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CORRESP

 FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17

C.F.R. §200.83). This letter requests confidential treatment of the bracketed portions of this letter

(designated by “[***]”).

 May 10, 2024

 FOIA
CONFIDENTIAL TREATMENT REQUESTED BY DAVITA INC. PURSUANT TO 17 C.F.R. §200.83 (“Rule 83”)

 (Contact: Christopher Berry, Chief Accounting
Officer, (253) 733-4638)

 U.S. Securities and Exchange Commission

Division of Corporation Finance

 Office of Industrial
Applications and Services

 100 F Street, NE

 Washington, D.C.
20549

Attn:
 Michael Fay

 
 Kristin Lochhead

Re:
 DaVita Inc.

 
 Form 10-K For the Fiscal Year Ended December 31, 2023

 
 Filed February 14, 2024

 
 File No. 001-14106

Ladies and Gentlemen:

 Thank you for your letter dated
April 11, 2024, addressed to Christopher Berry, Chief Accounting Officer of DaVita Inc. (“DaVita” or the “Company”), setting forth the comments of the staff of the Division of Corporate Finance (the “Staff”) on the
Company’s Form 10-K for the fiscal year ended December 31, 2023 filed on February 14, 2024 (the “2023 10-K”).

This response letter includes a request for confidential treatment of the portions of this letter bracketed below (designated by “[***]”) pursuant
to the Commission’s confidential treatment procedure under Rule 83.

 To facilitate the Staff’s review, we have reproduced the Staff’s
comments in italics below. Our response then follows each of the Staff’s comments.

 1

 FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17

C.F.R. §200.83). This letter requests confidential treatment of the bracketed portions of this letter

(designated by “[***]”).

 Terms and acronyms not defined within the responses below have the meanings assigned to them within the 2023 10-K.

 Staff Comment No. 1

Form 10-K For the Fiscal Year Ended December 31, 2023

Management’s Discussion and Analysis, page 58

1. In your response and in future filings, please further explain the IKC adjustment that resulted in $55 million in incremental shared savings
revenue. Discuss the circumstances that resulted in the lifting of certain revenue recognition constraints for some of your value-based care contracts with health plans and how you considered ASC 606 in your accounting.

Response:

 The Company acknowledges the Staff’s
comment. Our integrated kidney care (“IKC”) revenue is substantially composed of revenue from three primary sources: (i) special needs plans, (ii) our value-based care (“VBC”) contracts with health plans focused
primarily on Medicare Advantage (“MA”) patients, and (iii) the CMS Comprehensive Kidney Care Contracting (“CKCC”) demonstration program for our Medicare
fee-for-service patients. The following discussion pertains only to the VBC contract portion of our IKC business.

Our revenue recognition policy and accounting for these IKC arrangements are described in Notes 1 and 2 to the consolidated financial statements included in
our 2023 10-K.

 Introductory summary

The $55 million IKC adjustment referred to in the “Company overview” and “Ancillary services results of operations” sections of the
2023 10-K’s Management Discussion and Analysis (MD&A) relates solely to the VBC contract portion of our IKC business.

This adjustment represents revenue recognized in 2023 for 2023 services at a level incremental to what we would have recognized for 2023 services under prior
constraints as information and measurement limitations driving those recognition constraints were incrementally relieved.

 Those limitations are summarily
described in the last paragraph of our “Other revenues” policy in Note 1 to the consolidated financial statements included in our 2023 10-K, and changes in those limitations and their effect on the
constraints during 2023 are described in more detail below.

 For 2022 and prior annual reporting periods, the substantial majority of VBC shared savings
revenue earned in a period was recognized in a subsequent period. This resulted in recognition of amounts earned in prior periods of $94,361, $34,600 and $11,312 during 2023, 2022 and 2021, respectively, as disclosed in Note 2 to the consolidated
financial statements included in our 2023 10-K.

 2

 FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17

C.F.R. §200.83). This letter requests confidential treatment of the bracketed portions of this letter

(designated by “[***]”).

 However for 2023 and beyond, given both our increased experience and the changes and refinements we have made
with these VBC contracts, we expect that the majority of shared savings revenue earned in a period under these VBC contracts will be recognized in the period earned.

