Good morning, Ladies and gentlemen. My name is Michael Sen. As Chairman of the Supervisory Board, I hereby open the 2025 Ordinary Annual General Meeting of Fresenius Medical Care AG. In accordance with the Articles of Association, I take the chair of this Annual General Meeting. On behalf of the Supervisory Board and the Management Board, I would like to extend a very warm welcome to you. I would also like to welcome those who are following the publicly broadcast part of today's AGM on the internet. My introductory remarks and Mrs. Giza's speech will be broadcast to the interested public via the internet. These parts of the Annual General Meeting will be recorded and made available later on the company's website. Let me start with the following organizational information. Also this year, simultaneous interpreters make sure that you can follow the AGM in English or German.
The necessary receivers have been placed on your chairs. On Channel One, you will listen to German. On Channel Two, you will listen to English. Please note that the receivers only work within the specifically dedicated areas. Please leave the receivers on your seats after the conclusion of the AGM. Viewers following the publicly broadcast part of the Annual General Meeting on our website can also choose between the German and English language options.
Ladies and gentlemen, this general meeting is being simultaneously translated by interpreters to enable all participants to follow the entire meeting in English or German. You can find the necessary receivers on your chairs. Please turn the receivers to Channel Two to listen to the English translation. Channel One provides the German version. The receivers only work within the specifically dedicated areas. Please leave them on your chairs after the meeting. Viewers following the publicly broadcast part of the general meeting via our website can also choose between German and English on the website.
[Foregin Language].
I would now also like to extend a warm welcome to the members of the Management Board and would like to introduce them personally. Helen Giza serves as Chief Executive Officer. Craig Cordola is responsible for the care delivery segment encompassing the global healthcare services business. Martin Fischer serves as Chief Financial Officer. Dr. Jörg Hering is responsible for legal, compliance, and HR. Frank Maddox holds the position of Global Chief Medical Officer. Dr. Katarzyna Mazur-Hofsäss is responsible for the care enablement segment, which combines the product business under a cohesive global medical technology framework. So that all the members of the Management Board are present today. From the Supervisory Board, I would like to welcome the Deputy Chair, Stephanie Balling, the shareholder representatives, Sara Hennicken, Shervin Koranji, Dr.
Markus Kunert, Gregory Sorensen, and Pascal Witz, as well as the additional employee representatives, Ralf Erken, Beate Haslin-Teufel, Regina Karsch, Frank Michael Prescher, and Dr. Manuela Staus-Grabo, so that all the members of the Supervisory Board are also present today. I would also like to welcome the notaries, Dr. Carsten Angersbach and Jochen Rottmann. Dr. Angersbach, seated next to me on the right, has been entrusted with the task of taking the minutes of this Annual General Meeting. Mr. Rottmann is responsible for recording any statements, written questions, motions, or election nominations. However, please note that written questions, motions, or election nominations can only be considered if they are presented verbally once again during the general meeting. Mr. Rottmann is seated at the speaker's registration desk, seen from you at the front right of this room. From me on the left.
I would also like to welcome the proxies appointed by the company, as well as the representatives of our auditor.
[Foreign language] ladies and gentlemen.
On behalf of the Supervisory Board and the Management Board, I would like to welcome you, dear shareholders and shareholder representatives, as well as all those who are attending us online. I am truly pleased that we have the opportunity to come together here in Frankfurt once again this year for an in-person exchange. This year's Annual General Meeting is taking place at a pivotal moment. The world as we know it is disappearing much faster than expected. A new global order is emerging, one that will undoubtedly be marked by rising protectionism and trade conflicts. For an international company like Fresenius Medical Care, which also holds a strong market position in the United States, it is crucial to closely monitor these developments.
Equally important, however, is staying focused on what the company does best, providing high-quality solutions for the care of individuals with kidney disease and maintaining and expanding its leadership position. The key success factor for companies and entire economic regions will be adaptability. Only those who can adjust to change and ideally anticipate it will remain successful in the future. This is the focus of Fresenius Medical Care's transformation journey. In a challenging environment, Fresenius Medical Care successfully completed its first full fiscal year following its conversion into a stock corporation. It was indeed a demanding year, particularly in light of the geopolitical and geoeconomic changes we saw in 2024. The company was able to strengthen its position as the global leader in providing products and services for people with kidney disease, delivering top-tier medical care to its patients.
