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Investor News Dr. Dominik Heger Head of Investor Relations & Corporate Communications Fresenius Medical Care Else-Kr ner-Stra e 1 61352 Bad Homburg Germany T +49 6172 609-2601 F +49 6172 609-2301 Dominik.Heger@fmc-ag.com

Key Takeaway: Investor News Dr. Dominik Heger Head of Investor Relations & Corporate Communications Fresenius Medical Care Else-Kr ner-Stra e 1 61352 Bad Homburg Germany T +49 6172 609-2601 F +49 6172 609-2301 Dominik.Heger@fmc-ag.com www.freseniusmedicalcare.com February 22, 2017 F

Full Press Release Details

Investor News Dr. Dominik Heger
Head of Investor Relations & Corporate Communications
Fresenius Medical Care
Else-Kr ner-Stra e 1
61352 Bad Homburg
Germany
T +49 6172 609-2601
F +49 6172 609-2301
Dominik.Heger@fmc-ag.com
www.freseniusmedicalcare.com
February 22, 2017
Fresenius Medical Care delivers strong 2016 results and sets ambitious growth targets for 2017
Targets for 2016 achieved
Group revenue +7% in 2016 (+7% adjusted1)
Strong EBIT growth of 13% in 2016, resulting in improved EBIT margin of 14.7%
Net income +21% (+16% adjusted2)
Very good performance in Health Care Services, particularly in North America
Care Coordination continues to deliver significant organic revenue growth (+20%)
Dividend proposal of 0.96 (+20%) for fiscal year 2016
Key figures fourth quarter and full year 2016:
US$ million Q4 2016 Q4 2015 Growth yoy FY 2016 FY 2015 Growth yoy
Net revenue 4,687 4,348 +8 % 17,911 16,738 +7 %
Operating income (EBIT) 786 662 +19 % 2,638 2,327 +13 %
Net income 3 388 317 +23 % 1,243 1,029 +21 %
Net income adjusted 2 1,228 1,057 +16 %
Basic earnings per share (in $) 1.27 1.04 +22 % 4.07 3.38 +20 %
Dividend proposal (per share) 0.96 0.80 +20 %
1 At constant currency, excluding acquisitions in 2015 and 2016
2 Net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA, adjusted for acquisitions and based on an adjusted 2015 net income of $1,057m
3 Net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA
In our 20th anniversary year, we were able to mark another record year for Fresenius Medical Care and for our shareholders. I am pleased to confirm that we have achieved our financial targets for 2016. We were able to deliver a strong business performance across all segments and realize the planned savings of our Global Efficiency Program thanks to the outstanding dedication and commitment of our employees, said Rice Powell, Chief Executive Officer of Fresenius Medical Care. Our path to value-based care continues. We are further investing in the dynamic growth of our Care Coordination activities as well as the innovative development of our core dialysis business. For 2017, we have again set ourselves ambitious targets and will continue to deliver high-quality care for our patients.
Net revenue for the full year 2016 increased by 7% and reached $17,911 million (+8% at constant currency), driven by a strong performance in Health Care Services. Health Care Services revenue increased by 8% to $14,519 million (+9% at constant currency), mainly due to strong organic growth supported by positive price and volume effects. Dialysis Products revenue increased by 1% to $3,392 million (+4% at constant currency). The growth at constant currency was primarily supported by higher sales of dialyzers and machines. This was partially offset by lower sales of renal pharmaceuticals, resulting from the sale of our European marketing rights for certain renal pharmaceuticals to our joint venture, Vifor Fresenius Medical Care Renal Pharma, in 2015.
Net revenue in the fourth quarter of 2016 increased by 8% to $4,687 million (+9% at constant currency), mainly driven by higher Health Care Services revenue. Health Care Services revenue increased by 10% to $3,799 million (+10% at constant currency), mainly driven by positive price as well as volume effects. Dialysis Products revenue reached the same level as in the previous year ($888 million), an increase of 2% at constant currency.
Operating income (EBIT) for the full year 2016 increased by 13% to $2,638 million, leading to an improved operating income margin of 14.7% (+80 basis points). The development of the EBIT margin was supported by a strong margin development, particularly in North America.
In the fourth quarter of 2016, operating income rose by 19% to $786 million, leading to a strong operating income margin of 16.8% (+160 basis points). The increase in EBIT
margin was positively affected by the prior year impact from the GranuFlo settlement expense as well as the margin improvement in North America and Asia-Pacific and a favorable impact from Corporate due to reduced legal and consulting expenses.
Net interest expense for the full year 2016 increased by 4% to $406 million, particularly due to lower interest income as a result of the repayment of interest bearing notes receivables in the fourth quarter of 2015. This was partially offset by a lower debt level driven by a favorable cash flow development.
For the same reasons, net interest expense in the fourth quarter of 2016 increased by 11% to $98 million.