Our fiscal year 2023 therefore represents a transition year, reflecting a general shift in the timing of our revenue recognition for shared savings earned
under our VBC contracts with health plans, as it included a majority of shared savings revenues earned for both 2022 and 2023.

 Additional background and
context follow.

 General nature of these VBC arrangements:

Under our VBC contracts, we agree to provide certain care monitoring and care coordination services to a cohort of health plan members, typically dialysis
patients with whom we already have a relatively high degree of contact through our dialysis services. The business premise is that if we can provide more proactive, preventative, higher-touch care monitoring and coordination for these patients, we
can help reduce their total medical cost of care.

 The health plans that cover these patients therefore agree to compensate us by sharing with us a
portion of any aggregate reduction, or savings (i.e., “shared savings”) in the total medical cost of care that we are able to help drive for these patients. Similarly, many of our VBC contracts require us to bear full or partial shared
losses if aggregate medical costs for these members exceed the applicable shared savings benchmark or target.

 Heightened sensitivity to small changes:

 These VBC contracts result in our earned IKC revenue being highly sensitive to changes in third party medical costs about which we do not generally
have timely or direct visibility, since our entire revenue for these arrangements results from narrow margins on a much larger total cost pool.

 For
example, assume we have a VBC contract with an MA plan under which we agree to share equally in any reduction from $100 million of more than 5% in the total actual medical cost of care for health plan members attributed to our VBC contract for
a plan year. If total cost savings come in at 7%, we would earn $1 million in revenue (i.e., one-half of the total cost savings of $2 million). But if total cost savings come in at exactly 5%, we earn no
revenue at all – such that a 2% adverse change in underlying medical cost outcomes would result in a 100% reduction in our IKC shared savings revenue earned under this example contract.

Revenue recognition policy:

 As summarized in the section
titled “Other revenues” in Note 1 to the consolidated financial statements included in the 2023 10-K, our policy is to recognize revenue for these VBC contracts in the period in which our performance
obligation is met, in accordance with ASC Topic 606, subject to the recognition constraint described in ASC 606-10-32-11. That
obligation is a single group performance obligation to stand ready to provide services to health plan members aligned to our contract during the performance period.

 3

 FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17

C.F.R. §200.83). This letter requests confidential treatment of the bracketed portions of this letter

(designated by “[***]”).

 The performance periods for our VBC contracts are typically one year in length (i.e., a “plan
year”), most of them on a calendar year-end, and any of our shared savings consideration under the contract remains variable until outcomes for the performance year are finally determined, which typically
takes place through a final reconciliation that is not completed until six to 12 months after the plan year ends.

 ASC 606-10-32-11’s revenue recognition constraint provides that:

“An entity shall include in the transaction price some or all of an amount of variable consideration…only to the
extent it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the variable consideration is subsequently resolved.”

As such, it has been our policy to recognize shared savings revenue under these VBC contracts only at such times, and to the extent of amounts, that we
estimate it is probable that we will receive and retain for a particular performance period, whether within the performance period or thereafter as required by the constraint.

Changes in fiscal year 2023:

 Prior to 2023, information
and other measurement limitations typically constrained recognition of a majority of our shared savings revenue for these VBC contracts with health plans until a period subsequent to the actual performance period.

However, as noted above, as the experience of the Company and its health plan partners with these VBC contracts has grown, we have made (or experienced) a
number of changes and refinements in 2023 that management believes have helped to mitigate or alleviate many of these limitations, allowing us to recognize a greater share of expected shared savings revenues for these VBC contracts sooner than we
have in the past.

 These changes and refinements include:

1.
 Normalization of medical service utilization post-pandemic – In late 2022 and throughout 2023 as
the peak of the Covid-19 pandemic subsided, the dramatic disruption in utilization patterns of medical activity for health plan members has also subsided. This includes health plan members’ activities of
daily life, including those that lead to acute medical needs or changes in their rate of medical utilization, the incidence rate of medical events, as well as the timing of medical procedures, all of which improves the predictability of aggregate
medical costs for a particular patient population, not to mention the significantly reduced variability in medical costs that previously related to heightened mortality during the pandemic, both from Covid-19
itself and from delays in addressing other medical needs, among other factors.