Ladies and gentlemen, Fresenius Medical Care has continued to pursue its ambitious FME25 program consistently and successfully in the past fiscal year, making the company stronger overall. Creating sustainable value has been the goal of FME25 since the growth strategy was introduced first in October 2020. This plan is proving successful. In 2024, Fresenius Medical Care remained committed to its financial discipline. The company consistently used the funds from the increased free cash flow after investments to further reduce its net financial debt. As a result, the leverage ratio decreased, providing Fresenius Medical Care with greater business flexibility. The sustainable reduction of debts, the realignment into two global operating segments, care delivery and care enablement, the strategic optimization of the legacy portfolio, and not least, the company's independence are beginning to pay off, as far as I think.
This has led to operational improvements in the care delivery and care enablement segments, as well as enhanced performance in terms of medium-term margin targets. In the past fiscal year, organic revenue growth increased by 4%, with a strong 18% growth in operating income. The realignment has also created value for you, our esteemed shareholders. At the end of 2024, the share price of Fresenius Medical Care increased by 16% compared to the closing price at the end of 2023. Over the past two years, the share price rose by 44%. This reflects the value creation, the increased confidence, and the more optimistic future expectations of the capital market. You will also benefit from this development through the dividend payment. For the 2024 fiscal year, the Management Board is proposing a dividend of EUR 1.44 per share. The proposed dividend reflects the company's improved operational performance.
It represents an increase of 21% compared to the previous year and marks the highest dividend per share in the company's history. Another positive signal: after nearly two years, Deutsche Börse announced the return of Fresenius Medical Care to the leading German DAX 40 index in December 2024. This is an important signal, both internally and externally, as Fresenius Medical Care is once again included in major indices and funds. An important driver of the company's success is the collaboration within the Management Board. Over the past year, Craig Cordola and Dr. Jörg Hering were appointed to the Management Board. Both contribute valuable expertise, competencies, and perspectives, and are excellent additions to the team led by the CEO, Helen Giza. For the current fiscal year, Fresenius Medical Care has set ambitious goals and communicated them to its stakeholders.
The aim is to continue driving profitable growth, further advance Fresenius Medical Care as a whole, and fulfill the commitments made to all stakeholder groups. Fresenius Medical Care has worked over the past years to regain trust, and maintaining this trust must remain a key objective for this year and the years to come. This also means strengthening the company's innovative capabilities. For example, the company has made significant progress in dialysis technology and personalized therapy, expanded the use of artificial intelligence in dialysis, and strengthened global research collaborations. Innovation, and especially the scalability of innovations, will also be critical for the dialysis business. Ultimately, they determine a company's future viability, particularly in such a dynamic environment as the healthcare industry. The market launch of the 5008X dialysis machine in the U.S. represents the scalability of such a promising innovation.
The 5008X presents a great opportunity for the company and its patients, as it is the first and only dialysis machine approved in the U.S. so far to offer so-called high-volume hemodiafiltration. By combining diffusion and convection, both small and larger molecules can be effectively filtered from the blood. As a result, the total amount of removed toxins is higher than with a single method. This combination provides patients with a higher quality of life and increases life expectancy. Also, artificial intelligence is increasingly playing a key role. The AI-based application developed by Fresenius Medical Care for the early detection and prevention of anemia is a promising step in this direction. These are only two examples of many that demonstrate the company's commitment to making innovation in the field of kidney disease accessible to its patients. Mrs.
Giza will go into more detail on the innovative capabilities of Fresenius Medical Care in her presentation later. Fresenius Medical Care will focus on successfully completing FME25 this year. The Management Team will then provide an update on the strategic direction for the next five years and beyond at the Capital Market Days in London in June. The goal is to continue on the path of profitable growth, create value, and further increase the relevance of Fresenius Medical Care. For a company, during a time when so many changes are happening simultaneously, it is important to have a clear direction, to pursue this course with determination while remaining flexible and adaptable. This is exactly what Fresenius Medical Care is doing.
