Following the divestiture of DMG, we expect management to allocate a sizable portion of the $4.9 billion in cash proceeds toward debt reduction, leaving our 2019 leverage estimate near 3 times. However, DaVita leases nearly all its dialysis clinics, creating an off-balance-sheet operating lease obligation totaling roughly $3.5 billion, by our estimate. Reimbursement pressures pose an acute risk to dialysis providers unseen elsewhere in the healthcare provider sector, given the industry's reliance on a small segment of the overall end-stage renal disease patient population to maintain profitable operations. While this remains a key operational risk, we think DaVita's superior cost position helps insulate it against adverse market conditions compared with smaller, more fragmented independent competitors.