Revenue Recognition Segment revenue by major payor (Tables)

3 Months Ended

Mar. 31, 2019

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
	March 31, 2019									March 31, 2018
	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	$	1,493,516		$	—		$	1,493,516		$	1,485,192		$	—		$	1,485,192
Medicaid and Managed Medicaid	154,190			—			154,190			157,496			—			157,496
Other government	106,127			84,475			190,602			107,119			82,537			189,656
Commercial	788,413			33,388			821,801			782,979			19,718			802,697
Other revenues:
Medicare and Medicare Advantage	—			61,700			61,700			—			142,758			142,758
Medicaid and Managed Medicaid	—			6			6			—			15,791			15,791
Commercial	—			32,619			32,619			—			40,420			40,420
Other(1)	4,905			17,750			22,655			5,114			38,941			44,055
Eliminations of intersegment revenues	(30,641		)	(3,336		)	(33,977		)	(18,422		)	(10,199		)	(28,621		)
Total	$	2,516,510		$	226,602		$	2,743,112		$	2,519,478		$	329,966		$	2,849,444

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