Fresenius Medical Care AG & Co. KGaA (FMS) 30 Oct 202020 Q3 Earnings call transcript

Ladies and gentlemen, thank you for standing by. I'm Hailey, your Chorus Call operator. Welcome, and thank you for joining the Fresenius Medical Care earnings call on the third quarter 2020 results. [Operator Instructions]. And I would now like to turn the conference over to Dominik, Head of Investor Relations. ahead. go Please

We to Hailey. the to all today. welcome Quarter Thank Fresenius would Medical you joining you the We for Care of XXXX. you, appreciate like Earnings Third Call

very it by we in safe all presentation call cautionary harbor big Now as our distributed my pleasure, always, earlier as out mentioning in to is that that and well the have as today. language statement materials the start our our is in

through please refer Instructions]. further these take through concerning business some is a the in some details our and us with the uncertainties, hand Chairman Giza, the our yours. our Officer, is, [Operator For of course, will The well CEO as filings. a I of Boston of Chief you to Chicago Helen more Powell, over Management With major and in to color of as course, from And now risks to documents today Rice the Board. floor is you and around Rice. Financial of development and the will give virtual go financials quarter. Rice the SEC also way us outlook. virtual in will way topics who

that start proud pandemic. Thank and you your by I are unprecedented the hope very safe am how of in to Medical the healthy. and your great interest saying Care, of you, face me very Fresenius much families ongoing employees Care and allow Please of in I to Hello, efforts you It's with Dominik. sincerely I appreciate everyone. have us today. Fresenius Medical this

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Let's start technology underlying holds as we the exchange Slide up two. the clouded business I'll real go good my remarks had In somewhat hope performance, on through unfavorable or by very we please. rates. our prepared quarter, next hour X,

in and resilience our quarter Our of model. proves the business the the third value proposition generation FMC core earnings strong

the the due months We have to the managed for to is but roughly headwind drive COVID-XX This States, be North effect development predominantly improvements partly we steady support, business first in this neutral to commercial due government that United to This our is mix. the also due an were year. to good of X continue despite we from the America, for. In to calcimimetics. continue efficiency able improved in

If new X-month world normal the new on figures, various pandemic impacts. pay, which the but at from knows outlook, is as accelerate this in time. and you to equipment, are are it cost et quarter The protective includes year long light cost the present support will our cover None COVID-XX targets treatment look Governmental anticipated of predictable. personal In continues us way or parts, our uncertain the for our our normal. around we will XXXX. back the reach anything in of see go and, to the cetera. to same XXXX. higher heroes how fourth confirming we our these additional time, goes for of you The into moving currently at feel the is normal We at that headwind volumes a

X. Slide to Turning

our services are grow, while and remaining steadfast quality. patients. consistently in to to we products quality high our We dialysis for of level commitment continue deliver very in We a

clinics just grow globally. XX treatments we XXX,XXX America clinic continuing service to clinics of to And home our seen provided to on than X% clinics, over we business, reducing are Although we expand million by in months our a more just over focus these our X with for North worldwide. are first patients growth XXXX. we X,XXX stronger In have the

Quality X. on priority our our the in the most care factor to and business patient is Turning important sustainability Slide top agenda.

committed to around We provide best possible are our the for outcomes globe. the patients

hospital regions. give further in during Here, of days the the you to like that our quarter. suspect patients questions I has hospitalized I'm have the focus happy pandemic, environment were spent Q&A, insight. would KPIs that that our to further the in Despite number days one have number I challenging may you most patients on down for the is the come of of of some the and the of in

Turning In income Including we for growth, X. to in very positive deliver continued significant third currency focused to management. strong of the operating quarter due part XXXX, performance to billion. the headwinds expense €X.X large and Slide of amounted stable the revenue to quarter and X%, foreign was

steady remain revenue effects, rate the result its negative products X% a despite saw business While headwinds. as these of FX decreased the Care exchange Services Health

Our Helen operating currency. presentation. some strength XX% and by to you insight during more And will income constant our operating have both increasing net we earnings with as in income deterred not was her at COVID-XX, normally do,

