Fresenius Medical Care AG & Co. KGaA (FMS): Lienzo del Modelo de Negocio [Actualizado en Ene-2025]

En el complejo mundo de la atención médica global, Fresenius Medical Care AG & Co. KGAA se erige como una fuerza pionera en el tratamiento de la enfermedad renal, transformando vidas a través de tecnologías innovadoras de diálisis y atención integral centrada en el paciente. Con un modelo de negocio robusto que abarca continentes e integra soluciones médicas de vanguardia, este gigante de la salud se ha posicionado estratégicamente como líder en atención renal, ofreciendo servicios integrales que abordan las necesidades críticas de los pacientes, los profesionales de la salud e instituciones médicas en todo el mundo. Descubra cómo el lienzo comercial único de Fresenius Medical Care impulsa la innovación médica y la accesibilidad mundial en la salud.

Fresenius Medical Care AG & Co. KGAA (FMS) - Modelo de negocio: asociaciones clave

Alianza estratégica con proveedores de atención médica y clínicas de diálisis en todo el mundo

Fresenius Medical Care mantiene asociaciones con 4,132 clínicas de diálisis a nivel mundial a partir de 2023. La compañía opera en 51 países en las regiones de América del Norte, Europa, América Latina, Medio Oriente, África y Asia-Pacífico.

Región	Número de clínicas de diálisis	Tratamientos de pacientes
América del norte	2,455	1,376,000 tratamientos anuales
Europa	812	456,000 tratamientos anuales
Mercados internacionales	865	385,000 tratamientos anuales

Colaboración con tecnología médica y compañías farmacéuticas

Fresenius Medical Care colabora con 37 socios de tecnología farmacéutica y médica, invirtiendo € 146.5 millones en investigación y desarrollo en 2022.

• Socios farmacéuticos clave: Roche, Novartis, AstraZeneca
• Colaboraciones de tecnología médica: saludos de Siemens, Philips Healthcare

Asociaciones con instituciones de investigación

La compañía mantiene asociaciones de investigación con 12 instituciones de investigación académica y médica líderes, incluidas Harvard Medical School y Mayo Clinic.

Institución de investigación	Área de enfoque	Duración de colaboración
Escuela de Medicina de Harvard	Investigación de enfermedades renales	5 años
Clínica de mayonesa	Innovación tecnológica de diálisis	3 años

Empresas conjuntas en mercados emergentes

Fresenius Medical Care ha establecido 4 empresas conjuntas significativas En los mercados emergentes:

• China: Asociación con Chindex International (inversión de € 58 millones)
• India: empresa conjunta con Max Healthcare (inversión de 42 millones de euros)
• Brasil: colaboración con DASA Diagnostics (inversión de 35 millones de euros)
• Medio Oriente: Asociación con Emirates Healthcare Group (inversión de 26 millones de euros)

Asociaciones de la cadena de suministro con fabricantes de equipos médicos

La compañía ha establecido asociaciones con 22 fabricantes de equipos médicos, con un valor total de adquisición de la cadena de suministro de € 2.3 mil millones en 2022.

Fabricante	Categoría de equipo	Valor de adquisición anual
Baxter International	Máquinas de diálisis	512 millones de euros
Fresenio Kabi	Consumibles médicos	385 millones de euros
B. Braun	Accesorios médicos	276 millones de euros

Fresenius Medical Care AG & Co. KGAA (FMS) - Modelo de negocio: actividades clave

Servicios de tratamiento de diálisis y atención renal

Fresenius Medical Care opera 4,149 clínicas de diálisis en todo el mundo a partir de 2023. La compañía proporciona Aproximadamente 346,000 pacientes con tratamientos de diálisis a nivel mundial. Tratamientos anuales de diálisis realizados: 42.3 millones de sesiones de pacientes.

Región	Número de clínicas de diálisis	Cobertura del paciente
América del norte	2,561 clínicas	196,000 pacientes
Europa	622 clínicas	68,000 pacientes
Asia-Pacífico	666 clínicas	52,000 pacientes
América Latina	300 clínicas	30,000 pacientes

Fabricación de dispositivos y equipos médicos

Producción anual de dispositivos médicos: € 6.4 mil millones en ingresos. Instalaciones de fabricación clave ubicadas en:

• Estados Unidos
• Alemania
• Porcelana
• México

Investigación y desarrollo de tecnologías de atención renal

Inversión de I + D: 392 millones de euros en 2023. Portafolio de patentes: 1.873 patentes activas en todo el mundo. Áreas de enfoque de investigación:

• Innovaciones de la máquina de diálisis
• Bloodline Technologies
• Desarrollo de la membrana del dializador
• Soluciones de salud digital

Prestación de servicios de atención médica global

Presencia operativa en 67 países. Total de empleados: 127,226 a partir de 2023. Métricas de entrega de servicios:

Categoría de servicio	Volumen anual	Cuota de mercado
Tratamientos de diálisis	42.3 millones de sesiones	38% del mercado global
Productos de diálisis	€ 4.2 mil millones de ingresos	35% del mercado global

Capacitación clínica y educación profesional en salud

Programas de capacitación anual: 287 cursos de desarrollo profesional. Profesionales de la salud capacitados: 24,600 en 2023. Las plataformas de entrenamiento incluyen:

• Módulos de aprendizaje en línea
• Talleres en persona
• Centros de simulación clínica
• Patrocinios de la Conferencia Internacional

Fresenius Medical Care AG & Co. KGAA (FMS) - Modelo de negocio: recursos clave

Extensa red de centros de diálisis a nivel mundial

A partir de 2023, Fresenius Medical Care opera 4,149 clínicas de diálisis en todo el mundo al otro lado 48 países.

Región	Número de centros de diálisis
América del norte	2,610
Europa	637
América Latina	479
Medio Oriente y África	238
Asia-Pacífico	185

Tecnología y equipo médico avanzado

La inversión en tecnología y equipo médico para 2023 fue 634 millones de euros.

• 5 principales instalaciones de fabricación a nivel mundial
• Modelos de máquina de diálisis patentada: 2060, 5008, 6008
• Capacidad de producción anual: 50,000 máquinas de diálisis

Profesionales de salud especializados y expertos médicos

Total de empleados a partir de 2023: 126,163 mundial.

Categoría profesional	Número de empleados
Nefrólogos	3,752
Enfermería	47,890
Personal técnico	36,521

Cartera de propiedad intelectual fuerte

Portafolio de patentes en 2023: 1.287 patentes activas.

• Patentes de tecnología de diálisis: 876
• Innovaciones de dispositivos médicos: 411

Capacidades de investigación y desarrollo robustas

Gastos de I + D para 2023: 520 millones de euros.

Área de enfoque de I + D	Inversión
Tecnología de diálisis	287 millones de euros
Innovación de dispositivos médicos	153 millones de euros
Soluciones de salud digital	80 millones de euros

Fresenius Medical Care AG & Co. KGAA (FMS) - Modelo de negocio: propuestas de valor

Soluciones integrales de tratamiento de enfermedad renal

Fresenius Medical Care proporciona servicios de tratamiento de enfermedad renal en etapa terminal (ESRD) en 4,092 clínicas de diálisis en todo el mundo a partir de 2022. La compañía administra 347,000 pacientes con diálisis en todo el mundo.

Categoría de tratamiento	Volumen de paciente	Alcance global
Pacientes con hemodiálisis	347,000	62 países
Pacientes de diálisis peritoneal	43,000	América del Norte, Europa, Asia

Atención médica de alta calidad y centrada en el paciente

La compañía mantiene una calificación de calidad de atención al paciente de 4.2/5 basada en evaluaciones de atención médica independientes.

• Tiempo de tratamiento promedio por paciente: 4.2 horas
• Tasa de satisfacción del paciente: 88%
• Relación de enfermera a paciente: 1:10

Tecnologías y terapias de diálisis innovadoras

Inversión en I + D en 2022: € 337 millones, centrándose en tecnologías de diálisis avanzadas.

Tecnología	Estado de patente	Penetración del mercado
5008 Máquina de diálisis Cordiax	Patente activa	73% de las clínicas
Hemodiafiltración en línea	Tecnología patentada	42 países

Accesibilidad global de los servicios de atención renal

Presencia operativa en 62 países con 4.092 clínicas de diálisis a partir de 2022.

• América del Norte: 2,100 clínicas
• Europa: 1.200 clínicas
• Asia-Pacífico: 600 clínicas
• América Latina: 192 clínicas

Enfoques de tratamiento personalizados

Protocolos de tratamiento personalizados implementados en el 87% de las clínicas, utilizando análisis de datos avanzados y sistemas de monitoreo específicos del paciente.

Métrico de personalización	Tasa de implementación	Tecnología utilizada
Planes de tratamiento individualizados	87%	Análisis impulsado por IA
Evaluación de riesgos genéticos	64%	Detección genómica

Fresenius Medical Care AG & Co. KGAA (FMS) - Modelo de negocios: relaciones con los clientes

Gestión de atención al paciente a largo plazo

Fresenius Medical Care administra aproximadamente 4,070 clínicas de diálisis a nivel mundial a partir de 2023, atendiendo a 348,000 pacientes en todo el mundo. La compañía mantiene una duración promedio del tratamiento del paciente de 4.2 años por paciente.

Métricas de atención al paciente	2023 estadísticas
Clínicas de diálisis globales totales	4,070
Total pacientes atendidos	348,000
Duración promedio del tratamiento del paciente	4.2 años

Servicios de consulta médica personalizada

La compañía ofrece una consulta especializada a 125,000 profesionales de la salud en su red, con un promedio de 30.5 horas de consulta por paciente anualmente.

