2Q Preview: Improved Sentiment Post-ESRD Proposed Rule and MOTHer HDx Trial Results; Continue to See Path Back to 2% Volume Growth by 2029

Research evidence excerpt

2Q Preview: Improved Sentiment Post-ESRD Proposed Rule and MOTHer HDx Trial Results; Continue to See Path Back to 2% Volume Growth by 2029

$235) on an increased multiple. Q1 2.87 2.87

Q2E 3.62 3.88

Proposed ESRD Rule a Positive Sign Q3E 3.85 3.92

In late June, CMS release the CY27 proposed rule for Medicare FFS ESRD payments (our Q4E 4.21 4.25

prior note). The rule proposes a 1.1% increase in total payments, though CMS estimates 12/26E 14.53 14.82

this would translate to a 1.9% increase in payments to large dialysis organizations (vs. a 12/27E 16.34 17.48

12/28E 19.16 20.48

decline for regional chains). While the 1.9% increase in payments is slightly below the

2.2% update finalized for CY26, the rule also proposes to incorporate phosphate AJ Rice

binders into the bundled base rate, which we view as a positive for DVA. The proposed Analyst

rule would permanently increase the ESRD PPS base rate to account for the cost of aj.rice@ubs.com

phosphate binders being fully incorporated into bundled payments beginning January 1, +1-212-713 4299

2027. We estimate that phosphate binders are currently on track to contribute ~$200 Joseph Overman

mln of revenue and ~$150 mln of patient care costs for DVA in 2026, consistent with Associate Analyst

management commentary for ~$50 mln of annual operating income benefit (flat Y/Y vs. joseph.overman@ubs.com

2025). If the proposal is finalized, we would expect some further shift towards generic +1-212-882 0086

utilization. This would create a potentially meaningful (though temporary) incremental Michael Wei

benefit for DVA as generic binders can be acquired at a much lower cost, while it would Associate Analyst

take time for reimbursement rates to catch up with the lower costs. michael.wei@ubs.com

+1-212-713 2565