North a a each the of growth rate business, X%. from from calcimimetics in The Turning growth particularly the unfavorable ,despite services from treatments due contributed organic in regions. and in several Pacific further growth number Latin We figures. the an the A in increase in benefiting America. to exchange obviously, positive EMEA same had were and reported the stronger the to we largely COVID-XX. was Slide from supported America and countries treatment In in development. But the the market of headwind region other organic X. to Asia all sizable the in there and improved COVID-XX slower We organic mix organic payer saw this by to delivered driven America quarter, regions. developments X% growth of four of from contributions headwinds North growth organic calcimimetics X% effects despite growth

growth Despite quarter. performance growth countries North for Slide on COVID-XX were challenges Health of America Turning a several X% East prior organic Asia included basis, In a the some Services slower by Care increase by the number across year adjustments, drivers to Pacific, X% had we same mentioned. higher X. regions, Care solid reimbursement the in In time, Middle driven by of discuss Helen in portion showed commercial and the Africa, the and Coordination. and same for in Growth in from growth presented which for treatments revenue. same a services. calcimimetics, expected market in lower an to addition, will growth At of previously faced global was headwinds treatments; the and the treatments effects COVID-XX. These an due market the achieved same-store strong driven Europe, drag Asian as growth dialysis on we region and a later;

revenues currency XX, headwinds. were Slide Product impacted to products. by sizable Turning

Eastern postponed growth saw dialysis peritoneal an currency chronic the negative planned Products X% tenders treatments, QX machines products. dialysis EMEA in by East. organic for by QX areas been Dialysis in the Middle products headwinds, in for of can revenue overall driven of acute treatment sales for and into Excluding the higher increase Europe The of and explained that were that for products be care have

Product hand, On increased the to non-Dialysis XX% the million. €XX by revenue other

it As development and remarks, current concludes to turn This the of my it's the due prepared pleasure pandemic. quarter, Helen. in previous the to this my partly over to is

a will Thank well. under third and hope remotely this comments again a operating you, doing already pandemic. and the working Rice, giving solid and my hi, would development. more focus that I side. on on our welcome I from ever you the flavor you're earnings outlined has warm quarter everyone, Chicago. revenue imagine all Who'd be Rice

meaningful minus legal €XX patient for the In I reduction for accounts as remind Moving the decreasing you as ESCOs €XX of and to recognition made to last minus million last we need on a third in million. had attribution analysis XX. revenue adjustments provide Slide in receivable To rates year. of quarter a well quarter, adjustment year, on savings of a a of disputes

this expected when perspective, to we impact it of positive from of current been headwinds but year. successful on negative and also revenue the the for that positive situation allowed in million. -- Humacyte course, to us investment well this, effect has an manage third year so to ESAs the and has the Maybe the organic perform growth of mentioned This we of On our effect or More from the currency of Rice commercial remeasurement our the the a basis other the vitamins. to was had already pharmaceuticals like has fair able had tightly interesting, hand, €XX quarter the effect calcimimetics cost operational management add to revenues. comparison. well as from value comes been as prior been higher of

group bar a left, group Now regional this and cost have million. points by cost income In to €XX XX you see the allocation let's corporate €XXX margins. and XX.X%. at the After numbers. increase results look cost reached the The in cost before improved allocation, on operating the margin corporate and a basis million contributions of chart and corresponding

level EMEA, a Unfortunately, in the margin In developments At million margin constant increased to in €XXX and America driven in income elective provide In headwinds, efficiency from performance increased effects, clinics year last Australia, currency currency currency XX.X%. very environment margin as foreign this an prior economic mentioned a operating resulting development very more was Besides expected by in In and XX%. initiatives us significant North the remained Now supported cost growth to operating million, at million, were our the reported was calcimimetics to same at despite and income ongoing operating the to a constant of commercial America, let's €XX the operating €XX million. able improved year focus measures effects. In and of is challenging a currency, look which negatively have €XX favorable we Pacific different. operating income on management of the region. XX.X%. and and surgeries, margin income Asia influenced income mix Cura A the stayed Latin by on in picture with a already the impact headwinds our gives transaction business level. at at increase the clearly regional from amounted COVID-XX.

we would of have Here, an seen XX%. increase

worth COVID. effects also on year-to-date it's think I of the commenting

the the effect through neutral of manage to focusing suspension able sequestration, United been This government to improvements COVID-XX been on. have but in CARES we the Act to States mentioned, we to due like September. the roughly be was the have support efficiency due Medicare Rice partly and steady also As in

now increased move with impact negative a will the COVID-XX. million on able As net a and result, costs to of we decrease to in to Nevertheless, the nearly absorb X in income had offset €X XX. were associated Slide months. treatments first we I

take now -- XX%. me cash we at Let the margin of last of €XXX for quarter. cash, resulting the QX, in operating In generated flow percent a look million a margin

recall, you this on the we leverage advanced expected the payments federal under ratio U.S. the and QX, of second advanced half in effect payment development cash in flow negative received program a net As and year.