Ladies and gentlemen, on behalf of the Supervisory Board, I would like to thank the Management Board under the leadership of Helen Giza and the 112,000 employees for their dedication in the past fiscal year. Through your efforts, Fresenius Medical Care has regained trust and is, I think, on a strong path. I would also like to thank very much my colleagues on the Supervisory Board. In the first year following the transformation of Fresenius Medical Care into a stock corporation, we quickly came together as a team with equal representation to constructively support the company on its successful path. The Supervisory Board has the necessary experience and expertise to continue actively supporting the company's transformation. I would also like to thank you, dear shareholders, for your continued support of the changes at Fresenius Medical Care over the past years.
I am confident that Fresenius Medical Care will continue to set the highest standards in dialysis treatment in the future for Fresenius Medical Care and for the benefit of millions of people with kidney diseases. Thank you. [Foreign language ]. Now we are going on, continuing here. Ladies and gentlemen, before we concede to the agenda, I would like to address some necessary formalities in the interest of streamlining the proceedings of the AGM. I will limit myself to announcing the essential points. For more organizational details, please refer to the information sheet you received at the entrance when presenting your admission tickets. Copies of the information sheet are also available at the information desk in the foyer. Since the convocation of the annual general meeting, all required documents and information have been made accessible on the company's website.
Since then, they also have been available for inspection at the company's offices and can also be inspected today at the information desk. As a meeting room, I exclusively designate this large room, namely the Harmony Room. I would like to point out already now that voting will only be possible here in this room. Requests to speak and motions are also possible only in this room. The attendance area of this AGM, in the meaning of the Stock Corporation Act, comprises the entire C2 upper floor of the Congress Center, Messe Frankfurt, which is delimited by the registration desk on the ground floor, as well as the C0 foyer on the ground floor, including the adjacent rooms accessible to the shareholders. You leave the attendance area and therefore the annual general meeting when you pass the registration desk on floor C0.
If you wish to leave the AGM prematurely before I have closed it, please sign out at the registration desk. Even if you only temporarily leave the AGM, please check in at the registration desk so that attendance can be accurately recorded. At the registration desk, your admission tickets were scanned for determining attendance. The part of the admission ticket that was returned to you at the registration desk is your voting card. If you possess more than one admission ticket and have not presented all of them, please do so at the registration desk in good time before voting starts. This is necessary to ensure that all shares you represent are included in the attendance list and considered in the vote. The annual general meeting will be transmitted acoustically to the designated upper floor C2 and the adjoining rooms accessible to the shareholders.
In this area, you can also follow the simultaneous translation using the receivers. The acoustic transmission, as well as the simultaneous translation into English, is a voluntary service so that you can follow the annual general meeting at any time. However, the company does not guarantee that the acoustic transmission outside the meeting room will always be perfect. Neither can the company guarantee the correctness of the content or the continuous technical availability of the simultaneous translation into English. Please also note that the reception range of the receivers may be limited in some adjoining rooms. The company offers its shareholders the option to be represented by proxies appointed by the company to exercise their voting rights. They will exercise their voting rights exclusively in accordance with the instructions given to them. Without clear instructions, a proxy appointed by the company cannot act on your behalf.
To grant a proxy authorization to the company-appointed proxies, please use the corresponding sections on your voting card. There you can provide instructions according to your voting preferences. Please submit the voting card with your instructions at the registration desk. Granting of proxy and giving voting instructions are only possible until voting starts. Our staff at the registration desk are happy to assist you with any questions regarding registration, as well as granting proxy authorizations and giving instructions. I would like to ask those shareholders or shareholder representatives who would like to take the floor to submit their requests to speak at the speaker's registration desk as early as possible. You can obtain the relevant forms at the speaker's registration desk located here at the front on your right from me to the left.
To ensure the orderly proceeding of the meeting, I will only give the floor to those shareholders and shareholder representatives who have submitted a request to speak. I will ask those ladies and gentlemen who have submitted a request to speak to come to the lectern for making their comments. The lectern is located to the right of the podium, close to the speaker's registration desk. For the benefit of all shareholders and to facilitate the efficient conduct of today's AGM, I would like to point out that only speeches relating to today's agenda are permitted. Please bear this in mind when requesting to speak. I also would like to point out that although the contributions during this AGM will be translated into English, German remains, however, the official language. Therefore, if you wish to speak, you must do so in German.