Income tax expense for the full year 2016 increased by 10% to $683 million. This translates into an effective tax rate of 30.6%, a decrease of 150 basis points compared to the same period of 2015. This decrease was supported by lower tax expense as a result of released tax liabilities, as well as the prior year impact from the non-tax deductible loss from the divestiture of our dialysis service business in Venezuela.
In the fourth quarter of 2016, income tax expense were $212 million, translating into an effective tax rate of 30.8% (-60 basis points).
For the full year 2016, net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA grew by 21% to $1,243 million and by 16% to $1,228 million on an adjusted basis4. Based on approximately 305.7 million shares (weighted average number of shares outstanding), basic earnings per share (EPS) increased from $3.38 to $4.07 (+20%). The increase in the weighted average number of shares outstanding was the result of stock options exercised.
In the fourth quarter of 2016, net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA grew by 23% to $388 million. Based on approximately 306.2 million shares (weighted average number of shares outstanding), basic EPS increased from $1.04 to $1.27 (+22%).
4 2015 net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA adjusted for the impacts of (i) the 2015 settlement cost for an agreement in principle for the GranuFlo case ($37 million) and (ii) acquisitions in 2015 ($9 million), resulting in an adjusted net income of $1,057 million; 2016 net income adjusted for 2016 acquisitions ($15 million), resulting in an adjusted net income of $1,228 million.
North America: For the full year 2016, North America revenue increased by 9% to $12,886 million (72% of total revenue). Health Care Services revenue grew by 10% to $11,982 million, driven by higher Dialysis Care revenue (+7% to $9,675 million) and increased Care Coordination revenue (+23% to $2,307 million). Dialysis treatments rose by 4%. As of the end of 2016, we had 188,987 patients being treated at the 2,306 clinics that we own, operate or manage in North America. Dialysis Products revenue increased by 3% to $904 million, supported by higher sales of machines, dialyzers and peritoneal dialysis products partially offset by lower sales of renal pharmaceuticals and bloodlines. Operating income in North America came in at $2,119 million (+18%). The operating income margin reached a level of 16.4% (+120 basis points) as a result of lower cost from health care supplies, a higher volume of dialysis treatments with commercial payers and the prior year impact from the GranuFlo settlement expense. The positive effect was partially offset by higher personnel expense and a cost impact related to the vesting of long term incentive plan grants. The operating income margin of Care Coordination decreased to 2.6%, mainly driven by increased costs for hospitalist and intensivist services.
In the fourth quarter of 2016, North America revenue increased by 9% to $3,374 million, mainly supported by higher dialysis treatments coupled with an increase in US revenue per treatment ($356, +$8). Care Coordination contributed revenues of $603 million (+20%). Operating income increased by 23% to $634 million in the fourth quarter, mainly supported by the prior year impact from the GranuFlo settlement expense and higher revenue from commercial payers as well as lower cost from health care supplies. This was partially offset by higher personnel expense and an unfavorable impact from Care Coordination. The Care Coordination EBIT margin of -1.1% in North America was mainly impacted by higher costs related to bad debt reserves for hospitalist and intensivist services.
EMEA: For the full year 2016, EMEA revenue increased by 1% to $2,667 million (+4% at constant currency). Health Care Services revenue for the EMEA segment increased by 6% to $1,294 million (+9% at constant currency), mainly as the result of contributions from acquisitions and same market treatment growth, partially offset by the negative effect of exchange rate fluctuations. Dialysis treatments increased by 8%. As of the end of 2016, we had 59,767 patients being treated at the 711 dialysis clinics that we own, operate or manage in EMEA. Dialysis Products revenue decreased by 2% to $1,373 million (flat at constant currency), mainly due to lower sales of renal pharmaceuticals (whose marketing rights were sold in 2015), dialyzers and machines, mostly offset by
increased sales of bloodlines and products for acute care treatments. Operating income in EMEA decreased by 9% to $524 million for the full year. The operating income margin decreased to 19.7% (-220 basis points), mainly due to the prior year impact from a gain from the sale of European marketing rights for certain renal pharmaceuticals, higher bad debt expense, lower income from equity method investees and unfavorable foreign exchange effects.
In the fourth quarter of 2016, EMEA revenue increased by 2% to $684 million (+4% at constant currency), mainly driven by a strong performance in Health Care Services (revenue +7% to $327 million, +10% at constant currency). Dialysis Products revenue in EMEA declined by 3% to $357 million in the fourth quarter (flat at constant currency). Operating income in EMEA decreased by 25% to $130 million due to the gain from the sale of European marketing rights for certain renal pharmaceuticals in 2015, lower income from equity method investees driven by higher product development cost, IT project cost as well as higher bad debt expense.
