Chronic Kidney Disease (CKD)

US Market 500,000 patients

Annual Growth 3%

Options Kidney Transplant or Dialysis (In-Center, Home, Hospital)

(End State Renal Disease) Kidneys function at 10-15% of normal capacity

Davita Field Structure Teammates Patients P&L

FA of 1 Clinic 10 to 30 100 $2 to $4M
Regional Ops Director (ROD) 300 1000 $50M
Divisional VP 1500 5000 $250M

Davita Chronic Dialysis Center Serves 178,000+ ICHD patients in the US

Teammates 17
Medical Director 1
Patients 80 4hours per treatment and 3 treatments per week
Home training rooms 2

Home Modality Options (Peritoneal Dialysis-PD or Home Hemodialysis-HHD)

Typical Davita Home Program Largest U.S provider of Home Dialysis, growing home at 4x ICHD
Teammates 4
Medical Director 1
Patients 15

Competitive Landscape Davita ROM FMC

Current Market Share 35% 25% 40%

Economic ecosystem Treatments Revenue Profits

Private 10% 30-40% 110-115%
Gov't 90% 60-70% (10-15%)

Operational Growth Levers Capacity Missed Treatments Modality Mix

Admissions Denovo Execution Private Pay

New Targets
1. Reduce ESRD market by 25% by 2030
2. 80% of new ESRD patients at home or transplant
3. Double the number of Kidneys for transplant by 2030
 175000

ts per week
Situation: DVP operating 60 clinics across DC, nothern VA and Maryland
Strong profits but only 10% of patients on home dialysis modalities

Objective: Improve Home dialysis rates

Home therapy has both business and clinical benefits

Clinical: PD is optimal first modality extending life and providing best quality of care
HHD has clinical advantages over ICHD
PD preserves vascular system access and residual renal function (70% greater
PD and HHD patients have better transplant outcomes: shorter recovery time

Business: CMS policies support

Lower capital investment for new clinics

PD penetration rate 10% in the US (Range: 22% in Sweden, 3% in Japan)

Davita is leader in Home Dialysis 26100 patients (90% PD and 10% HHD)

Interdependency between Home and In-Center ??

Challenges to high PD penetration

Patient: 2 years on therapy, 60% are hospital starts

Physician: 44% of nephrologists do not feel well-trained on PD, 87% of prgram directors
Industry: Supply Contraints

Threats of new entrants in Markets

One Competitor A is enterting DC Market with a focus on home and upstream CKD patient management
Buidling 5 clinics in washington DC and attempting to work with physicians and hospitals that Davita has relationships with

Context
New regulation impacts 50% of country and emphasizes Home and transplant
Estimates $20-$25M reduction to industry dialysis reimbursement annually

ETC-Payment Adjustments?

Key Stakeholders are FA and ROD

ysis modalities

ng best quality of care

al function (70% greater survival rate)

es: shorter recovery time between treatments

87% of prgram directors of fellowship believe that PD trainign is inadequate

as relationships with