Fresenius Medical Care AG & Co. KGaA
- Open
- 23.41
- Day high
- 23.44
- Day low
- 23.31
- Prev close
- 23.53
- Volume
- 123K
- Mkt cap
- $12.5B
- P/E (TTM)
- 12.0
- EPS (TTM)
- $1.95
- P/B
- 0.9
- P/S
- 0.5
- Yield
- 3.72%
- Per share
- $0.87
Fresenius Medical Care AG & Co. KGaA (FMS) is a Healthcare company listed on NYSE. The stock is down 7% over the past year. Drillr has 1 published research article covering FMS.
Fresenius Medical Care AG & Co. KGaA (FMS) financials & analyst ratings
Fundamentals (TTM)
Source: exchange market data + company filings. Figures are trailing-twelve-month or as most recently reported. For informational purposes only — not investment advice.
FMS earnings date, history & EPS estimates
| Report date | EPS est | EPS actual | Surprise | Revenue | Rev. surprise |
|---|---|---|---|---|---|
| Aug 4, 2026 | $0.62 | $0.66 | +7.1% | $5.6B | +2.2% |
| May 5, 2026 | $0.59 | $0.53 | -10.2% | $5.4B | -0.1% |
| Feb 24, 2026 | $0.67 | $0.83 | +23.9% | $6.0B | +25.1% |
| Feb 20, 2024 | $0.36 | $0.47 | +30.6% | $5.5B | +2.3% |
| Nov 1, 2023 | $0.31 | $0.28 | -9.7% | $5.2B | +0.1% |
| Aug 2, 2023 | $0.24 | $0.32 | +33.3% | $5.3B | -0.7% |
| Feb 21, 2023 | $0.22 | $0.44 | +100.0% | $5.4B | +1.5% |
| Jul 28, 2022 | $0.43 | $0.39 | -9.3% | $5.0B | +4.3% |
| May 4, 2022 | $0.26 | $0.34 | +30.8% | $5.0B | +4.0% |
| Feb 22, 2022 | $0.43 | $0.45 | +4.7% | $5.3B | +0.9% |
| Nov 2, 2021 | $0.45 | $0.47 | +4.4% | $5.2B | -5.1% |
| Jul 30, 2021 | $0.47 | $0.38 | -19.1% | $5.1B | +18.6% |
Fresenius Medical Care AG & Co. KGaA company profile
Overview
Fresenius Medical Care AG & Co. KGaA (NYSE:FMS) is a German-based multinational healthcare company that has been the world's largest provider of dialysis products and services since its founding in 1996. The company was created through the merger of Fresenius AG's dialysis division with National Medical Care, establishing a vertically integrated kidney care enterprise. Headquartered in Bad Homburg, Germany, Fresenius Medical Care operates over 4,100 outpatient dialysis clinics across approximately 150 countries and serves as both a direct care provider and a manufacturer of dialysis equipment and pharmaceuticals. The company has undergone significant strategic transformation in recent years, implementing its FME25 program to optimize operations and improve margins while maintaining its position as the dominant player in the global dialysis market.
Business
Fresenius Medical Care operates in the kidney care industry, specifically focusing on treating patients with end-stage renal disease (ESRD) and acute kidney failure. When kidneys fail, patients require dialysis treatment to artificially filter waste products and excess fluid from their blood - a process that healthy kidneys normally perform. The company operates through two primary business segments: Care Delivery represents approximately 75-80% of total revenue and encompasses the direct provision of dialysis treatments through the company's network of outpatient clinics. This segment includes in-center hemodialysis treatments, where patients visit clinics typically three times per week for 3-4 hour sessions, as well as peritoneal dialysis services that allow patients to perform treatments at home. The segment also provides laboratory services, vascular access procedures, and physician nephrology services. Additionally, Care Delivery includes value-based care contracts where the company manages the complete care journey for chronic kidney disease patients. Care Enablement accounts for roughly 20-25% of revenue and functions as the manufacturing and distribution arm of the business. This segment produces dialysis machines, including hemodialysis systems and peritoneal dialysis cyclers, along with consumable products such as dialyzers (artificial kidneys), bloodlines, dialysis solutions, and concentrates. The segment also manufactures renal pharmaceuticals and non-dialysis products like acute cardiopulmonary equipment. Care Enablement sells these products both to the company's own clinics and to third-party dialysis providers, hospitals, and specialized treatment centers worldwide. The company also operates ancillary services including ambulatory surgery centers for vascular access procedures, home dialysis support services, and renal pharmacy services that deliver medications directly to patients' homes.
