stockrowWhat it does
DaVita provides kidney care, principally dialysis for people whose kidneys have failed. Dialysis removes waste, salt and excess fluid from the blood when the kidneys can no longer do so. Patients generally need regular treatment for the rest of their lives or until they receive a kidney transplant.
Most of DaVita’s services are outpatient hemodialysis treatments, usually performed three times a week. Its centers provide the equipment, supplies and staff needed for treatment. The company also provides dialysis in hospitals and supports patients who perform dialysis at home. Home support can include equipment, supplies, training, monitoring and follow-up assistance.
Beyond dialysis, DaVita coordinates care for people at earlier stages of chronic kidney disease and for people with kidney failure. Its integrated kidney care business works with physicians, health plans and other providers on disease management. The company also provides laboratory testing and operates a transplant software business connecting patients and care teams.
DaVita’s principal business is in the United States, and it also operates dialysis centers internationally. It was founded in 1994 and is headquartered in Denver. Javier J. Rodriguez is chief executive officer.
How it makes money
DaVita earns most of its revenue by providing U.S. dialysis and related laboratory services. It also earns revenue from integrated kidney care, international operations and other ancillary services. U.S. dialysis revenue was $11.7 billion in FY2025, up from $11.3 billion in FY2024.
Dialysis revenue generally recurs as patients receive regular treatments. The company is paid by government programs and commercial health plans, while hospital inpatient dialysis is provided for a separately negotiated per-treatment fee. DaVita also earns management fees at some centers it does not control; those fees are typically based on a percentage of center revenue or cash collections.
For Medicare patients, dialysis facilities receive a bundled payment covering treatment-related goods and services, including most laboratory services and certain pharmaceuticals. The payment can be reduced if a facility does not meet specified quality measures. Commercial contracts can use a bundled per-treatment rate or separate payments for treatments and pharmaceuticals. Commercial rates are generally higher than Medicare rates, and commercial payors generate nearly all of DaVita’s profits.
Integrated kidney care uses several payment structures, including arrangements under which DaVita shares in savings or losses and compensation tied to outcomes. Its clinical research business earns fees under contracts with drug companies and other study sponsors. International operations provide dialysis and administrative services through outpatient centers.
For 2026, DaVita expects adjusted operating income within a range of $2.175 billion to $2.25 billion. That is a company outlook, not a revenue total.
| Segment | Revenue, FY2025 | Share | Change on the year |
|---|---|---|---|
| U S Dialysis And Related Lab Services with Intersegment | $11.8 billion | 44.1% | 3.54% |
| U S Dialysis | $11.7 billion | 43.9% | 3.65% |
| Other - Ancillary services | $1.9 billion | 7.15% | 27.7% |
| Other Operating Segments with Intersegment | $1.3 billion | 4.87% | 34.6% |
Customers and how it sells
DaVita serves people with chronic kidney disease and kidney failure, as well as hospitals, health plans and other organizations involved in kidney care. Patients generally seek outpatient dialysis near home, where their treating kidney specialist has practice privileges. The company also contracts with hospitals to provide inpatient treatment.
As of December 31, 2025, DaVita provided dialysis, administrative and related laboratory services to approximately 200,500 U.S. patients. Its network included 2,657 outpatient dialysis centers in 46 states and the District of Columbia, and contracts to provide inpatient dialysis in approximately 740 hospitals. Its integrated kidney care business served 66,000 patients in risk-based arrangements and another 9,400 in other arrangements across the United States.
International operations provided dialysis and administrative services to 585 outpatient centers in 14 countries outside the United States, serving approximately 94,500 patients as of December 31, 2025. Locations included Brazil, Colombia, Malaysia, Poland, Chile and Germany.
In 2025, government-based programs accounted for 68% of U.S. dialysis patient service revenues, and commercial sources, including hospital dialysis services, accounted for 32%. No single commercial payor accounted for more than 10% of total U.S. dialysis revenues.
| Segment | Revenue, FY2025 | Share | Change on the year |
|---|---|---|---|
| U S Dialysis And Related Lab Services with Intersegment | $11.8 billion | 44.1% | 3.54% |
| U S Dialysis | $11.7 billion | 43.9% | 3.65% |
| Other - Ancillary services | $1.9 billion | 7.15% | 27.7% |
| Other Operating Segments with Intersegment | $1.3 billion | 4.87% | 34.6% |
Suppliers and costs
DaVita relies on third parties for pharmaceuticals, clinical products, equipment and services. Disruptions to those supplies or services can affect its ability to care for patients, including those on home dialysis. The company also identifies its ability to obtain supplies and new technology at cost-effective prices as a risk.
