The Ledger

DaVita raised the floor on its 2026 profit guidance, and the spread between what it collects and what it spends per treatment is about $135. The dialysis operator reported October 29 that U.S. revenue per treatment was $415.25 against patient care cost per treatment of $280.22, per its 8-K earnings release. Consolidated revenue rose to $3.578 billion from $3.420 billion, and net income attributable to DaVita was $223 million, up from $150 million. Adjusted operating income guidance moved to $2.175 billion to $2.250 billion (from $2.150 billion at the low end) and adjusted diluted earnings per share guidance to $14.30 to $15.20 (from $14.10 at the low end); free cash flow guidance held at $1.0 billion to $1.25 billion. Volume is not doing the work: normalized non-acquired treatment growth was 0.4%, and operating income slipped to $499 million from $506 million a year ago, with a $62 million China-related impairment excluded from the adjusted figure. Who it hits: commercial insurers (the release flags continued downward pressure on commercial rates and the risk of fewer commercial patients), and competitors and independent clinics competing on the same payer mix. So what: with growth near flat, per-treatment economics and buybacks ($111 million in the quarter, $87 million more through October 27) carry the story. Confidence: High, from the company filing.

Encompass Health raised 2026 guidance as both patient volume and revenue per patient rose. The inpatient rehabilitation hospital operator reported October 28 that net operating revenue rose 8.9% to $1.6095 billion, discharges rose 5.7% to 69,605 (3.0% same-store), and net patient revenue per discharge rose 4.0% to $22,543, per its 8-K earnings release. Adjusted EBITDA (earnings before interest, taxes, depreciation and amortization) rose 15.5% to $346.6 million and adjusted earnings per share rose 23.6% to $1.52. Full-year guidance now stands at $1.395 billion to $1.415 billion of adjusted EBITDA (from $1.365 billion to $1.395 billion) and adjusted earnings per share of $6.23 to $6.37 (from $6.02 to $6.25). The company opened four hospitals with 189 beds in the first nine months of 2026. Who it hits: acute-care hospitals and skilled nursing facilities that compete for the same post-acute patients. So what: volume and price moved up together in this segment. The release does not break out why per-discharge revenue rose, so we do not attribute it. Confidence: High on figures; Low on cause.

Teladoc’s consumer business shrank 13% while its insurer-facing business grew 2%, and $998 million of convertible notes are now current. The virtual care company reported October 28 that third-quarter revenue fell 3% to $605.1 million, per its 8-K earnings release. BetterHelp revenue fell 13% to $206.6 million as average paying users fell 12% to 0.336 million, which the company ties to its shift toward insurance-covered services; Integrated Care revenue rose 2% to $398.5 million. Net loss narrowed to $26.9 million from $49.5 million and adjusted EBITDA rose 14% to $79.4 million. Cash was $849.9 million against $997.6 million of convertible senior notes now classified as current liabilities. Fourth-quarter guidance has BetterHelp revenue down 18.5% to 31.5%, and full-year revenue of $2.395 billion to $2.441 billion. Who it hits: employers and health plans buying virtual care, and consumer telehealth peers relying on cash-pay users. So what: the refinancing of the notes is the item to watch; the release does not state a plan, and we do not assume one. Confidence: High.

Insurer earnings arrive next week: Cigna on November 5, Humana on November 6. The Cigna Group will release third-quarter 2026 results Thursday, November 5 with a conference call that morning, per its earnings release announcement. Humana will release at 6:00 a.m. Eastern on November 6, with a call at 8:00 a.m. Its last formal guidance (second quarter) put the 2026 insurance benefit ratio, Humana’s equivalent of the medical loss ratio, at 92.75% plus or minus 25 basis points, per its second-quarter 8-K. Who it hits: Medicare Advantage and employer-plan operators and their vendors. So what: the insurer side of the payer-mix question is next. Confidence: Med on dates, which come from company announcements syndicated by third-party sites; the primary release pages were not opened.

THE DEAL SHEET

One new transaction spotted, from a company press release; the agreement is dated October 27 and we could not open the full release, so Confidence: Med. No new bankruptcy, rating action, or FTC or DOJ healthcare merger action dated October 28 to 30 could be confirmed from a primary source. Deals announced earlier in October (Cencora and American Oncology Network, EQT and QIAGEN, HealthSpan Partners and Surgery Partners) are not repeated here.