recoupment a year's -- operating increased payable year CapEx clinics lower cash new And activities flow on below of net return further This page, accounts of €XXX level parties. clarification €XXX following ratios a of expect of However, our the last the QX. first a risk-adjusted the to advanced including amounted due right. The X.Xx position confirmed the process cash you lastly, driven management XX, in And quarter leverage flow with the levels, inventory to financial the the free from number level stringent ratio. million, is by when this receivable accounts related leverage of and IFRS in on regulation, you and see very and at those to last clearly left to by debt-to-EBITDA ratio largely we million rate. bottom lower investment in next ratings to solid payments hurdle was leads year. look now on the improved decrease strict

at range the sorry, to excluding -- target effect funds of of received advanced ratio the the clearly be U.S. X program, of our in X.X, the would effect the under federal X.X. the payment Excluding

Let's to XX. turn Slide

Our guidance unchanged. slide is

We mid of are to and net XXXX. maintaining our single-digit high revenue income guidance for growth

seeing net uncertainty you our ask updated many significant fourth has and world. basis. would -- COVID-XX ahead upcoming not a on have No our made rising due of see impact we all the infection effects a an to been the the not be this net to we income have growth income credible target a many others, of funding moment. number into to rates CARES uncertainty all quarter. the faced Like delivered COVID-XX. the due This have Taking X-month of elections, around decision some we account, guidance We are of some to quite has it on consider to the the guidance. caused growth been U.S. and at treatment on in change why We range new for Act the

So neutral. support been and far, cost funding, due be to we measures effect manage stringent the able management to to of COVID-XX net have

to continue Dominik. able to of that, my prepared we'll turn deliver in range full and effects results We close to of our the remarks and year believe back the COVID-XX and I outlined that guidance be stated With remainder announced despite within the year. the it

over Rice, Q&A. presentation. Helen. Could you, to open you for Thank you, Thank line, turn to happy it please the the Hailey? I'm

Bank America. the is question first line [Operator of of Instructions]. Patrick Wood of the And from

Perfect.

maybe, hospital within North per XQ. per you first on the days falling year The the in patient Rice, one, flagged America

understand to some wrong were around question, you on the about you that is, whatever second you has base per at million be curious rough money half $XX within Or And COVID our choose as color the far. the -- for to I'm plus the incremental seen it, work would costs should take level? rate trying about you've in what's what maybe But million, maybe if of going shoes, then if to $XX year? guys, assuming, available quarter a we efficiencies conceptually for thinking be for EBIT get costs just to through impact CARES so business a, the if So just helped run or more no the that money obviously, not there. there's your first next it

days. Hospital you. thank Patrick,

a population, the seeing of here their going QX, in try in QX dialysis what -- avoided people what to anywhere many, in very cetera. et well part doctors' the is at People many So stay offices, hospital. seen near we're we've as as of hard is out looking

going stayed what And course up out a so a for et away get to be that's the be would patient, new, hemodialysis, access a normal getting inserted cetera, in someone hospitalizations having it and from for would of consider I that they an hospital. catheter or patient dialysis PD who's cleaned PD physicians

And that's driven so down I the somewhat. days think

patients And were about many of they it a people and the other that went they you of if the that. that survive obviously, came were Now COVID-positive side dialysis was to into equation able is hospital, of small think just unfortunately, out. days not and passed, them, number before they

way as for we So I the look it data think are interpreting at QX. we least that's the at

it plays in see QX. have We'll how to think be out. could different this I

seeing off have not done to shot, by it's people, if many long are work, putting need We they a et cetera. as vascular things

Helen the see piece, up finish something QX, see to different in And may let out. we of think I turns have a it. I'll So take on wait but just and little we'll one I'll and second it how that, piece on

the are through they with that close. et We're is COVID child set have the today. there big question the cannot going as some than a again, it in be open, are and fourth people are there. question. intensity answer we to we very of on. doing the come a back cetera, things what There in it going are what we they the seeing If to then have -- systems goes are schools think care, where that it we think U.S. different virtual And may deal to I forward. level fair schools today the are to place, biggest school XXXX in shut down and is entirely quarter today circumstances particularly an of question hinting is I as stipends, the But not

that. So severe it like will, Europe any here. for you'd lockdowns Helen, on try really you give hard does in us, the just as and depend if think, I well are of anything kind on how to calculus, It's to significant as add? to you

I look year additional the received, this money through we Rice. the we the that you if Patrick, Of that color receive already. have we first million would the of But have Thanks, guess XXX XX think million CARES the XXX XX if that just around million under applied QX, going we us about in half of you roughly million I applied about we to did at year. the Yes. applied with QX, QX. into which of funding how add, leaves

in pay and we say saw but in the half weren't lockdown first QX stipends -- Rice As COVID emergency that wouldn't and and year. mentioned, full measures certainly we the child so of things I has the in stabilized, like on the care, has

