"Our strong platform delivered once again in 2025, providing high quality, innovative care to our patients and achieving the financial targets we set out at the beginning of the year despite a challenging environment," said Javier Rodriguez, CEO of DaVita. "Given our ongoing investments and process improvements, we are confident in our ability to continue to deliver both clinically and financially in 2026 and beyond."
Financial and operating highlights for the quarter and year ended December 31, 2025:
Consolidated revenues were $3.620 billion and $13.643 billion for the three months and year ended December 31, 2025, respectively.
Operating income was $561 million and adjusted operating income was $586 million for the three months ended December 31, 2025. Operating income was $2,044 million and adjusted operating income was $2,094 million for the year ended December 31, 2025.
Diluted earnings per share from continuing operations was $2.94 and adjusted diluted earnings per share from continuing operations was $3.40 for the three months ended December 31, 2025. Diluted earnings per share from continuing operations was $9.51 and adjusted diluted earnings per share from continuing operations was $10.78 for the year ended December 31, 2025.
Operating cash flow was $541 million and free cash flow was $309 million for the three months ended December 31, 2025. Operating cash flow was $1,887 million and free cash flow was $1,024 million for the year ended December 31, 2025.
Refinanced existing Term Loan A-1 and revolving line of credit during the three months ended December 31, 2025, as described below. Additionally, refinanced existing Term Loan B-1 and issued 6.75% senior notes due 2033 during the year ended December 31, 2025.
Repurchased 2.7 million shares of the Company's common stock at an average price paid of $122.78 per share in the three months ended December 31, 2025. Repurchased 12.7 million shares of the Company's common stock at an average price paid of $140.09 per share in the year ended December 31, 2025.
Three months ended
Year ended December 31,
December 31, 2025
September 30, 2025
2025
2024
Net income attributable to DaVita Inc.:
(dollars in millions, except per share data)
Net income from continuing operations
$ 209
$ 150
$ 722
$ 936
Diluted per share from continuing operations
$ 2.94
$ 2.04
$ 9.51
$ 10.73
Adjusted net income from continuing operations(1)
$ 242
$ 185
$ 818
$ 845
Adjusted diluted per share from continuing
operations(1)
$ 3.40
$ 2.51
$ 10.78
$ 9.68
Net income
$ 234
$ 150
$ 747
$ 936
Diluted per share
$ 3.29
$ 2.04
$ 9.84
$ 10.73
(1)
For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 15.
Three months ended
Year ended December 31,
December 31, 2025
September 30, 2025
2025
2024
Amount
Margin
Amount
Margin
Amount
Margin
Amount
Margin
Operating income
(dollars in millions)
Operating income
$ 561
15.5 %
$ 506
14.8 %
$ 2,044
15.0 %
$ 2,090
16.3 %
Adjusted operating income(1)
$ 586
16.2 %
$ 517
15.1 %
$ 2,094
15.3 %
$ 1,981
15.5 %
(1)
For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 15.
U.S. dialysis metrics:
Volume: Total U.S. dialysis treatments for the fourth quarter of 2025 were 7,264,520, or an average of 91,608 treatments per day, representing a per day decrease of (0.1)% compared to the third quarter of 2025. Normalized non-acquired treatment growth in the fourth quarter of 2025 compared to the fourth quarter of 2024 was (0.6)%.
Three months ended
Quarter
change
Year ended
Year to date
change
December 31, 2025
September 30, 2025
December 31, 2025
December 31, 2024
(dollars in millions, except per treatment data)
Revenue per treatment
$ 422.60
$ 410.59
$ 12.01
$ 409.56
$ 391.32
$ 18.24
Patient care costs per treatment
$ 279.60
$ 273.54
$ 6.06
$ 273.34
$ 258.12
$ 15.22
General and administrative
$ 336
$ 322
$ 14
$ 1,253
$ 1,174
$ 79
Primary drivers of the changes in the table above were as follows:
Revenue: The quarter change was primarily driven by increases in average reimbursement rates and other normal fluctuations as well as slight improvement in mix and seasonal impact of flu vaccines. The year to date change was driven by the incorporation of phosphate binders into the ESRD Prospective Payment System bundle and an increase in average reimbursement rates from normal annual increases, including Medicare base rate.