Asia-Pacific: Total revenue for the Asia-Pacific segment increased by 9% to $1,632 million (+8% at constant currency) for the full year 2016. Health Care Services revenue increased by 9% to $730 million (+3% at constant currency), based on an increase of 6% in dialysis treatments. With an 8% growth in revenue to $902 million (+12% at constant currency), the product business showed an excellent sales performance across the entire dialysis products range. As of the end of 2016, we had 29,328 patients being treated at the 374 dialysis clinics that we own, operate or manage in Asia-Pacific. Operating income increased by 7% to $319 million. Due to unfavorable foreign exchange effects and costs associated with changes in the Management Board, the EBIT margin decreased slightly to 19.6% (-20 basis points).
In the fourth quarter of 2016, revenue in the Asia-Pacific segment increased by 10% to $433 million (+8% at constant currency), driven by a good revenue growth in both the Health Care Services business (+12%/+5% at constant currency) as well as the products business (+8%/+10% at constant currency). Operating income increased by 20% to $94 million. The EBIT margin increased accordingly to 21.8% (+180 basis points) in the fourth quarter, mainly due to the favorable effect of prior year costs related to customs duties in India.
Latin America: Total revenue for the Latin America segment decreased by 7% to $712 million (+13% at constant currency) for the full year 2016. Health Care Services revenue decreased by 9% to $513 million (+15% at constant currency), mainly as a
result of the negative effect of exchange rate fluctuations and the effect of closed or sold clinics (mainly Venezuela and Brazil), partially offset by increases in organic revenue per treatment. Dialysis treatments decreased by 3%, mainly due to the effect of closed or sold clinics. As of the end of 2016, we had 30,389 patients being treated at the 233 dialysis clinics that we own, operate or manage in Latin America. Dialysis Products revenue for the full year remained unchanged at $199 million (+7% at constant currency). The growth at constant currency was mainly driven by increased sales of dialyzers, hemodialysis solutions and concentrates, partially offset by lower sales of peritoneal dialysis products and machines. Operating income increased by a strong 37% to $66 million, mainly due to the prior-year loss from the divestment of the dialysis service business in Venezuela. The EBIT margin in Latin America increased to 9.2% (+290 basis points) for the full year, mainly driven by the above mentioned prior-year loss.
In the fourth quarter of 2016, revenue in the Latin America segment increased by 1% to $192 million (+13% at constant currency), mainly driven by a strong increase in Dialysis Products revenue (+11% to $56 million, +7% at constant currency). The growth at constant currency was the result of higher sales of dialyzers as well as hemodialysis solutions and concentrates, partially offset by lower sales of machines. Health Care Services revenue decreased by 3% to $136 million (+14% at constant currency), strongly impacted by unfavorable foreign exchange effects. Operating income in Latin America decreased by 18% to $19 million in the fourth quarter, mainly driven by higher bad debt expense. The EBIT margin decreased accordingly to 9.7% (-230 basis points).
In the full year 2016, the company generated net cash provided by operating activities of $2,140 million ($1,960 million for full year 2015), representing 11.9% of revenue, and thereby clearly reaching our target for 2016 (operating cash flow > 10% of revenue). The increase was mainly the result of improved inventory levels in North America driven by lower health care supplies, as well as increased earnings. This was partially offset by unfavorable effects from other working capital items and a $100 million discretionary cash contribution to pension plan assets in the United States. The number of DSO (days sales outstanding) as of December 31, 2016 was 70 days, a decrease of 1 day compared to the previous year.
In the fourth quarter of 2016, the company generated net cash provided by operating activities of $844 million, representing 18% of revenue ($548 million in the
fourth quarter of 2015). The increase was primarily attributable to higher net income, a favorable effect from DSO and deferred income tax payments in the United States.
As of December 31, 2016, Fresenius Medical Care had 109,319 employees (full-time equivalents) worldwide, compared to 104,033 employees at the end of December 2015. This increase of 5% was primarily attributable to our continued organic growth and acquisitions.
Recent events: Acquisition of a majority stake in Cura Group
In February 2017, Fresenius Medical Care announced the acquisition of a majority stake in Cura Group ( Cura ), a leading operator of high-quality day hospitals in Australia. In its 19 private day hospitals across Australia, Cura provides a variety of specialized ambulant services, such as ophthalmology and orthopedic surgeries in an outpatient setting. Cura was established in 2008 and generated revenue of AU$127 million ( 87 million) in the financial year 2015/2016. This acquisition allows Fresenius Medical Care to further leverage its core competence in operating outpatient facilities, extend its dialysis network and thereby lay the foundation for future growth in the Australian market. This transaction is subject to remaining shareholder agreements and authority approval.
Beginning January 1, 2017, Fresenius Medical Care AG & Co. KGaA focusses its reporting on financial statements in accordance with International Financial Reporting Standards (IFRS) in Euro currency. For full year 2017, the company expects revenue to grow by 8 to 10% at constant currency, based on 2016 revenue of 16,570 million. Net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA is expected to grow by 7 to 9% at constant currency, based on 2016 net income of 1,144 million. The effects of the agreement with the U.S. Departments of Veterans Affairs and Justice are excluded.
