Fresenius Medical Care is the world's largest provider of dialysis services and products, serving patients with end-stage kidney disease (ESKD). ESKD patients require dialysis — a life-sustaining blood-cleansing procedure — typically three times per week for the rest of their lives, creating a highly recurring, non-discretionary demand base. The company operates through two core businesses: Care Delivery, a global network of 3,601 dialysis clinics treating nearly 292,000 patients (roughly 70% in the U.S.); and Care Enablement, which manufactures and sells dialysis equipment and consumables — including HD machines, dialyzers, and PD products — to both Fresenius Medical Care's own clinics and third-party providers in over 140 countries. A third segment, Value-Based Care (operated through Interwell Health), manages risk-based kidney care contracts with payors, using a network of over 2,200 partner nephrologists to reduce total medical costs for CKD and ESKD patients. Care Delivery revenue is driven by treatment volumes and reimbursement rates, with U.S. Medicare setting a bundled rate per treatment and private insurers reimbursing at higher rates. Care Enablement revenue tracks global dialysis patient volumes and market share in devices and disposables. Fresenius Medical Care's vertically integrated model — owning clinics, manufacturing equipment, managing pharmaceuticals, and taking on risk contracts — is central to its strategy, and the company is commercializing high-volume hemodiafiltration (HVHDF) in the U.S. as a next-generation dialysis modality following FDA clearance in 2024.