Owner Scorecard


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FMS, Fresenius Medical Care AG

Not all healthcare systems provide payment for dialysis treatment.

Financial condition and results of operations Overview We are the world's leading provider of products and services for individuals with renal diseases, based on publicly reported revenue.

Our healthcare products include hemodialysis machines, peritoneal dialysis cyclers, dialyzers, peritoneal dialysis solutions, hemodialysis concentrates, solutions and granulates, bloodlines, renal pharmaceuticals, systems for water treatment, as well as acute cardiopulmonary and apheresis products.

Latest annual: FY2025 20-F · figures as filed, in EUR
FMS · Fresenius Medical Care AG
I

The business

What it sells, where the money comes from, the kind of company it is.

Revenue · FY2025
€19.6B
+1.5% YoY · 2% 5-yr CAGR
Vital signs · TTM, with 5-yr average
Revenue €19.6B 5-yr avg €19.1B
Gross margin 26% 5-yr avg 26%
Operating margin 9.3% 5-yr avg 8.4%
ROIC 8% 5-yr avg 6%

The business in brief

read the 10-K →

What this business is and what moves its needle, from its own SEC filings.

What it is
Revenue is Care Delivery (67%), Care Enablement (21%) and Value-Based Care (11%).
What moves the needle
Gross margin has run about 27% and operating margin about 11% through the cycle, a solid spread between what it charges and what the product costs to make. The operating margin has swung widely — from 7.0% to 18% — on a steadier 27% gross margin, so what moves it sits below the gross line, in operating spend and one-off charges more than in the cost of the product itself. On its own account, the filing leans hardest on customer concentration, set against the numbers in what the filing emphasizes, below.
Is it a good business?
Return on capital has sat near the cost of capital (median 9%). By owner earnings: roughly 8% of revenue reaches owners as cash, consistently. This is price-taker territory, where the balance sheet and the cycle matter more than any multiple; the rest is in the 10-K.

Every line is arithmetic on the company's filings, shown in full in the sections below.

Where the money comes from

read the 20-F →

Care Delivery is 67% of revenue, with Care Enablement the other meaningful segment at 21%.

Revenue by reportable segment, FY2025
  • Care Delivery67%€13.2B
  • Care Enablement21%€4.1B
  • Value-Based Care11%€2.2B
By geographyForeign countries97%Germany3%

From the segment footnote of the company's own 20-F. Shares are of total revenue; the profit bar shows each segment's share of segment operating profit, before unallocated corporate costs.

II

The record

Ten years of arithmetic, read across the cycle.

