Beat on Adjusted Operating Income and EPS
Q1 adjusted operating income of $482 million and adjusted EPS of $2.87, with adjusted OI about $50 million ahead of forecast (roughly half from operational outperformance and half timing).
Raised Full-Year Financial Guidance
Company raised and narrowed 2026 guidance: adjusted operating income to $2.15B–$2.25B and adjusted EPS to $14.10–$15.20, driven primarily by higher volume forecast and lower patient care costs.
Volume and Utilization Improvement
Treatment volume slightly ahead of forecast; treatments per normalized day up ~40 basis points year-over-year in Q1. Full-year treatment volume guidance raised from flat to +25–50 bps (implying +50–75 bps in treatments per normalized day).
Revenue per Treatment Momentum (Q1)
Revenue per treatment increased approximately 4% year-over-year in Q1 (Joel cited ~+$17.50), with management attributing ~2/3 to normal rate/mix and ~1/3 to timing.
Cost Productivity and Patient Care Costs
Patient care cost per treatment was roughly flat to Q4, and lower-than-expected overall due to better-than-expected productivity improvements, supporting margin expansion.
IKC Clinical & Economic Performance
Integrated Kidney Care (IKC) delivered YoY improvements across 3 key CKCC measurements; company generated the highest total aggregate savings of any participant, driven by a 4.5% improvement in gross savings rate since program start.
Capital Allocation & Balance Sheet Discipline
Repurchased ~5 million shares (3M in Q1 and 2M post-quarter including Berkshire Hathaway transaction). Leverage at 3.34x consolidated EBITDA, within target range of 3.0–3.5x.
Strategic Technology Investments and AI Deployment
Investments in modernized data infrastructure and AI use cases (e.g., ScheduleHub scheduling tool and proprietary EMR) intended to improve caregiver productivity, operations and scale benefits over time.