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Revenue Recognition Segment revenue by major payor (Tables) | 6 Months Ended
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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.

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- Definition Tabular disclosure of patient service revenue (net of contractual allowances and discounts), by major payor source of revenue for health care organizations. + References No definition available. + Details
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