So we left two how going to Rice of like all price know progresses on through which apply that, last to mentioned, challenges prices. demand QX, for the resulted things increased seeing pretty available year. it's with the much in question, we an bearing supply the have I as in are think Without pressure months mind on higher world what in depend PPE. really has this and of We

I go our months next the that of get out into But XXXX. as depending here. lot we're to So heads play think all around how obviously, of few uncertainty we on a trying

Dubajova Veronika The Sachs. is Goldman next question of from

longer we've figures number I'll the sort appreciate treatment of per disclosing. the a if on seems dynamics. me America the maybe like I keep just one had North But little it to please. revenue slippage. treatments, this revenues in first it I Obviously, of metric of bit two, look My is on is you're to a headline no at and

your what And at been question U.S., perspective. both rates that much sequentially your treatment for an Helen, mortality. where the was. would revenue and can that, mix maybe on year-on-year, my And is as you incremental the been in which quarter, of underlying is Or QX? us mortality referrals? this from trough? excluding from expected, one, same quarter to the headwind you third impact in about is quarter give calcimimetics as the of have is So expecting what hoping, was how dynamic X% If then in we market sort very referrals. especially might, to basis, into where see quantify, I it in us rate from reported look growth you've are of is sort can I the what you what Is headwind market decompose move just be Obviously, the is that probably the are, third do sort that some you've sense say, flagging something you here second is thinking per Rice, the right And from versus in U.S. to when risks from that? the

one. Please, Helen, go the ahead with first

calcimimetics Thank per negative far, But revenue the the was for calcimimetics. not America as that, we're always the effect effect. QX impact on of North disclosing into biggest you'll continue and not And see going QX well. you. disclosing impact revenue Veronika, negative we're by have to indicated in we our and treatment, that

question, it's On referrals. second mortality, Rice. Veronika,

to through here's the this. try So I'll way message

we back are or this normal the level. the week if What when coming to see As activities, will, steady drying-ed no they're in we to improvement getting third weekly, week they're second going better, referral that's doctor say occurrences, somewhat into the quite but more sort and referral But issue we we of there just two going to a base. really the would I saw yet, of because you referrals we one at good, a today, two is quarter Not quarter we see these look referral on the up. much track saw weighted. equally

XXXX. what we this, year. I it can over it said an next unknown this, side think If today, biggest Patrick, us, again, is through we stays the beyond way in believe, time, clear mortality coming way it We in work can our the the I But is the of is On intensity of QX and with for impact. it. as is

first we around COVID away. during don't see see just half As next I through going the of Markets Capital the I clearly at Day, least the said this year. world

feeling concern just have go our to how don't that's would driving some of on what's try at or We guidance you we that. better about on point. to enough this So give

U.S. revenue And to the flat number, helpful. very luck, or up That's my not Helen, excluding per can confirm us going if calcimimetics give I in you're if third calcimimetics, that least you at in treatment quarter? either the push was can the

I'm Yes. But though, a clarified forget, mentioned I we've have of seeing sorry, probably trend driver. is last mentioned, calcimimetics, And Oh, when Don't seeing biggest year as are impacted there. that from adjustment negative I course, prior of positive we the should mix. was with But are commercial that course. the year. we positive

sequestration have from We pharmaceuticals. the and impact positive of

into because there's the overall, prior as positive of a pluses minuses So that, the going can imagine, But trending lot and you of but year being adjustment. positive. biggest

question Bernstein. next of is from The Ludwig Susannah

Can you me? hear

Yes. Yes.

more if I to two you private do share due their is from question. it maintaining around newly as It's longer on your then growing is it do And growth is associate, to gains? Or my up I'll due Lisa sorry. around I'm with my Look, little One, slowly? faster questions. patient this, really payer this to private home insurance patients mix. diagnosed second patients ability the private is dialysis? have thrown. follow Or Clive, Is growing a think, faster, Medicare registered I And positive around coming comments year-on-year?

It's Rice. Lisa. Yes.

little say all bit would of correct. So I that of there's is a

of it if patient them mix we're let segment will. of business, to payer COVID, that Obviously, you on not rates and the try unfortunately book Positive out. surviving So of our seeing me the are patients being mix. are Medicare parse that with older mortality most

all we of has in who that obviously, as mix. has with our dropped population, -- as that patient off. they've grown what So contributes understand mortality segment And the

on. in also down places, new of is because, that. some coming doing we're some is and well a, share Payer very gained have Medicare up mix patients because So we with

So I would say it's of sum both.

