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Revenue Recognition Segment revenue by major payor (Tables)

9 Months Ended

Sep. 30, 2018

Revenues by major payor [Abstract]

Schedule of Revenue Sources, Health Care Organization [Table Text Block]

The following table summarizes the Company's segment revenues by primary payor source:



	For the three months ended
	September 30, 2018												September 30, 2017⁽¹⁾
	U.S. dialysis and related lab services				Other - Ancillary services and strategic initiatives				Consolidated				U.S. dialysis and related lab services				Other - Ancillary services and strategic initiatives				Consolidated
Patient service revenues:
Medicare and Medicare Advantage	$	1,513,191			$				$	1,513,191			$	1,338,155			$				$	1,338,155
Medicaid and Managed Medicaid	159,165								159,165				155,113								155,113
Other government	113,043				80,915				193,958				89,243				72,681				161,924
Commercial	786,470				31,364				817,834				783,171				17,334				800,505
Other revenues:
Medicare and Medicare Advantage					130,746				130,746								232,251				232,251
Medicaid and Managed Medicaid					12,042				12,042								17,142				17,142
Commercial					20,205				20,205								27,222				27,222
Other⁽²⁾	4,932				29,042				33,974				4,792				47,438				52,230
Eliminations of intersegment revenues	(25,424		)		(8,361		)		(33,785		)		(13,475		)		(5,996		)		(19,471		)
Total	$	2,551,377			$	295,953			$	2,847,330			$	2,356,999			$	408,072			$	2,765,071


(1)	As noted above, prior period amounts have not been adjusted under the cumulative effect method. In this table, the Company's dialysis and related lab services revenues for the three months ended September 30, 2017 has been presented net of the provision for uncollectible accounts of $119,321 to conform to the current period presentation.


(2)	Other consists of management fees and revenue from the Company's ancillary services and strategic initiatives.



	For the nine months ended
	September 30, 2018												September 30, 2017⁽¹⁾
	U.S. dialysis and related lab services				Other - Ancillary services and strategic initiatives				Consolidated				U.S. dialysis and related lab services				Other - Ancillary services and strategic initiatives				Consolidated
Patient service revenues:
Medicare and Medicare Advantage	$	4,524,449			$				$	4,524,449			$	3,924,255			$				$	3,924,255
Medicaid and Managed Medicaid	466,948								466,948				450,984								450,984
Other government	330,500				250,048				580,548				271,947				183,050				454,997
Commercial	2,366,182				70,156				2,436,338				2,304,745				46,537				2,351,282
Other revenues:
Medicare and Medicare Advantage					427,532				427,532								682,964				682,964
Medicaid and Managed Medicaid					43,991				43,991								54,757				54,757
Commercial					77,633				77,633								79,241				79,241
Other⁽²⁾	14,965				103,014				117,979				14,951				139,337				154,288
Eliminations of intersegment revenues	(63,943		)		(27,748		)		(91,691		)		(38,559		)		(18,488		)		(57,047		)
Total	$	7,639,101			$	944,626			$	8,583,727			$	6,928,323			$	1,167,398			$	8,095,721


(1)	As noted above, prior period amounts have not been adjusted under the cumulative effect method. In this table, the Company's dialysis and related lab services revenues for the nine months ended September 30, 2017 has been presented net of the provision for uncollectible accounts of $335,979 to conform to the current period presentation.