The record, 2016–2025

realized figures from each filing · older years to the left
2016’162017’172018’182019’192020’202021’212022’222023’232024’242025’25TTMTTMDec 2025
Income statement
€16.6B€17.8B€16.5B€17.5B€17.9B€17.6B€19.4B€19.5B€19.3B€19.6B€19.6BRevenueRevenue
34%34%31%31%31%27%25%25%25%26%26%Gross marginGross mgn
€2.4B€2.4B€3.0B€2.3B€2.3B€1.9B€1.5B€1.4B€1.4B€1.8B€1.8BOperating incomeOp. inc.
14.5%13.3%18.4%13.0%12.9%10.5%7.8%7.0%7.2%9.3%9.3%Operating marginOp. mgn
€1.1B€1.3B€2.0B€1.2B€1.2B€969M€673M€499M€538M€978M€978MNet incomeNet inc.
35%26%21%25%30%27%33%38%37%25%25%Effective tax rateTax rate
Cash flow & returns
€1.9B€2.2B€2.1B€2.6B€4.2B€2.5B€2.2B€2.6B€2.4B€2.7B€2.7BOperating cash flowOp. cash
€702M€735M€725M€1.6B€1.6B€1.6B€1.7B€1.6B€1.5B€1.5B€1.5BDepreciationDeprec.
€1.5B€177M(€645M)(€186M)€1.5B(€65M)(€225M)€517M€313M€239M€239MWorking capital & otherWC & other
€931M€944M€1.1B€1.1B€1.1BCapexCapex
5.6%5.3%6.4%6.4%5.5%Capex / revenueCapex/rev
€1.0B€1.5B€1.3B€1.4B€1.6BOwner earningsOwner earn.
6.0%8.2%8.1%8.3%8.1%Owner earnings marginOE mgn
€1.0B€1.2B€1.0B€1.4B€1.6BFree cash flowFCF
6.0%7.0%6.1%8.3%8.1%Free cash flow marginFCF mgn
€244M€294M€325M€355M€351M€392M€396M€329M€349M€423M€351MDividends paidDiv. paid
€0€58M€37M€600M€366M€585MBuybacksBuybacks
9%11%15%9%9%7%5%4%4%8%8%ROICROIC
11%13%17%10%10%8%5%4%4%7%7%Return on equityROE
9%10%14%7%7%5%2%1%1%4%5%Retained to equityRetained/eq
Balance sheet
€709M€978M€2.1B€1.0B€1.1B€1.5B€1.5B€1.6B€1.6B€2.0B€2.0BCash & investmentsCash+inv
€4.0B€3.9B€3.2B€3.4B€3.3B€3.3BReceivablesReceiv.
€1.3B€1.3B€1.5B€1.7B€1.9B€2.0B€2.3B€2.2B€2.1B€2.1B€2.1BInventoryInvent.
€576M€590M€641M€717M€729M€729MAccounts payablePayables
€4.7B€4.6B€4.1B€4.4B€4.4B€2.0B€2.3B€2.2B€2.1B€2.1B€4.7BOperating working capitalOper. WC
€6.9B€6.4B€7.8B€7.2B€7.3B€8.0B€8.2B€8.7B€7.9B€7.9B€7.9BCurrent assetsCur. assets
€5.3B€5.3B€6.3B€7.1B€6.1B€7.3B€6.5B€6.1B€5.7B€6.2B€6.2BCurrent liabilitiesCur. liab.
1.3×1.2×1.3×1.0×1.2×1.1×1.3×1.4×1.4×1.3×1.3×Current ratioCurr. ratio
€13.0B€12.1B€12.2B€14.0B€13.0B€14.4B€15.8B€15.4B€14.2B€14.0B€13.6BGoodwillGoodwill
€25.5B€24.0B€26.2B€32.9B€31.7B€34.4B€35.8B€33.9B€33.6B€31.0B€31.0BTotal assetsAssets
€7.4B€6.6B€6.3B€7.6B€6.9B€7.9B€7.8B€7.4B€6.3B€5.7B€5.7BTotal debtDebt
€6.7B€5.6B€4.1B€6.6B€5.8B€6.4B€6.3B€5.8B€4.6B€3.6B€3.6BNet debt / (cash)Net debt
5.6×5.7×6.8×4.6×5.6×5.2×4.2×3.2×3.4×4.8×4.8×Interest coverageInt. cov.
€10.0B€9.8B€11.8B€12.0B€11.2B€12.7B€14.0B€13.6B€14.6B€13.3B€13.3BShareholders’ equityEquity
Per share
306M307M307M303M294M293M293M293M293M291M279MShares out (diluted)Shares
€54.19€58.01€53.98€57.74€60.73€60.14€66.15€66.30€65.90€67.40€70.28Revenue / shareRev/sh
€3.74€4.17€6.47€3.96€3.96€3.31€2.30€1.70€1.83€3.36€3.50EPS (diluted)EPS
€3.28€4.75€4.36€4.76€5.72Owner earnings / shareOE/sh
€3.28€4.07€3.28€4.76€5.72Free cash flow / shareFCF/sh
€0.80€0.96€1.06€1.17€1.19€1.34€1.35€1.12€1.19€1.45€1.26Dividends / shareDiv/sh
€3.04€3.08€3.45€3.72€3.88Cap. spending / shareCapex/sh
€32.63€32.03€38.36€39.51€38.14€43.35€47.71€46.42€49.68€45.71€47.66Book value / shareBVPS
Per-share growththe realized rate an owner's share compounded
9-yr5-yr
Revenue / share+2.5%/yr+2.1%/yr
Owner earnings / share+13.3%/yr (3-yr)+13.3%/yr (3-yr)
EPS−1.2%/yr−3.2%/yr
Dividends / share+6.9%/yr+4.0%/yr
Capital spending / share+6.9%/yr (3-yr)+6.9%/yr (3-yr)
Book value / share+3.8%/yr+3.7%/yr

The record, charted

FY2016–2025

Each measure over its full record; the current point and the worst year marked.