notable XX% think, If at European XXXX. bottomed EBIT in It peaked historically, I Okay. Europe, XX.X%. by out look about And then at dialysis I to there is services business a XXXX country. Across business. margin profitability? margins turning a at, the dialysis difference EMEA the I'm in talking Mainly in the

do And geographic from sort the in you of long-term EBIT the for is reasonable what mix a think assuming region? a run here, rate fairly steady margin

Yes.

as And grown and in So service. were time. say business, has XX% know you product we that were I we over in a would probably EMEA XXXX, XX%

So that's driving what's and part compression grows of that we've you're said to going margin see as that is labor you to what of because always some there. do, have business service

that it the should I level teens. out in think

think see I XX% get there. to should is it drive and a the little low. higher, to I'd like we're trying efficiencies

The thing. it quarter in other growth, Eastern XXX new that Middle thing does put Lisa, margin. we is and the see when about patients, Europe we're good of XXX, pressure up is your that that you which seeing, the the in some reason picked But on kind East, a in

higher other have stipulating, the we're in is nationalistic, for They understand, their demanding COVID. Hungary, are our we of particularly some time problem The which nursing that places seeing that. like gone of countries wages, Poland, in staff, Europe more

And so we also have the there. pressure to on respond to accordingly. margins some That's put that

of from The Stanley. Michael question is next Morgan Jungling

of just questions, ago, -- I'm please. If a backdrop same the the -- to also the have is given treatment few in growth you you I sort of applicable slowing, XXXX guidance then would to midterm know just Two that at sequestration. with how that weeks look us away your of falling like had

a there it That's available, And that would that On one. from that if the X money guidance? you a Advantage. viewing XXXX that, you I call get basis, CARES is Medicare number question would are midterm of suits question benefit accept the number net as funding you the government? can got two, year if You've

Rice. it's Michael,

look we gave as we are COVID. guidance. include CMD, remember, did So at here XXXX, that you we What the midterm not saying guidance

and be trying to to will, will what or interesting going COVID's move what away, get an we of So year to where is understanding for take go. going into if contribute is that as us next you

us. that make will it So challenging for

simply result what If CARES X wait very that COVID up COVID happens an how going today, next was to 'XX. the we next or as see linear. where do have with it money it on have It's didn't package made of even or as you will take of none to the However, money of guys CMD, need resolved. we or well come that was course, again, what I we think And what as much for they nervous would why to the whenever comfortable to, year, is being that we bet and not a gave what about But have to very exactly and hockey happens COVID. a know to we that we we expenses we money, is said get the of with were we're keel. It's end available, we going offset knowing see the because in elected, be to expenses pretty are extraordinary to and what see stick. a would happens a in him. X look been not this as week guidance really number CARES Biden that it as here election Relative place Well, there for.

would have see goes. it just we where So to

we first simply not We exactly we we felt money it that, through you that did comfortable all because think didn't take us conversations. package If recall, for PPE came was we to our what that. of that needed needed very money

what happens another to there see the package we details package. what of just if the are have is So and

same intuitive treatment States, look growth, Maybe and in Because if partly anytime just fourth fourth on United at I I to also for but in the look the answered Okay. number it I market up look what sort quarter? improve quarter make rising soon. it, If the guidance. clarify that at the would XXXX can you've follow it cases of think something, I I that better would doesn't the want seem

very a same flat treatment market in high there's in that business for growth that chance assume quarter? with your up end we America can So fourth we North the

that's And happen. as It is attention paying at to rates really you be and that the then hospitalization you tell we the that certainly could the would mortality. to looking thing I have looked at have at and in that mortality as where the understand down, it QX. conundrum think not of we QX, to anywhere trying near we are rate was are governments all moment, seeing the locking I part are

So it's some lag the we It some that going mortality some there's there. rates to take daily. time -- takes get don't Michael, granted, time

to So we'd at have look that.

The not. you been going interesting and happens lots season. a flu for synergistic to us effect general be if will is discussed the or other There's general about be what public, that the to thing will,

there's moment. So arms our we'll this just way But at work bunch we can't our a that. of I unknowns around get think through that

As I said, good The the approaching growth are normal. is month-to-month. there referrals

feel good we pre-COVID. getting as the the about We're analytics So to that. close can mortality, that as And as and do continue closely we on we'll were tightly that. to manage we and where

question next Berenberg. Tom of is The Jones from

and growth issue, that's unfortunate in impact the I so of had maybe one other very for But acute Rice, Rice of of one kind the we're a on being obviously two, are focusing volume lot -- all for mortality patients. one the the coin, a side COVID of non-dialysis Helen. -- just equation. injury, investors on side of the kidney

are what just forward by question my offset your a think in related Or you X, have that you do is, there dynamic injury? that CKD maybe business, be of have services that of pandemic, thinking? been for the who you to to COVID a I'll where for is the further patients I spectrum damage pushed on mortality will wishful hospital patients side by other Helen, window up do down kidney share? guess a pick better you and, suffering pool that's question on through And the then this And up of X those non-ESRD acute the then roll you of bit think could could have lose do think bit if kidney clock side bigger a potentially therefore, a on acute So years that you is, that I patients a one. if some but follow you'll the question

