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Side-by-side financial comparison of Fresenius Medical Care AG (FMS) and SELECT MEDICAL HOLDINGS CORP (SEM), based on the latest 10-Q / 10-K filings. Click either name above to swap in a different company.
Fresenius Medical Care AG is the larger business by last-quarter revenue ($5.5B vs $1.4B, roughly 3.9× SELECT MEDICAL HOLDINGS CORP). Fresenius Medical Care AG runs the higher net margin — 7.9% vs 1.4%, a 6.5% gap on every dollar of revenue. On growth, SELECT MEDICAL HOLDINGS CORP posted the faster year-over-year revenue change (6.4% vs -0.3%).
Fresenius Medical Care AG & Co. KGaA is a German healthcare company which provides kidney dialysis services through a network of 4,171 outpatient dialysis centers, serving 345,425 patients. The company primarily treats end-stage renal disease (ESRD), which requires patients to undergo dialysis 3 times per week for the rest of their lives.
Select Medical is a healthcare company based in Pennsylvania. It owns long-term acute care and inpatient rehabilitation hospitals, as well as occupational health and physical therapy clinics. Select Medical is a subsidiary of Select Medical Holdings, which is listed on the New York Stock Exchange.
FMS vs SEM — Head-to-Head
Income Statement — Q4 2025 vs Q4 2025
| Metric | | |
|---|---|---|
| Revenue | $5.5B | $1.4B |
| Net Profit | $434.2M | $20.2M |
| Gross Margin | 27.4% | — |
| Operating Margin | 11.7% | 4.6% |
| Net Margin | 7.9% | 1.4% |
| Revenue YoY | -0.3% | 6.4% |
| Net Profit YoY | 240.4% | 225.7% |
| EPS (diluted) | — | $0.17 |
Green = leading value per metric. Periods may differ when fiscal calendars don't align — see 8-quarter trend below.
8-Quarter Revenue & Profit Trend
Side-by-side quarterly history — bar widths are scaled to the larger of the two companies so you can eyeball the size gap and growth trajectory without doing math. Quarters aligned by calendar period (report date) so offset fiscal years line up.
| Q4 25 | $5.5B | $1.4B | ||
| Q3 25 | — | $1.4B | ||
| Q2 25 | — | $1.3B | ||
| Q1 25 | — | $1.4B | ||
| Q4 24 | $5.5B | $1.3B | ||
| Q3 24 | — | $1.3B | ||
| Q2 24 | — | $1.3B | ||
| Q1 24 | — | $1.3B |
| Q4 25 | $434.2M | $20.2M | ||
| Q3 25 | — | $28.8M | ||
| Q2 25 | — | $40.6M | ||
| Q1 25 | — | $56.7M | ||
| Q4 24 | $127.6M | $-16.1M | ||
| Q3 24 | — | $55.6M | ||
| Q2 24 | — | $77.6M | ||
| Q1 24 | — | $96.9M |
| Q4 25 | 27.4% | — | ||
| Q3 25 | — | — | ||
| Q2 25 | — | — | ||
| Q1 25 | — | — | ||
| Q4 24 | 25.0% | — | ||
| Q3 24 | — | — | ||
| Q2 24 | — | — | ||
| Q1 24 | — | — |
| Q4 25 | 11.7% | 4.6% | ||
| Q3 25 | — | 5.4% | ||
| Q2 25 | — | 6.5% | ||
| Q1 25 | — | 8.3% | ||
| Q4 24 | 5.1% | 1.6% | ||
| Q3 24 | — | 4.3% | ||
| Q2 24 | — | 5.8% | ||
| Q1 24 | — | 9.0% |
| Q4 25 | 7.9% | 1.4% | ||
| Q3 25 | — | 2.1% | ||
| Q2 25 | — | 3.0% | ||
| Q1 25 | — | 4.2% | ||
| Q4 24 | 2.3% | -1.2% | ||
| Q3 24 | — | 4.4% | ||
| Q2 24 | — | 6.1% | ||
| Q1 24 | — | 7.3% |
| Q4 25 | — | $0.17 | ||
| Q3 25 | — | $0.23 | ||
| Q2 25 | — | $0.32 | ||
| Q1 25 | — | $0.44 | ||
| Q4 24 | — | $-0.12 | ||
| Q3 24 | — | $0.43 | ||
| Q2 24 | — | $0.60 | ||
| Q1 24 | — | $0.75 |
Balance Sheet & Financial Strength
Snapshot of each company's liquidity, leverage and book value from the latest filing — the kind of financial-strength check premium terminals charge for.
| Metric | | |
|---|---|---|
| Cash + ST InvestmentsLiquidity on hand | $1.7B | $26.5M |
| Total DebtLower is stronger | — | $1.8B |
| Stockholders' EquityBook value | $15.4B | $1.7B |
| Total Assets | $33.5B | $5.9B |
| Debt / EquityLower = less leverage | — | 1.06× |
8-quarter trend — quarters aligned by calendar period so offset fiscal years match up.