Share count
291Mpeak FY2017
ROIC
8%low FY2023
Gross margin
26%low FY2024
Net debt ÷ owner earnings
4.6×peak FY2016

Owner earnings vs. net income

Owner earningsNet income

The accountant's number, and the cash an owner can take; the gap is the tell.

€1.4Bowner earningsvs.€1.2Bnet incomelow FY2016

Where the cash went

ReinvestBuybacksDividendsAcquisitionsRetained

Each year's operating cash, by what management did with it: the mix, and how it drifts.

FY2016FY2025

Net income is the accountant's number; owner earnings is the cash an owner could take out. The walk between them, off the cash-flow statement, and whether the gap is widening or holding.

In fiscal 2019 the business turned €1.2B of profit into €1.4B of owner earnings: more cash than the profit line showed, after the non-cash charges and the capital it put back in.

Reported net income€1.2B
Owner earnings€1.4B · 8% of revenue
FY2019FY2018FY2017FY2016
Reported net income€1.2B€2.0B€1.3B€1.1B
Depreciation & amortizationnon-cash charge added back+€1.6B+€725M+€735M−€702M
Working capital & othertiming of cash in and out, other non-cash items−€186M−€645M+€177M+€1.5B
Cash from operations€2.6B€2.1B€2.2B€1.9B
Maintenance capital expenditurethe spending needed just to hold position and volume−€1.1B−€725M−€735M−€931M
Owner earnings€1.4B€1.3B€1.5B€1.0B
Growth capital expenditurediscretionary; spent to get bigger, not to stand still−€332M−€209M
Free cash flow€1.4B€1.0B€1.2B€1.0B
Owner-earnings marginowner earnings ÷ revenue8%8%8%6%

Owner earnings is the cash an owner could pull out without starving the business: operating cash less the capital it must spend to hold its position .

Maintenance capex is estimated as depreciation where a growing business invests above it; free cash flow is the figure the scorecard's free-cash margin reads.

III

Quality & stewardship

Returns, the balance sheet, capital allocation, and pay.

Owner’s Scorecard

FY2025 20-F · source on SEC EDGAR →

Will it survive?

  • Adequate
    Operating income €1.8B ÷ interest expense €384M
    What this means

    Comfortable in a normal year, but below the margin of safety Graham looked for. Worth checking how stable the coverage has been across a full cycle.

  • How heavy is the debt, net of cash? €3.6B · 2.0× operating profit
    Modest net debt
    Cash €1.6B + ST investments €447M − debt €5.7B
    What this means

    Netting €2.0B of cash and short-term investments against €5.7B of debt leaves €3.6B owed, about 2.0× a year's operating profit (3.1× on the gross debt, before the cash). Net debt is the leverage figure that matters: the cash is already set against the debt. Strategic or illiquid investments aren't counted here.

  • Long (60+ days)
    DSO 60 + DIO 54 − DPO 18 days
    What this means

    Days cash is tied up between paying suppliers and collecting from customers. Lower is better; a long cycle means growth itself eats cash.

Is it a good business?

  • Below average through the cycle
    10-yr median, range 4%–15%; 8% latest = NOPAT €1.4B ÷ invested capital €17.4B
    Industry peers: median 10%
    What this means

    The rate the business earns on the money tied up in it, Buffett's north star, because over time a stock tracks the ROIC beneath it. Above ~15% sustained hints at a moat; a return below the cost of capital (~8%) erodes value as a business grows rather than building it — the test Buffett weighs most. The headline is the median of the last 10 years (it ran 8% most recently), so one peak or trough year doesn't set the verdict. Asset-light businesses (R&D expensed, little capital) read artificially high, pair this with Owner Earnings.

  • Solid through the cycle
    4-yr median margin, range 6%–8%; latest €1.6B = operating cash €2.7B − maintenance capex €1.1B
    Industry peers: median 7%
    What this means

    What an owner could take out without starving the business: operating cash less the maintenance capital it must spend to hold its position — Buffett's owner earnings. That's 8% of revenue this year, a 8% median across 4 years.

  • Cash-backed
    Cash from ops €2.7B ÷ net income €978M
    What this means

    How much of reported profit showed up as operating cash. Above 1× is reassuring; well below suggests earnings lean on accruals. One year is noisy, growth and working-capital swings distort it, and this is operating cash, not free cash. Watch the multi-year trend.

