I mean, these are insane numbers. States are now starting to release the actual numbers on what the Republicans policy changes have done to health insurance costs with this with this legislation that they've passed this year. This is what the Democrats have been making a stink about. You've heard like Democrats are concerned in the shutdown fight about health care costs and health insurance and you think like, "Oh, Democrats are always concerned about health costs. That's nice. I care about health costs.I'm ...

Core Viewpoint - Geopolitical events, judicial rulings, new law legislation, and policy changes are significantly impacting stock movements across various industrial sectors [1] Group 1 - Geopolitical events are influencing market dynamics and causing volatility in stock prices [1] - Judicial rulings are leading to substantial shifts in investor sentiment and stock performance [1] - New law legislation is creating opportunities and challenges for different industries, affecting their market valuations [1] - Policy changes are reshaping the competitive landscape, prompting companies to adjust their strategies [1]

Trade Policy - US is expected to impose 50% tariffs on India's exports starting Wednesday [1] Government Response - Modi's government is accelerating policy changes in response to the potential tariffs [1]

Financial Data and Key Metrics Changes - First quarter adjusted operating income was $439 million, adjusted EPS was $2, and free cash flow was negative $45 million, with adjusted operating income above guidance due to strong expense management and international performance [18][25] - Revenue per treatment increased by $4, with approximately $10 attributed to new reimbursement for phosphate binders, partially offset by a $5 decline due to seasonal patient responsibility [21][40] - Patient care cost per treatment increased by $7 sequentially, driven by new costs associated with phosphate binders [21] Business Line Data and Key Metrics Changes - Adjusted international operating income increased by $29 million compared to the previous quarter, with a strong performance across various markets [22] - Integrated Kidney Care (IKC) reported operating losses of $29 million, in line with expectations, with seasonally stronger performance anticipated in the second half of the year [22] Market Data and Key Metrics Changes - Treatments per day declined by 40 basis points year-over-year and were approximately 50 basis points below forecast, primarily due to a higher missed treatment rate from a severe flu season [19] - The company expects an approximately 50 basis point decline in treatments for the year, influenced by flu-related impacts and the cyber incident [20] Company Strategy and Development Direction - The company remains committed to investing available capital in innovation and high-return growth opportunities, including a recent acquisition in Latin America [13] - The capital allocation strategy includes returning capital to shareholders through share repurchases, with approximately $680 million repurchased since the last earnings call [13] Management's Comments on Operating Environment and Future Outlook - Management highlighted the resilience of operations despite a cybersecurity incident that disrupted parts of the business, with uninterrupted patient care maintained [9][10] - The company reiterated its 2025 guidance range for adjusted operating income and adjusted EPS, despite headwinds from the cyber incident and a challenging flu season [16][25] Other Important Information - The company launched a community-based collaboration with the YMCA to support chronic kidney disease education and prevention, with early results showing 30% of participants screened had previously undiagnosed CKD [6][7] - The company is addressing regulatory and legal follow-ups related to the cyber incident, with most costs expected to be one-time items recognized in the second quarter [10][31] Q&A Session Summary Question: Impact of flu and cyber attack on treatment volume - The flu had a significant impact on the full year treatment volume, accounting for more than half of the 50 basis point revision, while the cyber incident contributed to a loss of approximately 500 admissions [29][30] Question: Costs related to the cyber attack - Majority of costs from the cyber attack will be one-time items recognized in Q2, with some direct costs likely covered by insurance and not included in adjusted operating income [31] Question: Phosphate binders uptake and drug mix - The mix leaned towards iron-based binders, leading to an increase in guidance for operating income contribution from phosphate binders to the upper end of the previous range [32][33] Question: Revenue per treatment expectations - Revenue per treatment is expected to remain within the previously guided range of 4.5% to 5.5%, with half of the increase coming from core business and half from orals [43][44] Question: International market performance - International operations had a strong quarter, with a significant year-over-year increase, and the company feels positive about the new acquisition's performance [58]