Segment reporting (Tables)

3 Months Ended

Mar. 31, 2016

Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes

The following is a summary of segment net revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes:

	Three months ended
	March 31,
	2016			2015
Segment net revenues:
U.S. dialysis and related lab services
Patient service revenues:
External sources	$	2,313,663		$	2,154,294
Intersegment revenues		14,308			11,856
Total dialysis and related lab services revenues		2,327,971			2,166,150
Less: Provision for uncollectible accounts		(104,751	)		(97,477	)
Net dialysis and related lab services patient service revenues		2,223,220			2,068,673
Other revenues⁽¹⁾		3,973			3,184
Total net dialysis and related lab services revenues		2,227,193			2,071,857
HCP
HCP revenues:
Capitated revenues		866,019			832,472
Net patient service revenues		108,238			80,210
Other revenues⁽²⁾		14,530			15,053
Intersegment capitated and other revenues		71			37
Total revenues		988,858			927,772
Other—Ancillary services and strategic initiatives
Net patient service revenues		51,383			35,624
Capitated revenues		21,028			18,043
Other external sources		307,053			246,562
Intersegment revenues		11,827			4,942
Total ancillary services and strategic initiatives revenues		391,291			305,171
Total net segment revenues		3,607,342			3,304,800
Elimination of intersegment revenues		(26,206	)		(16,835	)
Consolidated net revenues	$	3,581,136		$	3,287,965
Segment operating margin (loss):
U.S. dialysis and related lab services	$	440,055		$	(104,489	)
HCP		(57,145	)		60,294
Other—Ancillary services and strategic initiatives		(11,100	)		(13,828	)
Total segment operating margin (loss)		371,810			(58,023	)
Reconciliation of segment operating margin to consolidated income before income taxes:
Corporate administrative support		(6,921	)		(6,133	)
Consolidated operating income		364,889			(64,156	)
Debt expense		(102,884	)		(97,392	)
Debt redemption and refinancing charges
Other income (loss), net		2,976			(533	)
Consolidated income (loss) before income taxes	$	264,981		$	(162,081	)

⁽¹⁾	Includes management fees for providing management and administrative services to dialysis centers that are wholly-owned by third parties or centers in which the Company owns a noncontrolling equity investment.

⁽²⁾

Includes payments received for medical consulting services and management fees for providing management and administrative services to an unconsolidated joint venture that provides medical services in which the Company owns a 50% interest, as well as revenue related to the maintenance of existing physician networks.

Summary of Depreciation and Amortization Expense by Reportable Segment

Depreciation and amortization expense by reportable segment is as follows:

	Three months ended
	March 31,
	2016		2015
U.S. dialysis and related lab services	$	116,537	$	104,993
HCP		46,263		43,279
Ancillary services and strategic initiatives		6,555		5,517
	$	169,355	$	153,789

Summary of Assets by Reportable Segment

Summary of assets by reportable segment is as follows:

	March 31,		December 31,
	2016		2015
Segment assets
U.S. dialysis and related lab services (including equity investments of $30,747 and $29,801, respectively)	$	11,049,206	$	11,591,507
HCP (including equity investments of $23,990 and $22,714, respectively)		6,601,110		6,150,666
Other—Ancillary services and strategic initiatives (including equity investments of $20,322 and $20,853, respectively)		863,882		772,702
Consolidated assets	$	18,514,198	$	18,514,875

Summary of Expenditures for Property and Equipment by Reportable Segment

Expenditures for property and equipment by reportable segment is as follows:

	Three months ended
	March 31,
	2016		2015
U.S. dialysis and related lab services.	$	133,450	$	105,395
HCP		20,145		5,034
Ancillary services and strategic initiatives		19,592		10,992
	$	173,187	$	121,421