How is the cash used?

  • Returns about half
    Dividends + buybacks €936M ÷ Owner Earnings €1.6B
    What this means

    Of €1.6B Owner Earnings, €936M (59%) went back to shareholders, €351M dividends, €585M buybacks. Returning most of it is the mark of a mature business with little left to reinvest at a high return; reinvesting most could mean a long runway, or empire-building. The split doesn't say which; the return earned on it (see ROIC) does.

  • Investing or harvesting? 0.74×
    Harvesting
    Capex €1.1B ÷ depreciation €1.5B
    What this means

    Descriptive, not a grade. Above ~1× means investing faster than assets wear out (growth, or, sustained for years, today's earnings carrying less depreciation than tomorrow's will). Below means spending less than it's wearing out (efficiency, or a melting asset base). The ratio won't tell you which; the filings will.

Graham’s defensive tests · 2 of 5 met

Graham’s numerical criteria for the defensive investor (The Intelligent Investor, ch. 14), run on the filings. A floor of safety, not a buy signal; many fine modern businesses fail his strictest liquidity rules by design.

  • Adequate size
    Revenue ≥ $2B (a dollar floor) · €19.6B
    What this means

    Big enough to weather a storm. Graham's floor is a dollar figure — about $2B of revenue as a conservative modern stand-in. This company reports in its home currency and we carry no exchange rate, so we show the figure and leave the size bar for you to apply rather than convert it with a number we don't have.

  • Strong liquidity Miss
    Current ratio ≥ 2× · 1.26×
    What this means

    Current assets at least twice current liabilities, near-term bills covered without touching the business. Strict by design: many cash-rich modern firms run leaner and miss it, holding their cushion in longer-dated securities.

  • Conservative debt Miss
    Debt ≤ working capital · €5.7B vs €1.7B WC
    What this means

    Graham's rule that borrowings not exceed net current assets. Capital-heavy and buyback-heavy firms routinely fail it, read it next to interest coverage, not alone.

  • Earnings stability Pass
    A profit every year (10-yr record) · no losses
    What this means

    Graham wanted earnings in each of the past ten years, the stability a defensive owner leans on.

  • Dividend record Pass
    Uninterrupted dividends · paid every year (10)
    What this means

    An unbroken dividend was Graham's mark of durability. He wanted twenty years; the filings show about ten, and a single suspension breaks the streak. Non-payers, many fine modern compounders, fall outside his defensive net by design.

  • Earnings growth Miss
    Earnings +33% over the record · −54%
    What this means

    At least a third more earnings than a decade ago, averaging three years at each end. Net income (not per-share), so stock splits don't distort it, buybacks and dilution show up in the share-count line instead.

  • Moderate price
    P/E ≤ 15 and P/E × P/B ≤ 22.5 · decided by the price
    What this means

    Graham's valuation gate, the wall he kept between a sound business and a sound investment. Three-year average earnings are €2.41/share (latest year €3.50), the averaged base the calculator's gate runs on, and book value is €47.66/share. Enter a price in “What the price implies” just below for the P/E, P/B, and whether it clears. But this is the rule Buffett outgrew: there's no hard P/E law, and a wonderful business can deserve a far richer multiple if the thesis holds, treat it as the bargain-hunter's floor, not a verdict on the price.

Durability & moat, 2016–2025

Whether the record’s returns held, and what the capital reinvested earned.

  • Profitable years 10 of 10
    What this means

    Never lost money over the record, the earnings stability Graham insisted on.

  • Return on capital ≥ 15% 1 of 10 yrs
    What this means

    A moat shows up as a high return on invested capital that holds year after year, not one good vintage.

  • Operating margin 15% → 8% (3-yr avg ends)
    What this means

    Through the cycle the operating margin slipped — about 15% early to 8% lately, median 11% — competition or costs are biting in.

  • Reinvestment, incremental ROIC returns capital
    What this means

    The capital base barely grew: this business returns cash through dividends and buybacks rather than reinvesting. Judge it on the cash returned, not on compounding.

  • Owner earnings growth +4%/yr
    What this means

    Owner earnings grew about 4% a year over the record.

