DaVita's Q2 2026 diluted EPS rose 56% to $4.02 on revenue up 5.2% to $3.55B, driven largely by a 14.6% smaller share count and a cyber-hit prior-year quarter, while US dialysis operating income grew just 2.9% as cost per treatment outpaced revenue per treatment.
Revenue
$3.6B
+5.2% YoY
Net income
$265M
+33.1% YoY
Diluted EPS
$4.02
+55.8% YoY
Operating margin
16.3%
Overview: EPS up 56%, but mostly because there are far fewer shares
DaVita, which runs 2,671 US dialysis centers (dialysis filters the blood of patients whose kidneys have failed, usually three times a week), reported second-quarter 2026 revenue of $3.554 billion, up 5.2% from a year earlier. Operating income rose 7.7% to $579 million. Diluted earnings per share (EPS, profit divided by the number of shares) jumped 55.8% to $4.02.
Most of that EPS jump did not come from the dialysis business itself. Three things stacked on top of modest operating growth:
Buybacks. Diluted shares fell 14.6%, from 77.4 million to 66.1 million, so each remaining share gets a bigger slice of profit. Net income attributable to DaVita rose 33.1% to $265 million; the gap between 33% profit growth and 56% EPS growth is the buyback effect.
A weak prior-year quarter. Q2 2025 carried about $13.5 million of charges to clean up the April 2025 cyber attack, a tax charge from writing down a 2014 tax refund claim, and investment losses. On the company's adjusted basis (which strips out items it treats as one-offs), Q2 2025 EPS was $2.95, so adjusted EPS grew 36.3%, not 56%. Q2 2026 had no adjustments, so GAAP and adjusted EPS are the same $4.02.
Below-the-line swings. "Other income" moved from a $22.9 million loss to an $8.3 million gain (the 10-Q cites prior-year equity investment losses at Mozarc Medical Holding and net gains on other investments this year), and the overall tax rate fell from 25.4% to 21.1%.
The US dialysis business, which is 85% of revenue, grew operating income by 2.9% ($523M to $538M), or 0.4% against the prior year's adjusted $536M.
Key metrics
Metric
Q2 2026
Q2 2025
YoY Change
Revenue
$3,554M
$3,380M
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Operating margin is the share of revenue left after running the business, before interest and tax. Adjusted EPS and free cash flow are company-defined non-GAAP figures from the Q2 earnings releases (8-K Exhibit 99.1, Aug 4, 2026 and Aug 5, 2025). Q2 2025 per-treatment figures are from DaVita's Q2 2025 10-Q.
Year to date (six months), revenue was $6.970 billion (+5.6%), net income attributable to DaVita $463 million (+27.8%), and diluted EPS $6.86 versus $4.57 (+50.1%); adjusted EPS was $6.86 versus $4.93 (+39.1%).
US dialysis: volumes barely growing, costs rising faster than prices
Volume. DaVita performed an average of 92,649 dialysis treatments per day in the US, up 0.6% year over year. Stripping out acquisitions and calendar effects, "normalized non-acquired treatment growth" was +0.3%, an improvement on Q1's +0.1% and on the -0.8% of Q2 2025, when a severe flu season and the cyber attack hit patient numbers. The 10-Q says volume was slightly ahead of plan because mortality was lower than expected, partly offset by fewer patient transfers in and more missed treatments. DaVita also said it expects to roll out "expanded hemodialysis", a treatment that clears larger toxin molecules from the blood and may reduce mortality, broadly across its network in coming quarters. The 10-Q does not discuss GLP-1 weight-loss drugs.
Price. Average revenue per treatment was $415.87, up 2.8% from $404.58 a year ago but down 0.4% from Q1 ($417.59). The 10-Q blames the quarter-on-quarter dip on payor mix: fewer patients on commercial (private) insurance, which pays far more than Medicare. It specifically says the expiry of the enhanced Affordable Care Act premium tax credits at the end of 2025 "has had an adverse impact on enrollment in the Affordable Care Act exchanges and our commercial mix."
Cost. Patient care costs per treatment (mainly staff wages, drugs and supplies at the clinics) were $277.40, up 3.4% year over year, faster than the 2.8% rise in revenue per treatment. Year to date, the 10-Q attributes the rise mainly to higher wage rates, insurance costs and health benefits. Against Q1, costs per treatment actually fell 1.0%, thanks to seasonally lower payroll taxes, better staff productivity and lower drug costs including phosphate binders.
Per treatment, DaVita kept about $138.47 after direct patient care costs in Q2 2026, versus $136.22 a year earlier: +1.7%, well below the headline growth rates.
