Davita Inc. (DVA)

DaVita is a kidney care provider, treating patients at every stage from slowing the progression of the disease to supporting transplantation, at home, in its dialysis centres, in hospital and in skilled nursing facilities. The filing describes five stages of chronic kidney disease, graded by how well the kidneys filter waste and fluid out of the blood, and a patient at stage five has kidneys that have lost nearly all function. Because that loss is normally irreversible, those patients need continued dialysis or a kidney transplant to stay alive. At 31 December 2025 the company provided outpatient haemodialysis in the United States through 2,657 centres in 46 states and the District of Columbia.

How dialysis works

Haemodialysis is the most common treatment: a machine passes the patient's blood through a filter called a dialyser, divided by a semi-permeable membrane, with pre-mixed fluid on the other side, so toxins, salt and excess fluid cross out before the cleansed blood returns to the body. It is usually performed three times a week at a freestanding outpatient centre, a hospital-based outpatient centre, a skilled nursing facility or the patient's home. Peritoneal dialysis instead uses the patient's own abdominal cavity to remove fluid and toxins and is typically done at home, either by hand four times a day or by a machine that cycles solution through while the patient sleeps. A kidney transplant is described as the most desirable intervention, though the shortage of donors, the side effects of immunosuppressive drugs and the dangers of surgery limit its use for some patients.

What the centres do

Most of what the company provides is outpatient haemodialysis treatment. As a condition of enrolment in Medicare it contracts with a nephrologist or a group of nephrologists to act as medical director at each centre, and other nephrologists may apply for privileges to treat their patients there. Each centre has an administrator, sometimes a registered nurse, running daily operations, with staff typically covering nurses, patient care technicians, a social worker, a registered dietician and biomedical technician support. At 31 December 2025 the company had contracts to provide inpatient dialysis at approximately 740 hospitals, paid a negotiated fee per treatment. It also runs a separately licensed clinical laboratory specialising in testing for end stage kidney disease, and manages 52 outpatient centres it partly owns or that third parties own outright.

Who pays

United States dialysis is approximately 86% of what the group takes in, earned mainly from dialysis and related laboratory services, the administration of pharmaceuticals and management fees. Of the patient service side in 2025, Medicare and Medicare Advantage plans were 57%, Medicaid and managed Medicaid 7%, other government programmes 3%, and commercial insurance including hospital dialysis services 32%. Since 1972 the federal government has covered qualified patients under the Medicare programme for this disease regardless of age or means. For those patients all dialysis payments come as a single bundled rate covering the goods and services provided during treatment, including drugs such as erythropoiesis-stimulating agents, calcimimetics, vitamin D analogs and iron supplements, whatever quantity is given.

The other businesses

Integrated Kidney Care sells care management to health plans and government programmes for members with end stage or chronic kidney disease, combining health monitoring, clinical coordination, predictive analytics and claims analysis, paid either a contract fee or through shared savings, pay-for-performance and capitation arrangements. DaVita Clinical Research is a specialty clinical research organisation working on drug and device studies for sponsors. The transplant software business, MedSleuth, connects transplant candidates, centres, physicians and care teams. DaVita Venture Group looks for acquisitions, partnerships and venture investments in digital health, pharmaceuticals, medical devices and care delivery. Outside the United States the company operated 585 outpatient centres in 14 countries at 31 December 2025, serving approximately 94,500 patients, the largest counts in Brazil, Colombia, Malaysia, Poland and Chile.

Competition and people

In its United States dialysis business the company competes with large and medium-sized providers for acquisition targets, for patients and for physicians qualified to serve as medical directors, and with new entrants, private equity-backed kidney care providers and nephrologists who open their own units. The same competition for targets and physician relationships follows it abroad, alongside pressure in recruiting skilled clinical staff and in negotiating with commercial payors and hospitals. At 31 December 2025 it employed approximately 78,000 people, approximately 72% of them in the United States.

From DaVita's annual report on Form 10-K for the year ended 31 December 2025. The filing