DaVita expects treatment growth near top end of guidance
DaVita reported Q2 results in line with expectations, reaffirmed full-year guidance, and highlighted its strategic push into expanded HD with new Nipro dialyzers to improve mortality and drive volume growth. The call emphasized volume growth driven by clinical outcomes, while navigating commercial mix headwinds from ACA subsidy expiration. Management provided a nuanced outlook with a Q3 to Q4 OI ramp driven by IKC. Q2 adjusted EPS of $4.02 and AOI of $579M were in line with expectations.
Buzzberg readDaVita expects treatment growth near top end of guidanceDaVita reported Q2 results in line with expectations, reaffirmed full-year guidance, and highlighted its strategic push into expanded HD with new Nipro dialyzers to improve mortality and drive volume growth. The call emphasized volume growth driven by clinical outcomes, while navigating commercial mix headwinds from ACA subsidy expiration. Management provided a nuanced outlook with a Q3 to Q4 OI ramp driven by IKC. Q2 adjusted EPS of $4.02 and AOI of $579M were in line with expectations.Read full analysisCollapse analysis
DaVita reported Q2 results in line with expectations, reaffirmed full-year guidance, and highlighted its strategic push into expanded HD with new Nipro dialyzers to improve mortality and drive volume growth. The call emphasized volume growth driven by clinical outcomes, while navigating commercial mix headwinds from ACA subsidy expiration. Management provided a nuanced outlook with a Q3 to Q4 OI ramp driven by IKC. Q2 adjusted EPS of $4.02 and AOI of $579M were in line with expectations.
Reaffirmed FY2026 guidance for AOI ($2.2B mid) and EPS ($14.65 mid), despite reaffirming top-end volume growth and lower RPT guidance.
Treatment volume growth beat expectations due to lower mortality, but new patient admits from Fresenius closures are complete.
Commercial mix is deteriorating faster as new patient admissions have lower ACA coverage, creating a sustained RPT headwind into 2027.
Revenue$3.5541B
+4% QoQ
EPS$4.02
+40% QoQ
Gross margin32.7%
reported
Op margin16.06%
reported
What changed this quarter
01
Guidance
DaVita expects treatment growth near top end of guidance
Guidance tone
02
Capex
Expanded HD deployment begins without major capital investment
Management noted that expanded HD can be delivered on existing dialysis machines, making it faster to expand access without significant capital investment.
03
Clinical
Mortality benefit from expanded HD expected by 2028
Reaffirmed FY2026 guidance for AOI ($2.2B mid) and EPS ($14.65 mid), despite reaffirming top-end volume growth and lower RPT guidance.
04
Clinical
Phosphate binder transition reduced OTC use by over 50%
Treatment volume growth beat expectations due to lower mortality, but new patient admits from Fresenius closures are complete.
Demand & capex
Demand
Bookings & conversion
Management reaffirmed full-year guidance, balancing volume growth tailwinds against RPT headwinds from commercial mix dilution and phosphate binder transition. The tone is cautiously optimistic but maintains existing targets.
Capex
Investment and capacity
Management noted that expanded HD can be delivered on existing dialysis machines, making it faster to expand access without significant capital investment.
Tone · Confident
Management expressed confidence in clinical strategy and reiterated guidance, citing progress in mortality improvement and new technology deployment.
Supply-chain alpha
A1
DaVita's treatment volume growth is being driven almost entirely by reduced mortality, not new patient starts, and it is outperforming the industry's negative same-store growth.
“I think what we're saying is the benefit in the quarter relative to expectations was all mortality. It was actually mortality and then some because mistreatment rate came in a little worse than expected and admits was in line with expectat…”
The commercial mix headwind is shifting from existing patients dropping ACA coverage to new patient admissions coming in at a lower commercial mix, which will sustain the pressure through 2027.
“We think the more sustained dynamic that we're expecting through the rest of the year and into next year would be the new admits coming in at a lower commercial mix because of a lower QHP mix.”
DaVita's expanded HD rollout costs are not significant and will not impact 2026 guidance, with the economic benefit from mortality improvement delayed until 2028.
“The impact is insignificant until the mortality benefit kicks in, and that's when you'd see a positive economic impact. We wouldn't expect the positive mortality impact to start until 2028.”
The ongoing share repurchase agreement with Berkshire Hathaway is a structural capital return mechanism, signaling a stable and significant ownership relationship.
“we buy shares from Berkshire Hathaway each quarter pursuant to our repurchase agreement to maintain their ownership near 45%.”
… we closed on our minority investment in Alara Caring, which provides an exciting opportunity to help bring dialysis tailored home health services offerings to our patients. As a reminder, we invested $200 million and expect Alara to provide a small benefit to other income in 2026, likely mid single digit millions. Additionally, We repurchased 2.2 million shares during Q2 and additional 183,000 shares since the end of the quarter. As a reminder, we buy shares from Berkshire Hathaway each quarter pursuant to our repurchase agreement to maintain their ownership near 45%. Our leverage ratio at the end of the quarter was 3.37 times consolidated EBITDA within our target range of 3 to 3.5 times EBITDA. Debt expense in the quarter was $152 million. During the quarter, we issued $500 million of incremental debt with proceeds primarily used to repay revolver borrowings. For the full year, we are reiterating our adjusted operating income guidance range with a midpoint of $2.2 billion and our adjusted earnings per share guidance range with a midpoint of $14.65. To help you model the back half of the year, we anticipate a sequential increase in adjusted operating income of $50 to $100 …
DaVita's expanded HD rollout costs are not significant and will not impact 2026 guidance, with the economic benefit from mortality improvement delayed until 2028. — The financial model for the expanded HD transition relies on long-term mortality-driven volume growth, not immediate cost savings, aligning with DaVita's strategy to differentiate on outcomes.
“the recent FDA approval of new expanded HD dialyzer from Nipro represents an important milestone that should materially improve both market supply and economics”
… treatment to the need of individual patients. Expanded HD also offers meaningful operational advantages because it can be delivered on our existing dialysis machines, making it faster to expand access without significant capital investment. This brings us to our path forward. We continue to support both HDF and expanded HD and believe physicians should have the flexibility to choose the right therapy for each patient. That said, the recent FDA approval of new expanded HD dialyzer from Nipro represents an important milestone that should materially improve both market supply and economics. To capture this clinical opportunity, we have secured supply to these expanded HD dialyzers, which are fully compatible with our existing machines and provide highly effective clearance of metal molecules. As a result, we expect to begin deploying expanded HD broadly across our network in the coming quarters. This will allow us to expand access quickly and deliver this option to our patients and physicians partners. As we move forward, we'll continue evaluating how both approaches perform across different care settings and patient populations in the real world practice. I'll wrap up my prepared …
DaVita's treatment volume growth is being driven almost entirely by reduced mortality, not new patient starts, and it is outperforming the industry's negative same-store growth. — This confirms DaVita is gaining market share through superior clinical outcomes, a trend that could pressure competitors who cannot replicate the mortality improvements.
“This had nothing to do with any of the other volume dynamics that they've been talking about over the last 24 hours. This was purely about the 100 clinics they closed.”
Great. Thanks. I was wondering, the change in the expectation from Fresenius, is that just what you experienced in the quarter or have you also changed your expectation for how much you'll pick up from them during the year?
Yeah, so that is very specific to the 100 clinics that they called out, I guess, last quarter that they were going to be closing. To the best of our understanding, they are done with that effort, and so the pickup is done. I don't expect that to change at all over the course of the year. This had nothing to do with any of the other volume dynamics that they've been talking about over the last 24 hours. This was purely about the 100 clinics they closed.
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