DaVita is the largest U.S. dialysis provider, treating patients with end-stage kidney disease (ESKD). Dialysis is a non-negotiable, life-sustaining treatment — patients require it three times per week for the rest of their lives — creating an extremely durable and recurring patient base. DaVita operates 2,657 outpatient dialysis centers across 46 U.S. states, serving roughly 200,500 U.S. patients, primarily through in-center hemodialysis. DaVita also provides hospital inpatient dialysis under contracts with approximately 740 hospitals and supports home dialysis modalities. DaVita earns revenue on a per-treatment basis, with payments coming from Medicare, Medicaid, and commercial insurers. Payor mix is the critical financial driver: commercial insurers pay substantially higher rates than Medicare, and while commercial patients represent only ~11% of U.S. dialysis patients, they account for ~26% of U.S. dialysis patient service revenues. DaVita does not recruit patients directly — nephrologists refer patients to centers, making physician relationships the core competitive asset. Beyond U.S. dialysis, DaVita operates 585 outpatient centers across 14 countries and runs an Integrated Kidney Care (IKC) business managing ~66,000 patients in value-based care arrangements, which reached profitability in FY25. DaVita's capital allocation centers on share repurchases, targeting leverage of 3.0–3.5x EBITDA, with Berkshire Hathaway owning up to 45% of the company.