TD cut target to $2.50We are reducing our target price to C$2.50 from C$3.25 to reflect impaired visibility caused by a confluence of macro challenges. The most recent trigger is CMS' (Center for Medicare and Medicaid Services) publication of the finalized rule for the 2018 Physician Fee Schedule. The final rule included incremental reimbursement cuts relative to the proposed ruling CMS published in July 2017. CMS administers the U.S. Medicare program. Impact: NEGATIVE CMS Cuts Deeper Last week, CMS finalized a comprehensive restructuring of the CPT (Current Procedural Terminology) codes that cover anesthesiology used in conjunction with endoscopy. Of the five new codes CMS first proposed in July 2017, the final ruling maintained CMS' proposed rate cuts on four. However, CMS imposed deeper cuts on the fifth. The new codes describe various endoscopic procedures with greater specificity than the old codes. The changes come into effect January 1, 2018. Operating Metrics to Reset Lower Watch for CRH's operating metrics to reset lower, albeit from an impressive 53% Adjusted EBITDA margin in 2016. We are reducing our F2018 revenue forecast to $103.4 million from $108.3 million, and our Adjusted EBITDA forecast to $44 million from $48.3 million. Macro Headwinds Last night's news layers on to a soft macro environment, where headwinds have dragged CRH's nine-month performance, dampening revenue growth and eroding profitability. The net result is further deterioration in our visibility into the Q4/17 earnings performance and payer mix, and possibly beyond. Key macro headwinds include: (i) negative payer mix trends and (ii) higher proportions of high-deductible plans in the U.S. market. Multiple U.S. healthcare service providers recently cited similar challenges. TD Investment Conclusion We are maintaining our HOLD rating in view of CRH's strengths. Foremost is CRH's appeal as a play on secular growth in demand for colorectal screening. CRH's free cash flow profile and its strong balance sheet are other considerations. However, we are cautioning that CRH's shares seem unlikely to recapture investor interest until the market gains comfort regarding likely stabilization levels for CRH's key organic metrics. It could take several quarters to regain the required visibility.