Payor mix: Medicare growing, commercial shrinking
From the revenue-by-payor note in the 10-Q (US dialysis patient service revenue):
Payor
Q2 2026
Q2 2025
YoY
Share Q2 2026
Share Q2 2025
Medicare and Medicare Advantage
$1,749M
$1,660M
+5.4%
58.2%
57.1%
Medicaid and Managed Medicaid
$227M
$218M
+4.2%
7.6%
7.5%
Other government
$89M
$83M
+6.9%
3.0%
2.9%
Commercial
$940M
$947M
-0.7%
31.3%
32.6%
Commercial revenue fell in dollars while government revenue grew. That matters because commercial plans generate a disproportionate share of dialysis profit. The company's own risk factors call this "the concentration of profits generated by higher-paying commercial payor plans." On the government side, CMS's proposed 2027 Medicare dialysis rule would raise freestanding facilities' average payment by an estimated 1.1%, including an adjustment for adding phosphate binders to the base rate. That is below the 3.4% cost-per-treatment inflation DaVita just reported.
Other businesses and corporate costs
International (595 centers in 14 countries): revenue $386M, up 18.8% from $325M, but operating income fell to $25M from $36M. The 10-Q attributes the Q2 decline mainly to "a loss on sale of divested centers." Year to date, international operating income fell 17.9% to $55M, partly because Q2 2025 had a favorable change in the fair value of acquisition-related contingent payments.
Integrated kidney care (IKC), where DaVita takes on the total medical cost of kidney patients under value-based contracts: operating income of $40M versus $26M a year ago and a $19M loss in Q1, which the 10-Q attributes to "a net increase in shared savings." It covered about 64,900 patients in risk-based arrangements, representing roughly $5.8 billion of annualized medical spend. This line swings sharply from quarter to quarter because contract settlements arrive late.
Corporate support costs were $16M versus $42M a year ago, a $26M improvement. For the half year the 10-Q cites lower professional fees and lower long-term incentive pay. That is more than the entire $15M year-over-year rise in US dialysis operating income, so lower overhead, not the core business, delivered most of the operating income growth this quarter.
The cyber incident, one year on
The April 2025 cyber attack no longer shows up as charges. It still distorts comparisons in DaVita's favor. Days sales outstanding (how long customers take to pay) was 52 days at June 30, 2026, versus 58 a year earlier, when billing systems were disrupted. Six-month operating cash flow rose 60.9% to $811M, and the 10-Q explicitly credits "favorable collections... compared to the disruption in collections related to the cybersecurity incident" in 2025. Some of this year's cash-flow growth is therefore catch-up, not a new run rate.
Buybacks, Berkshire and leverage
DaVita bought back 2.24 million shares for $348 million in Q2 (average $154.95) and 5.24 million shares for $751 million in the first half. More than half the Q2 shares (1.22 million, $183 million) came from Berkshire Hathaway. Under a 2024 agreement, whenever Berkshire's stake reaches 45.0% of shares outstanding, DaVita must buy enough of Berkshire's shares each quarter to bring it back to 45.0%. Open-market buybacks therefore pull Berkshire into selling alongside. In June the average price jumped to $199.55, and $1.37 billion of buyback authorization remained as of July 31.
The buybacks are funded partly with debt. In June DaVita added a $500 million incremental term loan, partly to pay down its revolving credit line. Total debt was $10.85 billion ($10.18 billion net of cash). The leverage ratio under its credit agreement (net debt divided by a lender-defined EBITDA, roughly cash operating profit) was 3.37x, up from 3.34x in Q1 and within the 5.00x covenant maximum. After years of repurchases, DaVita's shareholders' equity is negative: a $765 million deficit at June 30. Quarterly interest expense was $150 million, 26% of operating income, at a 5.43% average rate.
Takeaway: The 56% EPS jump is mostly financial engineering and easy comparisons: a 14.6% smaller share count, a cyber-hit prior-year quarter, and a $26M drop in corporate costs. The core US dialysis business grew operating income just 2.9%, volumes rose only 0.3% on an underlying basis, and cost per treatment (+3.4%) is outpacing revenue per treatment (+2.8%) as commercial-insured patients shrink as a share of revenue.
Guidance and outlook
DaVita kept the 2026 guidance it had raised in May (from the Aug 4, 2026 earnings release): adjusted operating income of $2,150–$2,250 million, adjusted diluted EPS of $14.10–$15.20, and free cash flow of $1,000–$1,250 million. With $6.86 of EPS and $1,061M of operating income booked in the first half, the EPS range implies $7.24–$8.34 for the second half, above the first-half pace. That is plausible if buybacks keep shrinking the share count and Q3 benefits from more normalized treatment days (79.2 vs 78.8 a year ago, per the release).
Our read: DaVita can keep compounding EPS as long as buybacks continue and borrowing stays affordable. The operating trends are thin, though. The main risks to watch are further commercial-mix erosion from lower ACA exchange enrollment, a 2027 Medicare rate increase (proposed at 1.1%) below the pace of wage inflation, and leverage creeping up as buybacks are partly debt-funded. The upside case rests on lower mortality from newer therapies such as expanded hemodialysis, which could turn volume growth meaningfully positive after several flat years.