Contributions made in English cannot be included in the minutes. The AGM, except for my introductory remarks and Mrs. Giza's speech, will not be recorded. However, the cameras set up are used to transmit the event to the screen and to the back office where the staff supporting us in conducting the general meeting are located. The respective speaker will therefore be prominently displayed on the screen during their speech. If you do not wish to be displayed as the speaker in this manner, please let us know briefly. Furthermore, a photographer commissioned by us will take photographs during the AGM for documentation and communication purposes. Your personal rights will be fully respected during this process. I trust in your understanding that participants of the AGM are not permitted to make video or audio recordings. This applies also to camera and sound recordings with mobile phones.
I would like to ask you to mute your mobile phones while all are here in the meeting room. A stenographic transcript of the AGM is not kept. Our staff will be supported by stenographers only for the purpose of recording questions and motions raised during the meeting if necessary. These were my organizational remarks. Ladies and gentlemen, we now proceed to the items on the agenda. The agenda has been available on the company's website since the convening of the AGM. You also received information on this via your custodian banks. The agenda is also available for inspection today at the speaker's registration desk and at the information desk. Therefore, I assume that you are familiar with all the documents mentioned. The company received a counter motion to item three on the agenda prior to the annual general meeting.
The counter motion was duly published on the company's website. I would like to point out that a counter motion can only be considered at the annual general meeting if it is presented verbally. Apart from that, the company did not receive any counter motion or election nominations to be made accessible prior to the annual general meeting. I now call up agenda item one and invite Mrs. Helen Giza to explain the relevant documents and also discuss the outlook for the current fiscal year. Please, Mrs. Giza, the floor is yours.
Thank you, Michael, and also to the Fresenius Medical Care Supervisory Board for your guidance and advice throughout the year. Of course, thank you all for joining us today for the Fresenius Medical Care 2025 annual general meeting, whether we're here in Frankfurt or joining online.
We appreciate your support of this special company with its unique and powerful mission: creating a future worth living for patients worldwide every day. Michael spoke about the current challenges facing nations, regions, and indeed the world. For a global company like Fresenius Medical Care, which works within and across most of the world's borders, never in recent history has it been more true that we must firmly control what we alone can control. I'm proud to say we are. 2025 represents year three of our three-year turnaround and transformation journey. The results in 2024 and in the first quarter of this year demonstrate the strength of our business, the resilience of our people, the courage to drive change in systems and processes, the power of our innovation engine, and the ability to unlock new levels of value for our shareholders. 2024 was our proving year.
Our year to show that the momentum we generated in 2023 was no coincidence. Our year to prove that the time and talent we put behind redesigning and implementing an enhanced strategy, structure, and culture could deliver better top and bottom line results than the year before. We did it. We delivered on our commitments, indeed even over-delivering on some of those commitments, and we built credibility. A commitment is a promise. Today's Fresenius Medical Care delivers on its promises. We have delivered without missing a beat throughout the last nine quarters. Let's take a look at our fiscal 2024 performance. A year of promises delivered. Running a company is about controlling what you can control while ensuring you are prepared to manage the unexpected. While 2025 has already been marked with unprecedented geopolitical and market instability, 2024 delivered its own level of volatility.
In 2024, many dialysis patients the world over found themselves unwillingly caught up in a host of devastating natural disasters and regional conflicts. I am proud of our teams for ensuring materials, supplies, and services were available to patients and customers in need. In crisis after crisis, our people ensured uninterrupted support for patients whose lives are dependent on high-quality care. These kinds of headwinds can be expected to a certain degree, but not predicted. When I speak of delivering on our commitments, it's a message made all the more powerful knowing that we succeeded in the face of challenges such as these. As you know, our FME25 transformation program was implemented to deliver meaningful, sustainable savings and shareholder value. Since that launch, we have raised and raised again our savings commitment.
