Revenue Recognition Segment revenue by major payor (Tables)

9 Months Ended

Sep. 30, 2021

Disaggregation of Revenue [Table Text Block]

The following table summarizes the Company's segment revenues by primary payor source:


	Three months ended September 30, 2021						Three months ended September 30, 2020
	U.S. dialysis		Other - Ancillary services		Consolidated		U.S. dialysis		Other - Ancillary services		Consolidated
Dialysis patient service revenues:
Medicare and Medicare Advantage(1)	$	1,543,819	$		$	1,543,819	$	1,541,707	$		$	1,541,707
Medicaid and Managed Medicaid	203,169				203,169		193,254				193,254
Other government(1)	82,624		113,260		195,884		83,602		98,044		181,646
Commercial	862,218		54,857		917,075		858,247		43,845		902,092
Other revenues:
Medicare and Medicare Advantage			77,277		77,277				111,248		111,248
Medicaid and Managed Medicaid			377		377				412		412
Commercial			7,164		7,164				7,799		7,799
Other(2)	6,216		9,442		15,658		17,409		9,895		27,304
Eliminations of intersegment revenues	(22,104)		—		(22,104)		(37,317)		(4,079)		(41,396)
Total	$	2,675,942	$	262,377	$	2,938,319	$	2,656,902	$	267,164	$	2,924,066

(1)During the first quarter of 2021, the Company realigned the classification of revenue previously disclosed in the “Other government” category to the “Medicare and Medicare Advantage” category for certain government-reimbursed plans which have structure and payment characteristics similar to traditional Medicare Advantage plans. The classification of revenue for these plans for the three months ended September 30, 2020 has also been recast to conform to the current period presentation.

(2)Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services.


	Nine months ended September 30, 2021						Nine months ended September 30, 2020
	U.S. dialysis		Other - Ancillary services		Consolidated		U.S. dialysis		Other - Ancillary services		Consolidated
Dialysis patient service revenues:
Medicare and Medicare Advantage(1)	$	4,586,278	$		$	4,586,278	$	4,619,852	$		$	4,619,852
Medicaid and Managed Medicaid	585,053				585,053		547,045				547,045
Other government(1)	245,125		338,553		583,678		253,654		283,431		537,085
Commercial	2,528,499		157,172		2,685,671		2,534,388		118,869		2,653,257
Other revenues:
Medicare and Medicare Advantage			243,085		243,085				309,555		309,555
Medicaid and Managed Medicaid			981		981				1,061		1,061
Commercial			14,387		14,387				27,370		27,370
Other(2)	19,308		31,107		50,415		30,846		36,600		67,446
Eliminations of intersegment revenues	(70,424)		(4,294)		(74,718)		(104,987)		(12,402)		(117,389)
Total	$	7,893,839	$	780,991	$	8,674,830	$	7,880,798	$	764,484	$	8,645,282

(1)During the first quarter of 2021, the Company realigned the classification of revenue previously disclosed in the “Other government” category to the “Medicare and Medicare Advantage” category for certain government-reimbursed plans which have structure and payment characteristics similar to traditional Medicare Advantage plans. The classification of revenue for these plans for the nine months ended September 30, 2020 has also been recast to conform to the current period presentation.

(2)Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services.