Sure.

contribution look, we from a today, that is we AKI are are Tom, So there seeing patients. seeing

look we at we it it. at in will, Now point it's as this a particular and one-for-one, not if you understand time

will think to I that. continued there be contribution a

future. that to to lose sight well, be to to as that one-to-one? will doing the know be do acquire We know growth to are we what be? can The shouldn't are that we're ever if we make do think how we clinics. do people to out to fact we doing get this, need think growth you looking how see your things real how the we And will missing And other question to help I that look what it for. continue get try something, us anything, of also sure so does people the is, to differently, a

would come what not. We've acute single-digit QX that On the our ICU, Angeles, is the our QX Los systems was us fact the seen particularly need gave when good kidneys mid-single, the the clearly help and through leaving was upper of acute services Tom, Chicago, back so to acute of the in coming providing went hopefully, see their for good treatment and then we to of we be to the side, yes, and a going in them in experience, were those growth or then business. question QX. very my York into mind, were the many It no there in when of cycle and New their clinics health will what side services City, understanding coming patients those

us So that's clearly some giving benefit.

that to if in That's mean clear. by a comment constant were clarification, currency then margins you you one seems contradiction EMEA your Okay. was margins very Helen, bit affected me. explain just be to what really. just could of That a terms And I -- wondering by currency. in

mechanism So be the helpful. that explain that, would you behind briefly just if could

Tom. course, Of

we in our dollar €XX lot region. effects transaction and region, currency in EMEA a well. transaction impacting euro within about quarter. our A the hedge have do effect between we some have the as East on can, that do million but we did So We Middle of the was where EMEA

Commerzbank. The question of next Oliver from is Metzger

Medicare Advantage. about is one first The

for the commented that past, start from enroll 'XX. become the first October visibility you to as So should better, in up beginning patients

per metrics how about and I'm up already for clinics. at is about have Slide do the It's patients So a My any patients' treatment Advantage you little is second the have many treatment. confused but that regions. commented basically see treatment report among that that last patients growth their treatments most contract? remember a even XX. call, you higher, indication patient means question skip In provided slower you patients do growth, more that which I you you bit signed to Medicare some

discrepancy comment can development how please? this you could be So this or about explained,

that tell Advantage. you I Oliver, on it's can Nothing Medicare Rice.

week up week not of are We're week. we set the in do We're tallying second just enrollment. enrollment think to that. not to I

So there. the you're little ahead a of game

take believe figure be when January January we'll will we out. that mid-December, closes us a of enrollment us weeks we've gives in the then to that December able As into until and couple said, probably it

as have you good going little be about it. My region-specific, work make home to from to patients, seeing digit. come question, it to we're didn't do second side. growth, on answer are and a my is high but more patients PD you your single I'd Remember, that's Now okay. to would It's the and home they -- guess if

I X% they medically they growth week. PD typically week, or QX, home be a times does physician it we then with a treatments obviously, go to said. do although I -- X going appropriate it's And think PD hemodialysis if X agreement, to from in treatments as patient have X, can X to are justified, were

a to for We're little you. to We always, going and into dig would what can sure think difference. to that's back find, Oliver. bit But going that verify I pretty be have So I'm that. that Dominik, through be come the we

Christoph from Credit question next Suisse. Gretler is of The

two I questions. have still

are you offset rate costs. running you Could on maybe for of now kind the past. is below, the least were run -- First corporate substantially you that I were in just at for discussing and They guiding line the net fairly year-to-date, think, come the again back full on I comp year easy QX a us? a you're earnings then is your base running of And guidance. essentially on is growth income and second XX% mean question kind just update side.

already kind a helpful. still we're for would kind this of end in growth? expectation 'XX -- is So That mean basically October. fiscal of a high kind pointing with be scenario to reasonable you're really of of for I single-digit that central

do number take and Hi, Helen, to I'll you take Chris. one, want number two?

costs, Happy QX. and will you X.XX. Yes. that going Yes, we of to. between so corporate recall at we X.XX guided Year-to-date, XX. Chris, do we're into X yes, have some phasing spend