Plataformas de salud digital y apoyo al paciente

Fresenius invirtió 88.5 millones de euros en tecnologías de salud digital en 2022, desarrollando plataformas con las siguientes capacidades:

• Sistemas de monitoreo de pacientes remotos
• Integración de registros de salud electrónicos
• Plataformas de consulta de telemedicina

Monitoreo médico continuo y seguimiento

La Compañía utiliza tecnologías de monitoreo avanzado con una tasa de precisión de seguimiento del paciente del 97.3%, realizando aproximadamente 1,4 millones de controles de salud remotos anualmente.

Capacitación y apoyo profesional de la salud

Fresenius Medical Care asigna € 45.3 millones anuales para programas de capacitación profesional en salud, apoyando a 12.500 profesionales médicos a través de iniciativas especializadas de educación renal.

Métricas del programa de capacitación	Cifras anuales
Inversión de capacitación	45,3 millones de euros
Profesionales capacitados	12,500

Fresenius Medical Care AG & Co. KGAA (FMS) - Modelo de negocio: canales

Centros de diálisis patentados en todo el mundo

A partir de 2023, Fresenius Medical Care opera 4.149 centros de diálisis al otro lado de 48 países. El recuento global de tratamiento del paciente alcanzó 347,000 pacientes en su red.

Región	Número de centros	Cobertura del paciente
América del norte	2,586	189,000 pacientes
Europa	882	76,000 pacientes
Asia-Pacífico	481	52,000 pacientes
América Latina	200	30,000 pacientes

Plataformas de telesalud digital

Fresenio lanzado Nephrocare Connect plataforma digital con 87,000 usuarios activos en 2023, habilitando el monitoreo y el manejo remoto de los pacientes.

Redes de distribución de equipos médicos

Los canales de distribución incluyen:

• Ventas directas del hospital: 2,300 millones de euros ganancia
• Distribuidores de suministros médicos: 1.700 millones de euros ganancia
• Mercado de equipos médicos en línea: 450 millones de euros ganancia

Ventas directas a instituciones de atención médica

En 2023, las ventas institucionales directas llegaron 4.900 millones de euros, con clientes clave que incluyen:

Tipo de cliente	Volumen de ventas
Hospitales	2,300 millones de euros
Centros de diálisis	1.600 millones de euros
Sistemas de atención médica del gobierno	€ 1.0 mil millones

Portales de participación del paciente en línea

Plataformas de compromiso digital que sirven 347,000 pacientes con características que incluyen:

• Seguimiento del tratamiento: 92% adopción de usuarios
• Programación de citas: 85% adopción de usuarios
• Acceso a registros médicos: 78% adopción de usuarios

Fresenius Medical Care AG & Co. KGAA (FMS) - Modelo de negocio: segmentos de clientes

Pacientes con enfermedad renal crónica

A partir de 2022, Fresenius Medical Care sirvió aproximadamente 346,000 pacientes a nivel mundial con enfermedad renal en etapa terminal (ESRD).

Región	Población de pacientes
América del norte	125,000 pacientes
Europa	87,000 pacientes
Asia-Pacífico	98,000 pacientes
América Latina	36,000 pacientes

Centros de tratamiento de diálisis

Fresenius opera 4.149 centros de diálisis en todo el mundo a partir de 2022.

• Estados Unidos: 2.455 centros
• Alemania: 287 centros
• Otros mercados internacionales: 1.407 centros

Profesionales de la salud

Fresenio emplea Aproximadamente 133,000 profesionales de la salud globalmente en 2022.

Categoría profesional	Número de profesionales
Nefrólogos	3,200
Enfermería	68,500
Técnico	41,300
Personal administrativo	20,000

Sistemas de atención médica del gobierno

Fresenius sirve sistemas de salud en 67 países con modelos de reembolso que varían según la región.

• Estados Unidos Medicare: fuente de reembolso principal
• Seguro de salud pública de Alemania: segmento de mercado clave
• Sistemas de salud nacionales europeos: cobertura significativa

Proveedores privados de seguros de salud

Fresenius contrata con Más de 3.500 proveedores de seguros privados a nivel mundial.

Región	Número de aseguradoras privadas
América del norte	1.850 aseguradoras
Europa	1.100 aseguradoras
Asia-Pacífico	550 aseguradoras

Fresenius Medical Care AG & Co. KGAA (FMS) - Modelo de negocio: Estructura de costos

Gastos de fabricación de equipos médicos

En 2022, Fresenius Medical Care informó costos de fabricación totales de € 4.53 mil millones. El desglose de los gastos de fabricación incluye:

Categoría de gastos	Cantidad (€ millones)
Costos de materia prima	2,150
Costos de mano de obra directa	1,380
Sobrecarga de fabricación	1,000

Salarios profesionales de la salud

Los gastos totales de personal para 2022 fueron de € 6.7 mil millones, con la siguiente distribución salarial:

• Técnicos de diálisis: salario anual promedio de € 52,000
• Nefrólogos: salario anual promedio € 135,000
• Personal de enfermería: salario anual promedio de € 48,000

Inversiones de investigación y desarrollo

El gasto de I + D en 2022 totalizó € 438 millones, lo que representa el 3.2% de los ingresos totales.