In accordance with IFRS reporting in Euro currency, we have also translated our medium-term targets for 2020 that were set at our Capital Markets Day in 2014. This growth strategy expressed a goal to increase revenues to $28 billion, in accordance with U.S. GAAP, by fiscal year 2020. In accordance with IFRS in Euro, this revenue goal would be 21 billion by fiscal year 2020 utilizing the currency exchange rates at the time Vision 2020 was presented in April 2014. At currency rates prevailing at the beginning of 2017,
this vision represents revenue of 24 billion in 2020. In addition, we indicated average annual revenue growth of approximately 10% and average annual growth of net income attributable to shareholders of FMC-AG & Co. KGaA in the high single-digits. These goals are unchanged.
Fresenius Medical Care will hold a conference call to discuss the results of the fourth quarter & full year 2016 on Wednesday, February 22, at 3.30 p.m. CEDT/ 9.30 a.m. EDT. The company invites investors to follow the live webcast of the call at the company s website www.freseniusmedicalcare.com in the Investors/Events section. A replay will be available shortly after the call.
Please refer to our statement of earnings included at the end of this news and to the attachments as separate excel- and PDF-files for a complete overview of the results for the fourth quarter/full year 2016.
Fresenius Medical Care is the world s largest provider of products and services for individuals with renal diseases of which around 3 million patients worldwide regularly undergo dialysis treatment. Through its network of 3,624 dialysis clinics, Fresenius Medical Care provides dialysis treatments for 308,471 patients around the globe. Fresenius Medical Care is also the leading provider of dialysis products such as dialysis machines or dialyzers. Along with the core business, the company focuses on expanding the range of related medical services in the field of Care Coordination. Fresenius Medical Care is listed on the Frankfurt Stock Exchange (FME) and on the New York Stock Exchange (FMS).
For more information visit the Company s website at www.freseniusmedicalcare.com.
This release contains forward-looking statements that are subject to various risks and uncertainties. Actual results could differ materially from those described in these forward-looking statements due to certain factors, including changes in business, economic and competitive conditions, regulatory reforms, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, and the availability of financing. These and other risks and uncertainties are detailed in Fresenius Medical Care AG & Co. KGaA s reports filed with the U.S. Securities and Exchange Commission. Fresenius Medical Care AG & Co. KGaA does not undertake any responsibility to update the forward-looking statements in this release.
Fresenius Medical Care AG & Co. KGaA
COMPLETE OVERVIEW OF THE RESULTS FOR THE FOURTH QUARTER AND FULL YEAR 2016
phone: +49 6172 609 2525
fax: +49 6172 609 2301
Statement of earnings page 2
Segment information page 3
Balance sheet page 4
Cash flow page 5
Revenue development page 6
Key metrics page 7
Quality data page 8
Reconciliation U.S. GAAP page 9
Reconciliation special items page 10
Reconciliation guidance page 11
Disclaimer
This release contains forward-looking statements that are subject to various risks and uncertainties. Actual results could differ materially from those described in these forward-looking statements due to certain factors, including changes in business, economic and competitive conditions, regulatory reforms, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, and the availability of financing. These and other risks and uncertainties are detailed in Fresenius Medical Care AG & Co. KGaA s reports filed with the U.S. Securities and Exchange Commission. Fresenius Medical Care AG & Co. KGaA does not undertake any responsibility to update the forward-looking statements in this release.
Statement of earnings
Three months ended December 31 Twelve months ended December 31
in US$ million, except share data, audited 2016 2015 Change 2016 2015 Change
Health Care revenue 3,888 3,552 9.5 % 14,949 13,801 8.3 %