The business is labor intensive. Dialysis centers employ nurses, patient care technicians, social workers, dietitians, biomedical technicians and administrative staff. DaVita also contracts with physicians to serve as medical directors. Labor, medical supplies, pharmaceuticals, technology and professional liability are among its costs.
Patient care cost per treatment rose 2.4% in the third quarter of 2026 compared with a year earlier. Lower phosphate-binder costs partly offset typical labor expense growth, while medical supply and professional liability costs were higher than DaVita anticipated. Technology spending also increased as the company invested in its systems.
DaVita generally leases center space and invests in improvements and equipment. Developing a typical new outpatient dialysis center generally requires approximately $2 million for leasehold improvements and other capital expenditures.
- Revenue$13.6B
- Cost of revenue−$9.2B
- Selling, general and administrative−$1.7B
- Other operating costs−$682.3M
- Operating income$2.0B
Competitive position
DaVita competes for dialysis patients, physician relationships, medical directors, clinical staff, hospital contracts and acquisition targets. It also competes for commercial health-plan contracts. Other dialysis facilities operate in most geographic areas where DaVita has centers, and the company faces providers ranging from established chains to individual nephrologists opening their own facilities.
Fresenius Medical Care is DaVita’s largest competitor. It operates outpatient dialysis centers worldwide and manufactures its own supplies and equipment, which may give it cost advantages. In integrated kidney care, DaVita also competes with other dialysis providers and non-traditional entrants seeking arrangements with payors, physicians and hospitals.
DaVita’s network and relationships connect it with patients and referring physicians. Nearly 5,200 nephrologists refer patients to its outpatient centers, and the company has contracts with over 900 individual physicians and physician groups for medical director services. Some centers operate through joint ventures with physicians, hospitals and other healthcare providers.
Our reading: The center network and physician relationships provide a meaningful local presence, but they do not prevent patients and physicians from using competing facilities. Our reading: Experience with integrated care and payor relationships may help DaVita compete beyond dialysis, although other providers are pursuing similar arrangements.
| Competitor | Where they compete | Threat (our reading) |
|---|---|---|
| Fresenius Medical Care | Dialysis centers, patients and physician relationships | High |
Growth opportunities
DaVita seeks growth by developing and acquiring dialysis centers, retaining patients and maintaining relationships with referring providers. It can also expand capacity at existing centers by extending hours, enlarging facilities or relocating them. Internationally, it has expanded through acquisitions and development of outpatient centers.
In 2025, consolidated patient growth was 4.9%, primarily driven by 17.6% international patient growth. The company had a net increase of 76 international dialysis centers, primarily from acquisitions. U.S. dialysis revenue growth was 3.5% in 2025, supported by higher average patient service revenue per treatment.
Integrated kidney care is another area of investment. DaVita expects its partnership with Humana to expand upstream care to approximately 10,000 chronic kidney disease patients. It expects integrated kidney care to deliver at least $65 million of adjusted operating income in 2026, an increase of at least $25 million over its prior guidance.
DaVita has also completed expanded hemodialysis pilots in 150 centers for more than 10,000 patients. The treatment uses a type of dialyzer designed to improve clearance of middle-sized molecules from the blood. The company expects to bring the treatment to the vast majority of eligible patients in November and anticipates a positive impact from lower mortality and higher volume growth beginning in the back half of 2028.
- $11.6BFY2021
- $11.6BFY2022
- $12.1BFY2023
- $12.8BFY2024
- $13.6BFY2025
Structural risks
- Payor mix and pricing: Commercial payors generate nearly all of DaVita’s profits. A decline in higher-paying commercial coverage or difficulty maintaining contracts on competitive terms could affect results. Medicare rates are generally lower, and reimbursement changes can affect the business.
- Regulation and legal matters: DaVita operates under extensive healthcare laws and requirements that can change. It is also subject to lawsuits, investigations, audits and other legal proceedings.
- Labor and supplies: The business is labor intensive and depends on clinical staff and third-party suppliers. Labor shortages, cost increases or disruptions to pharmaceuticals, equipment and services can affect operations.
- Technology and security: DaVita relies on clinical, billing and other information systems. It experienced a cybersecurity incident in 2025, and a security breach or system disruption can affect operations and cash collections.
- Competition and treatment changes: Other dialysis providers compete for patients, physicians and contracts. New technologies, drugs or therapies may also reduce demand for dialysis over time.
- Debt and cash flow: DaVita’s cash flows can vary, and it may need sufficient cash to service debt and meet other obligations.
Bottom line
Our reading
DaVita is a recurring-care business built around a large dialysis network and relationships with physicians, hospitals and payors. Its exposure is concentrated in the difference between commercial and government reimbursement: commercial payors generate nearly all of its profits even though most patients have government coverage. Integrated kidney care and international expansion offer additional lines of business, while reimbursement, labor and technology costs remain central to results.