Área de enfoque de I + D	Inversión (millones de euros)
Tecnología de diálisis	210
Soluciones de salud digital	128
Investigación clínica	100

Infraestructura operativa global

Los costos de infraestructura operacional para 2022 ascendieron a € 2.1 mil millones, que incluyen:

• Mantenimiento de la instalación: € 480 millones
• Logística global: € 350 millones
• Infraestructura: € 270 millones
• Cumplimiento y gastos regulatorios: 200 millones de euros

Mantenimiento de tecnología e innovación

Las inversiones de mantenimiento e innovación de tecnología en 2022 alcanzaron € 675 millones.

Categoría de inversión tecnológica	Cantidad (€ millones)
Actualizaciones de plataforma digital	285
Modernización de equipos médicos	220
Inversiones de ciberseguridad	170

Fresenius Medical Care AG & Co. KGAA (FMS) - Modelo de negocios: flujos de ingresos

Servicios de tratamiento de diálisis

En 2022, Fresenius Medical Care generó € 17.9 mil millones en ingresos totales, con servicios de tratamiento de diálisis que representan una porción significativa de este ingreso.

Categoría de servicio	Ingresos (millones de euros)	Porcentaje de ingresos totales
Servicios de diálisis de América del Norte	9,543	53.3%
Servicios de diálisis de la región de EMEA	3,876	21.6%
Servicios de diálisis de América Latina	1,987	11.1%
Servicios de diálisis de Asia-Pacífico	2,494	14%

Ventas de equipos médicos

Las ventas de equipos médicos contribuyeron con 4,5 mil millones de euros a los ingresos de la compañía en 2022.

• Máquinas de diálisis: € 2.1 mil millones
• Consumibles de diálisis: 1.800 millones de euros
• Accesorios de diálisis: € 600 millones

Licencias de tecnología de salud

La licencia de tecnología de salud generó aproximadamente 287 millones de euros en ingresos para 2022.

Categoría de licencias	Ingresos (millones de euros)
Licencias de tecnología de diálisis	189
Licencias de soluciones de salud digital	98

Servicios de consultoría y capacitación

Los servicios de consultoría y capacitación generaron € 156 millones en ingresos en 2022.

• Programas de capacitación clínica: € 87 millones
• Consultoría de gestión de salud: 69 millones de euros

Contratos de servicio de atención médica global

Global Healthcare Service Contracts contribuyó con 612 millones de euros a los ingresos de la compañía en 2022.

Tipo de contrato	Ingresos (millones de euros)	Distribución geográfica
Contratos de instalaciones de salud a largo plazo	398	América del Norte, Europa
Contratos internacionales de gestión de la salud	214	Asia-Pacífico, América Latina

Fresenius Medical Care AG & Co. KGaA (FMS) - Canvas Business Model: Value Propositions

You're looking at the core value Fresenius Medical Care AG & Co. KGaA (FMS) delivers to its stakeholders. It's not just about providing a service; it's about owning the entire ecosystem, from the machine to the chair the patient sits in.

Vertically Integrated Care: Providing both dialysis services and proprietary products.

Fresenius Medical Care AG & Co. KGaA operates as the world's leading vertically integrated kidney care company. This integration means they capture value across the continuum of care delivery and product manufacturing. You see this clearly when you look at their scale in both segments.

Metric	Value	Year/Date	Source Context
Dialyzers Sold	174 M	2024
Hemodialysis Machine Market Share	~50%	2024
Dialysis Treatments Performed	Around 48 M	2024

Global Access to Treatment: Life-sustaining dialysis for ~299,000 patients globally.

The sheer scale of their global footprint is a massive value driver, offering consistency and reach. As of March 31, 2025, Fresenius Medical Care AG & Co. KGaA was treating 299,358 patients across 3,674 dialysis clinics worldwide. This represents life-sustaining care for roughly 299,000 patients globally. That's a massive installed base providing predictable service demand.

Value-Based Kidney Care: Shifting risk to improve patient outcomes and manage costs.

The strategic shift toward Value-Based Care (VBC) in the U.S. is central to their forward strategy. This segment manages risk under contracts with payors, aiming for better patient health at a lower total cost of care. In fiscal year 2024, this segment generated EUR 1.8 billion in revenue in the U.S. alone. For the first quarter of 2025, the Care Delivery U.S. revenue, which includes VBC, grew by 6% year-on-year to EUR 3,302 million, with the growing VBC business cited as a positive impact factor. The Q2 2025 presentation also highlighted that Value-Based Care revenue growth was driven by member months.