Less: patient service bad debt provision 89 90 -0.9 % 430 409 5.0 %
Net Health Care revenue 3,799 3,462 9.7 % 14,519 13,392 8.4 %
Dialysis Products revenue 888 886 0.3 % 3,392 3,346 1.4 %
Total net revenue 4,687 4,348 7.8 % 17,911 16,738 7.0 %
Costs of revenue 3,095 2,880 7.5 % 12,131 11,407 6.4 %
Gross profit 1,592 1,468 8.4 % 5,780 5,331 8.4 %
Selling, general and administrative 768 775 -1.1 % 3,045 2,895 5.1 %
Research and development 42 40 5.7 % 162 140 15.7 %
Income from equity method investees (4 ) (9 ) -59.3 % (65 ) (31 ) 106.4 %
Operating income (EBIT) 786 662 18.8 % 2,638 2,327 13.4 %
Interest income (8 ) (37 ) -77.6 % (47 ) (117 ) -60.0 %
Interest expense 106 125 -15.1 % 453 508 -11.0 %
Interest expense, net 98 88 11.1 % 406 391 3.6 %
Income before taxes 688 574 20.0 % 2,232 1,936 15.3 %
Income tax expense 212 180 17.6 % 683 623 9.8 %
Net income 476 394 21.1 % 1,549 1,313 17.9 %
Less: Net income attributable to noncontrolling interests 88 77 15.0 % 306 284 7.7 %
Net income attributable to shareholders of FMC AG & Co. KGaA 388 317 22.5 % 1,243 1,029 20.8 %
Operating income (EBIT) 786 662 18.8 % 2,638 2,327 13.4 %
Depreciation and amortization 204 181 12.6 % 775 717 8.2 %
EBITDA 990 843 17.5 % 3,413 3,044 12.1 %
EBITDA margin 21.1 % 19.4 % 19.1 % 18.2 %
Weighted average number of shares 306,181,415 305,147,599 305,748,381 304,440,184
Basic earnings per share $1.27 $1.04 22.1 % $4.07 $3.38 20.3 %
Basic earnings per ADS $0.63 $0.52 22.1 % $2.03 $1.69 20.3 %
In percent of revenue
Costs of revenue 66.0 % 66.2 % 67.7 % 68.1 %
Gross profit 34.0 % 33.8 % 32.3 % 31.9 %
Operating income (EBIT) 16.8 % 15.2 % 14.7 % 13.9 %
Net income attributable to shareholders of FMC AG & Co. KGaA 8.3 % 7.3 % 6.9 % 6.2 %
Three months ended December 31 Twelve months ended December 31
audited 2016 2015 Change 2016 2015 Change
Total
Revenue in US$ million 4,687 4,348 7.8 % 17,911 16,738 7.0 %
Operating income (EBIT) in US$ million 786 662 18.8 % 2,638 2,327 13.4 %
Operating income margin in % 16.8 % 15.2 % 14.7 % 13.9 %
Delivered EBIT in US$ million 698 585 19.3 % 2,332 2,043 14.1 %
Days sales outstanding (DSO) 70 71
Employees (full-time equivalents) 109,319 104,033
North America
Revenue in US$ million 3,374 3,084 9.4 % 12,886 11,813 9.1 %
Operating income (EBIT) in US$ million 634 514 23.3 % 2,119 1,798 17.9 %
Operating income margin in % 18.8 % 16.7 % 16.4 % 15.2 %
Delivered EBIT in US$ million 549 440 24.9 % 1,824 1,524 19.7 %
Days sales outstanding (DSO) 54 53
U.S.
Revenue per dialysis treatment in US$ 356 348 2.5 % 351 346 1.7 %
Cost per dialysis treatment in US$ 269 268 0.2 % 278 279 -0.4 %
EMEA
Revenue in US$ million 684 673 1.6 % 2,667 2,629 1.4 %
Operating income (EBIT) in US$ million 130 172 -24.5 % 524 577 -9.1 %
Operating income margin in % 18.9 % 25.5 % 19.7 % 21.9 %
Delivered EBIT in US$ million 129 171 -24.9 % 520 574 -9.3 %
Days sales outstanding (DSO) 101 104
Asia-Pacific
Revenue in US$ million 433 394 9.9 % 1,632 1,502 8.7 %
Operating income (EBIT) in US$ million 94 79 19.9 % 319 298 7.1 %
Operating income margin in % 21.8 % 20.0 % 19.6 % 19.8 %
Delivered EBIT in US$ million 92 77 19.7 % 312 291 7.4 %
Days sales outstanding (DSO) 105 113
Latin America
Revenue in US$ million 192 190 1.0 % 712 766 -7.1 %
Operating income (EBIT) in US$ million 19 23 -18.2 % 66 48 36.5 %
Operating income margin in % 9.7 % 12.0 % 9.2 % 6.3 %
Delivered EBIT in US$ million 19 23 -18.8 % 66 48 36.7 %
Days sales outstanding (DSO) 143 141
Corporate
Revenue in US$ million 4 7 -52.5 % 14 28 -48.0 %
Operating income (EBIT) in US$ million (91 ) (126 ) -28.0 % (390 ) (394 ) -0.8 %
Delivered EBIT in US$ million (91 ) (126 ) -27.9 % (390 ) (394 ) -0.8 %
December 31 December 31
in US$ million, except debt/EBITDA ratio 2016 2015
(audited) (audited)
Assets
Current assets 7,314 6,768
Goodwill and Intangible assets 14,514 13,863
Other non-current assets 5,106 4,734
Total assets 26,934 25,365
Liabilities and equity
Current liabilities 5,037 4,149
Long-term liabilities 9,199 9,692
Noncontrolling interests subject to put provisions and other temporary equity 1,241 1,028
Total equity 11,457 10,496
Total liabilities and equity 26,934 25,365