  • Worst year 2023 · 7.0% op. margin
    What this means

    Stayed profitable even in its hardest year, the resilience that survives recessions.

  • Share count −0.5%/yr
    What this means

    The share count is shrinking, buybacks are quietly growing your slice of the business.

  • Dividend record rising
    What this means

    Paid and raised the dividend across the record, the continuity Graham prized.

Does AI threaten the moat?

Moderate contestability

AI is likely to reshape costs and some products here without clearly contesting or sparing the core moat; how the company itself frames it is the tell.

In its own filing Raised, but not as a competitor

The filing raises AI among its risks, but in other terms (security, regulation, energy or the like), not as a competitor to its product; it frames AI mainly as a capability.

The question is whether a moat the record shows as durable outlasts a technology that lowers the cost of part of what the firm sells. The durability is read in the record above, the filing's own framing of AI beside it; the industry label decides nothing on its own.

Read from the filing's own risk factors, paired with the industry's structure under its SIC code; the durability is read above, the price below.

All figures as filed; the source filing is linked above.

Current Position

as of fiscal year-end, Dec 31, 2025

Can the business pay what it owes this year, off the freshest balance sheet: the quality of the assets, the debt actually coming due, and what a low ratio means here.

Current assets€7.9B
  • Cash & short-term investments€2.0B
  • Receivables€3.3B
  • Inventory€2.1B
  • Other current assets€460M
Current liabilities€6.2B
  • Debt due within a year€2M
  • Accounts payable€729M
  • Other current liabilities€5.5B
Current ratio1.26×all current assets ÷ what's due · Graham looked for 2×
Quick ratio0.92×stricter: inventory excluded
Cash ratio0.33×strictest: cash alone against what's due
Working capital€1.7Bthe cushion left after near-term bills
Debt due this year vs. cash€2M due · €2.0B cash covered by cash on hand, no refinancing forced · both figures from the Dec 31, 2025 balance sheet
Deeper floors
Tangible book value(€1.5B)equity stripped of goodwill & intangibles
Net current asset value(€8.8B)Graham's net-net: current assets less all liabilities
Debt incl. operating leases€5.7Bno operating-lease liability tagged this quarter, so debt alone
Deferred revenue€98Mcustomer cash collected before delivery; operating float

From the company's latest filing.

How the cash was used, 2016–2019

Over the record, the business generated €8.8B of operating cash; how management split it reads as a balanced allocator, splitting cash between the business, owners, and the balance sheet.

  • Reinvested€4.1B · 46%
  • Dividends€1.2B · 14%
  • Buybacks€695M · 8%
  • Retained (debt / cash)€2.8B · 32%
  • Returned to owners€1.9B

    37% of the owner earnings the business produced over the span, €1.2B as dividends and €695M as buybacks.

  • Source of fundingOperating cash

    Operating cash covered reinvestment and returns; over the span debt fell €1.7B and cash and short-term investments rose €1.3B.

  • Average price paid for buybacks

    Buybacks ran €695M over the span, but the filings don't tag the share count needed to deduce the average price paid.

  • Net change in share count−8.7%

    The diluted count fell from 306M to 279M, so the buybacks outran the stock issued to staff.

  • Dividend record€1.17/sh

    Paid in 4 of the years on record, the per-share dividend growing about 14% a year. It was never cut over the span.

  • Return on what it retained4%

    Of the earnings it kept rather than paid out (€3.7B over the span), annual owner earnings (first three years vs last three) grew €147M, so each retained €1 added about 0.04 of yearly owner earnings. Buffett's test, run on owner earnings instead of market value.

Buybacks are gross of stock issued to staff; the share-count line above is the net of that, the figure that decides whether owners gained. The average price paid blends a year of purchases (and any accelerated repurchase), so it is close, not exact. The record of where the cash went and on what terms.

Acquisitions & goodwill

from the balance sheet & the 10-year cash-flow record

Goodwill grows only when a company acquires and falls only when it concedes it overpaid. The size of that bet, the cash put into buying rather than building, and how much has already been written off.

Goodwill & intangibles€14.8B48% of all assets; the premium carried on the balance sheet for businesses acquired
Against book equityexceeds itgoodwill alone is larger than the company’s entire book equity; stripped of the acquisition premium, there is no net book worth
Cash spent acquiring€0over 10 years buying other businesses, against €4.1B of capital spent building

None written down over the record; the goodwill is still carried at full cost. That is the deals holding their value on the books so far; whether they keep doing so is the test an owner watches, since the write-down, when it comes, is the admission the price was too high.