High-Quality Clinical Standards: 65% of U.S. centers achieved 3+ star CMS ratings (2023 data).

Quality metrics, as measured by the Centers for Medicare & Medicaid Services (CMS) Star Ratings, underpin trust with payors and patients. The commitment to clinical excellence is a key value proposition:

• 65% of U.S. centers achieved 3+ star CMS ratings (2023 data).
• Patient satisfaction is tracked, with a global patient Net Promoter Score (NPS) of 72 achieved in 2024.

Innovation in Therapy: Rollout of advanced therapies like high-volume HDF.

Fresenius Medical Care AG & Co. KGaA is actively bringing advanced treatment modalities to market, which improves clinical value. The CONVINCE research study demonstrated significant clinical benefit for High-Volume Hemodiafiltration (Hv-HDF), showing a 23% reduction in all-cause mortality compared to high-flux dialysis. The company is executing the U.S. rollout of the enabling 5008X CAREsystem, with a full commercial launch planned for 2026, following the report of the first U.S. chronic dialysis unit implementing high-volume HDF in late 2025.

The value here is offering a superior, evidence-based therapy that promises better longevity for patients.

Finance: draft 13-week cash view by Friday.

Fresenius Medical Care AG & Co. KGaA (FMC) - Canvas Business Model: Customer Relationships

You're looking at how Fresenius Medical Care AG & Co. KGaA (FMC) manages its relationships with the people and institutions it serves. It's a mix of direct, high-touch care and sophisticated B2B contracting, all underpinned by a massive global footprint.

Personalized Care: Integrated and personalized care models for chronic patients.

Fresenius Medical Care AG & Co. KGaA (FMC) is shifting its focus toward integrated, outcome-oriented care, especially in the U.S. market, which is reflected in the new Value-Based Care (VBC) segment, established as of June 1, 2025. This segment is designed to manage the long-term care for chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients by aligning incentives with better health results, such as reducing hospital admissions and encouraging home dialysis transitions. The company's commitment to personalized, high-quality treatment is supported by clinical evidence from its own studies.

Here's a snapshot of the scale and focus areas driving these relationships as of mid-2025:

Metric	Value (As of March 31, 2025, unless noted)	Context
Patients Treated Worldwide	299,358	Directly cared for by Fresenius Medical Care AG & Co. KGaA (FMC)
Dialysis Clinics Global Network	3,674	The physical touchpoints for patient care delivery
Projected U.S. Annual Patient Growth (2025-2035)	2 plus percent	Indicates expected growth in the core relationship base
HVHDF Mortality Reduction (CONVINCE Study)	4.4%	Reduction over 2.5 years with High-Volume Hemodiafiltration (HVHDF) therapy

The company's aspiration is to lift renal care to the next level using digitalization, data analytics, and artificial intelligence to move from reactive to preventive healthcare. This involves monitoring each patient's wellbeing with algorithms to forecast the future and intervene as early as possible.

Dedicated Clinic Staff: Direct, high-touch interaction in the Care Delivery segment.

The Care Delivery segment is where the most direct, high-touch relationship occurs. This involves the day-to-day interaction between patients and the dedicated clinical staff across the global network of clinics. The sheer scale of this operation means that consistency in care quality is a major focus for maintaining patient trust. The company measures this relationship quality directly through global satisfaction scores.

Key indicators of the relationship environment include:

• Global patient Net Promoter Score (NPS) of 72 in 2024 (unchanged from 2023).
• Total employees globally as of March 31, 2025: 112,035 (headcount).
• The company cares for approximately 4.2 million patients worldwide who regularly undergo dialysis treatment, positioning Fresenius Medical Care AG & Co. KGaA (FMC) as the leading provider.

Honestly, maintaining a high NPS score across nearly 3,700 clinics is a testament to the frontline staff's daily efforts.

Account Management: B2B relationships with hospitals and independent dialysis centers.

For B2B customer relationships, Fresenius Medical Care AG & Co. KGaA (FMC) engages with hospitals and independent providers both through direct service delivery and through its Care Enablement segment, which supplies products to others. The newer Value-Based Care (VBC) segment, which focuses on contracting and performance management, represents a key evolution in this B2B relationship, moving toward shared risk and reward with payors and partners.

The relationship structure involves deep integration with external healthcare providers:

Relationship Aspect	Metric/Detail	Year/Date
Value-Based Care Partner Nephrologists	2,200 partner nephrologists	2024
Value-Based Care Revenue	1.8 billion euros	2024
Global Dialysis Market Size Estimate	€80 to €84 billion	2024
Product Sales Reach	Customers in more than 140 countries	Current

The Strategic Procurement Team manages the acquisition interface, focusing on quality, service, and total cost when cultivating partnerships with suppliers, which is an extension of their B2B relationship management philosophy.

