DaVita reported in-line Q4 2025 results with full-year AOI at the top half of guidance, driven by strong IKC performance (first profitable year) and better-than-expected RPT. Management guided 2026 AOI growth of 3.2% and EPS growth of 33%, supported by capital allocation and the removal of the Mozark investment headwind. The company remains cautious on volume growth, assuming flat treatment volume in 2026, and is investing in clinical initiatives to drive long-term mortality improvements. Full Year 2025 AOI came in at $2.094B, top half of guidance; IKC reached profitability ahead of schedule with $22M full-year OI.
DaVita reported in-line Q4 2025 results with full-year AOI at the top half of guidance, driven by strong IKC performance (first profitable year) and better-than-expected RPT. Management guided 2026 AOI growth of 3.2% and EPS growth of 33%, supported by capital allocation and the removal of the Mozark investment headwind. The company remains cautious on volume growth, assuming flat treatment volume in 2026, and is investing in clinical initiatives to drive long-term mortality improvements. Full Year 2025 AOI came in at $2.094B, top half of guidance; IKC reached profitability ahead of schedule with $22M full-year OI.
DaVita reported in-line Q4 2025 results with full-year AOI at the top half of guidance, driven by strong IKC performance (first profitable year) and better-than-expected RPT. Management guided 2026 AOI growth of 3.2% and EPS growth of 33%, supported by capital allocation and…
Full Year 2025 AOI came in at $2.094B, top half of guidance; IKC reached profitability ahead of schedule with $22M full-year OI.
2026 Guidance: AOI $2.085-2.235B (3.2% growth), EPS $13.60-15.00 (33% growth), FCF $1.0-1.25B.
Management expects flat US treatment volume in 2026, with no improvement in non-flu mortality; IKC to add $20M incremental OI.
Management is confident in delivering 3.2% AOI growth and 33% EPS growth in 2026, driven by cost management, IKC profitability, and capital allocation, despite volume headwinds.
Management expressed optimism about clinical initiatives, IKC profitability, and long-term growth targets despite near-term headwinds.
“Innovations such as medium cutoff dialyzers and hemodial filtration enable the clearance of a broader range of toxins from the body during the treatment. These technologies help the patients recover more quickly after dialysis and show pro…”
“open enrollment performed better than forecasted by CBO or ourselves. And we're all waiting to see the real number, which is right now we are measuring selection of a plan. or enrollment of a plan.”
| Metric | Period | Range | Midpoint | Status |
|---|---|---|---|---|
| EPS | FY2026 | $13.60–$15.00 | $14.30 | GUIDED |
| Free cash flow | FY2026 | $1B–$1.25B | $1.125B | GUIDED |
| Op margin | FY2026 | $2.085B–$2.235B | $2.16B | GUIDED |
| Op marginIKC | FY2026 | $20M | $20M | GUIDED |
| UnitsUS_DIALYSIS_TREATMENT_VO | FY2026 | 0% | 0% | GUIDED |
| UnitsREVENUE_PER_TREATMENT | FY2026 | 1%–2% | 1.5% | GUIDED |
Berkshire Hathaway continues to be a significant shareholder in DaVita, with ongoing share repurchases under their agreement, maintaining ownership at or below 45%.
“As is typical, a portion of these shares were repurchased from Berkshire Hathaway pursuant to the terms of our publicly filed repurchase agreement, which formulaically results in Berkshire's ownership remaining at or below 45%.”
… was $46 million and full year adjusted OI was $22 million. We saw strength across all three of the businesses within IKC and final reconciliations of our 2024 performance resulted in higher than expected shared savings revenue. Switching to capital allocation. During the fourth quarter, we repurchased 2.7 million shares, and we repurchased an additional 1.7 million shares since the end of the quarter. As is typical, a portion of these shares were repurchased from Berkshire Hathaway pursuant to the terms of our publicly filed repurchase agreement, which formulaically results in Berkshire's ownership remaining at or below 45%. For the full year 2025, we repurchased nearly 13 million shares for approximately $1.8 billion. At year end, our leverage ratio was 3.26 times consolidated EBITDA down from the third quarter and at the midpoint of our target leverage range of three to three and a half times. With that, let me turn to 2026. As Javier said, we were guiding to an adjusted operating income range with a midpoint of $2.16 billion. At this midpoint, we have built in the following assumptions for U.S. dialysis. Treatment volume will be approximately flat to 2025. This assumes a flu …
Gilead's (GILD) hemodiafiltration technology, which uses high-volume replacement fluid, is being used in clinical studies and is expected to be a significant growth driver for DaVita's dialysis technology. The impact was mentioned as 'possible revenue recognition' but more importantly, the technology uptake will be driven by the upcoming HeMo study data. — If HeMo study data (with Gilead's tech) is positive, CMS will issue a national coverage determination in 2026, unlocking a large new market for GILD's technology and DaVita's implementation.
“Innovations such as medium cutoff dialyzers and hemodial filtration enable the clearance of a broader range of toxins from the body during the treatment. These technologies help the patients recover more quickly after dialysis and show”
… is a clinical imperative. Second is GLP-1 adoption and adherence. A growing body of evidence confirms that GLP-1s can reduce major adverse cardiac events and mortality for many dialysis patients. We're actively working with physicians to help our patients navigate the clinical, operational, and financial complexities of these drugs. Third is advancing dialysis technologies to remove middle molecules. Innovations such as medium cutoff dialyzers and hemodial filtration enable the clearance of a broader range of toxins from the body during the treatment. These technologies help the patients recover more quickly after dialysis and show promise of reducing mortality by as much as 20% or more. Finally, Today, we announced a strategic clinical partnership with Alara Caring, a leading home care provider, to establish an ESKD-focused offering. This model spans Alara's skilled home health, personal care, and hospice service lines and is designed to lower hospitalizations and mistreatment rates while improving the overall patient experience. Joel will provide more details about the investment we're making alongside this strategic partnership. Together, these clinical initiatives demonstrate …
The expiration of enhanced premium tax credits is expected to be a $40M headwind in 2026, but the fear of a mass exodus of patients from commercial plans is not materializing. Open enrollment performed better than expected, with patients proving 'sophisticated' in their insurance choices. — Resilient enrollment on ACA exchanges reduces the risk of volume loss and patient churn to other payers, a positive read for large health insurers with broad ACA exposure.
Can you give us more detail on how you expect the ACA headwind to play out this year from a cadence perspective and maybe comment on open enrollment, how that played out relative to expectations and whether, you know, what level of attrition you're expecting on that ACA enrollment throughout the year? Thanks.
Thank you, Andrew. So the number that we gave, we said approximately 40 million this year, 70 million next year, and 10 the year after that. The reality is that we're seeing what you're seeing in the broader market, which is open enrollment performed better than forecasted by CBO or ourselves. And we're all waiting to see the real number, which is right now we are measuring selection of a plan. or enrollment of a plan. And then of course, people are trying to see what the payment of the plan will be to see what the yield will be. We don't have any additional color than what you or the marketplace has on what that will be since it's the first time that these enhanced premium tax credits have gone away. But so far, it has been more resilient than people expected. And we will see once the bills start to come if people pay. We will say that our patients during the pandemic and at other time periods, because they are so ill and needing of the healthcare system, are really sophisticated understanding their insurance needs. So, on average, they will go out of their way to stay insured. And that's why last call, we said that there was basically two populations, our current patient population, which we think will be more resilient And then you have the incoming population, which is, in essence, right now a CKD population that might not value insurance as much as someone that's already had their kidneys filled, and that's why the number grows over time. But we will obviously be watching it during the quarter, and we will see once the payments go into effect.