DaVita 2026 UBS Global Healthcare Conference

Yeah. Look, year is not over yet. First of all, thank you for having us, and hello, everyone. Year is not over yet, but I think we have a pretty good sense of the contours for the year. I will get to the U.S. dialysis business second, but I will start with the other two businesses, international and IKC. International is just clicking along as expected. Nothing surprising there, positive or negative. We have always said over the long term, 1% addition to OI growth, and that is happening. IKC is having a strong year. We are looking at about a 2% contribution to OI growth this year versus the normal 1% we call out. The business, I think, is just hitting its stride.

Five years ago, I think we called out 2026 was going to be the first break-even year, and it has just continued to click along, growing, delivering great value to patients and payers, and we are feeling really good about that. In terms of U.S. dialysis, going into the year, we expected it would be a tough year. We knew we had challenges on commercial mix from the ACA. We knew we were not going to get back to our normal 2% volume growth. That was the start. I would say the things that have gone well are, one, volume, that we are growing this year, and we are happy about that, and we think that sets a good foundation for next year. Second, revenue per treatment has been stronger than expected. The big challenge for us has been on the cost side.

While there are things in patient care costs that have been a little noisy, the big headwind has really been on G&A, and in particular, IT. We have been investing a lot in IT. IT has been growing north of 20% a year for the last, I think this is four years in a row.

We are able to mitigate some of that by bringing the non-IT component of G&A down, but that number continues to be higher than we forecasted, and I would say it is an intentional decision. We see opportunity to invest there. G&A will continue to grow, although we think it will decelerate, and the benefits of that show up everywhere else in the P&L, in volume, in RPT, in patient care costs, and in G&A. We feel good about the IT investment, but it certainly has been a bit of a headwind for the year.

Yeah. I am not going to try and predict what the new Congress is going to do from a politics or policy standpoint. There is not much dialysis-specific that I think anyone campaigned on. I think the big opportunity for us is on payer mix, and in particular, somehow reversing the impact of the enhanced premium tax credits. If there is a way for the exchanges to get back to where they were or continue to grow from where they are today, that will certainly have a positive impact on revenue per treatment and our bottom line.

Yeah. So, look, we've got a lot of energy around the goals of the plan, of increasing innovation, increasing quality, and driving competition. We've got a lot of shared goals with the government on that. I think where we differ from them is why we are where we are and how to solve that. The government seems to have a lot of energy for holding the large dialysis organizations accountable for some of the problems. You see that in the bill and some of the questions they have about charitable premium assistance. You see that in other things the government has done. You remember, they subpoenaed us. We've disclosed this in our 10-Q and our 10-K around FTC concerns.

In our discussions with them around the FTC issues as well as this plan, what we're trying to emphasize is, one, we believe DaVita's part of the solution, not part of the problem. We have delivered on mortality benefits and higher quality. We have delivered lower costs for the system, and we see an opportunity for us to partner with the government to help solve these problems. We do not see taking money out of the system, either through charitable premium assistance or other areas, as a viable path to accomplishing their goals.

Yeah. So look, I think you have to start with exactly what you said. Charitable premium assistance is about helping patients maintain their coverage through a very, very challenging part of their lives, when they're getting onto dialysis and dealing with clinical issues and financial issues and psychosocial issues associated with that. Most patients on charitable premium assistance are not using it for commercial. They're using it for Medicare or Medicare Advantage. Eliminating charitable premium assistance will hurt patients. It'll cost the government more money, and we don't think it will have any impact, or it certainly won't have any positive impact on spurring competition or driving innovation. We think it'll do the exact opposite.

This is a component of the dialysis ecosystem that has been tested time and time again, and it has remained durable, and we think it is just a reasonable component of how the system works today.