Tech-Enabled Engagement: Digital platforms for patient communication and monitoring.

Digital platforms are crucial for keeping patients and care teams connected, allowing for continuous monitoring of medical outcomes and user experience. Fresenius Medical Care AG & Co. KGaA (FMC) uses proprietary informatics and patient engagement tools to support its VBC models and general patient management. The company has a history of deploying these tools to enhance access and continuity of care.

The digital engagement tools include:

• PatientHub app: Used predominantly in the U.S. market.
• MyCompanion app: Available across 23 countries in Europe, Africa, Asia-Pacific, and Latin America.
• Remote Telehealth Visits (U.S. only): Almost 250,000 recorded between patients, care teams, and physicians.
• Combined Active App Users (PatientHub/MyCompanion): More than 25,000 as of December 2022.

These platforms give users real-time access to treatment data, supporting the shift toward holistic home care solutions powered by AI advancements.

Fresenius Medical Care AG & Co. KGaA (FMS) - Canvas Business Model: Channels

You're looking at how Fresenius Medical Care AG & Co. KGaA gets its services and products to the people who need them, which is quite a global operation, honestly.

Dialysis Clinic Network: Primary channel for B2C service delivery.

The physical clinic network remains the backbone for in-center dialysis service delivery. As of March 31, 2025, Fresenius Medical Care AG & Co. KGaA treated approximately 299,358 patients across a global network of 3,674 dialysis clinics. This is slightly down from the year-end 2024 figure of roughly 3,700 clinics caring for over 299,000 patients. In the United States, the company serves over 190,000 patients, operating within a market where Fresenius Medical Care AG & Co. KGaA and DaVita control about 70% of the dialysis centers. The in-center modality still dominates the US market, accounting for 75.6% of the market share in 2024. The estimated size of the global dialysis market in 2024 was between €80 billion and €84 billion.

Here's a quick look at the scale of the Care Delivery channel as of early 2025:

Metric	Value (As of Q1 2025 or latest reported)	Scope
Global Dialysis Patients Cared For	299,358	As of March 31, 2025
Global Dialysis Clinics	3,674	As of March 31, 2025
US Patients Served	Over 190,000	Current estimate
US In-Center Market Share (2024)	75.6%	Market Segment Share

Direct Sales Force: For B2B sales of dialysis equipment and consumables (Care Enablement).

The Care Enablement segment handles the distribution of healthcare products and equipment, which relies on a commercial operation and sales force to reach customers. Fresenius Medical Care AG & Co. KGaA sells its dialysis products to customers in more than 140 countries. This segment also encompasses manufacturing and R&D activities. For context on the product side, R&D expenditure in 2024 corresponded to 4% of the company's health care product revenue. The company's vertical integration means this sales force also supplies the company's own clinics.

Home Dialysis Programs: Direct delivery of equipment and supplies to patient homes.

The push toward home dialysis is a key channel strategy, offering flexibility and potentially better outcomes. In the US market, in-home dialysis centers are projected to grow at the fastest Compound Annual Growth Rate (CAGR) of 7.0% from 2025 to 2030. This aligns with the ambition, though challenging, set forth by US initiatives to shift a high percentage of End-Stage Renal Disease (ESRD) patients to home treatment before 2025. Fresenius Medical Care AG & Co. KGaA has been actively expanding its home dialysis program, announcing such an expansion in a key European market in July 2022.

Key aspects of the home treatment channel include:

• In-home segment CAGR (US, 2025-2030) projected at 7.0%.
• The company is a leading player in the Home Dialysis Machines market.
• The strategy aims to support earlier interventions to prevent kidney failure.

Value-Based Care Platforms: Digital and clinical networks like InterWell Health.

The Value-Based Care (VBC) segment, officially created as a reportable segment on June 1, 2025, is a critical channel for managing the total cost of care for chronic kidney disease patients outside of traditional fee-for-service models. The core of this channel is InterWell Health (IWH), which resulted from a three-way merger announced in 2022. Fresenius Medical Care AG & Co. KGaA recently reinforced this channel by investing EUR 312 million in September 2025 to increase its ownership stake in IWH by buying out non-physician investors. IWH is partnering with over 2,200 nephrologists in the US.

The financial performance and scale of this channel are significant:

InterWell Health demonstrated strong performance, generating €1,035 million in revenue for the first half of 2025 (H1 2025), showing a 23.5% revenue growth. The initial merger projected that by 2025, IWH would manage more than 270,000 covered lives and have $11 billion in costs under management, up from $6 billion and 100,000 lives previously. This strategic expansion significantly increased the total addressable market in the US from about $50 billion to approximately $170 billion.

Finance: draft 13-week cash view by Friday.