 4

 FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17

C.F.R. §200.83). This letter requests confidential treatment of the bracketed portions of this letter

(designated by “[***]”).

2.
 VBC contracts moving into maturity – Most of our VBC contracts were still in their first or second
plan years in 2021 and 2022, and our two largest VBC plans just reached final reconciliation of their first plan year in 2023.

Most interpretive or measurement questions under these complex and custom arrangements are resolved between the parties within the first two
plan years. As a result, the Company now has significantly more confidence in its alignment with counterparties on interpretations concerning measurements required under these contracts. This, in turn, provides us higher confidence in our own
estimates of expected shared savings achieved for the plan year made before completion of final reconciliation.

3.
 Improved member alignment information – The alignment or attribution of health plan members into
our VBC contracts’ accountable cost pools by member month for a plan year can be quite complex and subject to significant time lags, particularly where there are multiple levels of nested attribution mechanics involved. Attribution occurs
primarily by a combination of insurance and clinical criteria, some of which operate prospectively and others retrospectively.

We have worked with our health plan counterparties to modify elements of our VBC contracts, or to codify protocols or practices related to
these contracts, to provide us with earlier clarity on which of their members are aligned to our contracts. This is a fundamental, first-order data element underlying any reliable cost and expected shared savings estimates, which remains sensitive
to complex member alignment or patient attribution mechanics.

 While we continue to lack patient-level alignment information until six to
12 months after the plan year ends, our understanding of the expected aggregate impact of the alignment process for these contracts has developed as we have gained multiple plan years of experience with individual health plans as well as increased
our population of other health plan contracts in the same or similar localities, allowing us to compare and contrast information among contracts to better inform our estimates.

4.
 Obtaining data validation more frequently – Measures of shared savings under our VBC contracts are
also subject to potentially significant adjustment for a number of patient characteristics and clinical quality measures as well as CMS-assigned risk adjustment factor (RAF) scores for each patient.

 While we continue to lack key patient-level cost, characteristic and clinical quality information until six to 12 months
after the plan year ends, we have modified contracts with our VBC contract counterparties, or established agreed protocols or practices pursuant thereto, to receive more timely and granular data on patient, cost, and other characteristics as well as
summarized interim data validation to ensure that both parties are tracking toward similar financial reconciliation outcomes. This has allowed us to refine our estimates of ultimate shared savings outcomes prior to final determination.

 5

 FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17

C.F.R. §200.83). This letter requests confidential treatment of the bracketed portions of this letter

(designated by “[***]”).

5.
 Improved actuarial data analysis – With the improvements in timing and granularity of data
described above, moderation of the estimate-distorting effects of the Covid-19 pandemic, as well as continued experience with the unique characteristics of the CKD and ESRD patient populations and these types
of VBC contracts, we have achieved greater confidence in the degree of predictive accuracy of the actuarial models we use to estimate expected shared savings for our VBC contracts.

As a result of these changes and refinements in 2023, and with most of our VBC contracts reaching the end of a performance period (plan year) on
December 31, 2023, we were able to recognize a greater share of expected shared savings revenue earned in 2023 as these changes and refinements resulted in a greater portion of that amount becoming probable of ultimately being received
and retained.

 And as a result of these changes and refinements, we now expect that the majority of our ultimate VBC revenues realized will be recognized
in the years in which they were earned for subsequent periods as well.

 Proposed revision in future filings:

As requested by the Staff, the Company proposes to expand its description of this adjustment as follows in its MD&A discussion of Ancillary services
results of operation in future Forms 10-Q and Forms 10-K that include the period of this adjustment (with changes marked):

“Items impacting operating income

 IKC
adjustment. The increase in IKC revenues for 2023 was primarily due to the lifting of certain revenue recognition constraints for some of our value-based care contracts with health plans, allowing us to recognize approximately $55 million
in incremental shared savings revenues compared to what we would have recognized under prior period constraints.

 Since we launched our IKC VBC
business, the Covid-19 pandemic and its distorting effects on medical utilization have subsided, our VBC contracts have continued to mature, we have begun to receive more timely and granular data from our
health plan partners,