once again see a beginning valuation that was in excess of what earnings justified. However, we also see that stock price inevitably moved back to earnings, and have tracked earnings ever since, notwithstanding a brief bout of overvaluation in calendar year 2011.
The consensuses of 16 analysts reporting to Capital IQ expect Laboratory Corp. of America (LH) to resume growing earnings at the rate of 12% per annum over the next five years. Consequently, we would argue that Laboratory Corporation of America (LH) appears very attractively valued at current levels.
Summary and Conclusions
We believe that growth stock investing does contain a higher level of risk than is encountered when investing in blue-chip dividend paying stocks. On the other hand, if purchased at appropriate valuations, the power of compounding enables growth stocks to deliver much higher long-term returns than the average dividend paying company. But obviously this potentially stronger performance comes at a higher level of risk. Therefore, in order for this to happen, we further believe that the level of growth must be above-average and consistent in order for superior performance to be achieved.
With the above said, we believe that the diagnostic testing industry offers investors the opportunity to find quality companies that can grow at above-average rates. Moreover, we believe that the three candidates discussed in this article are currently available at attractive valuations offering long-term above-average performance at reasonable levels of risk. Quest Diagnostics does provide a middle ground that may appeal to the dividend growth investor in need of more growth today with more income later.