Fresenius Medical Care AG & Co. KGaA (FMS) - Canvas Business Model: Customer Segments

The customer segments for Fresenius Medical Care AG & Co. KGaA are diverse, spanning direct patient care, business-to-business product sales, and relationships with the entities that finance the care.

ESRD Patients: Individuals requiring life-sustaining dialysis treatment.

Fresenius Medical Care AG & Co. KGaA directly cares for a significant portion of the global dialysis population. As of March 31, 2025, the company was serving approximately 299,358 patients across its global network of 3,674 dialysis clinics. This patient base is the core of the Care Delivery segment. The company estimates that around 4.2 million patients worldwide regularly undergo dialysis treatment, positioning its direct patient base as a substantial, but not total, market share of those needing the service. Looking forward, the global market for dialysis patients is projected to see an average annual growth of 4 to 5 percent between 2025 and 2035. In the U.S. specifically, the patient number growth is projected at 2 plus percent in the same timeframe. For context on the U.S. market as of March 31, 2025, there are 7,556 dialysis centers treating over 500,000 patients for dialysis, with about 433,400 receiving in-center treatment and 78,400 at home.

CKD Patients (Stages 3-5): Focus on early intervention through the Value-Based Care segment.

A key focus area is the earlier management of Chronic Kidney Disease (CKD) through the Value-Based Care segment, which was formally introduced as a reportable segment as of June 1, 2025. This segment targets patients before they reach End-Stage Renal Disease (ESRD). The revenue performance shows rapid adoption; for the first half of 2025, this segment saw a 23.5% increase in revenue. More recently, in the third quarter of 2025, Value-Based Care revenue grew by 27% (or 31% at constant currency) to €1,611 million. To illustrate the scale of this focus, in 2024, this segment served over 130,000 patient lives and worked with more than 2,000 nephrologists, generating approximately €1.8 billion in revenue that year. The strategic ambition in this area, established earlier, targeted managing care for over 270,000 people with kidney disease by 2025.

The scale of the Value-Based Care segment's financial contribution relative to the whole is important to track:

Metric	Time Period	Value
Value-Based Care Revenue	Q3 2025	€1,611 million
Value-Based Care Revenue Growth (Organic)	Q3 2025	31%
Care Delivery Revenue	Q1 2025	€3,857 million
Care Enablement Revenue	Q3 2025	€4,075 million

Other Healthcare Providers: Hospitals and independent dialysis centers purchasing products (B2B).

The Care Enablement segment serves other healthcare providers by supplying products, equipment, and related services. This segment is vertically integrated with the company's own clinics but also sells externally. For instance, in the third quarter of 2025, Care Enablement revenue reached €4,075 million. In 2024, the Care Enablement products business generated €5,557 million in revenue. Fresenius Medical Care AG & Co. KGaA is a major supplier in the MedTech space, holding around a 50% share in the hemodialysis machines market and selling approximately 174 million dialyzers in 2024. The company sells its healthcare products to customers in more than 140 countries.

Government/Commercial Payors: Insurers and state-funded programs covering treatment costs.

Government payors are a critical customer segment because they fund a significant portion of the services provided. For the nine months ended September 30, 2025, approximately 16% of the company's consolidated revenue came from U.S. federally-funded healthcare benefit programs like Medicare and Medicaid. This is consistent with the figure for the six months ended June 30, 2025, which was approximately 17%. Reimbursement rates set by the Centers for Medicare & Medicaid Services (CMS) directly impact revenue realization. For calendar year 2025, the proposed U.S. ESRD PPS (Prospective Payment System) base rate was $273.82. Legislative changes to these rates represent a direct financial risk to the revenue stream from this segment. The company's ability to manage a favorable payor mix is noted as a positive impact on Care Delivery U.S. revenue in Q1 2025.

You should keep a close eye on the CMS proposed rate for CY 2026, which CMS anticipated would result in a payment increase of 1.9% to ESRD facilities.

Fresenius Medical Care AG & Co. KGaA (FMS) - Canvas Business Model: Cost Structure

You're looking at the expense side of the Fresenius Medical Care AG & Co. KGaA (FMS) engine, which is heavily weighted toward service delivery and manufacturing. The cost structure reflects a vertically integrated model where a significant portion of spending supports the global clinic network and product supply chain.

Personnel Costs

Labor is a major component here, supporting the care of hundreds of thousands of patients. As of June 30, 2025, Fresenius Medical Care had a global headcount of 112,445 employees, up from 111,513 at the end of 2024. These costs cover the essential nurses, technicians, and physicians running the clinics.

• The development of operating income in Q1 2025 was negatively impacted by higher personnel expenses, which developed in line with expectations.
• As of December 31, 2024, 1,384 employees were dedicated to Research & Development worldwide.