Equity/assets ratio 43 % 41 %
Debt
Short-term debt 603 109
Short-term debt from related parties 3 19
Current portion of long-term debt and capital lease obligations 763 664
Long-term debt and capital lease obligations, less current portion 7,203 7,854
Total debt 8,572 8,646
Debt/EBITDA ratio 2.4 2.8
Three months ended December 31 Twelve months ended December 31
in US$ million, audited 2016 2015 2016 2015
Operating activities
Net income 476 394 1,549 1,313
Depreciation / amortization 204 181 775 717
Change in working capital and other non-cash items 164 (27 ) (184 ) (70 )
Net cash provided by operating activities 844 548 2,140 1,960
In percent of revenue 18.0 % 12.6 % 11.9 % 11.7 %
Investing activities
Purchases of property, plant and equipment (282 ) (306 ) (1,030 ) (953 )
Proceeds from sale of property, plant and equipment 3 7 18 18
Capital expenditures, net (279 ) (299 ) (1,012 ) (935 )
Free cash flow 565 249 1,128 1,025
In percent of revenue 12.1 % 5.7 % 6.3 % 6.1 %
Acquisitions and investments, net of cash acquired, and purchases of intangible assets (191 ) (151 ) (578 ) (317 )
Proceeds from divestitures 18 209 211 251
Acquisitions and investments, net of divestitures (173 ) 58 (367 ) (66 )
Free cash flow after investing activities 392 307 761 959
in US$ million, audited 2016 2015 Change Change at cc Organic growth Same market treatment growth 1
Three months ended December 31
Total revenue 4,687 4,348 7.8 % 8.6 % 7.1 %
Net Health Care 3,799 3,462 9.7 % 10.3 % 8.4 % 2.8 %
Dialysis Products 888 886 0.3 % 1.6 % 2.0 %
North America 3,374 3,084 9.4 % 9.4 % 8.0 %
Net Health Care 3,144 2,845 10.5 % 10.5 % 8.9 % 3.2 % 2
Thereof Net Care Coordination revenue 603 501 20.3 % 20.3 % 22.4 %
Thereof Net Dialysis Care revenue 2,541 2,344 8.4 % 8.4 % 5.9 % 3.2 % 2
Dialysis Products 230 239 -3.6 % -3.6 % -3.3 %
EMEA 684 673 1.6 % 4.4 % 1.8 %
Net Health Care 327 306 6.9 % 9.9 % 3.6 % 3.3 %
Dialysis Products 357 367 -2.7 % -0.2 % 0.4 %
Asia-Pacific 433 394 9.9 % 7.9 % 7.7 %
Net Health Care 192 171 11.9 % 4.8 % 4.2 % 3.6 %
Dialysis Products 241 223 8.4 % 10.4 % 10.4 %
Latin America 192 190 1.0 % 12.5 % 12.4 %
Net Health Care 136 140 -2.5 % 14.4 % 14.0 % 1.9 %
Dialysis Products 56 50 10.9 % 7.3 % 8.3 %
Corporate 4 7 -52.5 % -51.7 %
Twelve months ended December 31
Total revenue 17,911 16,738 7.0 % 8.3 % 7.0 %
Net Health Care 14,519 13,392 8.4 % 9.5 % 7.6 % 3.2 %
Dialysis Products 3,392 3,346 1.4 % 3.6 % 4.4 %
North America 12,886 11,813 9.1 % 9.1 % 7.4 %
Net Health Care 11,982 10,932 9.6 % 9.6 % 7.7 % 3.6 % 3
Thereof Net Care Coordination revenue 2,307 1,882 22.5 % 22.5 % 20.0 %
Thereof Net Dialysis Care revenue 9,675 9,050 6.9 % 6.9 % 5.1 % 3.6 % 3
Dialysis Products 904 881 2.6 % 2.6 % 2.7 %
EMEA 2,667 2,629 1.4 % 4.1 % 2.3 %
Net Health Care 1,294 1,226 5.6 % 8.9 % 3.4 % 3.6 %
Dialysis Products 1,373 1,403 -2.2 % -0.1 % 1.4 %
Asia-Pacific 1,632 1,502 8.7 % 8.0 % 8.2 %
Net Health Care 730 667 9.4 % 3.3 % 3.9 % 4.7 %
Dialysis Products 902 835 8.1 % 11.7 % 11.7 %
Latin America 712 766 -7.1 % 13.1 % 17.0 %
Net Health Care 513 567 -9.5 % 15.2 % 19.7 % 1.9 %
Dialysis Products 199 199 -0.3 % 6.9 % 9.5 %
Corporate 14 28 -48.0 % -47.9 %
1 same market treatment growth = organic growth less price effects
2 U.S. (excl. Mexico), same market treatment growth North America: 2.7%
3 U.S. (excl. Mexico), same market treatment growth North America: 3.1%
cc = constant currency. Changes in revenue include the impact of changes in foreign currency exchange rates. We use the non-GAAP financial measure at Constant Exchange Rates or Constant Currency to show changes in our revenue without giving effect to period-to-period currency fluctuations. Under U.S. GAAP, revenues received in local (non-U.S. dollar) currency are translated into U.S. dollars at the average exchange rate for the period presented. Once we translate the local currency revenues for the Constant Currency, we then calculate the change, as a percentage, of the current period revenues using the prior period exchange rates versus the prior period revenues. This resulting percentage is a non-GAAP measure referring to a change as a percentage at Constant Currency.