Patient care costs: The quarter change was primarily due to increased health benefit expense as well as increased medical supply costs. The year to date change was primarily driven by increased pharmaceutical costs, primarily driven by the incorporation of phosphate binders, increased compensation expenses, medical supply costs, and health benefit expense.
General and administrative: The quarter change was primarily due to professional fees, IT-related costs, and health benefit costs, partially offset by a decrease in costs related to the previously disclosed cybersecurity incident. The year to date change was primarily driven by increases in IT-related costs and costs related to the cybersecurity incident, as well as increases in compensation expense, partially offset by decreased center closure costs.
Certain items impacting the quarter:
Debt transaction. In November 2025, we entered into the Eighth Amendment to our senior secured credit agreement to refinance our existing Term Loan A-1 and revolving line of credit facilities maturing April 28, 2028 with a new Term Loan A-2 facility in the aggregate principal amount of $2.0 billion and revolving line of credit facility in the aggregate principal amount of up to $1.5 billion. We used a portion of the proceeds from this transaction to pay off the remaining principal balance outstanding on our Term Loan A-1 in the amount of $1.9 billion and related accrued interest and fees. The remaining borrowings added cash to the balance sheet for general corporate purposes.
Mozarc investment. During the fourth quarter of 2025, we incurred impairment and restructuring charges of $20.5 million as part of equity investment losses related to Mozarc Medical Holding LLC (Mozarc), partially offset by a $12.6 million gain on remeasurement of contingent consideration. The impairment and restructuring charges, net of the remeasurement gain, are excluded from our adjusted non-GAAP metrics.
Share repurchases. During the three months ended December 31, 2025, we repurchased 2.7 million shares for $331 million, at an average price paid of $122.78 per share.
Subsequent to December 31, 2025 through February 2, 2026, the Company has repurchased 1.7 million shares of our common stock for $200 million at an average price paid of $120.56 per share.
Financial and operating metrics:
Three months ended
December 31,
Twelve months ended
December 31,
2025
2024
2025
2024
Cash flow:
(dollars in millions)
Operating cash flow
$ 541
$ 548
$ 1,887
$ 2,022
Free cash flow(1)
$ 309
$ 281
$ 1,024
$ 1,162
(1)
For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 15.
Three months endedDecember 31, 2025
Year ended
December 31, 2025
Effective income tax rate on:
Income from continuing operations
20.0 %
21.8 %
Income from continuing operations attributable to DaVita Inc.(1)
27.7 %
29.1 %
Adjusted income from continuing operations attributable to DaVita Inc.(1)
24.9 %
25.8 %
(1)
For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 15.
Center activity: As of December 31, 2025, we provided dialysis services to a total of approximately 295,000 patients at 3,242 outpatient dialysis centers, of which 2,657 centers were located in the United States and 585 centers were located in 14 countries outside of the United States. During the fourth quarter of 2025, we acquired one and closed six dialysis centers in the United States, and acquired three, opened one, and closed five dialysis centers outside of the United States.
Integrated kidney care (IKC): As of December 31, 2025, we had approximately 66,000 patients in risk-based integrated care arrangements representing approximately $5.6 billion in annualized medical spend. We also had an additional 9,400 patients in other integrated care arrangements; we do not include the medical spend for these patients in this annualized medical spend estimate. For an additional description of these metrics, see footnote 6 in the "Supplemental Financial Data" table below.
Outlook:
The following forward-looking measures and the underlying assumptions involve significant known and unknown risks and uncertainties, including those described below, and actual results may vary materially from these forward-looking measures. We do not provide guidance for operating income or diluted net income per share attributable to DaVita Inc. or operating cash flow on a basis consistent with United States generally accepted accounting principles (GAAP) nor a reconciliation of forward-looking non-GAAP financial measures to the most directly comparable GAAP financial measures on a forward-looking basis because we are unable to predict certain items contained in the GAAP measures without unreasonable efforts. These current non-GAAP financial measures do not include certain items, including cybersecurity costs and foreign currency fluctuations, which may be significant. The guidance for our effective income tax rate on adjusted income attributable to DaVita Inc. also excludes the amount of third-party owners' income and related taxes attributable to non-tax paying entities.