With the release of our fiscal year 2024 earnings in February of this year, I announced our intention to raise again our total FME25 savings target from EUR 650 million to EUR 750 million by the end of 2025, a 50% increase over the original target of EUR 500 million. I am fully confident in our ability to deliver this expanded target. In fact, we delivered EUR 68 million of additional savings alone in the first quarter of 2025, which is already a very strong start. Combined with our work to reshape our structure, systems, processes, and capabilities, you see demonstrated today a stronger-than-ever Fresenius Medical Care, driven by a mindset of intentionality that permeates all areas and aspects of the company. Across the company, we are taking action. It's about embracing change that benefits our long-term financial health and value creation.
Of course, the sustained health of a company comes from both cost and efficiency savings and profitable growth. Last year, I spoke of the continued lingering devastating effects of the COVID-19 pandemic on the healthcare sector and the effect on patient volumes in the dialysis industry in particular. Importantly, starting in the third quarter of last year, we saw the first signs of positive same-market treatment growth in the United States. That progress continued in the fourth quarter, and as the year came to a close, we announced full-year positive growth. We are seeing early improvements in underlying market trends, and we are working with great diligence and focus to ensure we are positioned to gain from it.
Our care delivery team is hard at work improving internal and patient-facing processes to ensure nothing stands in the way of a patient's access to care and that we remain singularly focused on patient safety and quality. I am very proud to say it's paying off. Last year, we were honored to receive a Net Promoter Score of 72, which matched our 2023 results and speaks to the criticality of operational consistency. Scoring is based on patient surveys, and our score of 72 demonstrates very strong patient satisfaction with the quality of our services. Supporting this feedback is annual analysis performed by the US Centers for Medicare and Medicaid Services, or CMS for short. In the most recent ratings for 2023, 65% of our US dialysis centers received a rating of three stars or higher, outperforming the nationwide average.
In addition, Interwell, our value-based care business, achieved best-in-class quality performance in the first year of the United States government's comprehensive kidney care contracting program. Impressively, Interwell operated all 10 of the top 10 highest-scoring kidney contracting entities. Though they represent unique links in the healthcare value chain, it's important to see our two global businesses, care delivery and care enablement, not as independent, but interdependent, for the ultimate benefit of patients and shareholders alike. An investment in Fresenius Medical Care is an investment in the world's only globally vertically integrated kidney care company. The integration of both our healthcare services and medtech business segments represents a kind of virtuous cycle, a self-reinforcing system that both enables and challenges each other to continuously improve. Our care delivery service business supports our care enablement medtech business with insights into the data of millions of treatments performed each year.
In return, care enablement serves care delivery with early access to innovation in dialysis technology. Aided by our world-class global medical office, both segments benefit from the latest scientific advancements, data technology, artificial intelligence, and connectivity. This is a powerful combination, a winning combination, and it's a model that sets us apart from and above the competition. Nowhere is that combination more evident and more powerful than in this year's upcoming commercial launch of high-volume hemodiafiltration in the United States, powered by our innovative new 5008X machine. Last year, we achieved a major milestone, the 510(k) clearance for the 5008X machine from the United States Food and Drug Administration. The 5008X is the first and still only machine for high-volume hemodiafiltration dialysis therapy in the United States to receive FDA approval to date. Work will continue throughout this year to bring the technology and treatment to market.
Currently, 11 dialysis patients are being treated on it at a United States pilot clinic. Expect to start seeing it more broadly in U.S. clinics later this year, followed by a full-scale commercial launch in 2026. High-volume HDF is already the treatment standard across most of Europe, Latin America, and Asia, and we have very well experience with it. Our great familiarity with this treatment, combined with the outcome and promising results of an external research study, reiterated the significant patient health and well-being benefits available with HDF. Recall the European Convince study reported a 23% reduction in mortality for patients treated with high-volume HDF versus standard hemodialysis. This could equate to an additional 18 months of life on average for a patient. The US is a critically important market for the healthcare industry.
