This is a big purchase and both acquisitions are in the same or similar core business imageas Fresenius in Germany.  The Medicare law provides for bundled rates and larger chains run an advantage there. 

Fresenius Medical Care AG agreed to buy Liberty Dialysis Holdings Inc. for $1.7 billion, one of two acquisitions announced today to expand its U.S. clinic network.

Liberty Dialysis, a closely held company based in Mercer Island, Washington, has 260 clinics with annual revenue of about $1 billion, Bad Homburg, Germany-based Fresenius Medical said in a statement today. The deal is expected to close early next year, the German company said. Fresenius Medical also will buy U.S.-based American Access Care Holdings LLC for $385 million.

American Access runs outpatient clinics for procedures such as fistulas and grafts that give permanent surgical access to veins, reducing the need to use temporary catheters for dialysis blood-cleaning treatment. Using such procedures may help Fresenius reduce the number of expensive-to-treat infections, Clive said. Catheters also tend to make patients require higher doses of some drugs, she said.

Fresenius Medical Agrees to Buy Liberty Dialysis of U.S. for $1.7 Billion - Bloomberg

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