Author Topic: DVA DaVita HealthCare Partners  (Read 216249 times)

no_free_lunch

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Re: DVA DaVita HealthCare Partners
« Reply #90 on: December 14, 2016, 09:06:33 PM »
So I have been following this one for years due to the Buffet link.  I can see how it will likely do well in a 2-5 year time horizon.  I just wonder if people would be comfortable with it over a longer time horizon, like 20 years.  I read earlier in the thread how there is a chance of a technological disruption.  Lab grown kidney's or something along those lines.  How do you handle that risk?


cubsfan

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Re: DVA DaVita HealthCare Partners
« Reply #91 on: December 15, 2016, 05:57:00 AM »
Regarding the kidney transplant issue, this is not a simple procedure. And success is not just due to availability of kidneys.
It's dangerous depending on the patient's health and age. I had discussions earlier this year with Director of U of Chicago Kidney Transplant Center.

The problem for many of these "candidates" is that they are unhealthy and many times overweight. U of Chicago will not do a transplant on individuals above a certain body mass index - those candidates have to lose a significant amount of weight.
The side effects of  infection, drugs, etc can be fatal.  Risk of infections goes up significantly with overweight patients.
 Powerful drugs to fight these infections can damage the heart, etc.

Her opinion: those on dialysis can live very long and healthy lives without a transplant.
Transplants should not be viewed as a silver bullet. I am not a doctor - but this is how I understand the issue.
« Last Edit: December 15, 2016, 06:44:54 AM by cubsfan »

flesh

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Re: DVA DaVita HealthCare Partners
« Reply #92 on: December 15, 2016, 10:15:28 AM »
Regarding the kidney transplant issue, this is not a simple procedure. And success is not just due to availability of kidneys.
It's dangerous depending on the patient's health and age. I had discussions earlier this year with Director of U of Chicago Kidney Transplant Center.

The problem for many of these "candidates" is that they are unhealthy and many times overweight. U of Chicago will not do a transplant on individuals above a certain body mass index - those candidates have to lose a significant amount of weight.
The side effects of  infection, drugs, etc can be fatal.  Risk of infections goes up significantly with overweight patients.
 Powerful drugs to fight these infections can damage the heart, etc.

Her opinion: those on dialysis can live very long and healthy lives without a transplant.
Transplants should not be viewed as a silver bullet. I am not a doctor - but this is how I understand the issue.

Now we are getting somewhere. I forwarded this to my bro in law to discuss with his doctor buddies. I'll try to find some statistics on what portion of esrd patients are eligible for any sort of transplant.


cubsfan

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Re: DVA DaVita HealthCare Partners
« Reply #93 on: December 15, 2016, 12:23:45 PM »
If you want to check this presentation from the U of Chicago Transplant Center - it reviews some of the issues
for families of transplant candidates. There are many factors (ex. see slide 11 for body mass index) - they won't
attempt a transplant if your body fat is 40%+. There are rejection issues, long term medication side effects, infections, etc .
You get a team of doctors to evaluate you as a candidate - it's not simply an issue of availability of a kidney.
Families often misunderstand and think if they give a kidney to their sibling - everything is a "go".
It's not at all like that.

With dialysis you do not have these complications or trauma.




rogermunibond

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Re: DVA DaVita HealthCare Partners
« Reply #94 on: December 15, 2016, 01:27:45 PM »
http://www.nejm.org/doi/full/10.1056/NEJMoa1508380

I think I posted on this before non-compatible kidney donation (from live donor) got a major study write up in the NEJM.  Over 1000 transplants and very good results.  Still up in the air if the results are good enough for more widespread adoption.
« Last Edit: December 15, 2016, 01:30:40 PM by rogermunibond »

bennycx

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Re: DVA DaVita HealthCare Partners
« Reply #95 on: December 15, 2016, 05:26:39 PM »
I'm comfortable with this investment other than seeing some reports saying that Davita provides worse quality of care than non-profits? Can anyone quantify this?

rogermunibond

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Re: DVA DaVita HealthCare Partners
« Reply #96 on: December 15, 2016, 05:45:34 PM »
https://data.medicare.gov/data/dialysis-facility-compare

CMS has made dialysis center data available, and they have consumer comparison site.

From my perusing Davita and Fresenius did about avg, mostly 3 stars.  Some nonprofits did much better, but the thing is a lot of nonprofits that had their own dialysis have gotten out of the biz.

fareastwarriors

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Re: DVA DaVita HealthCare Partners
« Reply #97 on: December 25, 2016, 08:31:10 PM »


flesh

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Re: DVA DaVita HealthCare Partners
« Reply #99 on: February 02, 2017, 10:55:11 AM »
http://pressreleases.davita.com/2017-02-01-DaVita-Finalizes-Acquisition-of-Mountain-View-Medical-Group

This acquisition took forever to close. Not sure why.

http://www.denverpost.com/2017/02/01/federal-government-pay-davita-millions-underpayment-claims/

Over 500 million coming in from the govt.

Good things happening along with the new epo contract which is accretive.