Fresenius Medical Care, the dialysis pioneer, will be the first to market with this device and treatment option. It's a landmark moment in the industry. We will set the new standard of care in the United States. This is big. This is exciting. This is what to expect from the industry leader in kidney care. In February, I was pleased to report strong financial performance and enhanced value creation for fiscal year 2024. Last year's performance drove improvement toward our target operating income margin bands for 2025, supported by both operating segments. With a margin contribution of more than 10%, care delivery reached the lower end of its target band of 10-14%. The improvement reflected our turnaround efforts as well as price and volume effects, the realization of productivity gains and labor efficiency enhancements, and a refocused international portfolio.
Care enablement drove an exceptionally strong margin performance in 2024, 6.1%, nearly tripling its prior year contribution. The improvements we have made in this segment, including the rationalization of our supply chain and manufacturing footprints, positive volume and pricing effects, and broad-scale cost and efficiency improvements, supported this performance and also strengthened the base of our operations. The improved profitability of both segments was supported by the acceleration of our FME25 transformation program, which, as I shared earlier, now reflects a EUR 750 million savings target by the end of this year. Deleveraging is another promise made and kept. In 2024, our net leverage ratio improved from 3.4x at the end of 2022 to 2.9x . This is below our self-imposed target range, and it earned us an investment-grade rating with stable outlook from S&P, Moody's, and Fitch.
Of course, the capstone of our financial year was our December return to the DAX 40 index. It's where we worked hard to be, and it's where we are committed to stay. A significant component of our strategic focus in 2024 was the continued execution against our portfolio optimization plan, our commitment to divest non-core and lower-margin assets. Last year, we announced clinic exits from all Latin American countries, from Sub-Saharan Africa, and also Türkiye. With the exception of Brazil, which is on track to close in the first half of this year, all of these clinic operation divestments closed last year. We also announced the exit of non-core assets, National Cardiovascular Partners in the United States, and CuraDay Hospitals Group in Australia. This year, we announced the divestiture of select assets of Spectra Laboratories, our US lab service business, as well as clinic operations in Malaysia.
This is the result of our changed strategic approach. We focus on core assets with strict capital allocation perspectives to create and enhance shareholder value. It's the right strategy, and it's something we can all be proud of. Accounting for a 1.6% headwind from divestments, in 2024, we realized a 2% growth in revenue. We also achieved an impressive 18% growth in operating income, coming in at the upper end of our outlook for the year. In light of our performance and in accordance with our current dividend policy, for 2024, the Supervisory Board and the Management Board proposed a dividend of EUR 1.44 per share. This is a 21% increase, the biggest single-year increase in our history, and the highest dividend we have ever paid. It delivers on our promise of improving shareholder returns, and it's an exciting achievement that we are very happy to share with all of you.
Turning now to forward-looking perspectives for 2025, we are assuming continued positive U.S.A market treatment growth of 0.5% plus. Once mortality has normalized, indications support a recovery to 2% plus in 2026 and beyond. Our 2025 revenue outlook anticipates positive to low single-digit percent growth. This assumption includes headwinds from the successful execution of our portfolio optimization plan. Divestments executed in 2024 are expected to have a negative impact of around 1% in 2025. For operating income growth, we expect a very strong year. We are guiding for a high teens-high 20 % growth range, which raises the implied operating income margin to 11%-12% this year. We expect both operating segments to make further progress within or into their margin target bands of 8%-12% for care enablement and 10%-14% for care delivery.
I recognize that tariffs are top of mind for companies and consumers alike. We have all seen 2024 was, in many ways, a pivotal year. Year two of our three-year turnaround and transformation plan. It was a proving year, harnessing the momentum generated from our first year of restructuring and a new operating model. It was a credibility year, a year of big commitments made and promises kept. We have a lot to be proud of and thankful for. 112,000 Fresenius Medical Care employees and their families count on us for their livelihoods. Nearly 300,000 patients depend on us in an even more fundamental way. On behalf of the great people of Fresenius Medical Care, thank you for investing in our company. Today and together, we stand with one foot in the present and the other in the future.
Against the backdrop of massive global change, we're set to make our own history. I can't wait to show you what lies ahead. Thank you.
[Foreign language] .
Thank you very much, Ms. Giza. Now, I would like to say goodbye to those of you following the annual general meeting online. Thank you for your interest in our company and best wishes to all. Goodbye. The internet broadcast ends now.