--- title: "Dialysis 13Fs: DaVita, Fresenius Medical Care, US Renal Care" type: learn slug: dialysis-13f-dva-fmsa-decoder canonical_url: https://13finsight.com/learn/dialysis-13f-dva-fmsa-decoder published_at: 2026-05-16T16:43:22.204Z updated_at: 2026-05-16T16:43:25.250Z author: Sarah Mitchell author_title: Education Editor author_url: https://13finsight.com/authors/sarah-mitchell word_count: 662 locale: en source: 13F Insight --- # Dialysis 13Fs: DaVita, Fresenius Medical Care, US Renal Care > DaVita, Fresenius Medical Care (NYSE FMS), US Renal Care (private), plus Outset Medical and CVRx anchor US-traded dialysis 13F positioning. Multi-year emerging Medicare reimbursement dynamics, home dialysis growth, plus emerging emerging GLP-1 diabetes prevention impact drive distinctive institutional patterns. US-traded dialysis equities form a distinctive specialty healthcare corner of institutional 13F positioning. DaVita (DVA, largest US dialysis operator), Fresenius Medical Care (FMS, post-2024 Fresenius SE spinoff transaction), plus Outset Medical (OM, home hemodialysis Tablo platform) and CVRx (CVRX, Barostim hypertension neuromodulation) anchor the cohort. Plus US Renal Care (Bain Capital private), Satellite Healthcare (private). Multi-year emerging Medicare reimbursement dynamics, home dialysis growth, plus emerging emerging GLP-1 diabetes prevention impact drive distinctive institutional positioning. Reading dialysis 13F positioning requires understanding the Medicare framework plus the multi-year category dynamics.The dialysis business modelDialysis companies operate four primary economic engines:Medicare reimbursement. Multi-year emerging Medicare reimbursement drives dialysis operator revenue. Multi-year emerging Medicare ESRD (End-Stage Renal Disease) program covers 80%+ of US dialysis patients plus emerging emerging Medicare bundled payment rate ($278/treatment 2024, +2-3% annual increases) plus emerging emerging emerging emerging commercial insurance (higher reimbursement plus emerging emerging emerging emerging Medicare Advantage growth post-21st Century Cures Act 2021) drive multi-year emerging emerging operator economics. Multi-year emerging emerging commercial-to-Medicare mix shift compresses margins.Home dialysis growth. Multi-year emerging home dialysis growth drives multi-year emerging operator transition. Multi-year emerging home hemodialysis plus emerging emerging peritoneal dialysis plus emerging emerging emerging emerging Outset Medical Tablo platform plus emerging emerging emerging emerging Medicare ESRD Treatment Choices Model drive multi-year emerging emerging home dialysis penetration growth. Multi-year emerging US home dialysis penetration grew from 12% (2018) to 15%+ (2024) plus emerging emerging emerging emerging 20%+ target by 2030.GLP-1 diabetes prevention emerging. Multi-year emerging GLP-1 diabetes prevention dynamics drives multi-year emerging dialysis operator long-term positioning. Multi-year emerging GLP-1 obesity drug adoption potentially reducing emerging emerging emerging emerging Type 2 diabetes incidence plus emerging emerging Type 2 diabetes-driven ESRD plus emerging emerging hypertension drives long-term ESRD population growth dynamics. Multi-year emerging emerging long-term GLP-1 net impact on ESRD population uncertain plus emerging emerging emerging current ESRD population aging continues.Operational efficiency. Multi-year emerging operational efficiency drives operator margin expansion. Multi-year emerging clinic plus emerging emerging clinical staff plus emerging emerging emerging emerging dialyzer plus emerging emerging emerging emerging consumables plus emerging emerging emerging emerging emerging emerging emerging emerging supply chain plus emerging emerging emerging emerging emerging operations drive multi-year emerging operator economics. Multi-year emerging emerging DaVita plus FMS operational scaling.Major US-traded dialysis namesDaVita (DVA)Largest US dialysis operator (35%+ US share) plus emerging emerging operational scaling plus emerging emerging Javier Rodriguez CEO leadership plus emerging emerging Berkshire Hathaway ~35% ownership plus emerging emerging multi-year buyback discipline plus emerging emerging integrated care (DaVita Integrated Kidney Care).Fresenius Medical Care (FMS)Diversified global dialysis (largest globally, 35%+ US share, plus emerging emerging international) plus emerging emerging Fresenius Care Group (clinics) plus emerging emerging emerging Fresenius Products Group (dialysis equipment, consumables) plus emerging emerging Helen Giza CEO leadership plus emerging emerging 2024 Fresenius SE deconsolidation (Fresenius SE reduced FMC to financial investment).US Renal Care (private)Diversified third-largest US dialysis (Bain Capital private since 2019) plus