Operating Expenses

These are the day-to-day costs of keeping the lights on and the machines running across the massive global footprint. The prompt specifies costs for running 3,674 global clinics, though as of June 30, 2025, Fresenius Medical Care operated 3,676 dialysis clinics worldwide. For the full year 2024, Total Operating Expenses were reported at $4.41 billion.

Cost of Goods Sold

This category covers the manufacturing and distribution expenses for the dialysis products Fresenius Medical Care sells both internally to its clinics and externally to other providers. Based on 2024 figures, this is the largest single cost component. Here's a quick look at the 2024 financial breakdown, which sets the baseline for 2025 costs:

Metric (2024)	Amount (USD millions)	Source Context
Total Revenue	$20,010	Change of 24.1% over 10 years
Total Gross Profit	$4,920
Inferred Cost of Goods Sold	$15,090	Calculated as Revenue minus Gross Profit

Transformation Costs

Fresenius Medical Care is investing heavily in its FME25+ transformation program to optimize its operating structure. The total one-time investment anticipated for the entire program, which is targeted to run until the end of 2027, is set between EUR 1,000 million to EUR 1,050 million. For the current fiscal year 2025, the company specifically assumed related one-time costs in the range of EUR 100 million to EUR 150 million.

• The FME25+ program targets a cumulative total of €1.05 billion of sustainable savings by the end of 2027.
• In Q3 2025 alone, related one-time costs (special items) for the transformation program amounted to EUR 41 million.

R&D Investment

Funding research and development is intrinsic to the growth strategy, focusing on improving renal therapies and developing new products like the 5008X high-volume hemodiafiltration machine, which is anticipated for a U.S. launch by year-end 2025. While a specific 2025 absolute spend isn't immediately clear, the commitment is shown through investment focus and personnel.

• In 2024, R&D expenditure was 4% of the company's health care product revenue.
• The patent portfolio at the end of 2024 comprised some 9,529 property rights across approximately 1,586 patent families.
• Fresenius Medical Care Ventures makes targeted investments in start-ups across diagnostics, therapies, and digital solutions.

Finance: review the Q3 2025 operating cash flow margin of 11.3% against the 2024 COGS percentage to project 2026 product cost leverage by next Tuesday.

Fresenius Medical Care AG & Co. KGaA (FMS) - Canvas Business Model: Revenue Streams

You're looking at how Fresenius Medical Care AG & Co. KGaA actually brings in the money, which is critical for understanding its valuation. Honestly, it's all about the volume of patients and the services provided, plus the growing shift to value-based models. Here's the quick math on the streams we see as of late 2025, based on the latest reports.

The core revenue generation is split across its operating segments, which now explicitly include Value-Based Care as a distinct unit. The 2024 revenue base for the current year's guidance was quite substantial.

Revenue Stream Component	Most Recent Reported Period Figure	Context/Segment
2024 Revenue Base for 2025 Outlook	EUR 19,336 million	Full Year 2024 Reported Revenue
Value-Based Care Premiums (VBC)	EUR 1,035 million	Q2 2025 Revenue for VBC Segment
Dialysis Services Revenue (Care Delivery)	EUR 3,857 million	Q1 2025 Revenue for Care Delivery Segment
Product Sales Revenue (Care Enablement)	EUR 1,367 million	Q1 2025 Revenue for Care Enablement Segment

Dialysis Services Revenue is the bread and butter, covering the fees for every in-center and home dialysis treatment you know they provide. The Care Delivery segment brought in EUR 3,857 million in the first quarter of 2025, showing the ongoing scale of their care delivery operations.

Product Sales Revenue, which falls under Care Enablement, represents the sales of the necessary hardware and supplies. For the first quarter of 2025, this stream generated EUR 1,367 million. This segment benefits from the vertical integration, selling machines and consumables to their own clinics and external customers.

Value-Based Care Premiums are becoming a more distinct and important revenue stream, reflecting the shift to performance-based contracts. In the second quarter of 2025 alone, this segment generated EUR 1,035 million. To give you a sense of scale, the U.S. VBC business generated EUR 1.8 billion in revenue for the full year 2024.

Pharmaceutical Sales revenue is typically embedded within the service or product segments, but the focus remains on the major buckets. You won't find a standalone Pharma Sales number that cleanly separates from the others in the primary reporting structure, but the overall segment performance reflects the entire value chain.

The 2025 Outlook confirms management's expectation for revenue growth to be positive to a low-single digit percent rate when compared to the 2024 figure of EUR 19,336 million. This suggests continued, albeit modest, top-line expansion this year, defintely a sign of stabilization.

• 2024 Full Year Revenue Base: EUR 19,336 million.
• Expected 2025 Revenue Growth Rate: Positive to a low-single digit percent rate.
• Q2 2025 VBC Revenue: EUR 1,035 million.
• 2024 U.S. VBC Revenue: EUR 1.8 billion.
• Q1 2025 Care Delivery Revenue: EUR 3,857 million.

Finance: draft 13-week cash view by Friday.