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DaVita: Going Beyond Kidney Care in Push to Overhaul Health Care

Updated 5/8/2013

Warren Buffett's Berkshire Hathaway (BRK.A), already the largest investor in DaVita, has agreed to nearly double their stake in the company. Once finalized Berkshire would hold a 25% stake in the the leading kidney dialysis provider in the country. DaVita shares rose over 3% in after hours trading on Tuesday's news that they had entered the "standstill" agreement with Berkshire. According to a recent regulatory filing, Buffett's company owned roughly 15 million shares of DaVita as recently as March. That put their stake in the company at 14.2% before this new agreement.

Nearly half a million Americans depend on kidney dialysis to keep them alive and one in three of those patients gets their treatment from a company called DaVita (DVA). High demand has this Denver-based health care company growing faster than ever.

“When your kidney fails, you die unless you’re one of the fortunate few who get transplanted,” explains DaVita’s Chairman and CEO Kent Thiry. “When we go to the bathroom, we urinate out the toxins in everything that we eat and drink and breathe. When your kidney doesn’t work, you can’t get rid of those toxins.”

DaVita has nearly 2,000 dialysis centers throughout the country. Patients typically visit a center three times a week for three to four hours. As Thiry explains, patients are then hooked up to a machine that removes their blood, cleans it, and puts it back into their body.

That process is where DaVita makes most of its money, but last year’s $4.4 billion acquisition of “HealthCare Partners” has helped the company expand past kidney care too.

But getting a return on that investment will be no small feat given well established competitors like Universal Health Services (UHS), Athena Health (ATHN) and HCA Healthcare (HCA). The competition hasn't dampened Thiry's aspiration to completely overhaul the American health care system.

“Davita is passionate about the potential for integrated care,” he says. “American healthcare has historically grown up in a very fragmented, siloed way…If people couldn’t serve as their own general contractor, they would see a cardiologist and other physicians, go to a hospital, go to a pharmacy, but all of that had to be coordinated by them. What our population health management business does is become the general contractor, become the quarterback, and become the coordinator for those 800,000 Americans. The result is a big improvement in the quality of care, big improvement in illness prevention, and big savings for the taxpayer.”

This expansion past kidney care is part of the reason the company’s stock has surged 47% in the last year. But growth isn’t something new for DaVita. It’s grown consistently for about 15 years.

“Our attitude has been all along to have a very long term point of view,” Thiry points out. “A lot a lot of companies that are higher growth kind of pass us twice. They pass us on the way up and they pass us on the way down…In this particular 15 year stretch we’re winning and we have a lot of respect for the fact that over the next 15 years they might outperform us.”

DaVita’s future success and that of competitors like Fresenius (FMS), the world’s largest dialysis provider, may depend a lot on what happens next year when Obamacare is fully implemented. Thiry is ready for the change.

“On the kidney care front, there hasn’t been a lot of change yet, but there could be next year because of the introduction of what are called exchanges, a different way for people to access health insurance…As long as it’s a level playing field we’re a big fan of anything that creates for fluidity, accountability, and transparency in health care. The population health management side, we’re hoping that Obamacare moves more of the country, again, to demanding coordinated and integrated care."

Integrated care, international expansion, growth outside of kidney care, and demographics are driving the company’s future.

“The aging of America for most of what we do is going to lead to more demand for our services," says Thiry. "This is particularly true in kidney care because diabetes and hypertension are the biggest causes of kidney failure…Our mission is however, to help prevent that; to help prevent kidney failure, to help prevent other chronic illnesses and at the same time reduce costs and improve quality once people have them."

DaVita is certainly doing their best to make those better treatments a reality, but they’re in a very competitive business and keeping this stock growing will be no easy task for Thiry and his team.

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