Revenue model
Fresenius Medical Care generates revenue through multiple complementary business models across its integrated platform. The Care Delivery segment primarily operates on a fee-for-service model, receiving payments from government payers (Medicare, Medicaid), commercial insurance plans, and international health systems for each dialysis treatment provided. In the United States, the company receives approximately $240-250 per treatment from Medicare, with commercial insurance typically paying higher rates. The segment also generates revenue through value-based care contracts where it receives capitated payments to manage the total cost of care for chronic kidney disease patients. The Care Enablement segment follows a traditional product sales model, selling dialysis equipment, consumables, and pharmaceuticals to both internal clinics and external customers. This creates a unique competitive advantage as the company can optimize its supply chain costs while also capturing external market share. Revenue is generated through direct sales to hospitals, independent dialysis providers, and distributors globally. Several factors significantly impact the company's margins and profitability. Positive margin drivers include aging demographics driving increased dialysis demand, the company's scale advantages in procurement and operations, pricing improvements in commercial contracts, and operational efficiency gains from the FME25 transformation program. The recent introduction of high-volume hemodiafiltration technology could potentially improve patient outcomes and justify premium pricing. Margin pressures come from several sources including labor cost inflation, particularly for nursing staff which represents a significant operational expense. Elevated patient mortality rates in recent years have reduced treatment volumes and fixed cost absorption. Government reimbursement pressure, especially from Medicare, creates ongoing pricing headwinds. Additionally, competition from hospital-based programs and independent providers can pressure market share, while regulatory changes such as the inclusion of oral medications in bundled payments create reimbursement uncertainty.
Competitive moat
Fresenius Medical Care possesses a strong competitive moat built primarily on its unique vertically integrated business model and dominant market position. The company's most significant advantage is its scale and integration - as both the largest dialysis provider and equipment manufacturer globally, it achieves cost advantages unavailable to competitors. This vertical integration allows the company to optimize its supply chain, reduce equipment costs for its own clinics, and capture margins at multiple points in the value chain. The company's network effects create additional competitive advantages. With over 4,100 clinics worldwide, Fresenius Medical Care can offer patients geographic convenience and continuity of care, while its scale enables superior procurement terms and operational efficiencies. The high switching costs for patients also provide stability, as dialysis patients typically require treatment three times per week and develop relationships with specific care teams. Regulatory barriers further strengthen the moat. Dialysis clinics require significant regulatory approvals and compliance capabilities, while the medical complexity of kidney care creates high barriers to entry. The company's established relationships with nephrologists and integrated care model make it difficult for new entrants to gain market share. However, the moat faces some challenges. Government reimbursement pressure represents a significant long-term risk, as Medicare and other payers seek to control healthcare costs. The emergence of home dialysis technologies and potential future innovations in artificial kidneys or regenerative medicine could disrupt the traditional in-center model. Additionally, hospital-based competition and value-based care models are creating new competitive dynamics that could pressure the company's traditional fee-for-service approach. While the moat remains strong in the medium term, the company must continue investing in innovation and operational efficiency to maintain its competitive position.
Risks & safety
Fresenius Medical Care demonstrates moderate financial safety with manageable debt levels but limited cash generation flexibility. • Liquidity and Debt: Net leverage ratio of 2.8x EBITDA as of Q1 2025, down from 3.2x in 2023. Total debt of approximately €12-13 billion against €16.7 billion market cap. Current ratio of 1.46x indicates adequate short-term liquidity with €1.2 billion in cash and short-term investments. • Cash Flow: Free cash flow of €1.8 billion in 2024, though this benefited from portfolio divestitures. Operating cash flow of €2.5 billion provides reasonable coverage of capital expenditures and dividend payments. However, free cash flow can be volatile due to working capital fluctuations and transformation costs. • Valuation Metrics: Trading at 23.9x P/E ratio and 5.1x EV/EBITDA based on 2024 results. Price-to-book ratio of 0.88x suggests reasonable valuation relative to tangible assets. Graham number indicates potential undervaluation, though this must be weighed against industry-specific risks. • Other Considerations: Dividend yield of approximately 5% provides income support. Government reimbursement dependence creates regulatory risk. FME25 transformation program has delivered €567 million in savings, improving operational efficiency and financial flexibility.
Recent development
Fresenius Medical Care has undergone significant strategic transformation over the past several years, centered around its FME25 program launched to optimize operations and improve profitability. The company increased its total savings target from €650 million to €750 million, having already achieved €567 million in sustainable cost reductions through 2024. This transformation included restructuring the organization into two focused segments - Care Delivery and Care Enablement - to better align operations with market dynamics. A major strategic initiative has been portfolio optimization, with the company divesting non-core assets and exiting underperforming markets. Through 2024, Fresenius Medical Care generated €750 million in cash proceeds from divestitures, including the sale of select Spectra Laboratories assets and exits from approximately a dozen dialysis service markets. This strategy aims to focus resources on higher-margin opportunities while improving overall portfolio quality. The company has made significant investments in innovative treatment technologies, most notably receiving FDA approval for its 5008X Hemodiafiltration machine in 2024. High-volume hemodiafiltration represents a potentially transformative technology that could improve patient outcomes by up to 23% mortality reduction while providing operational benefits. The company began pilot programs with select patients and is preparing for broader commercial launch. Value-based care expansion remains a key strategic priority, with the company targeting growth from 100,000 to 275,000 covered lives by 2025. This includes developing comprehensive chronic kidney disease management programs and expanding partnerships with health systems and payers. The company has also focused on improving operational efficiency, reducing open nursing positions, decreasing contract labor costs, and implementing process improvements to reduce missed treatments and improve patient retention.
FMS company profile · for informational purposes only — not investment advice.
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