Core Viewpoint - DaVita Inc. reported strong fourth-quarter earnings and provided optimistic guidance for fiscal 2026, leading to a significant increase in stock price [1]. Earnings Summary - Adjusted earnings were $3.40 per share, surpassing the consensus estimate of $3.16 [2]. - Sales reached $3.62 billion, reflecting a year-over-year increase of 5.8% and exceeding the consensus of $3.497 billion [2]. - Revenue per treatment increased from $410.59 to $422.60, driven by higher average reimbursement rates and seasonal factors [2]. Year-to-Date Changes - The year-to-date performance was influenced by the inclusion of phosphate binders in the ESRD Prospective Payment System and annual increases in average reimbursement rates, including Medicare [3]. - Total U.S. dialysis treatments for Q4 2025 were 7,264,520, averaging 91,608 treatments per day, which is a slight decrease of 0.1% from Q3 2025 [3]. Cost and Treatment Growth - Normalized non-acquired treatment growth for Q4 2025 compared to Q4 2024 was down by 0.6% [4]. - Patient care costs per treatment rose from $273.54 to $279.60, primarily due to increased health benefit expenses and medical supply costs [4]. Guidance - For fiscal 2026, DaVita anticipates adjusted earnings between $13.60 and $15.00 per share, exceeding the consensus of $12.65 [5]. - Adjusted operating income is expected to range from $2.09 billion to $2.24 billion, with treatment volume projected to remain flat compared to 2025 [5]. - Revenue per treatment is expected to grow by approximately 1% to 2%, while cost growth is anticipated to be between 1.25% and 2.25% [5]. Additional Investments - DaVita's CFO mentioned an estimated $40 million headwind from the expiration of enhanced premium tax credits, which is offset by the removal of a $45 million headwind from a previous cyber incident [6]. - DaVita is making a minority investment of approximately $200 million in Elara Caring, which is expected to positively impact other income lines [7]. Analyst View - Barclays has maintained an Equal-Weight rating on DaVita and raised the price target from $143 to $158 [8]. - Following the earnings report, DaVita's stock rose by 21.69% to $135.31 [8].

Financial Data and Key Metrics Changes - Fourth quarter revenue was effectively flat year-over-year but exceeded the midpoint of guidance by 3%, with Sleep Health and Respiratory Health segments showing growth while Diabetes Health contracted [6][30] - Adjusted EBITDA for the fourth quarter contracted 2% year-over-year but was above the high end of guidance, with an adjusted EBITDA margin of 23.4%, slightly down from 23.8% in the prior year [7][38] - Free cash flow for the fourth quarter was $73 million, up 10% year-over-year and well above guidance [7][40] Business Line Data and Key Metrics Changes - Sleep Health revenue increased 3.4% year-over-year to $356.5 million, with new starts surpassing 120,000 for the third consecutive quarter [31] - Respiratory Health revenue was $165.3 million, up 1% year-over-year, with a record oxygen census of over 330,000 patients [33] - Diabetes Health revenue decreased 7.3% year-over-year to $171.3 million, but showed sequential growth of $30.2 million over the third quarter [34] - Wellness at Home revenue was $163.5 million, down 0.8% year-over-year, primarily due to the sale of certain custom rehab assets [35] Market Data and Key Metrics Changes - Full year 2024 net revenue was $3.26 billion, growing 1.9% year-over-year despite pressures from divestitures and reimbursement changes [30] - Sleep Health segment grew 4.5%, Respiratory Health grew 6.0%, while Diabetes Health declined 6.9% for the full year [30] Company Strategy and Development Direction - The company is focusing on five areas: One Adapt initiative, AI and automation, clinical relevance, organic growth, and strengthening the balance sheet [8][24] - A new segment structure was implemented to enhance visibility into customer needs and improve service excellence [12] - The company aims to lead in innovation within the home health industry and expand the value delivered to patients [13][16] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the company's progress and the potential for growth, particularly in the Sleep Health and Respiratory Health segments [5][51] - The company anticipates 2025 to be a transition year for growth, with expectations for accelerated growth in 2026 and beyond [51] Other Important Information - The company reduced debt by $170 million over the past year, with a net leverage ratio of 2.8x at year-end 2024 [24][42] - The company expects 2025 revenue guidance of $3.22 billion to $3.36 billion, reflecting a slight decline to modest growth [46] Q&A Session Summary Question: Can you talk more about the conversations with carriers over additional capitated arrangements? - Management confirmed ongoing discussions with various proposed capitated arrangements and noted a strong relationship with Humana, which has been complimentary about performance [55][56] Question: Can you discuss your working capital outlook and cash flow improvement? - Management expressed satisfaction with free cash flow performance in 2024 and expects continued improvement in days sales outstanding and inventory management [57][59] Question: What are your thoughts on the Diabetes business contribution to 2025 guidance? - Management indicated that while there are improving trends, they are cautious about committing to growth in the Diabetes segment until proven [66][68] Question: Can you elaborate on the changes made in the Diabetes resupply outreach program? - Management highlighted the implementation of a new leadership team and a focus on better patient outreach, which has led to improved retention and reduced attrition [86][90] Question: What is the impact of the purchase versus rental revenue situation? - Management explained that the shift is primarily in the Sleep segment, with revenue being recognized differently due to changes in reimbursement practices [100][102] Question: Can you provide updates on the capitated contract with Humana? - Management confirmed that the extension of the Humana contract was a positive development, with both parties satisfied with the ongoing relationship [109][111]