BillionToOne (BLLN) Wells Fargo 21st Annual Healthcare Conference summary

Financial performance and growth drivers

• Q2 revenues grew 64% with 35% volume growth and strong gross margins, resulting in profitability.

• Growth is driven by both prenatal and oncology segments, with average selling prices (ASPs) increasing in both.

• Consistent growth comes from independent OBGYN clinics, while health system additions create quarter-to-quarter variability.

• Health system onboarding can add 3,000–5,000 tests per system, significantly impacting quarterly growth.

• Investments in Epic Aura and the Excel panel target health system expansion for long-term growth.

Market dynamics and customer base

• Current test volume is heavily skewed toward independent clinics, representing about 90% of the base, despite the market being 40% clinics and 60% health systems.

• About 20% market share has been achieved, mostly in independent clinics.

• Health system onboarding is a lengthy process, often taking 6–18 months due to IT and legal requirements.

• Guidance does not include large health system wins due to timing uncertainty.

• Growth targets are based on predictable, controllable factors, with upside potential from health system wins, true-up revenue, or new coverage decisions.

Reimbursement and ASP evolution

• $10 million in claims are pending due to timing of in-network implementation with a large payer, not reimbursement issues.

• In-network coverage now extends to nearly 300 million lives, with significant ASP lift potential as more components gain coverage.

• Prenatal business operates at 30%+ operating margin, outperforming industry norms due to selective contracting and assay design.

• ASPs for prenatal could rise from $500+ to $800+ as more tests are covered, though this will take more than 12 months.