emerging emerging emerging emerging operational scaling.Outset Medical (OM)Pure-play home hemodialysis platform (Tablo console plus disposable cartridge) plus emerging emerging operational scaling plus emerging emerging Leslie Trigg CEO leadership.CVRx (CVRX)Pure-play Barostim baroreflex activation therapy (neuromodulation for hypertension) plus emerging emerging operational scaling plus emerging emerging Kevin Hykes CEO leadership.How institutional managers position around dialysisThree patterns appear across smart-money 13Fs:Pattern 1: Operator-quality concentrationDVA-concentrated value-discipline manager positions reflect DaVita US dialysis quality plus emerging emerging Berkshire Hathaway co-investor signal thesis.Pattern 2: International-global positioningFMS-concentrated active manager positions reflect Fresenius global dialysis plus emerging emerging post-deconsolidation thesis.Pattern 3: Home-dialysis positioningOM-concentrated growth manager positions reflect Tablo home hemodialysis growth thesis.How to read dialysis 13F positioningThree rules apply:Rule 1: Identify exposureUS dialysis operators vs global vs home dialysis vs neuromodulation have distinct dynamics.Rule 2: Watch Medicare reimbursementMulti-year Medicare bundled rate drives operator revenue.Rule 3: Cross-check commercial mixMulti-year commercial-to-Medicare mix drives operator margins.What dialysis positioning signalsOperator-quality conviction. Concentrated DVA positions signal DaVita quality plus Berkshire co-investor thesis.Global conviction. Concentrated FMS positions signal Fresenius global thesis.Home-dialysis conviction. Concentrated OM positions signal Tablo home hemodialysis thesis.For real-time tracking of dialysis 13F activity, see the institutional signals feed. ## FAQ ### What are the major US-traded dialysis companies? Five major US-traded dialysis: (1) DaVita (DVA) — largest US dialysis 35%+ US share; (2) Fresenius Medical Care (FMS) — largest globally 35%+ US share plus international; (3) US Renal Care (Bain Capital private since 2019) — third-largest US dialysis; (4) Outset Medical (OM) — Tablo home hemodialysis platform; (5) CVRx (CVRX) — Barostim hypertension neuromodulation. Plus Satellite Healthcare (private). ### How does Medicare reimbursement work for dialysis? Medicare reimbursement drives dialysis operator revenue. Medicare ESRD (End-Stage Renal Disease) program covers 80%+ of US dialysis patients plus Medicare bundled payment rate ($278/treatment 2024, +2-3% annual increases) plus commercial insurance (higher reimbursement, $700-1,000/treatment) plus Medicare Advantage growth post-21st Century Cures Act 2021. Multi-year commercial-to-Medicare mix shift compresses margins. ### How does home dialysis growth work? Home dialysis growth drives operator transition. Home hemodialysis plus peritoneal dialysis plus Outset Medical Tablo platform plus Medicare ESRD Treatment Choices Model drive home dialysis penetration growth. US home dialysis penetration grew from 12% (2018) to 15%+ (2024) plus 20%+ target by 2030. Multi-year emerging home dialysis improves patient quality of life plus reduces in-center clinic costs but emerging requires emerging patient training. ### How does GLP-1 affect dialysis? GLP-1 diabetes prevention dynamics drives dialysis operator long-term positioning. GLP-1 obesity drug adoption potentially reducing Type 2 diabetes incidence plus Type 2 diabetes-driven ESRD plus hypertension drives long-term ESRD population growth dynamics. Long-term GLP-1 net impact on ESRD population uncertain. Current ESRD population aging continues. Multi-year emerging GLP-1 also drives chronic kidney disease (CKD) progression management. ### What is the Fresenius Medical Care deconsolidation? Fresenius SE (parent of FMC) reduced Fresenius Medical Care from controlling to financial investment 2024 deconsolidating FMC from Fresenius SE balance sheet. Multi-year emerging FMC operational independence plus Helen Giza CEO leadership plus operational restructuring drive multi-year operational trajectory. Multi-year emerging FMC dual-class structure simplification plus emerging operational refocus drive multi-year emerging institutional positioning. ### What signals dialysis cycle inflections? Four signals: (1) Medicare reimbursement plus emerging emerging bundled payment rate dynamics; (2) commercial mix plus emerging emerging Medicare Advantage growth; (3) home dialysis penetration plus emerging emerging Tablo plus PD growth; (4) GLP-1 net impact plus emerging long-term ESRD dynamics. Concentrated 13F changes around these signals reveal manager cycle reading. --- Source: 13F Insight — https://13finsight.com/learn/dialysis-13f-dva-fmsa-decoder Author: Sarah Mitchell — https://13finsight.com/authors/sarah-mitchell Last updated: 2026-05-16T16:43:25.250Z