Goodwill, acquired intangibles and equity from the latest balance sheet; acquisition spend and write-downs summed across the 10-year record, from the company's own filings.

Inverting the record

Invert: instead of why Fresenius Medical Care AG is a good business, the question is what would make owning it a mistake, and whether those marks are in the record. Disconfirming tests across 2016–2025.

None of the 5 tests turned up a mark; each came back clean. A clean panel says only that these particular ways of being wrong are not written into the record.

Each test came back clean
  • Is it less profitable than it was?
  • Did the share count rise anyway?
  • Did debt outgrow the business?
  • Did reported profit become cash?
  • Did receivables and inventory outpace sales?

Each test is read from the filings and is noisy alone; a flag can mark a cyclical trough or a year of heavy investment as easily as a problem. The filing says which.

Peers, Health Care Providers & Services

The same industry, side by side on owner economics. Each figure is a through-cycle median, so a peak or trough year can’t distort it; the group median at the foot is the line to read each against.

CompanyRevenueGross marginOp. marginROICOwner earn. margin
HCAHCA Healthcare Inc.$75.6B11.7%16%10%
FMSFresenius Medical Care AG€19.6B29%11.7%9%8%
UHSUniversal Health$17.4B10.8%10%7%
CYHCommunity Health Systems Inc.$12.5B84%5.8%5%0%
EHCEncompass Health$5.9B15.0%10%13%
PACSPACS Group Inc.$5.3B6.3%21%5%
ENSGEnsign Group$5.0B20%7.7%17%5%
ACHCAcadia Healthcare Company Inc.$3.3B13.1%5%11%
Group median29%11.3%10%8%
IV

The price

What a price has to assume.

What the price implies

reverse-DCF

Enter the home-market price, not the US ADR quote. Fresenius Medical Care AG reports in EUR, and every figure here (owner earnings, book value, the share count) is on that EUR, ordinary-share basis. Enter the price on the same basis: the local-exchange quote per ordinary share in EUR. A US ADR price in dollars bundles the ADR-to-ordinary ratio and the exchange rate, so it will not reconcile with these figures and would throw the multiple off.

Type today's close and see the owner-earnings growth you'd have to believe to justify it, beside what Fresenius Medical Care AG has delivered.

Through the cycle, Fresenius Medical Care AG earns about €1.6B on its 8.1% median owner-earnings margin. This year’s 8.1% margin runs in line with that. Normalize, below, values the price on that through-cycle figure rather than the latest year.

Base

The assumptions

9.0% = the 4.55% 10-year Treasury (Jul 15, 2026) + 4.45 points of equity premium. The rate you require is yours to set.

Enter a price above to run it.

Implied by the price
Owner-earnings growth · ’16→’19+3%/yr
Owner-earnings yield
P/E (3-yr earnings ’23–’25)
P/B
Graham’s price gate

Graham capped the multiple at 15×; Buffett and Munger let that rule go: a wonderful business can deserve 50× if the thesis holds. The gate marks the bargain-hunter's floor.

Against a high-grade bond: Graham’s yardstick bond yield%

Prefilled with the 10-year Treasury (4.55%, as of Jul 15, 2026). Edit it for today’s exact figure, or a AAA corporate yield.

Graham measured a stock against the bond you could own instead, the heart of his margin of safety. Enter a price above to weigh the owner-earnings yield against this bond.

Owner earnings €1.6B on 279M shares outstanding, per the 20-F cover, as of 2025-12-31; net debt €3.6B. The base is the latest year by default; Normalize values it on the through-cycle median owner-earnings margin (to avoid paying on a peak year). Net of stock comp treats option pay as the expense it is. The dials set the multiple a growth belief justifies; the price, and every dollar on this page, is yours.

Cite: Owner Scorecard, "Fresenius Medical Care AG (FMS), the owner's record," https://ownerscorecard.com/c/FMS, data as of 2026-07-09.

Manual order: ← FLX its page in the Manual FMX →

Industry order: ← EUDA the Health Care Providers & Services chapter HCA →