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Revenue Recognition Segment revenue by major payor (Tables)

6 Months Ended

Jun. 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
	June 30, 2018												June 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	$	1,526,066			$				$	1,526,066			$	1,313,504			$				$	1,313,504
Medicaid and Managed Medicaid	150,288								150,288				151,286								151,286
Other government	110,338				86,530				196,868				90,712				62,604				153,316
Commercial	796,732				19,139				815,871				764,864				15,324				780,188
Other revenues:
Medicare and Medicare Advantage					154,028				154,028								225,511				225,511
Medicaid and Managed Medicaid					16,158				16,158								19,020				19,020
Commercial					17,006				17,006								26,812				26,812
Other⁽²⁾	4,919				35,034				39,953				4,849				44,322				49,171
Eliminations of intersegment revenues	(20,096		)		(9,189		)		(29,285		)		(13,285		)		(6,124		)		(19,409		)
Total	$	2,568,247			$	318,706			$	2,886,953			$	2,311,930			$	387,469			$	2,699,399


(1)	As noted above, prior period amounts have not been adjusted under the cumulative effect method. The Company's dialysis and related lab services revenues for the three months ended June 30, 2017 has been presented net of the provision for uncollectible accounts of $109,600 in this table 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 six months ended
	June 30, 2018												June 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	$	3,011,258			$				$	3,011,258			$	2,586,100			$				$	2,586,100
Medicaid and Managed Medicaid	307,783								307,783				295,871								295,871
Other government	217,458				169,068				386,526				182,704				110,366				293,070
Commercial	1,579,711				38,857				1,618,568				1,521,574				29,206				1,550,780
Other revenues:
Medicare and Medicare Advantage					296,786				296,786								450,713				450,713
Medicaid and Managed Medicaid					31,949				31,949								37,615				37,615
Commercial					57,427				57,427								52,020				52,020
Other⁽²⁾	10,033				73,973				84,006				10,159				91,899				102,058
Eliminations of intersegment revenues	(38,519		)		(19,387		)		(57,906		)		(25,084		)		(12,493		)		(37,577		)
Total	$	5,087,724			$	648,673			$	5,736,397			$	4,571,324			$	759,326			$	5,330,650


(1)	As noted above, prior period amounts have not been adjusted under the cumulative effect method. The Company's dialysis and related lab services revenues for the six months ended June 30, 2017 has been presented net of the provision for uncollectible accounts of $216,658 in this table to conform to the current period presentation.