Revenue Recognition Segment revenue by major payor (Tables)

9 Months Ended

Sep. 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
	September 30, 2019									September 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	$	1,558,890		$			$	1,558,890		$	1,513,191		$			$	1,513,191
Medicaid and Managed Medicaid	176,292						176,292			159,165						159,165
Other government	116,984			90,947			207,931			113,043			80,915			193,958
Commercial	828,953			37,276			866,229			786,470			31,364			817,834
Other revenues:
Medicare and Medicare Advantage				65,759			65,759						130,746			130,746
Medicaid and Managed Medicaid				227			227						12,042			12,042
Commercial				33,503			33,503						20,205			20,205
Other(1)	10,308			20,784			31,092			4,932			29,042			33,974
Eliminations of intersegment revenues	(32,362		)	(3,483		)	(35,845		)	(25,424		)	(8,361		)	(33,785		)
Total	$	2,659,065		$	245,013		$	2,904,078		$	2,551,377		$	295,953		$	2,847,330

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

	For the nine months ended
	September 30, 2019									September 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	$	4,572,599		$			$	4,572,599		$	4,524,449		$			$	4,524,449
Medicaid and Managed Medicaid	490,723						490,723			466,948						466,948
Other government	333,675			264,191			597,866			330,500			250,048			580,548
Commercial	2,458,360			103,760			2,562,120			2,366,182			70,156			2,436,338
Other revenues:
Medicare and Medicare Advantage				191,472			191,472						427,532			427,532
Medicaid and Managed Medicaid				327			327						43,991			43,991
Commercial				98,428			98,428						77,633			77,633
Other(1)	20,715			59,204			79,919			14,965			103,014			117,979
Eliminations of intersegment revenues	(93,337		)	(10,222		)	(103,559		)	(63,943		)	(27,748		)	(91,691		)
Total	$	7,782,735		$	707,160		$	8,489,895		$	7,639,101		$	944,626		$	8,583,727

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