Author Topic: DVA – DaVita HealthCare Partners  (Read 215872 times)

MrB

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Re: DVA – DaVita HealthCare Partners
« Reply #140 on: August 03, 2017, 02:02:19 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.
Attached chart from the above data might provide a bit more insight.


cubsfan

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Re: DVA – DaVita HealthCare Partners
« Reply #141 on: August 03, 2017, 02:16:35 PM »
Well, I hope you're right cause I own DVA and bought more today.

But the CA legislation also proposes a cap on profits - above 15% gets rebated to payors.
What do you expect from a socialist state like CA?

CA is going to end up with a shortage of dialysis clinics if they continue down this route.

From some of the links and the conference calls you can see the dialysis industry is fighting this - saying it will force many, perhaps 20% of these clinics to close, because they are unprofitable and not enough skilled help. This will flood the ER's with patients. You wonder if CA politicians actually have any brains at all. These unions are self serving. Bad for everyone except some employees.

MrB

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Re: DVA – DaVita HealthCare Partners
« Reply #142 on: August 03, 2017, 03:04:54 PM »

MrB

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Re: DVA – DaVita HealthCare Partners
« Reply #143 on: August 05, 2017, 12:36:10 PM »
Don't think I've seen this posted here. Long term history of Davita from 1979 and background to the industry; good read.
Favorite quote "We are very much a new company," Thiry explained in an October 23, 2000 interview with the Los Angeles Business Journal. "The previous company was almost exclusively focused on shareholders, and our new mission is to be the provider, partner, and employer of choice. We realize that we have to satisfy our shareholders with a reasonable return, but that is not our primary mission." He did not do that bad considering returns were not his primary focus.

http://www.referenceforbusiness.com/history2/15/DaVita-Inc.html

MrB

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Re: DVA – DaVita HealthCare Partners
« Reply #144 on: August 06, 2017, 01:54:21 PM »
Historical lows

sleepydragon

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Re: DVA – DaVita HealthCare Partners
« Reply #145 on: August 06, 2017, 06:24:52 PM »
Don't think I've seen this posted here. Long term history of Davita from 1979 and background to the industry; good read.
Favorite quote "We are very much a new company," Thiry explained in an October 23, 2000 interview with the Los Angeles Business Journal. "The previous company was almost exclusively focused on shareholders, and our new mission is to be the provider, partner, and employer of choice. We realize that we have to satisfy our shareholders with a reasonable return, but that is not our primary mission." He did not do that bad considering returns were not his primary focus.

http://www.referenceforbusiness.com/history2/15/DaVita-Inc.html

This one is good study too:
https://www.usrds.org/2015/download/vol2_USRDS_ESRD_15.pdf

cubsfan

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Re: DVA – DaVita HealthCare Partners
« Reply #146 on: August 06, 2017, 08:40:34 PM »
you guys are posting some great stuff - thank  you!

sleepydragon

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Re: DVA – DaVita HealthCare Partners
« Reply #147 on: August 06, 2017, 09:30:19 PM »
From Bank of America research, I found following is interesting:

One of the dynamics within the US health care system broadly is the implicit cost
shifting from the government onto the private sector. The government (both Medicare
and Medicaid) set rates and although providers can lobby the government, they cannot
negotiate rates and are a rate taker. Historically, the government has set rates below
inflation as a way to help balance the budget. When 60% of your revenue is paying less
than inflation, providers go back to the 40% where they can negotiate, and try to get
rates that are above inflation. This has been a specific problem for dialysis, because
until 2014, dialysis was not guaranteed an automatic market basket update and each
year had to lobby Congress for an update
. As a result, many years the industry didn’t
receive any update, and we would estimate that over the past 40 years, the update has
averaged about 1%. Below we provide a theoretical example that is illustrative of what
has happened to dialysis rates over time. If we assume that rate in 1972 for both
commercial and Medicare were set at $150, but grew by 1% for Medicare each year and
commercial by 4%, then in 2016, Medicare rates would be $232 and Commercial rates
would be $842

----
so before 2014, medicare rates have failed to grow with inflation. On average it grows only 1% prior to 2014.
Good if it can grow with inflation going forward. Even a small growth compounded will make 70% of DVA business become profit positive.

However, the 2018 rate was only a growth of 0.8%: https://www.healthindustrywashingtonwatch.com/2017/07/articles/regulatory-developments/medicare-medicaid-services-regulations/cms-proposes-update-to-medicare-esrd-pps-payments-for-2018/


Rasputin

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Re: DVA – DaVita HealthCare Partners
« Reply #148 on: August 07, 2017, 06:22:49 AM »
On top of pressure on CMS ESRD PPS, mortality rate has come down, causing higher percentage of treatment paid by government.  It's crept up from 87% to almost 90% now  since 2005. 

While DVA Kidney Care rev per treatment has only grown $25 from 2005 to 2017 (from $322 to $347), I estimate commercial rate per treatment has grown from $830 in 2005 to $1150 in 2017.  It's a rough estimate because Davita rounds percentage of treatment paid by government to closest percent. 

In a sense, DVA KC is not rewarded for driving mortality rate lower.  It's a crazy payment system, but I like the moat.  It's an 8% position for me now. 

sleepydragon

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Re: DVA – DaVita HealthCare Partners
« Reply #149 on: August 07, 2017, 08:16:04 AM »