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Revenue Recognition Segment revenue by major payor (Tables) | 9 Months Ended
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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.

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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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