Current 2026 guidance
Low
High
(dollars in millions, except per share data)
Adjusted operating income
$2,085
$2,235
Adjusted diluted net income from continuing operations per share attributable to DaVita Inc.
$13.60
$15.00
Free cash flow
$1,000
$1,250
The following table outlines normalized treatment days by quarter for 2026 and each quarter in 2025, for comparison. Normalized treatment days are adjusted for the mix of days of the week for each quarter and serve as a means to more readily compare calendar effects on each quarter's treatment volume.
Normalized Treatment Days
2025
2026
Q1
76.9
76.5
Q2
78.0
78.0
Q3
78.8
79.2
Q4
79.5
78.8
Total
313.2
312.4
Certain columns, rows or percentages may not sum or recalculate due to the presentation of rounded numbers.
We will be holding a conference call to discuss our results for the fourth quarter ended December 31, 2025, on February 2, 2026, at 5:00 p.m. Eastern Time. To join the conference call, please dial (877) 918-6630 from the U.S. or (517) 308-9042 from outside the U.S., and provide the operator the password "Earnings." This call is being webcast and can be accessed at the DaVita Investor Relations website investors.davita.com. A replay of the conference call will also be available at investors.davita.com.
Forward looking statements
DaVita Inc. and its representatives may from time to time make written and oral forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 (PSLRA), including statements in this release, filings with the Securities and Exchange Commission (SEC), reports to stockholders and in meetings with investors and analysts. All statements in this release, during the related presentation or other meetings, other than statements of historical fact, are forward-looking statements and as such are intended to be covered by the safe harbor for "forward-looking statements" provided by the PSLRA. These forward-looking statements could include, among other things, statements about our balance sheet and liquidity, our expenses, revenues, billings and collections, patient census, the impact of the cybersecurity incident experienced by the Company in 2025, the potential impact of the One Big Beautiful Bill Act (OBBBA) and federal government policy changes or shutdowns, including with respect to federal funding and reimbursement rates of Medicare, Medicare Advantage, Medicaid and other government programs, availability or cost of supplies, including without limitation the impact of evolving trade policies and tariffs and any reduction in clinical and other supplies due to any disruptions experienced by third party vendors, including with respect to our ability to provide home dialysis services, treatment volumes, mix expectation, such as the percentage or number of patients under commercial insurance, including potential impacts to such mix as a result of U.S. administration policies, current macroeconomic, marketplace and labor market conditions, and overall impact on our patients and teammates, as well as other statements regarding our outlook, future operations, financial condition and prospects, capital allocation plans, expenses, cost saving initiatives, other strategic initiatives, use of contract labor, government and commercial payment rates, expectations related to value-based care (VBC), integrated kidney care (IKC), Medicare Advantage (MA) plan enrollment and our international operations, expectations regarding increased competition and marketplace changes, including those related to new or potential entrants in the dialysis and pre-dialysis marketplace and the potential impact of innovative technologies, drugs, or other treatments on the dialysis industry, and expectations regarding our share repurchase program. All statements in this release, other than statements of historical fact, are forward-looking statements. Without limiting the foregoing, statements including the words "expect," "intend," "will," "could," "plan," "anticipate," "believe," "forecast," "guidance," "outlook," "goals," and similar expressions are intended to identify forward-looking statements. These forward-looking statements are based on DaVita's current expectations and are based solely on information available as of the date of this release. DaVita undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of changed circumstances, new information, future events or otherwise, except as may be required by law. Actual future events and results could differ materially from any forward-looking statements due to numerous factors that involve substantial known and unknown risks and uncertainties. These risks and uncertainties include, among other things:
