This case traces DaVita's transformation from a struggling dialysis provider to an industry leader, and invites students to assess the strategy behind its rise. It explores how operational execution, organizational culture, and regulatory policy interact to shape industry structure and firm performance in a healthcare services market. Students analyze the economics of the dialysis industry, evaluate DaVita's competitive positioning, and consider how shifts in regulation and payment-from fee-for-service to value-based care-may affect the firm's strategic options moving forward.