Revenue Recognition Segment revenue by major payor (Tables)

6 Months Ended

Jun. 30, 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
	June 30, 2019									June 30, 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	$	1,520,193		$			$	1,520,193		$	1,526,066		$			$	1,526,066
Medicaid and Managed Medicaid	160,242						160,242			150,288						150,288
Other government	110,565			88,770			199,335			110,338			86,530			196,868
Commercial	840,993			33,095			874,088			796,732			19,139			815,871
Other revenues:
Medicare and Medicare Advantage				64,012			64,012						154,028			154,028
Medicaid and Managed Medicaid				94			94						16,158			16,158
Commercial				32,307			32,307						17,006			17,006
Other(1)	5,501			20,670			26,171			4,919			35,034			39,953
Eliminations of intersegment revenues	(30,334		)	(3,403		)	(33,737		)	(20,096		)	(9,189		)	(29,285		)
Total	$	2,607,160		$	235,545		$	2,842,705		$	2,568,247		$	318,706		$	2,886,953

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

	For the six months ended
	June 30, 2019									June 30, 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	$	3,013,709		$			$	3,013,709		$	3,011,258		$			$	3,011,258
Medicaid and Managed Medicaid	314,431						314,431			307,783						307,783
Other government	216,692			173,245			389,937			217,458			169,068			386,526
Commercial	1,629,407			66,483			1,695,890			1,579,711			38,857			1,618,568
Other revenues:
Medicare and Medicare Advantage				125,713			125,713						296,786			296,786
Medicaid and Managed Medicaid				100			100						31,949			31,949
Commercial				64,925			64,925						57,427			57,427
Other(1)	10,406			38,420			48,826			10,033			73,973			84,006
Eliminations of intersegment revenues	(60,975		)	(6,739		)	(67,714		)	(38,519		)	(19,387		)	(57,906		)
Total	$	5,123,670		$	462,147		$	5,585,817		$	5,087,724		$	648,673		$	5,736,397

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