Some QX spend, timing of the our an into that and we also spend will project is as R&D see in well. monetary increase going of

albeit are that the end trending perhaps guidance in this we that timing QX. comfortable in of of that. But towards you'll staying on feel I think lower range, I So yes, some see

where crap, would we run a think Chris, to it's Rice, holy if if Look, me you going on going you terrible your year, X at to not QX, that We disaster it's on take going quarters a it's we believe you all. through be to the be the say, It's you are that guidance. don't don't. lost it's way. be guys numbers,

going down, don't U.S., is we schools pay no can't trying now, to close as said, to any happening just If if going if ramp trying be right Helen's guys. as this can fourth different going the then spending astronomically the is patients. face Act it million. I told shut mind for to what we down, If we which we the with earnings, an we we going issue border CARES the calcimimetics, it Helen need gets Here's is think Europe it's that QX be you also it that's care know us for U.S., spoken see the We long in because for shut intensity can our that not know we that's XX staring staff pragmatic keep really treating what COVID mean, to last." spoke to the in them as as child do. And looks in the quarter, And us. at there's what will well situation, we're when QX we're but particularly, drives in keep to like the you level has -- to how because beyond of have well. our to money that negativity do EMEA come to about, in do. a We're moment, way size be we At than then "Here's in we

down total cost in that you, So of you you many uncertainties early that ramp-up just market call if keep of in got will. Asia and and you've us would can was in we -- experienced December, endured shutting I and when expenses. But February experience space Then we've that conservative, the tell mind, January, And it's there. that the X there shutdowns, the to Europe, light. it an that or went came what of think we It's closed, X in U.S., we lightly. speed the weeks in prudent not of take schools happened to just

the You've not of on that say day us it's that. never possible heard at over to going COVID's end or be to predict because this quarter

the approaching Chris. we're QX we that's are, why So way our

major be appreciate And I that this we kind there I assuming it mean, follow-up. offset that. I a would as an obviously this of guess, or I has mean to no no incremental react? to income have. I savings? what of think 'XX, with you have I so maybe the booked What's concern can revenue, into extent market I also mean Okay. a incremental, that's CARES basically looking cost kind Act capacity actually your investors X,

maybe some So kind of that on if have you incremental thoughts be helpful. just would

Yes.

or asked it's there'll the say a a believe just So there'll because the one's on. country the do apart Democrats It's be going take they too CARES the done. that fall package? let to do you CARES be there'd question no have election. -- CARES two I just yes, Republican One, would going can't over I whether package. I the stay, think get don't much before never things. I And be thought think is, a do. package you could me I

will to Clearly, try real decided talking we've lot I to you we'll huge that, would Democrats, That there what time if comes Republicans a say they of they defray Exactly industry that. about are paying be we a package. it, be a see. with to because both has, spent help that for gauge, huge us understand a have help sides, the So the that what increases of if with personal them, details would is equipment, the will. for protective

So goes. to it have where we'll see

will if costs there I can we're be we Or on? you on to those do my help time the they there'll back around want think to to figure very long some you find fashion rare going get levers. much the kind pull something settled, defray think in come election once see we find it and looking approach out that than little form it. The that's to in need help be But approaches how more it Relative I from they'll what us won't going they and they nonetheless, of us the to to hang I package, cover how a We'll can how do some wasn't, that? at. we -- the decide I they've government they're mind, Democrats -- different that to shape, might do post-election. and But be a what can said what wanted I Republicans. think or

any, of and it. of government I could that administration some one mean kind come just CARES the Okay. competitor appreciate back and doesn't conclusion of I like I you mean the don't since it. need the HCA actually are giving to take your money I companies thought

So the that's I basically kind But of appreciate background maybe. comments. your

all we asked been we be extremely I've were Yes. had what government exactly U.S. to discussions and wanted lot. what and And they use that take the the money for for. Yes. in we extremely No. Yes. that with would thoughtful careful a that And used it was that

Chris. plan. lot that. couldn't had we the cases, on wasn't if not of minds made depends money I told some in We mind, money buybacks, where were up our PPE, It use That about you you took, of you we couldn't accessed good things it people it money. In that And our We for was for to a something giving never are. bonuses, you like it share do. back. use needed ever of there's so was feel examples in that that type Keeping

is David JPMorgan. from question next of The Adlington

can the on -- question sort delving firstly, of lower us your missed So I'm the bit a more the in which rates, the you impacted a wondering different maybe of try into and those growth. ballpark was in and deaths, maybe biggest impact, just each how terms of growth. the just referral same of But treatments maybe COVID impact your just a way. organic terms the in quantify give asking

And sort following on of that. from

clarification question, being the just you into year? payments other then now rather question. how could in In patients by that? number repaid quantify COVID wondered I'm you you sort mean And than terms your of and that you -- And QX, the talked from just it. guys about advanced of maybe numbers of are just but a the next misunderstanding But impacts or if many Helen, thinking of what how death, QX? I deaths patients of Can COVID? QX about saw clarify you QX you how