We believe that revenue growth is a key indication of how a company is progressing from period to period and that the non-GAAP financial measure Constant Currency is useful to investors, lenders, and other creditors because such information enables them to gauge the impact of currency fluctuations on a company s revenue from period to period. However, we also believe that the usefulness of data on Constant Currency period-over-period changes is subject to limitations, particularly if the currency effects that are eliminated constitute a significant element of our revenue and significantly impact our performance. We therefore limit our use of Constant Currency period-over-period changes to a measure for the impact of currency fluctuations on the translation of local currency revenue into U.S. dollars. We do not evaluate our results and performance without considering both Constant Currency period-over-period changes in non-U.S. GAAP revenue on the one hand and changes in revenue prepared in accordance with U.S. GAAP on the other. We caution the readers of this report to follow a similar approach by considering data on Constant Currency period-over-period changes only in addition to, and not as a substitute for or superior to, changes in revenue prepared in accordance with U.S. GAAP. We present the fluctuation derived from U.S. GAAP revenue next to the fluctuation derived from non-GAAP revenue. Because the reconciliation is inherent in the disclosure, we believe that a separate reconciliation would not provide any additional benefit.
Key metrics North America segment
Three months ended December 31 Twelve months ended December 31
audited 2016 2015 Change 2016 2015 Change
Care Coordination
Net revenue in US$ million 603 501 20.3 % 2,307 1,882 22.5 %
Operating income (EBIT) in US$ million (7 ) 13 n.a. 59 97 -38.9 %
Operating income margin in % -1.1 % 2.5 % 2.6 % 5.2 %
Delivered EBIT in US$ million (10 ) 5 n.a. 34 57 -41.4 %
Dialysis
Net revenue in US$ million 2,771 2,583 7.3 % 10,579 9,931 6.5 %
Operating income (EBIT) in US$ million 641 501 27.7 % 2,060 1,701 21.1 %
Operating income margin in % 23.1 % 19.4 % 19.5 % 17.1 %
Delivered EBIT in US$ million 559 435 28.8 % 1,790 1,467 22.1 %
Key metrics Care Coordination
Twelve months ended December 31
audited 2016 2015 Growth in %
North America
Member months under medical cost management 1) 387,244 208,933 85 %
Medical cost under management (in US$ million) 1) 2,814 1,660 70 %
Care Coordination patient encounters 5,539,703 5,005,695 11 %
1) The 2016 metrics may be understated due to a physician mapping issue related to the BPCI program within a CMS system which has not yet been resolved. Additionally, data presented for the metrics are subject to finalization by CMS, which may result in changes from previously reported metrics.
Key metrics Dialysis Care Services
Twelve months ended December 31
audited Clinics Growth in % De novos Patients Growth in % Treatments Growth in %
Total 3,624 6 % 122 308,471 5 % 46,529,154 4 %
North America 2,306 4 % 76 188,987 3 % 28,882,107 4 %
EMEA 711 8 % 21 59,767 9 % 8,872,231 8 %
Asia-Pacific 374 17 % 21 29,328 11 % 4,003,957 6 %
Latin America 233 2 % 4 30,389 1 % 4,770,859 -3 %
North America EMEA Latin America Asia-Pacific
in % of patients Q4 2016 Q3 2016 Q4 2016 Q3 2016 Q4 2016 Q3 2016 Q4 2016 Q3 2016
Clinical Performance
Single Pool Kt/v > 1.2 98 97 96 96 91 93 97 97
No catheter (> 90 days) 84 86 81 81 82 81 91 91
Hemoglobin = 10-12 g/dl 73 73 78 77 52 52 60 59
Hemoglobin = 10-13 g/dl 79 79 77 77 68 67 68 67
Albumin > 3.5 g/dl 1) 78 77 91 91 91 88 89 88
Phosphate < 5.5 mg/dl 64 64 77 76 77 76 72 72
Calcium = 8.4-10.2 mg/dl 84 84 76 75 79 75 75 75
Hospitalization days 10.0 9.8 9.4 9.4 3.8 3.7 4.4 4.3
Demographics
Average age (in years) 63 63 64 64 59 58 65 65
Average time on dialysis (in years) 4.0 4.0 5.7 5.6 5.2 5.2 5.1 5.0
Average body weight (in kg) 83 83 73 72 68 68 61 61
Prevalence of diabetes (in%) 62 61 32 32 22 26 42 43
1) International standard BCR CRM470
Reconciliation of non U.S. GAAP financial measures to the most directly comparable U.S. GAAP financial measures
Three months ended December 31 Twelve months ended December 31
in US$ million, audited 2016 2015 2016 2015
Delivered EBIT reconciliation
Total
Operating income (EBIT) 786 662 2,638 2,327
