Author Topic: DVA DaVita HealthCare Partners  (Read 216035 times)

KCLarkin

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Re: DVA DaVita HealthCare Partners
« Reply #50 on: September 02, 2016, 08:23:54 AM »
Seems like a good entry point.

I'm somewhat stuck on the economics of the dialysis business. According to the NYT, most of their patients pay $200 per session via medicare etc. These patients are unprofitable. All of the profits come from a sliver of patients who pay more than $4000 via private insurance.

http://www.nytimes.com/2016/07/02/business/unitedhealthcare-sues-dialysis-chain-over-billing.html?_r=0

Like most of the U.S. healthcare system, this seems very broken. Why aren't private insurers demanding a "fair" price? And is this "two-tiered" system sustainable?


orthopa

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Re: DVA DaVita HealthCare Partners
« Reply #51 on: September 06, 2016, 10:56:25 AM »
Its interesting value wise here but I need to learn more about the business. Dialysis centers are popping up all over the place here and are constantly booked. Its a slow process so hard to "turn over" patients quickly but pts very dependent obviously due to lack of kidneys avail and if not getting tx will die.

flesh

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Re: DVA DaVita HealthCare Partners
« Reply #52 on: October 24, 2016, 08:56:34 AM »
ANyone know why the big down spike today?Heavy volume.


flesh

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Re: DVA DaVita HealthCare Partners
« Reply #54 on: October 24, 2016, 09:21:35 AM »
Great thanks a bunch!

So basically, davita's employees "encourage" patients to get off medicare/medicaid and steer them towards commercial insurance. Their premiums are paid by a charity in which all the dialysis companies likely contribute too. Because this is an "option" for patients and comes with some perks and doesn't cost them anything, why not.

On the one hand, clearly they make more money and this cost's the commercial insurers more money(rising insurance costs for everyone) . On the other hand, if a charity wants to pay someone's premiums for them and they benefit in more ways than one, is this so bad? If I'm an employee administering dialysis and I know there's a better option for my patient that doesn't cost anything, should I speak up?
Can anyone shed some light on the advantages/disadvantages of commercial vs medicaid/medicare from a dialysis patient's pov?

Before obama care these patients would have been considered catastrophic and as a result would be unlikely to be on commercial insurance. I don't know the dva story back to pre obamacare, maybe someone here does? Did dva receive more money from medicare/medicaid pre obamacare per patient?

flesh

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Re: DVA DaVita HealthCare Partners
« Reply #55 on: October 24, 2016, 06:37:08 PM »
I found this site and this post helpful.

http://ihatedialysis.com/forum/index.php?topic=32917.0

frankhkii

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Re: DVA DaVita HealthCare Partners
« Reply #56 on: October 26, 2016, 12:19:45 PM »
At current prices Mr Market seems to be pricing in a large hit from the recent article about steering customers to AKF. Can someone who has followed or invested with DVA for a while explain the workings of these higher paying commercial plans and give a valid argument for why they won't go away? If the CMS is able to revise enrollment rules for Medicare and Medicade and/or make "regulatory changes that would allow individual market plans to limit their payment to healthcare providers to Medicare-based amounts" it seems this entire division would be unprofitable. Since this would put them out of business resulting in catastrophic consequences for their patients, it seems a long shot, but its hard to invest with the knowledge and comfort I currently have on why this couldn't or won't happen.

Any links or recommendations to help me understand this outside of DVA filings/calls would be helpful. So much of their profitability comes from these plans and it seems there is a lot of pressure on them while their leverage to fight back is hard to see.

Thanks for any help. 
« Last Edit: October 27, 2016, 11:38:17 AM by frankhkii »

whiterose

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Re: DVA DaVita HealthCare Partners
« Reply #57 on: October 28, 2016, 12:43:15 PM »
The stock is down nearly 30% from the July highs. It was either way overpriced back then or now seems a good time to enter. Maybe it will drop until the market sees BRK or Weschler stepping in. Does anyone have any particular insights? Thanks!

valueinvesting101

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Re: DVA DaVita HealthCare Partners
« Reply #58 on: October 28, 2016, 12:54:21 PM »
DaVita Falls on Report It Encouraged Unneeded Insurance (Sunday) By Lee Spears

(Bloomberg) -- DaVita Inc. fell as much as 3.9% to lowest since 2013 after St. Louis Post-Dispatch reported Oct. 23 that DVA encouraged patients who were eligible for Medicaid to buy private insurance.

flesh

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Re: DVA DaVita HealthCare Partners
« Reply #59 on: October 28, 2016, 01:34:52 PM »
At current prices Mr Market seems to be pricing in a large hit from the recent article about steering customers to AKF. Can someone who has followed or invested with DVA for a while explain the workings of these higher paying commercial plans and give a valid argument for why they won't go away? If the CMS is able to revise enrollment rules for Medicare and Medicade and/or make "regulatory changes that would allow individual market plans to limit their payment to healthcare providers to Medicare-based amounts" it seems this entire division would be unprofitable. Since this would put them out of business resulting in catastrophic consequences for their patients, it seems a long shot, but its hard to invest with the knowledge and comfort I currently have on why this couldn't or won't happen.

Any links or recommendations to help me understand this outside of DVA filings/calls would be helpful. So much of their profitability comes from these plans and it seems there is a lot of pressure on them while their leverage to fight back is hard to see.

Thanks for any help.

I am long.

Here's the short story to get you started.
 Davita is the low cost provider.... 10-15% lower cost per patient vs fresenius by my unit economics estimates. Davita and Fresenius have around 1/3 of us market each. The other 1/3 Is mom in pops not benefiting from the economies of scale. Davita and Fresenius have slowed their acquisitions in the us at this point to keep the current market share balance. As a result, any change in pay would cause mom and pops to shut down. Also, patients may have to drive further to get their treatments.