Sure.

can walk Let Helen me then and first through one, the you advanced your take payments.

the I components there. look there's organic growth, X a at So way guess to

missed their in if didn't that kind we quarter. see referrals treatment. because them, a come and for go, to lots treatment, obviously, and And that skipping is quarter even And to and and dried there. that weren't going We in for here not America U.S.-specific. people Latin docs, going see of third hand-in-hand second not treatment of some saw folks Asia going and treatments piece up, Europe are of their people weren't with So

I think see that, back. So referrals coming we

normal I different Missed level any than today we are us. pre-COVID. see approaching looking what not they're a treatments normally As said, for

put to bit. if I then that's you ticked So what's you figures on, it's treatments mortality the out give Those back. can't trend piece, And I mortality lines little up honestly I find a are come the going will. till, at and the of help in going back sense all the get moment. think a

doesn't going if back next don't very you come I relative whatever it's seeing that, of think of work what's I time. our we're to see we'll bottom-out, the do take another out takes this call going If COVID if we to and through and top that we clear. as look I a and into this we we've QX, way then what impacts, It's natural to a and late. overcome going that we'll go over on you figure to kind it try of just that if to it's when does find be that round, season, bad QX intense said, flu see if of us, year intensify, rest to and to have been will, going important mortality year, when for I think

to. We want of is continue We We comfortable I can what have trajectory a mortality But message acquire guys can't to the we want this. with we I'm I to can do? the leave to help growth can us lot of this. clinics. of things the about all do change you think

better. were to telehealth the I'm and CKD the this a levers one can't that the get folks in make of people we ways, to thinking, of back physicians, but change. to little biggest be be we But do we able some out came to try proportion, may That's the do thing physiological will this on with the we their more what blowing it's So and why a cetera. pull seeing need to et to patients, first best

Helen, for predict through moment. to guys. work take you know can't going hard had you it's So for see have for hard intensity can we yes, you I at but are. this. the us, we're oh, question advanced to payment But what It's let's think levels David. that the the -- I

to so the received start of that that statement. back quarter. second first David, And advanced days we early my payments just after the quarter, recoupment time will. receipt. I at We end at million €XXX clarify approximately Yes. expected XXX

I did if is the I we XXX understand XXXX. said that flow would we that as be could to days. impact as when now recall, What that, recoupment that normalize So cash the in of getting expect you long update, cash QX

cash would quarter first to with us still have we of through expect So that next year.

the of going us XXXX. it that to on payments saying advanced all being benefit would I et was cetera, think see net of through normalize now was I whereas So ratio, with we a our because of debt-to-EBITDA

that David. So clarifies, hopefully,

from Vane-Tempest is question of next James The Jefferies.

I if please. can, two, Just

what And little per commercial talked the Firstly, been just about impact in has a correct. increasing treatment the revenue looking, if hold why year, your -- mix. that just And the guidance. if I'm just I'm that's that revenue remainder so, curious top sequentially, and But you be. wondering exchange secondly, the of declining bottom would bit like then if looks it for rates line would QX. And

Helen, you want take to those?

so guidance in is Yes. always Sure. constant currency. our James,

smaller the might -- we thinking sorry, asked I our when kind of drivers we're And moving clarifying sequestration on see of on the but though second even and parts. Veronika other Overall, how calcimimetics there's So a the won't the a positive kind kind by explain RPT. offset questions. I year favorability, covered prior of adjustments, I continued to pluses question about mentioned, that. trends seeing her mix, of some Obviously, as lot of think but the the minuses in Yes, obviously translation, trend, it relief, guidance terms but and it. of the commercial affect we're some those of then

So yes.

just somewhat. think commercial it's Probably, and lot obviously, quarter out mix, parts. kind the in a the of of I moving going adjust on lot I once think neutralized you a

it And if to well. culprit, I would would relative we back to Rice. biggest it's in half think calcimimetics of drag to say told guys -- was on our James, that us got as it you you when that that's what's the be the And Yes. XXXX, And I just we'll you as start would get into see will, you pulling if remember really through that going came here. drag. a year. QX we

session. the like back for closing Dominik question-and-answer turn to the would comments. concludes this And to over I conference

you, Hailey. Thank

or know of have I time time. now. So we are did of there unfortunately, run out follow-ups, would X been X out but we

safe hope than only next can you. and and call year. our you next I to more So on say earnings that -- Thank stay hear ever,

well, safe. Be Stay everybody.

Goodbye. now may pleasant Thank for Ladies and telephone. and your disconnect has day. concluded, you gentlemen, joining, and you the a have conference