less noncontrolling interests (88 ) (77 ) (306 ) (284 )
Delivered EBIT 698 585 2,332 2,043
North America
Operating income (EBIT) 634 514 2,119 1,798
less noncontrolling interests (85 ) (74 ) (295 ) (274 )
Delivered EBIT 549 440 1,824 1,524
Care Coordination
Operating income (EBIT) (7 ) 13 59 97
less noncontrolling interests (3 ) (8 ) (25 ) (40 )
Delivered EBIT (10 ) 5 34 57
Dialysis
Operating income (EBIT) 641 501 2,060 1,701
less noncontrolling interests (82 ) (66 ) (270 ) (234 )
Delivered EBIT 559 435 1,790 1,467
EMEA
Operating income (EBIT) 130 172 524 577
less noncontrolling interests (1 ) (1 ) (4 ) (3 )
Delivered EBIT 129 171 520 574
Asia-Pacific
Operating income (EBIT) 94 79 319 298
less noncontrolling interests (2 ) (2 ) (7 ) (7 )
Delivered EBIT 92 77 312 291
Latin America
Operating income (EBIT) 19 23 66 48
less noncontrolling interests
Delivered EBIT 19 23 66 48
Corporate
Operating income (EBIT) (91 ) (126 ) (390 ) (394 )
less noncontrolling interests
Delivered EBIT (91 ) (126 ) (390 ) (394 )
Reconciliation of net cash provided by operating activities to EBITDA 1)
Total EBITDA 3,413 3,044
Interest expense, net (406 ) (391 )
Income tax expense (683 ) (623 )
Change in working capital and other non-cash items (184 ) (70 )
Net cash provided by operating activities 2,140 1,960
Annualized EBITDA 2)
Operating income (EBIT) 2,626 2,327
Depreciation and amortization 784 717
Non-cash charges 99 83
Annualized EBITDA 3,509 3,127
1) EBITDA is the basis for determining compliance with certain covenants in Fresenius Medical Care s long-term debt instruments.
2) EBITDA 2016: including largest acquisitions.
Reconciliation of non U.S. GAAP financial measures to the most directly comparable U.S. GAAP financial measures
Twelve months ended December 31
in US$ million, audited 2016 2015
Operating performance excluding acquisition impact and special items - basis for Guidance 2016
Revenue 17,911 16,738
Contributions from acquisitions closed in 2015 and 2016 (275 ) (74 )
Revenue excluding acquisition impact 17,636 16,664
Operating income (EBIT) 2,638 2,327
Contributions from acquisitions closed in 2015 and 2016 (39 ) (16 )
Settlement costs for an agreement in principle for the GranuFlo case 60
Operating income (EBIT) excluding acquisition impact and special items 2,599 2,371
Net income (1) 1,243 1,029
Contributions from acquisitions closed in 2015 and 2016 (15 ) (9 )
Settlement costs for an agreement in principle for the GranuFlo case 37
Net income excluding acquisition impact and special items (1) 1,228 1,057
(1) attributable to shareholders of FMC AG & Co. KGaA
Reconciliation of non U.S. GAAP financial measures to the most directly comparable U.S. GAAP financial measures
Three months ended December 31 Twelve months ended December 31
in US$ million, audited 2016 2015 2016 2015
Operating performance excluding special items
Total
Operating income (EBIT) 786 662 2,638 2,327
Special items 42 61
Settlement costs for an agreement in principle for the GranuFlo case 60 60
Divestment of dialysis service business in Venezuela 26
Sale of European marketing rights for certain renalpharmaceuticals 1 (18 ) (25 )
Operating income (EBIT) excluding special items 786 704 2,638 2,388
North America
Operating income (EBIT) 634 514 2,119 1,798
Special items 60 60
Operating income (EBIT) excluding special items 634 574 2,119 1,858
EMEA
Operating income (EBIT) 130 172 524 577
Special items (18 ) (25 )
Operating income (EBIT) excluding special items 130 154 524 552
Asia-Pacific
Operating income (EBIT) 94 79 319 298
Special items
Operating income (EBIT) excluding special items 94 79 319 298
Latin America
Operating income (EBIT) 19 23 66 48
Special items 26
Operating income (EBIT) excluding special items 19 23 66 74
Corporate
Operating income (EBIT) (91 ) (126 ) (390 ) (394 )
Special items
Operating income (EBIT) excluding special items (91 ) (126 ) (390 ) (394 )
Net income 2 388 317 1,243 1,029
Special items 30 53
Settlement costs for an agreement in principle for the GranuFlo case 37 37
Divestment of dialysis service business in Venezuela 27
Sale of European marketing rights for certain renal pharmaceuticals 1 (7 ) (11 )
Net income excluding special items 2 388 347 1,243 1,082
1 to our Joint Venture Vifor Fresenius Medical Care Renal Pharma
2 attributable to shareholders of FMC AG & Co. KGaA
Last updated: Feb 22, 2017