| Q4 25 | $1.7B | $26.5M | ||
| Q3 25 | — | $60.1M | ||
| Q2 25 | — | $52.3M | ||
| Q1 25 | — | $53.2M | ||
| Q4 24 | $1.3B | $59.7M | ||
| Q3 24 | — | $191.5M | ||
| Q2 24 | — | $111.2M | ||
| Q1 24 | — | $92.6M |
| Q4 25 | — | $1.8B | ||
| Q3 25 | — | $1.7B | ||
| Q2 25 | — | $1.8B | ||
| Q1 25 | — | $1.8B | ||
| Q4 24 | — | $1.7B | ||
| Q3 24 | — | $3.1B | ||
| Q2 24 | — | $3.6B | ||
| Q1 24 | — | $3.8B |
| Q4 25 | $15.4B | $1.7B | ||
| Q3 25 | — | $1.7B | ||
| Q2 25 | — | $1.7B | ||
| Q1 25 | — | $1.7B | ||
| Q4 24 | $17.0B | $1.7B | ||
| Q3 24 | — | $1.9B | ||
| Q2 24 | — | $1.4B | ||
| Q1 24 | — | $1.4B |
| Q4 25 | $33.5B | $5.9B | ||
| Q3 25 | — | $5.7B | ||
| Q2 25 | — | $5.7B | ||
| Q1 25 | — | $5.7B | ||
| Q4 24 | $36.3B | $5.6B | ||
| Q3 24 | — | $8.0B | ||
| Q2 24 | — | $7.9B | ||
| Q1 24 | — | $7.9B |
| Q4 25 | — | 1.06× | ||
| Q3 25 | — | 1.03× | ||
| Q2 25 | — | 1.10× | ||
| Q1 25 | — | 1.03× | ||
| Q4 24 | — | 1.01× | ||
| Q3 24 | — | 1.62× | ||
| Q2 24 | — | 2.54× | ||
| Q1 24 | — | 2.75× |
Cash Flow & Capital Efficiency
How much cash each business actually produces after reinvestment. Net income can be massaged; cash flow is harder to fake.
| Metric | | |
|---|---|---|
| Operating Cash FlowLast quarter | $2.9B | $64.3M |
| Free Cash FlowOCF − Capex | — | $5.2M |
| FCF MarginFCF / Revenue | — | 0.4% |
| Capex IntensityCapex / Revenue; lower = less reinvestment burden | — | 4.2% |
| Cash ConversionOCF / Net Profit; >1× = earnings back up with cash | 6.67× | 3.19× |
| TTM Free Cash FlowTrailing 4 quarters | — | $117.2M |
8-quarter trend — quarters aligned by calendar period so offset fiscal years match up.
| Q4 25 | $2.9B | $64.3M | ||
| Q3 25 | — | $175.3M | ||
| Q2 25 | — | $110.3M | ||
| Q1 25 | — | $-3.5M | ||
| Q4 24 | $2.6B | $125.4M | ||
| Q3 24 | — | $181.0M | ||
| Q2 24 | — | $278.2M | ||
| Q1 24 | — | $-66.7M |
| Q4 25 | — | $5.2M | ||
| Q3 25 | — | $122.2M | ||
| Q2 25 | — | $45.6M | ||
| Q1 25 | — | $-55.8M | ||
| Q4 24 | — | $62.0M | ||
| Q3 24 | — | $130.3M | ||
| Q2 24 | — | $222.6M | ||
| Q1 24 | — | $-119.2M |
| Q4 25 | — | 0.4% | ||
| Q3 25 | — | 9.0% | ||
| Q2 25 | — | 3.4% | ||
| Q1 25 | — | -4.1% | ||
| Q4 24 | — | 4.7% | ||
| Q3 24 | — | 10.2% | ||
| Q2 24 | — | 17.4% | ||
| Q1 24 | — | -9.0% |
| Q4 25 | — | 4.2% | ||
| Q3 25 | — | 3.9% | ||
| Q2 25 | — | 4.8% | ||
| Q1 25 | — | 3.9% | ||
| Q4 24 | — | 4.8% | ||
| Q3 24 | — | 4.0% | ||
| Q2 24 | — | 4.3% | ||
| Q1 24 | — | 4.0% |
| Q4 25 | 6.67× | 3.19× | ||
| Q3 25 | — | 6.09× | ||
| Q2 25 | — | 2.72× | ||
| Q1 25 | — | -0.06× | ||
| Q4 24 | 20.20× | — | ||
| Q3 24 | — | 3.25× | ||
| Q2 24 | — | 3.59× | ||
| Q1 24 | — | -0.69× |
Financial Flow Comparison
Sankey diagram of revenue → gross profit → operating profit → net profit for each company. Charts shown full-width and stacked so both segment hierarchies are readable side-by-side on desktop and mobile.
Revenue Breakdown by Segment
FMS
Segment breakdown not available.
SEM
| Critical Illness Recovery Hospitals | $629.7M | 45% |
| Health Care Patient Service Non Medicare | $428.6M | 31% |
| Rehabilitation Hospitals | $339.2M | 24% |