external conditions, including those related to general economic, political and global health conditions, including without limitation, the impact of global events and political or governmental volatility; the impact of the domestic political environment and related developments on the current healthcare marketplace, our patients and on our business, including without limitation, developments related to domestic policy initiatives and guidance or potential government shutdowns; the continuing impact of infectious diseases on the chronic kidney disease population and our patient population; supply chain challenges and disruptions, including without limitation, with respect to certain key services, critical clinical supplies and equipment we obtain from third parties, and including any impacts on our supply chain and cost of supplies as a result of natural disasters or evolving trade policies, including tariffs; the potential impact on our patients and industry of new or potential entrants in the dialysis and pre-dialysis marketplace and innovative technologies, drugs, or other treatments; elevated teammate turnover or labor costs; the impact of continued increased competition from dialysis providers and others; and our ability to respond to challenging U.S. and global economic and marketplace conditions, including, among other things, our ability to successfully identify cost saving opportunities;
the concentration of profits generated by higher-paying commercial payor plans for which there is continued downward pressure on average realized payment rates; our ability to negotiate and maintain contracts with these payors on competitive terms or at all; a reduction in the number or percentage of our patients under commercial plans, including, without limitation, as a result of healthcare, immigration or other policies implemented by the U.S. administration, continuing legislative efforts to restrict or prohibit the use and/or availability of charitable premium assistance, as a result of payors implementing restrictive plan designs or resulting from negotiations with large commercial payors that we have in the past, and currently are, conducting on a concurrent basis;
risks arising from laws, regulations or requirements applicable to us or changes thereto, including, without limitation, the OBBBA and those related to trade policy, healthcare, privacy, antitrust matters, and acquisition, merger, joint venture or similar transactions and/or labor matters, and potential impacts of changes in interpretation or enforcement thereof or related litigation impacting, among other things, coverage or reimbursement rates for our services or the number of patients enrolled in or that select higher-paying commercial plans, and the risk that we make incorrect assumptions about how our patients will respond to any such developments;
our ability to successfully implement strategic and operational initiatives in a complex, evolving and highly regulated environment, including, without limitation, with respect to IKC and VBC initiatives and home based dialysis;
a reduction in government payment rates under the Medicare End Stage Renal Disease program, state Medicaid or other government-based programs and the impact of the MA benchmark structure and adjustment methodologies;
our reliance on significant suppliers, service providers and other third party vendors to provide key support to our business operations and enable our provision of services to patients, including, among others, suppliers of certain pharmaceuticals, administrative or other services or critical clinical products; and risks resulting from a closure, reduction or other disruption in the services or products provided to us by such suppliers, service providers and third party vendors;
our ability to successfully maintain, operate or upgrade our information systems or those of third-party service providers upon which we rely and our ability to successfully adopt or adapt to new technologies, treatments or therapies;
legal and compliance risks, such as compliance with complex, and at times, evolving government regulations and requirements, and with additional laws that may apply to our operations as we expand geographically or enter into new lines of business;
noncompliance by us or our business associates with any privacy or security laws or any security breach by us or a third party, such as the cybersecurity incident experienced by the Company in 2025, including, among other things, any such non-compliance or breach involving the misappropriation, loss or other unauthorized use or disclosure of confidential information;
our ability to attract, retain and motivate teammates, including key leadership personnel, and our ability to manage potential disruptions to our business and operations, including potential work stoppages, operating cost increases or productivity decreases whether due to union organizing activities, political unrest or legislative or other changes, demand for labor, volatility and uncertainty in the labor market, the current challenging and highly competitive labor market conditions, including due to the ongoing nationwide shortage of skilled clinical personnel, or other reasons;
changes in practice patterns related to pharmaceuticals, medical equipment or supplies, reimbursement and payment policies and processes, or pricing, including with respect to oral phosphate binders, among other things;
our ability to develop and maintain relationships with physicians and hospitals, changing affiliation models for physicians, and the emergence of new models of care or other initiatives that, among other things, may erode our patient base and impact reimbursement rates;
our ability to complete and successfully integrate and operate acquisitions, mergers, dispositions, joint ventures or other strategic transactions on terms favorable to us or at all; and our ability to continue to successfully expand our operations and services in markets outside the United States, or to businesses or products outside of dialysis services;
the variability of our cash flows, including, without limitation, any extended billing or collections cycles including, without limitation, due to defects or operational issues in our billing systems, the impact of the cybersecurity incident experienced by the Company in 2025 or defects or operational issues in the billing systems or services of third parties on which we rely; the risk that we may not be able to generate or access sufficient cash in the future to service our indebtedness or to fund our other liquidity needs;
the effects on us or others of natural or other disasters, public health crises or severe adverse weather events such as hurricanes, earthquakes, fires or flooding;
factors that may impact our ability to repurchase stock under our share repurchase program and the timing of any such stock repurchases, as well as any use by us of a considerable amount of available funds to repurchase stock;
our goals and disclosures related to sustainability matters, including, among other things, evolving regulatory requirements affecting environmental, social and governance standards, measurements and reporting requirements; and
the other risk factors, trends and uncertainties set forth in our Annual Report on Form 10-K for the year ended December 31, 2024 and Quarterly Reports on Form 10-Q for the quarters ended March 31, June 30 and September 30, 2025, and the risks and uncertainties discussed in any subsequent reports that we file or furnish with the SEC from time to time.
The financial information presented in this release is unaudited and is subject to change as a result of subsequent events or adjustments, if any, arising prior to the filing of the Company's Yearly Report on Form 10-K for the year ended December 31, 2025.
DAVITA INC.
CONSOLIDATED STATEMENTS OF INCOME
(unaudited)
(dollars and shares in thousands, except per share data)
Three months ended December 31,
Year ended December 31,
2025
2024
2025
2024
Dialysis patient service revenues
$ 3,399,232
$ 3,119,180
$ 13,007,186
$ 12,260,375
Other revenues
220,555
175,503
635,883
555,175
Total revenues
3,619,787
3,294,683
13,643,069
12,815,550
Operating expenses:
Patient care costs
2,409,517
2,225,371
9,243,476
8,598,521
General and administrative
472,362
414,482
1,673,630
1,538,341
Depreciation and amortization
186,703
174,102
715,348
723,860
Equity investment income, net
(9,865)
(10,315)
(33,000)
(26,189)
Gain on changes in ownership interests
—
(74,319)
—
(109,466)
Total operating expenses
3,058,717
2,729,321
11,599,454
10,725,067
Operating income
561,070
565,362
2,043,615
2,090,483
Debt expense
(148,252)
(138,721)
(579,926)
(470,469)
Debt extinguishment and modification costs
(9,028)
—
(14,178)
(19,813)
Other loss, net
(21,031)
(12,908)
(102,688)
(69,808)
Income from continuing operations before income taxes
382,759
413,733
1,346,823
1,530,393
Income tax expense
76,728
64,488
293,107
279,656
Net income from continuing operations
306,031
349,245
1,053,716
1,250,737
Net income from discontinued operations, net of tax
25,000
—
25,000
—
Net income
331,031
349,245
1,078,716
1,250,737
Less: Net income attributable to noncontrolling interests
(96,814)
(89,916)
(331,913)
(314,395)
Net income attributable to DaVita Inc.
$ 234,217
$ 259,329
$ 746,803
$ 936,342
Earnings per share attributable to DaVita Inc.:
Basic net income from continuing operations
$ 3.00
$ 3.18
$ 9.72
$ 11.02
Basic net income
$ 3.36
$ 3.18
$ 10.06
$ 11.02
Diluted net income from continuing operations
$ 2.94
$ 3.09
$ 9.51
$ 10.73
Diluted net income
$ 3.29
$ 3.09
$ 9.84
$ 10.73
Weighted average shares for earnings per share:
Basic shares
69,652
81,620
74,227
84,991
Diluted shares
71,261
83,854
75,885
87,274
Amounts attributable to DaVita Inc.:
