siemenscomfinance

Healthy financingSiemens provides efficient financing solutions for innovative technologies and sustainable infrastructure

Customer success stories

2 3

Dear Readers

Our commitment to the success of our customers goes beyond merely delivering the latest diagnostic and treatment technology We also support healthcare providers through close collaboration and mutual partnerships

Healthcare budgets are tight already but will have to be stretched even more to meet the substantial increase in investment needs One driving force behind this trend is demographic change with its rising number of elderly people and its growing demand for affordable high-quality medical care

But how can hospital operators doctors in private practices and other healthcare service providers adequately respond without relinquishing their financial flexibility

Customized financing solutions are as individual as the investments themselves and on the following pages we have illustrated their tremendous diversity Each of the showcased projects draws from innovative healthcare solutions and compatible financing concepts that have been tailored to the business models and challenges of our customers

Enjoy your read

Sincerely

Roland Chalons-Browne

Roland Chalons-BrowneCEO Financial Services

5

Content

More quality for your patients ndash

new opportunities for you

Servicio Murciano de Salud Spain

A perfect partnership

ViewRay Inc USA

Risk capital for safe radiation therapy

Biosynergie France

Clearing the way with an ldquoall-inclusiverdquo offer

North Oakland ndash North Macomb Imaging USA

Tax-exempt solution for non-profit groups

Ministry of Health Croatia

State-of-the-art equipment for Croatian hospitals

Evangelisches Krankenhaus Bielefeld gGmbH Germany

Strategic partnership with flat-rate financing

Regent Surgical Health USA

Convincing single-source financing

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

Chengdu Western Hospital China

Rapid growth without side effects

The best recommendation your own

6

8

10

12

14

16

18

20

22

24

26

6 7

More quality for your patients ndash new opportunities for youThe perfect combination of healthcare experience and financial know-how

Benefits for SFS customers at a glance

Unrivaled combination of financing expertise and business know-how for customer- and industry-specific financing solutions

Comprehensive market and industry knowledge to support sustainable investments and healthy growth

Tailored financing solutions for more success on the market thanks to effective resource-saving investments in innovative technologies and sustainable infrastructure

Broad portfolio of financing solutions to offer the best solution for specific customer needs

Extensive experience as a Siemens division that offers proven solutions drawing from expert knowledge in industry and finance

Far-reaching refinancing within the Siemens Group for guaranteed security and reliable evaluation of the technical and economic feasibility of projects

Global network of financial service providers in around 30 countries provides direct access to banks export credit agencies and Siemens finance experts

Hospital operators and physicians in private practice can turn to Financial Services (SFS) the financial division of Siemens when they need a skilled partner capable of developing needs-based financial solutions that per-fectly complement the range of prod-ucts offered by the Healthcare Sector

Siemens Financial Services offers cus-tomized financial solutions that clear the way for liquidity-preserving invest-ments in innovative products and com-plete solutions as well as service and consulting guidance in healthcare Our product range includes leasing hire-purchase structured financing private equity project and equity participations as well as project and export financing

Our customers profit from the fact that our understanding of the health-care system stems not only from stud-ies and analyses but also from the years of experience we have gained as a part of Siemens and as the financ-ing partner of the Healthcare Sector

Business conditions for healthcare will change dramatically in years to come In the past the key problem was financial feasibility But soon demo-graphic change will make its presence felt driving up the number of elderly people and shrinking the labor pool Both developments will result in ris-ing investment needs among all play-ers in the healthcare system ndash and thus in rising financing needs

Working together the Healthcare Sec-tor at Siemens and Siemens Financial Services offer exactly those things that the healthcare system requires around the world attractive complete packages of technical solutions and perfectly tai-lored financing By doing so we ensure that our customers can become even more successful in their businesses

Servicio

Murcianode Salud

98

ldquoWe decided to use this solution because our medical centers were facing financial collapse We would not have been able to acquire new equipment if we had taken conventional approaches For this reason we had to go in a completely new directionrdquo

Maria Angeles PalaciosHealth Adviser of Murcia

A summary of the benefits

As a technical partner Siemens assumes economic responsibility and delivers cutting-edge technology

A long-term solution that acts as a role model for Spainrsquos national healthcare system

The challenge

For years the healthcare system in the Murcia region of Spain was chronically underfinanced The funds needed to make additions and expansions to the two university medical centers that the system operates in Cartagena and Mar Menor could only be obtained from the European Investment Bank There was little financial leeway to acquire the necessary technical equipment ndash a totally new approach was needed

The solution

For Spainrsquos healthcare system Siemens developed a visionary model of public- private partnerships In this arrangement Siemens took on the role of a technical partner assuming the responsibility for the financing acquisition maintenance operation and ongoing upgrades of all medical information and communication technology equipment As compensation Siemens receives a portion of the income generated by both medical centers and also assumes part of the entrepreneurial risk The partnership agreement runs for 15 years

To be able to play this role Siemens Healthcare and Financial Services had to develop new forms of collaboration and draw on their extensive business and financial acumen The result is a solution underpinned by economic sustainability

Servicio Murciano de Salud Spain

A perfect partnership

The healthcare system in the Murcia region of Spain and Siemens have taken a new direction in their work to provide two university medical centers with the latest medical information and communication technology in order to increase the centersrsquo operational efficiency a trendsetting form of public-private partner-ship with Siemens for Spainrsquos healthcare system

1110

ldquoThe risk capital team at Financial Services is an important partner for us It not only invested in us but also introduced us to financing tools that optimized our net working capital and can make it easier for our customers to acquire our systemsrdquo

Greg M Ayers MD PhD CEO and President of ViewRay Inc

A summary of the benefits

Support of innovative technology to help cancer patients

Win-win situation for Siemens Healthcare and ViewRay

Comprehensive support for an up-and-coming company in the medical-technology industry Risk capital can be complemented by vendor finance tools

The challenge

Radiation therapy uses ionizing radiation to systematically fight tumors and halt their growth In the process healthy tissue should be protected from the unwanted effects of the radiation This aim is complicated by the fact that some organs move during the radiation treat-ment For this reason ViewRay set out to develop a system that facilitates the pre-cise management of the radiated region during the treatment

The solution

Using ViewRayrsquos system of MRI-guided radiation therapy the physician can con-tinuously monitor where the radiation is hitting the tumor or healthy tissue and thus aim its beam more precisely Siemens delivers not only the necessary MRI components and technical assis-tance but also financial support from Financial Servicesrsquo subsidiary Siemens Venture Capital (SVC) For this develop-mental work SVC provided ViewRay with risk capital

ViewRay Inc US

Risk capital for safe radiation therapy

The US company ViewRay Inc specializes in radiation therapy systems used to treat cancer With the strong support of Financial Services (Siemens Venture Capital) the company was able to develop an MRI-guided radiation therapy system

1312

ldquoThe distribution of the payments throughout the financing period and the holistic approach with a central contact person for the equipment reagents and financing really appealed to us because it was all so simple The Siemens solu-tion enabled our lab group to calmly and deliberately work on the expansion of our new test infrastructurerdquo

Franccedilois LeacuteonardCo-President Biosynergie

A summary of the benefits

60-month flexible finance arrangement

Transparent predictable and affordable payments

A holistic approach and streamlined processes with a central contact person

The challenge

Since France reorganized its regulatory frameworks for laboratories providers of laboratory and analysis services have been compelled to increase their opera-tional efficiency As this goal could not be achieved by Biosynergie by simply merging the previously autonomous labs the company wanted to acquire an analy-sis clinical chemistry and immunoassay platform for the entire laboratory group

The idea was to create one centralized platform that would cater for all labora-tory samples but a financing solution had to be found in order to make the investment viable

The solution

Siemens Healthcare Diagnostics offered Biosynergie a fully automated clinical chemistry and immunoassay system with an efficiency that facilitated economies of scale and thus more cost-effective operations on its previous setup To best address the needs of the lab group Siemens put together an all-inclusive package that included instruments main-tenance insurance and financing The financing covered a period of five years based on monthly payments aligned to the expected use of the system and the anticipated income generated An addi-tional agreement covering reagents was also arranged

Biosynergie France

Clearing the way with an ldquoall-inclusiverdquo offer

Biosynergie is a group of nine medical laboratories that joined together in 1994 in anticipation of regulatory changes Biosynergie selected an all-inclusive solution from Siemens when it decided to acquire a new joint analysis clinical chemistry and immunoassay platform

1514

ldquoOur working experience with Siemens Financial Services has been very posi-tive The team is very knowledgeable not only as relates to putting the tax-exempt financing together but also of our business model and how we provide service to our patients This made it very easy for us to work to-gether Additionally their professional-ism and customer service exceeded our expectations We look forward to work-ing with them again in the futurerdquo

Janelle SpannExecutive Director North Oakland ndashNorth Macomb Imaging Inc

A summary of the benefits

Customer was able to achieve a lending rate which mir-rored what is available via the tax-exempt bond market in a more timely and efficient manner (as compared to issuing a bond)

The challenge

When North Oakland ndash North Macomb Imaging was planning to acquire a new MRI system from Siemens the top priori-ties were to finance not only the equip-ment but also the necessary structural changes Given the customerrsquos status as a non-profit entity North Oakland ndash North Macomb Imaging was interested in secur-ing tax-exempt financing

The solution

Siemens offers tax-exempt financing to qualifying non-profit organizations in the US and was able to offer an attractive tax-exempt financing package for North Oakland ndash North Macomb Imaging

North Oakland ndash North Macomb Imaging US

Tax-exempt solution for non-profit groups

North Oakland ndash North Macomb Imaging is jointly run by three non-profit hospitals For this reason it becomes even more important to finance capital expenditures in a way that conserves resources ndash particularly when major equipment like a new magnetic resonance imaging (MRI) system is needed

1716

Ministry of Health

ldquoWe are proud that Siemens Croatia is recognized as a quality partner and supplier of medical equipment with proven solutions for all healthcare areas With tailored financing solutions from Siemens Financial Services we are able to react more flexible to customer needs The state-of-the-art devices will now also be available to Croatian patientsrdquo

Mladen Fogec Siemens Croatia Country CEO

A summary of the benefits

The Ministry of Health (MOH) and the involved hospitals received state-of-the-art medical imaging technology

Extended warranty services assure best availability of the systems throughout the contract period and beyond

The MOH has one contract partner for the technical solution and for long-term financing and at the same time acquires ownership of the equipment

Through the long-term supplier loan the substantial investment does not cause immediate burden to the national healthcare budget Neither does the MOH have interest rate risk or foreign currency risks as the final price for medical equipment and services is covered by the financing costs

The challenge

All the tasks including delivery installa-tion and training as well as building adap-tations have to be completed within 240 days The Ministry of Health requested also a six-year warranty service The whole package had to be offered at a fixed price in local currency without cur-rency exchange clause and bankable col-laterals with extended yearly repayments over a period of six years

The solution

Due to many limitations the markets were not able to offer long-term refinanc-ing in local currency or hedging over one year So during the tendering phase Siemens Financial Services with its local and regional office was strongly involved in risk assessment structuring and pric-ing of the respective transactions based on sovereign risk

In the end Siemens could offer to the Ministry of Health the desired equipment and services as well as the long repay-ment period in form of a six-year supplier loan and fulfill the pre-defined conditions of the Ministry of Healthrsquos tender

Ministry of Health Croatia

State-of-the-art equipment for Croatian hospitals

The Croatian Ministry of Health has modernized and expanded the pool of equipment (four state-of-the-art Symbia TruePoint SPECTCT systems two 2-head gamma cameras four MAGNETOM Avanto 15 T scanners four ONCOR LINAC and three SOMATOM SENSATION OPEN CT simulators) in many of its public hospitals across the country to provide state-of-the-art medical and imaging services to the patients These tenders which were supervised by Transparency Interna-tional have generated one of the largest contracts for Siemens Healthcare in Central and Eastern Europe

1918

ldquoWe found a good partner in Siemens In addition to the equipment purchase the innovative concept is an important component of the agreement We decided to purchase the entire pack-age Only a few people can offer some-thing like this We wanted everything to come from a single sourcerdquo

Dr Heiner Meyer zu LoumlsebeckManaging Director of the Evangelisches Krankenhaus Bielefeld(Dr Heiner Meyer zu Loumlsebeck was Managing Director from September 2007 to mid-January 2012)

A summary of the benefits

Rent-and-invest solution with monthly flat-rate pay-ments covering equipment service financing training and upgrades

Planning security covering an extended period of time

Financing of the installment payment using ldquopay as you earnrdquo

Use of the latest technology without overburdening the budget and liquidity

Guaranteeing and increase of internal financing ability

The challenge

Together with the Betheler Krankenhaus Mara the maximum-care facility Evan-gelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia with approximately 1500 beds 30 departments and 4200 employees In addition it is the biggest employer in the city of Bielefeld As part of the scheduled expansion of the hos-pital and its radiology department EvKB was looking for a strategic partner who not only delivered innovative medical technology but could also help it gain a long-range competitive edge

The solution

Siemens devised an equipment availabil-ity model with integrated capital expen-diture financing and the hospital con-cluded a ten-year partnership agreement based on it The complete single-source solution creates a decade of planning security in terms of the use of state-of-the-art medical technology and the costs related to it

The project covers the planning delivery and implementation of more than 80 medical-equipment products for the next ten years The products include large-scale equipment like MRIs CTs and X-ray units as well as ultrasound systems

In addition to the investment volume the financing flat rate covered by the agreement covers consulting services training process optimization equipment maintenance and technical upgrades The parties to the contract have combined all of this into a package that will be covered by a flat monthly installment payment for a period of 120 months

Evangelisches Krankenhaus Bielefeld gGmbH Germany

Strategic partnership with flat-rate financing

The Evangelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia As part of a scheduled expansion of some departments ndash particularly radiology ndash the hospital entered into a strategic partnership with Siemens Thanks to this alliance the hospital has gained a long-range competitive edge created by innovative medical technology without taking on financial risks that are difficult to calculate

2120

ldquoRegent has worked successfully with members of the Siemens team on a number of debt financings over the past five years Their ability to under-write both de novo and turnaround sit-uations to assess the potential for a variety of facilities and to craft creative financing structures makes them good colleagues with whom to do businessrdquo

Michael KarnesCFO Regent Surgical Health

A summary of the benefits

Financing from Siemens enabled the customer to develop a new outpatient surgery facility

The community benefits from having access to an outpatient surgery center which is often viewed as a more effective option for certain types of procedures

The challenge

Since being established in 2001 Regent Surgical Health has set up 18 medical centers that the company continues to successfully run on its own The company also holds minority stakes in ambula-tory surgical centers in the United States that it operates jointly with local part-ners For a center that it was planning to build with 18 local private physicians in Anchorage the capital of Alaska Regent needed an end-to-end financing solution that covered development of a new facility and acquisition of equipment

The solution

Thanks to Siemensrsquo experience with the business model on which the ambulatory surgical centers are based Financial Services was able to devise and offer a comprehensive financing solution that met the needs of Regent and the physicians involved in the project

Regent Surgical Health US

Convincing single-source financing

Regent Surgical Health operates a number of ambulatory surgical centers and a specialty hospital in the United States The company is known for running sustainably efficient facilities and for offering a high degree of autonomy to the private physicians with whom it works locally To set up an ambulatory surgical center in Alaska Regent needed a comprehensive financing concept

2322

ldquoOur strategy of renting high-tech equipment for five years was served by the innovative solution offered by Financial Services As a result we can keep our cost structures competitive while delivering high-quality and dependable service to the communityrdquo

Professor Amarilio Vieira de Macedo NetoPresident of the Hospital de Clinicas de Porto Alegre

A summary of the benefits

The financing structure meets the customerrsquos needs without hurting the liquidity of Siemens Healthcare Diagnostics

The customer can adjust spendings on laboratory equipment and operations to their utilization rate and thus match them to the hospitalrsquos own growth

The challenge

Siemens Healthcare Diagnostics the worldrsquos largest company specializing in clinical diagnostics seemed like a logical partner for the university medical cen-ter in the southern Brazilian city With the necessity to increase its performance to attend the high daily demand HCPA invested in Siemens equipment But it was crucial to find a financing solution based on monthly installments

The solution

Working together Siemens Health-care Diagnostics and Financial Services devised a viable needs-based financing structure and found a suitable local partner the Gaap Locaccedilatildeo de Bens company It served as the purchaser of the equipment and rented it back to Siemens Healthcare Diagnostics The Siemens division then rented it to HCPA under the same terms The agreement runs for three years and includes an option for two additional years

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

The Hospital de Clinicas de Porto Alegre (HCPA) wanted to finance its laboratory equipment and operations on a usage basis instead of purchasing the equipment Siemens was not only able to supply the right solution for clinical diagnostics but also devised a usage-based financing structure ndash using an unconventional approach

2524

ldquoThe working relationship with Siemens is helping Chengdu Western Hospital better manage its rapid expansion Thanks to the financing provided by Siemens we can offer our patients world-class technology without having to assume the financial burden that would have been associated with a major investment in the equipment for our new facility This really helps us reach our growth objectives in an effec-tive economically healthy mannerrdquo

Hao Shi Quan President of Chengdu Western Hospital

A summary of the benefits

The hospitalrsquos growth target could be quickly met without the additional financial burden created by a loan

Fast decision-making process due to single-source financing and the option of flexibly incorporating the equipment of other providers

World-class medical technology meets the needs of customers and patients

The challenge

Chengdu is one of Chinarsquos most appeal-ing cities in which to live And one factor that makes it so attractive to its citizens is its state-of-the-art efficient healthcare system which includes Chengdu West-ern Hospital as a key component To meet the cityrsquos growing demands the health-care operator has made extensive capi-tal expenditures and expanded the facil-ityrsquos capacity from 200 to 800 beds The operatorrsquos objective was also to equip the newly erected facility with cutting-edge medical technology without over-burdening its already stretched financial resources

The solution

For Chengdu Western Hospital Siemens put together a customized hire-purchase solution that helped support the hospi-talrsquos expansion strategy The financing agreement was arranged with a five-year term and enabled the hospital to acquire the latest medical technology from Siemens and other providers To obtain the required equipment the healthcare operator did not have to take out any new loans instead through the arrange-ment with Siemens the Chengdu West-ern Hospital was able to make the financ-ing payments from the income generated by the investment As a major portion of the technical equipment was made by Siemens Chengdu Western Hospital also benefited from the fast decision-making process facilitated by Siemensrsquo concept ldquotechnology and financing from a single sourcerdquo

Chengdu Western Hospital China

Rapid growth without side effects

As the rapidly expanding capital of the Chinese province of Sichuan the city of Chengdu needed state-of-the-art healthcare infrastructure To meet this need Chengdu Western Hospital launched a systematic expansion strategy To ensure that the goal is achieved efficiently the healthcare operator chose to finance the complete range of medical technology with Siemens

成都西区医院

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

2 3

Dear Readers

Our commitment to the success of our customers goes beyond merely delivering the latest diagnostic and treatment technology We also support healthcare providers through close collaboration and mutual partnerships

Healthcare budgets are tight already but will have to be stretched even more to meet the substantial increase in investment needs One driving force behind this trend is demographic change with its rising number of elderly people and its growing demand for affordable high-quality medical care

But how can hospital operators doctors in private practices and other healthcare service providers adequately respond without relinquishing their financial flexibility

Customized financing solutions are as individual as the investments themselves and on the following pages we have illustrated their tremendous diversity Each of the showcased projects draws from innovative healthcare solutions and compatible financing concepts that have been tailored to the business models and challenges of our customers

Enjoy your read

Sincerely

Roland Chalons-Browne

Roland Chalons-BrowneCEO Financial Services

5

Content

More quality for your patients ndash

new opportunities for you

Servicio Murciano de Salud Spain

A perfect partnership

ViewRay Inc USA

Risk capital for safe radiation therapy

Biosynergie France

Clearing the way with an ldquoall-inclusiverdquo offer

North Oakland ndash North Macomb Imaging USA

Tax-exempt solution for non-profit groups

Ministry of Health Croatia

State-of-the-art equipment for Croatian hospitals

Evangelisches Krankenhaus Bielefeld gGmbH Germany

Strategic partnership with flat-rate financing

Regent Surgical Health USA

Convincing single-source financing

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

Chengdu Western Hospital China

Rapid growth without side effects

The best recommendation your own

6

8

10

12

14

16

18

20

22

24

26

6 7

More quality for your patients ndash new opportunities for youThe perfect combination of healthcare experience and financial know-how

Benefits for SFS customers at a glance

Unrivaled combination of financing expertise and business know-how for customer- and industry-specific financing solutions

Comprehensive market and industry knowledge to support sustainable investments and healthy growth

Tailored financing solutions for more success on the market thanks to effective resource-saving investments in innovative technologies and sustainable infrastructure

Broad portfolio of financing solutions to offer the best solution for specific customer needs

Extensive experience as a Siemens division that offers proven solutions drawing from expert knowledge in industry and finance

Far-reaching refinancing within the Siemens Group for guaranteed security and reliable evaluation of the technical and economic feasibility of projects

Global network of financial service providers in around 30 countries provides direct access to banks export credit agencies and Siemens finance experts

Hospital operators and physicians in private practice can turn to Financial Services (SFS) the financial division of Siemens when they need a skilled partner capable of developing needs-based financial solutions that per-fectly complement the range of prod-ucts offered by the Healthcare Sector

Siemens Financial Services offers cus-tomized financial solutions that clear the way for liquidity-preserving invest-ments in innovative products and com-plete solutions as well as service and consulting guidance in healthcare Our product range includes leasing hire-purchase structured financing private equity project and equity participations as well as project and export financing

Our customers profit from the fact that our understanding of the health-care system stems not only from stud-ies and analyses but also from the years of experience we have gained as a part of Siemens and as the financ-ing partner of the Healthcare Sector

Business conditions for healthcare will change dramatically in years to come In the past the key problem was financial feasibility But soon demo-graphic change will make its presence felt driving up the number of elderly people and shrinking the labor pool Both developments will result in ris-ing investment needs among all play-ers in the healthcare system ndash and thus in rising financing needs

Working together the Healthcare Sec-tor at Siemens and Siemens Financial Services offer exactly those things that the healthcare system requires around the world attractive complete packages of technical solutions and perfectly tai-lored financing By doing so we ensure that our customers can become even more successful in their businesses

Servicio

Murcianode Salud

98

ldquoWe decided to use this solution because our medical centers were facing financial collapse We would not have been able to acquire new equipment if we had taken conventional approaches For this reason we had to go in a completely new directionrdquo

Maria Angeles PalaciosHealth Adviser of Murcia

A summary of the benefits

As a technical partner Siemens assumes economic responsibility and delivers cutting-edge technology

A long-term solution that acts as a role model for Spainrsquos national healthcare system

The challenge

For years the healthcare system in the Murcia region of Spain was chronically underfinanced The funds needed to make additions and expansions to the two university medical centers that the system operates in Cartagena and Mar Menor could only be obtained from the European Investment Bank There was little financial leeway to acquire the necessary technical equipment ndash a totally new approach was needed

The solution

For Spainrsquos healthcare system Siemens developed a visionary model of public- private partnerships In this arrangement Siemens took on the role of a technical partner assuming the responsibility for the financing acquisition maintenance operation and ongoing upgrades of all medical information and communication technology equipment As compensation Siemens receives a portion of the income generated by both medical centers and also assumes part of the entrepreneurial risk The partnership agreement runs for 15 years

To be able to play this role Siemens Healthcare and Financial Services had to develop new forms of collaboration and draw on their extensive business and financial acumen The result is a solution underpinned by economic sustainability

Servicio Murciano de Salud Spain

A perfect partnership

The healthcare system in the Murcia region of Spain and Siemens have taken a new direction in their work to provide two university medical centers with the latest medical information and communication technology in order to increase the centersrsquo operational efficiency a trendsetting form of public-private partner-ship with Siemens for Spainrsquos healthcare system

1110

ldquoThe risk capital team at Financial Services is an important partner for us It not only invested in us but also introduced us to financing tools that optimized our net working capital and can make it easier for our customers to acquire our systemsrdquo

Greg M Ayers MD PhD CEO and President of ViewRay Inc

A summary of the benefits

Support of innovative technology to help cancer patients

Win-win situation for Siemens Healthcare and ViewRay

Comprehensive support for an up-and-coming company in the medical-technology industry Risk capital can be complemented by vendor finance tools

The challenge

Radiation therapy uses ionizing radiation to systematically fight tumors and halt their growth In the process healthy tissue should be protected from the unwanted effects of the radiation This aim is complicated by the fact that some organs move during the radiation treat-ment For this reason ViewRay set out to develop a system that facilitates the pre-cise management of the radiated region during the treatment

The solution

Using ViewRayrsquos system of MRI-guided radiation therapy the physician can con-tinuously monitor where the radiation is hitting the tumor or healthy tissue and thus aim its beam more precisely Siemens delivers not only the necessary MRI components and technical assis-tance but also financial support from Financial Servicesrsquo subsidiary Siemens Venture Capital (SVC) For this develop-mental work SVC provided ViewRay with risk capital

ViewRay Inc US

Risk capital for safe radiation therapy

The US company ViewRay Inc specializes in radiation therapy systems used to treat cancer With the strong support of Financial Services (Siemens Venture Capital) the company was able to develop an MRI-guided radiation therapy system

1312

ldquoThe distribution of the payments throughout the financing period and the holistic approach with a central contact person for the equipment reagents and financing really appealed to us because it was all so simple The Siemens solu-tion enabled our lab group to calmly and deliberately work on the expansion of our new test infrastructurerdquo

Franccedilois LeacuteonardCo-President Biosynergie

A summary of the benefits

60-month flexible finance arrangement

Transparent predictable and affordable payments

A holistic approach and streamlined processes with a central contact person

The challenge

Since France reorganized its regulatory frameworks for laboratories providers of laboratory and analysis services have been compelled to increase their opera-tional efficiency As this goal could not be achieved by Biosynergie by simply merging the previously autonomous labs the company wanted to acquire an analy-sis clinical chemistry and immunoassay platform for the entire laboratory group

The idea was to create one centralized platform that would cater for all labora-tory samples but a financing solution had to be found in order to make the investment viable

The solution

Siemens Healthcare Diagnostics offered Biosynergie a fully automated clinical chemistry and immunoassay system with an efficiency that facilitated economies of scale and thus more cost-effective operations on its previous setup To best address the needs of the lab group Siemens put together an all-inclusive package that included instruments main-tenance insurance and financing The financing covered a period of five years based on monthly payments aligned to the expected use of the system and the anticipated income generated An addi-tional agreement covering reagents was also arranged

Biosynergie France

Clearing the way with an ldquoall-inclusiverdquo offer

Biosynergie is a group of nine medical laboratories that joined together in 1994 in anticipation of regulatory changes Biosynergie selected an all-inclusive solution from Siemens when it decided to acquire a new joint analysis clinical chemistry and immunoassay platform

1514

ldquoOur working experience with Siemens Financial Services has been very posi-tive The team is very knowledgeable not only as relates to putting the tax-exempt financing together but also of our business model and how we provide service to our patients This made it very easy for us to work to-gether Additionally their professional-ism and customer service exceeded our expectations We look forward to work-ing with them again in the futurerdquo

Janelle SpannExecutive Director North Oakland ndashNorth Macomb Imaging Inc

A summary of the benefits

Customer was able to achieve a lending rate which mir-rored what is available via the tax-exempt bond market in a more timely and efficient manner (as compared to issuing a bond)

The challenge

When North Oakland ndash North Macomb Imaging was planning to acquire a new MRI system from Siemens the top priori-ties were to finance not only the equip-ment but also the necessary structural changes Given the customerrsquos status as a non-profit entity North Oakland ndash North Macomb Imaging was interested in secur-ing tax-exempt financing

The solution

Siemens offers tax-exempt financing to qualifying non-profit organizations in the US and was able to offer an attractive tax-exempt financing package for North Oakland ndash North Macomb Imaging

North Oakland ndash North Macomb Imaging US

Tax-exempt solution for non-profit groups

North Oakland ndash North Macomb Imaging is jointly run by three non-profit hospitals For this reason it becomes even more important to finance capital expenditures in a way that conserves resources ndash particularly when major equipment like a new magnetic resonance imaging (MRI) system is needed

1716

Ministry of Health

ldquoWe are proud that Siemens Croatia is recognized as a quality partner and supplier of medical equipment with proven solutions for all healthcare areas With tailored financing solutions from Siemens Financial Services we are able to react more flexible to customer needs The state-of-the-art devices will now also be available to Croatian patientsrdquo

Mladen Fogec Siemens Croatia Country CEO

A summary of the benefits

The Ministry of Health (MOH) and the involved hospitals received state-of-the-art medical imaging technology

Extended warranty services assure best availability of the systems throughout the contract period and beyond

The MOH has one contract partner for the technical solution and for long-term financing and at the same time acquires ownership of the equipment

Through the long-term supplier loan the substantial investment does not cause immediate burden to the national healthcare budget Neither does the MOH have interest rate risk or foreign currency risks as the final price for medical equipment and services is covered by the financing costs

The challenge

All the tasks including delivery installa-tion and training as well as building adap-tations have to be completed within 240 days The Ministry of Health requested also a six-year warranty service The whole package had to be offered at a fixed price in local currency without cur-rency exchange clause and bankable col-laterals with extended yearly repayments over a period of six years

The solution

Due to many limitations the markets were not able to offer long-term refinanc-ing in local currency or hedging over one year So during the tendering phase Siemens Financial Services with its local and regional office was strongly involved in risk assessment structuring and pric-ing of the respective transactions based on sovereign risk

In the end Siemens could offer to the Ministry of Health the desired equipment and services as well as the long repay-ment period in form of a six-year supplier loan and fulfill the pre-defined conditions of the Ministry of Healthrsquos tender

Ministry of Health Croatia

State-of-the-art equipment for Croatian hospitals

The Croatian Ministry of Health has modernized and expanded the pool of equipment (four state-of-the-art Symbia TruePoint SPECTCT systems two 2-head gamma cameras four MAGNETOM Avanto 15 T scanners four ONCOR LINAC and three SOMATOM SENSATION OPEN CT simulators) in many of its public hospitals across the country to provide state-of-the-art medical and imaging services to the patients These tenders which were supervised by Transparency Interna-tional have generated one of the largest contracts for Siemens Healthcare in Central and Eastern Europe

1918

ldquoWe found a good partner in Siemens In addition to the equipment purchase the innovative concept is an important component of the agreement We decided to purchase the entire pack-age Only a few people can offer some-thing like this We wanted everything to come from a single sourcerdquo

Dr Heiner Meyer zu LoumlsebeckManaging Director of the Evangelisches Krankenhaus Bielefeld(Dr Heiner Meyer zu Loumlsebeck was Managing Director from September 2007 to mid-January 2012)

A summary of the benefits

Rent-and-invest solution with monthly flat-rate pay-ments covering equipment service financing training and upgrades

Planning security covering an extended period of time

Financing of the installment payment using ldquopay as you earnrdquo

Use of the latest technology without overburdening the budget and liquidity

Guaranteeing and increase of internal financing ability

The challenge

Together with the Betheler Krankenhaus Mara the maximum-care facility Evan-gelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia with approximately 1500 beds 30 departments and 4200 employees In addition it is the biggest employer in the city of Bielefeld As part of the scheduled expansion of the hos-pital and its radiology department EvKB was looking for a strategic partner who not only delivered innovative medical technology but could also help it gain a long-range competitive edge

The solution

Siemens devised an equipment availabil-ity model with integrated capital expen-diture financing and the hospital con-cluded a ten-year partnership agreement based on it The complete single-source solution creates a decade of planning security in terms of the use of state-of-the-art medical technology and the costs related to it

The project covers the planning delivery and implementation of more than 80 medical-equipment products for the next ten years The products include large-scale equipment like MRIs CTs and X-ray units as well as ultrasound systems

In addition to the investment volume the financing flat rate covered by the agreement covers consulting services training process optimization equipment maintenance and technical upgrades The parties to the contract have combined all of this into a package that will be covered by a flat monthly installment payment for a period of 120 months

Evangelisches Krankenhaus Bielefeld gGmbH Germany

Strategic partnership with flat-rate financing

The Evangelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia As part of a scheduled expansion of some departments ndash particularly radiology ndash the hospital entered into a strategic partnership with Siemens Thanks to this alliance the hospital has gained a long-range competitive edge created by innovative medical technology without taking on financial risks that are difficult to calculate

2120

ldquoRegent has worked successfully with members of the Siemens team on a number of debt financings over the past five years Their ability to under-write both de novo and turnaround sit-uations to assess the potential for a variety of facilities and to craft creative financing structures makes them good colleagues with whom to do businessrdquo

Michael KarnesCFO Regent Surgical Health

A summary of the benefits

Financing from Siemens enabled the customer to develop a new outpatient surgery facility

The community benefits from having access to an outpatient surgery center which is often viewed as a more effective option for certain types of procedures

The challenge

Since being established in 2001 Regent Surgical Health has set up 18 medical centers that the company continues to successfully run on its own The company also holds minority stakes in ambula-tory surgical centers in the United States that it operates jointly with local part-ners For a center that it was planning to build with 18 local private physicians in Anchorage the capital of Alaska Regent needed an end-to-end financing solution that covered development of a new facility and acquisition of equipment

The solution

Thanks to Siemensrsquo experience with the business model on which the ambulatory surgical centers are based Financial Services was able to devise and offer a comprehensive financing solution that met the needs of Regent and the physicians involved in the project

Regent Surgical Health US

Convincing single-source financing

Regent Surgical Health operates a number of ambulatory surgical centers and a specialty hospital in the United States The company is known for running sustainably efficient facilities and for offering a high degree of autonomy to the private physicians with whom it works locally To set up an ambulatory surgical center in Alaska Regent needed a comprehensive financing concept

2322

ldquoOur strategy of renting high-tech equipment for five years was served by the innovative solution offered by Financial Services As a result we can keep our cost structures competitive while delivering high-quality and dependable service to the communityrdquo

Professor Amarilio Vieira de Macedo NetoPresident of the Hospital de Clinicas de Porto Alegre

A summary of the benefits

The financing structure meets the customerrsquos needs without hurting the liquidity of Siemens Healthcare Diagnostics

The customer can adjust spendings on laboratory equipment and operations to their utilization rate and thus match them to the hospitalrsquos own growth

The challenge

Siemens Healthcare Diagnostics the worldrsquos largest company specializing in clinical diagnostics seemed like a logical partner for the university medical cen-ter in the southern Brazilian city With the necessity to increase its performance to attend the high daily demand HCPA invested in Siemens equipment But it was crucial to find a financing solution based on monthly installments

The solution

Working together Siemens Health-care Diagnostics and Financial Services devised a viable needs-based financing structure and found a suitable local partner the Gaap Locaccedilatildeo de Bens company It served as the purchaser of the equipment and rented it back to Siemens Healthcare Diagnostics The Siemens division then rented it to HCPA under the same terms The agreement runs for three years and includes an option for two additional years

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

The Hospital de Clinicas de Porto Alegre (HCPA) wanted to finance its laboratory equipment and operations on a usage basis instead of purchasing the equipment Siemens was not only able to supply the right solution for clinical diagnostics but also devised a usage-based financing structure ndash using an unconventional approach

2524

ldquoThe working relationship with Siemens is helping Chengdu Western Hospital better manage its rapid expansion Thanks to the financing provided by Siemens we can offer our patients world-class technology without having to assume the financial burden that would have been associated with a major investment in the equipment for our new facility This really helps us reach our growth objectives in an effec-tive economically healthy mannerrdquo

Hao Shi Quan President of Chengdu Western Hospital

A summary of the benefits

The hospitalrsquos growth target could be quickly met without the additional financial burden created by a loan

Fast decision-making process due to single-source financing and the option of flexibly incorporating the equipment of other providers

World-class medical technology meets the needs of customers and patients

The challenge

Chengdu is one of Chinarsquos most appeal-ing cities in which to live And one factor that makes it so attractive to its citizens is its state-of-the-art efficient healthcare system which includes Chengdu West-ern Hospital as a key component To meet the cityrsquos growing demands the health-care operator has made extensive capi-tal expenditures and expanded the facil-ityrsquos capacity from 200 to 800 beds The operatorrsquos objective was also to equip the newly erected facility with cutting-edge medical technology without over-burdening its already stretched financial resources

The solution

For Chengdu Western Hospital Siemens put together a customized hire-purchase solution that helped support the hospi-talrsquos expansion strategy The financing agreement was arranged with a five-year term and enabled the hospital to acquire the latest medical technology from Siemens and other providers To obtain the required equipment the healthcare operator did not have to take out any new loans instead through the arrange-ment with Siemens the Chengdu West-ern Hospital was able to make the financ-ing payments from the income generated by the investment As a major portion of the technical equipment was made by Siemens Chengdu Western Hospital also benefited from the fast decision-making process facilitated by Siemensrsquo concept ldquotechnology and financing from a single sourcerdquo

Chengdu Western Hospital China

Rapid growth without side effects

As the rapidly expanding capital of the Chinese province of Sichuan the city of Chengdu needed state-of-the-art healthcare infrastructure To meet this need Chengdu Western Hospital launched a systematic expansion strategy To ensure that the goal is achieved efficiently the healthcare operator chose to finance the complete range of medical technology with Siemens

成都西区医院

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

5

Content

More quality for your patients ndash

new opportunities for you

Servicio Murciano de Salud Spain

A perfect partnership

ViewRay Inc USA

Risk capital for safe radiation therapy

Biosynergie France

Clearing the way with an ldquoall-inclusiverdquo offer

North Oakland ndash North Macomb Imaging USA

Tax-exempt solution for non-profit groups

Ministry of Health Croatia

State-of-the-art equipment for Croatian hospitals

Evangelisches Krankenhaus Bielefeld gGmbH Germany

Strategic partnership with flat-rate financing

Regent Surgical Health USA

Convincing single-source financing

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

Chengdu Western Hospital China

Rapid growth without side effects

The best recommendation your own

6

8

10

12

14

16

18

20

22

24

26

6 7

More quality for your patients ndash new opportunities for youThe perfect combination of healthcare experience and financial know-how

Benefits for SFS customers at a glance

Unrivaled combination of financing expertise and business know-how for customer- and industry-specific financing solutions

Comprehensive market and industry knowledge to support sustainable investments and healthy growth

Tailored financing solutions for more success on the market thanks to effective resource-saving investments in innovative technologies and sustainable infrastructure

Broad portfolio of financing solutions to offer the best solution for specific customer needs

Extensive experience as a Siemens division that offers proven solutions drawing from expert knowledge in industry and finance

Far-reaching refinancing within the Siemens Group for guaranteed security and reliable evaluation of the technical and economic feasibility of projects

Global network of financial service providers in around 30 countries provides direct access to banks export credit agencies and Siemens finance experts

Hospital operators and physicians in private practice can turn to Financial Services (SFS) the financial division of Siemens when they need a skilled partner capable of developing needs-based financial solutions that per-fectly complement the range of prod-ucts offered by the Healthcare Sector

Siemens Financial Services offers cus-tomized financial solutions that clear the way for liquidity-preserving invest-ments in innovative products and com-plete solutions as well as service and consulting guidance in healthcare Our product range includes leasing hire-purchase structured financing private equity project and equity participations as well as project and export financing

Our customers profit from the fact that our understanding of the health-care system stems not only from stud-ies and analyses but also from the years of experience we have gained as a part of Siemens and as the financ-ing partner of the Healthcare Sector

Business conditions for healthcare will change dramatically in years to come In the past the key problem was financial feasibility But soon demo-graphic change will make its presence felt driving up the number of elderly people and shrinking the labor pool Both developments will result in ris-ing investment needs among all play-ers in the healthcare system ndash and thus in rising financing needs

Working together the Healthcare Sec-tor at Siemens and Siemens Financial Services offer exactly those things that the healthcare system requires around the world attractive complete packages of technical solutions and perfectly tai-lored financing By doing so we ensure that our customers can become even more successful in their businesses

Servicio

Murcianode Salud

98

ldquoWe decided to use this solution because our medical centers were facing financial collapse We would not have been able to acquire new equipment if we had taken conventional approaches For this reason we had to go in a completely new directionrdquo

Maria Angeles PalaciosHealth Adviser of Murcia

A summary of the benefits

As a technical partner Siemens assumes economic responsibility and delivers cutting-edge technology

A long-term solution that acts as a role model for Spainrsquos national healthcare system

The challenge

For years the healthcare system in the Murcia region of Spain was chronically underfinanced The funds needed to make additions and expansions to the two university medical centers that the system operates in Cartagena and Mar Menor could only be obtained from the European Investment Bank There was little financial leeway to acquire the necessary technical equipment ndash a totally new approach was needed

The solution

For Spainrsquos healthcare system Siemens developed a visionary model of public- private partnerships In this arrangement Siemens took on the role of a technical partner assuming the responsibility for the financing acquisition maintenance operation and ongoing upgrades of all medical information and communication technology equipment As compensation Siemens receives a portion of the income generated by both medical centers and also assumes part of the entrepreneurial risk The partnership agreement runs for 15 years

To be able to play this role Siemens Healthcare and Financial Services had to develop new forms of collaboration and draw on their extensive business and financial acumen The result is a solution underpinned by economic sustainability

Servicio Murciano de Salud Spain

A perfect partnership

The healthcare system in the Murcia region of Spain and Siemens have taken a new direction in their work to provide two university medical centers with the latest medical information and communication technology in order to increase the centersrsquo operational efficiency a trendsetting form of public-private partner-ship with Siemens for Spainrsquos healthcare system

1110

ldquoThe risk capital team at Financial Services is an important partner for us It not only invested in us but also introduced us to financing tools that optimized our net working capital and can make it easier for our customers to acquire our systemsrdquo

Greg M Ayers MD PhD CEO and President of ViewRay Inc

A summary of the benefits

Support of innovative technology to help cancer patients

Win-win situation for Siemens Healthcare and ViewRay

Comprehensive support for an up-and-coming company in the medical-technology industry Risk capital can be complemented by vendor finance tools

The challenge

Radiation therapy uses ionizing radiation to systematically fight tumors and halt their growth In the process healthy tissue should be protected from the unwanted effects of the radiation This aim is complicated by the fact that some organs move during the radiation treat-ment For this reason ViewRay set out to develop a system that facilitates the pre-cise management of the radiated region during the treatment

The solution

Using ViewRayrsquos system of MRI-guided radiation therapy the physician can con-tinuously monitor where the radiation is hitting the tumor or healthy tissue and thus aim its beam more precisely Siemens delivers not only the necessary MRI components and technical assis-tance but also financial support from Financial Servicesrsquo subsidiary Siemens Venture Capital (SVC) For this develop-mental work SVC provided ViewRay with risk capital

ViewRay Inc US

Risk capital for safe radiation therapy

The US company ViewRay Inc specializes in radiation therapy systems used to treat cancer With the strong support of Financial Services (Siemens Venture Capital) the company was able to develop an MRI-guided radiation therapy system

1312

ldquoThe distribution of the payments throughout the financing period and the holistic approach with a central contact person for the equipment reagents and financing really appealed to us because it was all so simple The Siemens solu-tion enabled our lab group to calmly and deliberately work on the expansion of our new test infrastructurerdquo

Franccedilois LeacuteonardCo-President Biosynergie

A summary of the benefits

60-month flexible finance arrangement

Transparent predictable and affordable payments

A holistic approach and streamlined processes with a central contact person

The challenge

Since France reorganized its regulatory frameworks for laboratories providers of laboratory and analysis services have been compelled to increase their opera-tional efficiency As this goal could not be achieved by Biosynergie by simply merging the previously autonomous labs the company wanted to acquire an analy-sis clinical chemistry and immunoassay platform for the entire laboratory group

The idea was to create one centralized platform that would cater for all labora-tory samples but a financing solution had to be found in order to make the investment viable

The solution

Siemens Healthcare Diagnostics offered Biosynergie a fully automated clinical chemistry and immunoassay system with an efficiency that facilitated economies of scale and thus more cost-effective operations on its previous setup To best address the needs of the lab group Siemens put together an all-inclusive package that included instruments main-tenance insurance and financing The financing covered a period of five years based on monthly payments aligned to the expected use of the system and the anticipated income generated An addi-tional agreement covering reagents was also arranged

Biosynergie France

Clearing the way with an ldquoall-inclusiverdquo offer

Biosynergie is a group of nine medical laboratories that joined together in 1994 in anticipation of regulatory changes Biosynergie selected an all-inclusive solution from Siemens when it decided to acquire a new joint analysis clinical chemistry and immunoassay platform

1514

ldquoOur working experience with Siemens Financial Services has been very posi-tive The team is very knowledgeable not only as relates to putting the tax-exempt financing together but also of our business model and how we provide service to our patients This made it very easy for us to work to-gether Additionally their professional-ism and customer service exceeded our expectations We look forward to work-ing with them again in the futurerdquo

Janelle SpannExecutive Director North Oakland ndashNorth Macomb Imaging Inc

A summary of the benefits

Customer was able to achieve a lending rate which mir-rored what is available via the tax-exempt bond market in a more timely and efficient manner (as compared to issuing a bond)

The challenge

When North Oakland ndash North Macomb Imaging was planning to acquire a new MRI system from Siemens the top priori-ties were to finance not only the equip-ment but also the necessary structural changes Given the customerrsquos status as a non-profit entity North Oakland ndash North Macomb Imaging was interested in secur-ing tax-exempt financing

The solution

Siemens offers tax-exempt financing to qualifying non-profit organizations in the US and was able to offer an attractive tax-exempt financing package for North Oakland ndash North Macomb Imaging

North Oakland ndash North Macomb Imaging US

Tax-exempt solution for non-profit groups

North Oakland ndash North Macomb Imaging is jointly run by three non-profit hospitals For this reason it becomes even more important to finance capital expenditures in a way that conserves resources ndash particularly when major equipment like a new magnetic resonance imaging (MRI) system is needed

1716

Ministry of Health

ldquoWe are proud that Siemens Croatia is recognized as a quality partner and supplier of medical equipment with proven solutions for all healthcare areas With tailored financing solutions from Siemens Financial Services we are able to react more flexible to customer needs The state-of-the-art devices will now also be available to Croatian patientsrdquo

Mladen Fogec Siemens Croatia Country CEO

A summary of the benefits

The Ministry of Health (MOH) and the involved hospitals received state-of-the-art medical imaging technology

Extended warranty services assure best availability of the systems throughout the contract period and beyond

The MOH has one contract partner for the technical solution and for long-term financing and at the same time acquires ownership of the equipment

Through the long-term supplier loan the substantial investment does not cause immediate burden to the national healthcare budget Neither does the MOH have interest rate risk or foreign currency risks as the final price for medical equipment and services is covered by the financing costs

The challenge

All the tasks including delivery installa-tion and training as well as building adap-tations have to be completed within 240 days The Ministry of Health requested also a six-year warranty service The whole package had to be offered at a fixed price in local currency without cur-rency exchange clause and bankable col-laterals with extended yearly repayments over a period of six years

The solution

Due to many limitations the markets were not able to offer long-term refinanc-ing in local currency or hedging over one year So during the tendering phase Siemens Financial Services with its local and regional office was strongly involved in risk assessment structuring and pric-ing of the respective transactions based on sovereign risk

In the end Siemens could offer to the Ministry of Health the desired equipment and services as well as the long repay-ment period in form of a six-year supplier loan and fulfill the pre-defined conditions of the Ministry of Healthrsquos tender

Ministry of Health Croatia

State-of-the-art equipment for Croatian hospitals

The Croatian Ministry of Health has modernized and expanded the pool of equipment (four state-of-the-art Symbia TruePoint SPECTCT systems two 2-head gamma cameras four MAGNETOM Avanto 15 T scanners four ONCOR LINAC and three SOMATOM SENSATION OPEN CT simulators) in many of its public hospitals across the country to provide state-of-the-art medical and imaging services to the patients These tenders which were supervised by Transparency Interna-tional have generated one of the largest contracts for Siemens Healthcare in Central and Eastern Europe

1918

ldquoWe found a good partner in Siemens In addition to the equipment purchase the innovative concept is an important component of the agreement We decided to purchase the entire pack-age Only a few people can offer some-thing like this We wanted everything to come from a single sourcerdquo

Dr Heiner Meyer zu LoumlsebeckManaging Director of the Evangelisches Krankenhaus Bielefeld(Dr Heiner Meyer zu Loumlsebeck was Managing Director from September 2007 to mid-January 2012)

A summary of the benefits

Rent-and-invest solution with monthly flat-rate pay-ments covering equipment service financing training and upgrades

Planning security covering an extended period of time

Financing of the installment payment using ldquopay as you earnrdquo

Use of the latest technology without overburdening the budget and liquidity

Guaranteeing and increase of internal financing ability

The challenge

Together with the Betheler Krankenhaus Mara the maximum-care facility Evan-gelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia with approximately 1500 beds 30 departments and 4200 employees In addition it is the biggest employer in the city of Bielefeld As part of the scheduled expansion of the hos-pital and its radiology department EvKB was looking for a strategic partner who not only delivered innovative medical technology but could also help it gain a long-range competitive edge

The solution

Siemens devised an equipment availabil-ity model with integrated capital expen-diture financing and the hospital con-cluded a ten-year partnership agreement based on it The complete single-source solution creates a decade of planning security in terms of the use of state-of-the-art medical technology and the costs related to it

The project covers the planning delivery and implementation of more than 80 medical-equipment products for the next ten years The products include large-scale equipment like MRIs CTs and X-ray units as well as ultrasound systems

In addition to the investment volume the financing flat rate covered by the agreement covers consulting services training process optimization equipment maintenance and technical upgrades The parties to the contract have combined all of this into a package that will be covered by a flat monthly installment payment for a period of 120 months

Evangelisches Krankenhaus Bielefeld gGmbH Germany

Strategic partnership with flat-rate financing

The Evangelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia As part of a scheduled expansion of some departments ndash particularly radiology ndash the hospital entered into a strategic partnership with Siemens Thanks to this alliance the hospital has gained a long-range competitive edge created by innovative medical technology without taking on financial risks that are difficult to calculate

2120

ldquoRegent has worked successfully with members of the Siemens team on a number of debt financings over the past five years Their ability to under-write both de novo and turnaround sit-uations to assess the potential for a variety of facilities and to craft creative financing structures makes them good colleagues with whom to do businessrdquo

Michael KarnesCFO Regent Surgical Health

A summary of the benefits

Financing from Siemens enabled the customer to develop a new outpatient surgery facility

The community benefits from having access to an outpatient surgery center which is often viewed as a more effective option for certain types of procedures

The challenge

Since being established in 2001 Regent Surgical Health has set up 18 medical centers that the company continues to successfully run on its own The company also holds minority stakes in ambula-tory surgical centers in the United States that it operates jointly with local part-ners For a center that it was planning to build with 18 local private physicians in Anchorage the capital of Alaska Regent needed an end-to-end financing solution that covered development of a new facility and acquisition of equipment

The solution

Thanks to Siemensrsquo experience with the business model on which the ambulatory surgical centers are based Financial Services was able to devise and offer a comprehensive financing solution that met the needs of Regent and the physicians involved in the project

Regent Surgical Health US

Convincing single-source financing

Regent Surgical Health operates a number of ambulatory surgical centers and a specialty hospital in the United States The company is known for running sustainably efficient facilities and for offering a high degree of autonomy to the private physicians with whom it works locally To set up an ambulatory surgical center in Alaska Regent needed a comprehensive financing concept

2322

ldquoOur strategy of renting high-tech equipment for five years was served by the innovative solution offered by Financial Services As a result we can keep our cost structures competitive while delivering high-quality and dependable service to the communityrdquo

Professor Amarilio Vieira de Macedo NetoPresident of the Hospital de Clinicas de Porto Alegre

A summary of the benefits

The financing structure meets the customerrsquos needs without hurting the liquidity of Siemens Healthcare Diagnostics

The customer can adjust spendings on laboratory equipment and operations to their utilization rate and thus match them to the hospitalrsquos own growth

The challenge

Siemens Healthcare Diagnostics the worldrsquos largest company specializing in clinical diagnostics seemed like a logical partner for the university medical cen-ter in the southern Brazilian city With the necessity to increase its performance to attend the high daily demand HCPA invested in Siemens equipment But it was crucial to find a financing solution based on monthly installments

The solution

Working together Siemens Health-care Diagnostics and Financial Services devised a viable needs-based financing structure and found a suitable local partner the Gaap Locaccedilatildeo de Bens company It served as the purchaser of the equipment and rented it back to Siemens Healthcare Diagnostics The Siemens division then rented it to HCPA under the same terms The agreement runs for three years and includes an option for two additional years

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

The Hospital de Clinicas de Porto Alegre (HCPA) wanted to finance its laboratory equipment and operations on a usage basis instead of purchasing the equipment Siemens was not only able to supply the right solution for clinical diagnostics but also devised a usage-based financing structure ndash using an unconventional approach

2524

ldquoThe working relationship with Siemens is helping Chengdu Western Hospital better manage its rapid expansion Thanks to the financing provided by Siemens we can offer our patients world-class technology without having to assume the financial burden that would have been associated with a major investment in the equipment for our new facility This really helps us reach our growth objectives in an effec-tive economically healthy mannerrdquo

Hao Shi Quan President of Chengdu Western Hospital

A summary of the benefits

The hospitalrsquos growth target could be quickly met without the additional financial burden created by a loan

Fast decision-making process due to single-source financing and the option of flexibly incorporating the equipment of other providers

World-class medical technology meets the needs of customers and patients

The challenge

Chengdu is one of Chinarsquos most appeal-ing cities in which to live And one factor that makes it so attractive to its citizens is its state-of-the-art efficient healthcare system which includes Chengdu West-ern Hospital as a key component To meet the cityrsquos growing demands the health-care operator has made extensive capi-tal expenditures and expanded the facil-ityrsquos capacity from 200 to 800 beds The operatorrsquos objective was also to equip the newly erected facility with cutting-edge medical technology without over-burdening its already stretched financial resources

The solution

For Chengdu Western Hospital Siemens put together a customized hire-purchase solution that helped support the hospi-talrsquos expansion strategy The financing agreement was arranged with a five-year term and enabled the hospital to acquire the latest medical technology from Siemens and other providers To obtain the required equipment the healthcare operator did not have to take out any new loans instead through the arrange-ment with Siemens the Chengdu West-ern Hospital was able to make the financ-ing payments from the income generated by the investment As a major portion of the technical equipment was made by Siemens Chengdu Western Hospital also benefited from the fast decision-making process facilitated by Siemensrsquo concept ldquotechnology and financing from a single sourcerdquo

Chengdu Western Hospital China

Rapid growth without side effects

As the rapidly expanding capital of the Chinese province of Sichuan the city of Chengdu needed state-of-the-art healthcare infrastructure To meet this need Chengdu Western Hospital launched a systematic expansion strategy To ensure that the goal is achieved efficiently the healthcare operator chose to finance the complete range of medical technology with Siemens

成都西区医院

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

6 7

More quality for your patients ndash new opportunities for youThe perfect combination of healthcare experience and financial know-how

Benefits for SFS customers at a glance

Unrivaled combination of financing expertise and business know-how for customer- and industry-specific financing solutions

Comprehensive market and industry knowledge to support sustainable investments and healthy growth

Tailored financing solutions for more success on the market thanks to effective resource-saving investments in innovative technologies and sustainable infrastructure

Broad portfolio of financing solutions to offer the best solution for specific customer needs

Extensive experience as a Siemens division that offers proven solutions drawing from expert knowledge in industry and finance

Far-reaching refinancing within the Siemens Group for guaranteed security and reliable evaluation of the technical and economic feasibility of projects

Global network of financial service providers in around 30 countries provides direct access to banks export credit agencies and Siemens finance experts

Hospital operators and physicians in private practice can turn to Financial Services (SFS) the financial division of Siemens when they need a skilled partner capable of developing needs-based financial solutions that per-fectly complement the range of prod-ucts offered by the Healthcare Sector

Siemens Financial Services offers cus-tomized financial solutions that clear the way for liquidity-preserving invest-ments in innovative products and com-plete solutions as well as service and consulting guidance in healthcare Our product range includes leasing hire-purchase structured financing private equity project and equity participations as well as project and export financing

Our customers profit from the fact that our understanding of the health-care system stems not only from stud-ies and analyses but also from the years of experience we have gained as a part of Siemens and as the financ-ing partner of the Healthcare Sector

Business conditions for healthcare will change dramatically in years to come In the past the key problem was financial feasibility But soon demo-graphic change will make its presence felt driving up the number of elderly people and shrinking the labor pool Both developments will result in ris-ing investment needs among all play-ers in the healthcare system ndash and thus in rising financing needs

Working together the Healthcare Sec-tor at Siemens and Siemens Financial Services offer exactly those things that the healthcare system requires around the world attractive complete packages of technical solutions and perfectly tai-lored financing By doing so we ensure that our customers can become even more successful in their businesses

Servicio

Murcianode Salud

98

ldquoWe decided to use this solution because our medical centers were facing financial collapse We would not have been able to acquire new equipment if we had taken conventional approaches For this reason we had to go in a completely new directionrdquo

Maria Angeles PalaciosHealth Adviser of Murcia

A summary of the benefits

As a technical partner Siemens assumes economic responsibility and delivers cutting-edge technology

A long-term solution that acts as a role model for Spainrsquos national healthcare system

The challenge

For years the healthcare system in the Murcia region of Spain was chronically underfinanced The funds needed to make additions and expansions to the two university medical centers that the system operates in Cartagena and Mar Menor could only be obtained from the European Investment Bank There was little financial leeway to acquire the necessary technical equipment ndash a totally new approach was needed

The solution

For Spainrsquos healthcare system Siemens developed a visionary model of public- private partnerships In this arrangement Siemens took on the role of a technical partner assuming the responsibility for the financing acquisition maintenance operation and ongoing upgrades of all medical information and communication technology equipment As compensation Siemens receives a portion of the income generated by both medical centers and also assumes part of the entrepreneurial risk The partnership agreement runs for 15 years

To be able to play this role Siemens Healthcare and Financial Services had to develop new forms of collaboration and draw on their extensive business and financial acumen The result is a solution underpinned by economic sustainability

Servicio Murciano de Salud Spain

A perfect partnership

The healthcare system in the Murcia region of Spain and Siemens have taken a new direction in their work to provide two university medical centers with the latest medical information and communication technology in order to increase the centersrsquo operational efficiency a trendsetting form of public-private partner-ship with Siemens for Spainrsquos healthcare system

1110

ldquoThe risk capital team at Financial Services is an important partner for us It not only invested in us but also introduced us to financing tools that optimized our net working capital and can make it easier for our customers to acquire our systemsrdquo

Greg M Ayers MD PhD CEO and President of ViewRay Inc

A summary of the benefits

Support of innovative technology to help cancer patients

Win-win situation for Siemens Healthcare and ViewRay

Comprehensive support for an up-and-coming company in the medical-technology industry Risk capital can be complemented by vendor finance tools

The challenge

Radiation therapy uses ionizing radiation to systematically fight tumors and halt their growth In the process healthy tissue should be protected from the unwanted effects of the radiation This aim is complicated by the fact that some organs move during the radiation treat-ment For this reason ViewRay set out to develop a system that facilitates the pre-cise management of the radiated region during the treatment

The solution

Using ViewRayrsquos system of MRI-guided radiation therapy the physician can con-tinuously monitor where the radiation is hitting the tumor or healthy tissue and thus aim its beam more precisely Siemens delivers not only the necessary MRI components and technical assis-tance but also financial support from Financial Servicesrsquo subsidiary Siemens Venture Capital (SVC) For this develop-mental work SVC provided ViewRay with risk capital

ViewRay Inc US

Risk capital for safe radiation therapy

The US company ViewRay Inc specializes in radiation therapy systems used to treat cancer With the strong support of Financial Services (Siemens Venture Capital) the company was able to develop an MRI-guided radiation therapy system

1312

ldquoThe distribution of the payments throughout the financing period and the holistic approach with a central contact person for the equipment reagents and financing really appealed to us because it was all so simple The Siemens solu-tion enabled our lab group to calmly and deliberately work on the expansion of our new test infrastructurerdquo

Franccedilois LeacuteonardCo-President Biosynergie

A summary of the benefits

60-month flexible finance arrangement

Transparent predictable and affordable payments

A holistic approach and streamlined processes with a central contact person

The challenge

Since France reorganized its regulatory frameworks for laboratories providers of laboratory and analysis services have been compelled to increase their opera-tional efficiency As this goal could not be achieved by Biosynergie by simply merging the previously autonomous labs the company wanted to acquire an analy-sis clinical chemistry and immunoassay platform for the entire laboratory group

The idea was to create one centralized platform that would cater for all labora-tory samples but a financing solution had to be found in order to make the investment viable

The solution

Siemens Healthcare Diagnostics offered Biosynergie a fully automated clinical chemistry and immunoassay system with an efficiency that facilitated economies of scale and thus more cost-effective operations on its previous setup To best address the needs of the lab group Siemens put together an all-inclusive package that included instruments main-tenance insurance and financing The financing covered a period of five years based on monthly payments aligned to the expected use of the system and the anticipated income generated An addi-tional agreement covering reagents was also arranged

Biosynergie France

Clearing the way with an ldquoall-inclusiverdquo offer

Biosynergie is a group of nine medical laboratories that joined together in 1994 in anticipation of regulatory changes Biosynergie selected an all-inclusive solution from Siemens when it decided to acquire a new joint analysis clinical chemistry and immunoassay platform

1514

ldquoOur working experience with Siemens Financial Services has been very posi-tive The team is very knowledgeable not only as relates to putting the tax-exempt financing together but also of our business model and how we provide service to our patients This made it very easy for us to work to-gether Additionally their professional-ism and customer service exceeded our expectations We look forward to work-ing with them again in the futurerdquo

Janelle SpannExecutive Director North Oakland ndashNorth Macomb Imaging Inc

A summary of the benefits

Customer was able to achieve a lending rate which mir-rored what is available via the tax-exempt bond market in a more timely and efficient manner (as compared to issuing a bond)

The challenge

When North Oakland ndash North Macomb Imaging was planning to acquire a new MRI system from Siemens the top priori-ties were to finance not only the equip-ment but also the necessary structural changes Given the customerrsquos status as a non-profit entity North Oakland ndash North Macomb Imaging was interested in secur-ing tax-exempt financing

The solution

Siemens offers tax-exempt financing to qualifying non-profit organizations in the US and was able to offer an attractive tax-exempt financing package for North Oakland ndash North Macomb Imaging

North Oakland ndash North Macomb Imaging US

Tax-exempt solution for non-profit groups

North Oakland ndash North Macomb Imaging is jointly run by three non-profit hospitals For this reason it becomes even more important to finance capital expenditures in a way that conserves resources ndash particularly when major equipment like a new magnetic resonance imaging (MRI) system is needed

1716

Ministry of Health

ldquoWe are proud that Siemens Croatia is recognized as a quality partner and supplier of medical equipment with proven solutions for all healthcare areas With tailored financing solutions from Siemens Financial Services we are able to react more flexible to customer needs The state-of-the-art devices will now also be available to Croatian patientsrdquo

Mladen Fogec Siemens Croatia Country CEO

A summary of the benefits

The Ministry of Health (MOH) and the involved hospitals received state-of-the-art medical imaging technology

Extended warranty services assure best availability of the systems throughout the contract period and beyond

The MOH has one contract partner for the technical solution and for long-term financing and at the same time acquires ownership of the equipment

Through the long-term supplier loan the substantial investment does not cause immediate burden to the national healthcare budget Neither does the MOH have interest rate risk or foreign currency risks as the final price for medical equipment and services is covered by the financing costs

The challenge

All the tasks including delivery installa-tion and training as well as building adap-tations have to be completed within 240 days The Ministry of Health requested also a six-year warranty service The whole package had to be offered at a fixed price in local currency without cur-rency exchange clause and bankable col-laterals with extended yearly repayments over a period of six years

The solution

Due to many limitations the markets were not able to offer long-term refinanc-ing in local currency or hedging over one year So during the tendering phase Siemens Financial Services with its local and regional office was strongly involved in risk assessment structuring and pric-ing of the respective transactions based on sovereign risk

In the end Siemens could offer to the Ministry of Health the desired equipment and services as well as the long repay-ment period in form of a six-year supplier loan and fulfill the pre-defined conditions of the Ministry of Healthrsquos tender

Ministry of Health Croatia

State-of-the-art equipment for Croatian hospitals

The Croatian Ministry of Health has modernized and expanded the pool of equipment (four state-of-the-art Symbia TruePoint SPECTCT systems two 2-head gamma cameras four MAGNETOM Avanto 15 T scanners four ONCOR LINAC and three SOMATOM SENSATION OPEN CT simulators) in many of its public hospitals across the country to provide state-of-the-art medical and imaging services to the patients These tenders which were supervised by Transparency Interna-tional have generated one of the largest contracts for Siemens Healthcare in Central and Eastern Europe

1918

ldquoWe found a good partner in Siemens In addition to the equipment purchase the innovative concept is an important component of the agreement We decided to purchase the entire pack-age Only a few people can offer some-thing like this We wanted everything to come from a single sourcerdquo

Dr Heiner Meyer zu LoumlsebeckManaging Director of the Evangelisches Krankenhaus Bielefeld(Dr Heiner Meyer zu Loumlsebeck was Managing Director from September 2007 to mid-January 2012)

A summary of the benefits

Rent-and-invest solution with monthly flat-rate pay-ments covering equipment service financing training and upgrades

Planning security covering an extended period of time

Financing of the installment payment using ldquopay as you earnrdquo

Use of the latest technology without overburdening the budget and liquidity

Guaranteeing and increase of internal financing ability

The challenge

Together with the Betheler Krankenhaus Mara the maximum-care facility Evan-gelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia with approximately 1500 beds 30 departments and 4200 employees In addition it is the biggest employer in the city of Bielefeld As part of the scheduled expansion of the hos-pital and its radiology department EvKB was looking for a strategic partner who not only delivered innovative medical technology but could also help it gain a long-range competitive edge

The solution

Siemens devised an equipment availabil-ity model with integrated capital expen-diture financing and the hospital con-cluded a ten-year partnership agreement based on it The complete single-source solution creates a decade of planning security in terms of the use of state-of-the-art medical technology and the costs related to it

The project covers the planning delivery and implementation of more than 80 medical-equipment products for the next ten years The products include large-scale equipment like MRIs CTs and X-ray units as well as ultrasound systems

In addition to the investment volume the financing flat rate covered by the agreement covers consulting services training process optimization equipment maintenance and technical upgrades The parties to the contract have combined all of this into a package that will be covered by a flat monthly installment payment for a period of 120 months

Evangelisches Krankenhaus Bielefeld gGmbH Germany

Strategic partnership with flat-rate financing

The Evangelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia As part of a scheduled expansion of some departments ndash particularly radiology ndash the hospital entered into a strategic partnership with Siemens Thanks to this alliance the hospital has gained a long-range competitive edge created by innovative medical technology without taking on financial risks that are difficult to calculate

2120

ldquoRegent has worked successfully with members of the Siemens team on a number of debt financings over the past five years Their ability to under-write both de novo and turnaround sit-uations to assess the potential for a variety of facilities and to craft creative financing structures makes them good colleagues with whom to do businessrdquo

Michael KarnesCFO Regent Surgical Health

A summary of the benefits

Financing from Siemens enabled the customer to develop a new outpatient surgery facility

The community benefits from having access to an outpatient surgery center which is often viewed as a more effective option for certain types of procedures

The challenge

Since being established in 2001 Regent Surgical Health has set up 18 medical centers that the company continues to successfully run on its own The company also holds minority stakes in ambula-tory surgical centers in the United States that it operates jointly with local part-ners For a center that it was planning to build with 18 local private physicians in Anchorage the capital of Alaska Regent needed an end-to-end financing solution that covered development of a new facility and acquisition of equipment

The solution

Thanks to Siemensrsquo experience with the business model on which the ambulatory surgical centers are based Financial Services was able to devise and offer a comprehensive financing solution that met the needs of Regent and the physicians involved in the project

Regent Surgical Health US

Convincing single-source financing

Regent Surgical Health operates a number of ambulatory surgical centers and a specialty hospital in the United States The company is known for running sustainably efficient facilities and for offering a high degree of autonomy to the private physicians with whom it works locally To set up an ambulatory surgical center in Alaska Regent needed a comprehensive financing concept

2322

ldquoOur strategy of renting high-tech equipment for five years was served by the innovative solution offered by Financial Services As a result we can keep our cost structures competitive while delivering high-quality and dependable service to the communityrdquo

Professor Amarilio Vieira de Macedo NetoPresident of the Hospital de Clinicas de Porto Alegre

A summary of the benefits

The financing structure meets the customerrsquos needs without hurting the liquidity of Siemens Healthcare Diagnostics

The customer can adjust spendings on laboratory equipment and operations to their utilization rate and thus match them to the hospitalrsquos own growth

The challenge

Siemens Healthcare Diagnostics the worldrsquos largest company specializing in clinical diagnostics seemed like a logical partner for the university medical cen-ter in the southern Brazilian city With the necessity to increase its performance to attend the high daily demand HCPA invested in Siemens equipment But it was crucial to find a financing solution based on monthly installments

The solution

Working together Siemens Health-care Diagnostics and Financial Services devised a viable needs-based financing structure and found a suitable local partner the Gaap Locaccedilatildeo de Bens company It served as the purchaser of the equipment and rented it back to Siemens Healthcare Diagnostics The Siemens division then rented it to HCPA under the same terms The agreement runs for three years and includes an option for two additional years

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

The Hospital de Clinicas de Porto Alegre (HCPA) wanted to finance its laboratory equipment and operations on a usage basis instead of purchasing the equipment Siemens was not only able to supply the right solution for clinical diagnostics but also devised a usage-based financing structure ndash using an unconventional approach

2524

ldquoThe working relationship with Siemens is helping Chengdu Western Hospital better manage its rapid expansion Thanks to the financing provided by Siemens we can offer our patients world-class technology without having to assume the financial burden that would have been associated with a major investment in the equipment for our new facility This really helps us reach our growth objectives in an effec-tive economically healthy mannerrdquo

Hao Shi Quan President of Chengdu Western Hospital

A summary of the benefits

The hospitalrsquos growth target could be quickly met without the additional financial burden created by a loan

Fast decision-making process due to single-source financing and the option of flexibly incorporating the equipment of other providers

World-class medical technology meets the needs of customers and patients

The challenge

Chengdu is one of Chinarsquos most appeal-ing cities in which to live And one factor that makes it so attractive to its citizens is its state-of-the-art efficient healthcare system which includes Chengdu West-ern Hospital as a key component To meet the cityrsquos growing demands the health-care operator has made extensive capi-tal expenditures and expanded the facil-ityrsquos capacity from 200 to 800 beds The operatorrsquos objective was also to equip the newly erected facility with cutting-edge medical technology without over-burdening its already stretched financial resources

The solution

For Chengdu Western Hospital Siemens put together a customized hire-purchase solution that helped support the hospi-talrsquos expansion strategy The financing agreement was arranged with a five-year term and enabled the hospital to acquire the latest medical technology from Siemens and other providers To obtain the required equipment the healthcare operator did not have to take out any new loans instead through the arrange-ment with Siemens the Chengdu West-ern Hospital was able to make the financ-ing payments from the income generated by the investment As a major portion of the technical equipment was made by Siemens Chengdu Western Hospital also benefited from the fast decision-making process facilitated by Siemensrsquo concept ldquotechnology and financing from a single sourcerdquo

Chengdu Western Hospital China

Rapid growth without side effects

As the rapidly expanding capital of the Chinese province of Sichuan the city of Chengdu needed state-of-the-art healthcare infrastructure To meet this need Chengdu Western Hospital launched a systematic expansion strategy To ensure that the goal is achieved efficiently the healthcare operator chose to finance the complete range of medical technology with Siemens

成都西区医院

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

Servicio

Murcianode Salud

98

ldquoWe decided to use this solution because our medical centers were facing financial collapse We would not have been able to acquire new equipment if we had taken conventional approaches For this reason we had to go in a completely new directionrdquo

Maria Angeles PalaciosHealth Adviser of Murcia

A summary of the benefits

As a technical partner Siemens assumes economic responsibility and delivers cutting-edge technology

A long-term solution that acts as a role model for Spainrsquos national healthcare system

The challenge

For years the healthcare system in the Murcia region of Spain was chronically underfinanced The funds needed to make additions and expansions to the two university medical centers that the system operates in Cartagena and Mar Menor could only be obtained from the European Investment Bank There was little financial leeway to acquire the necessary technical equipment ndash a totally new approach was needed

The solution

For Spainrsquos healthcare system Siemens developed a visionary model of public- private partnerships In this arrangement Siemens took on the role of a technical partner assuming the responsibility for the financing acquisition maintenance operation and ongoing upgrades of all medical information and communication technology equipment As compensation Siemens receives a portion of the income generated by both medical centers and also assumes part of the entrepreneurial risk The partnership agreement runs for 15 years

To be able to play this role Siemens Healthcare and Financial Services had to develop new forms of collaboration and draw on their extensive business and financial acumen The result is a solution underpinned by economic sustainability

Servicio Murciano de Salud Spain

A perfect partnership

The healthcare system in the Murcia region of Spain and Siemens have taken a new direction in their work to provide two university medical centers with the latest medical information and communication technology in order to increase the centersrsquo operational efficiency a trendsetting form of public-private partner-ship with Siemens for Spainrsquos healthcare system

1110

ldquoThe risk capital team at Financial Services is an important partner for us It not only invested in us but also introduced us to financing tools that optimized our net working capital and can make it easier for our customers to acquire our systemsrdquo

Greg M Ayers MD PhD CEO and President of ViewRay Inc

A summary of the benefits

Support of innovative technology to help cancer patients

Win-win situation for Siemens Healthcare and ViewRay

Comprehensive support for an up-and-coming company in the medical-technology industry Risk capital can be complemented by vendor finance tools

The challenge

Radiation therapy uses ionizing radiation to systematically fight tumors and halt their growth In the process healthy tissue should be protected from the unwanted effects of the radiation This aim is complicated by the fact that some organs move during the radiation treat-ment For this reason ViewRay set out to develop a system that facilitates the pre-cise management of the radiated region during the treatment

The solution

Using ViewRayrsquos system of MRI-guided radiation therapy the physician can con-tinuously monitor where the radiation is hitting the tumor or healthy tissue and thus aim its beam more precisely Siemens delivers not only the necessary MRI components and technical assis-tance but also financial support from Financial Servicesrsquo subsidiary Siemens Venture Capital (SVC) For this develop-mental work SVC provided ViewRay with risk capital

ViewRay Inc US

Risk capital for safe radiation therapy

The US company ViewRay Inc specializes in radiation therapy systems used to treat cancer With the strong support of Financial Services (Siemens Venture Capital) the company was able to develop an MRI-guided radiation therapy system

1312

ldquoThe distribution of the payments throughout the financing period and the holistic approach with a central contact person for the equipment reagents and financing really appealed to us because it was all so simple The Siemens solu-tion enabled our lab group to calmly and deliberately work on the expansion of our new test infrastructurerdquo

Franccedilois LeacuteonardCo-President Biosynergie

A summary of the benefits

60-month flexible finance arrangement

Transparent predictable and affordable payments

A holistic approach and streamlined processes with a central contact person

The challenge

Since France reorganized its regulatory frameworks for laboratories providers of laboratory and analysis services have been compelled to increase their opera-tional efficiency As this goal could not be achieved by Biosynergie by simply merging the previously autonomous labs the company wanted to acquire an analy-sis clinical chemistry and immunoassay platform for the entire laboratory group

The idea was to create one centralized platform that would cater for all labora-tory samples but a financing solution had to be found in order to make the investment viable

The solution

Siemens Healthcare Diagnostics offered Biosynergie a fully automated clinical chemistry and immunoassay system with an efficiency that facilitated economies of scale and thus more cost-effective operations on its previous setup To best address the needs of the lab group Siemens put together an all-inclusive package that included instruments main-tenance insurance and financing The financing covered a period of five years based on monthly payments aligned to the expected use of the system and the anticipated income generated An addi-tional agreement covering reagents was also arranged

Biosynergie France

Clearing the way with an ldquoall-inclusiverdquo offer

Biosynergie is a group of nine medical laboratories that joined together in 1994 in anticipation of regulatory changes Biosynergie selected an all-inclusive solution from Siemens when it decided to acquire a new joint analysis clinical chemistry and immunoassay platform

1514

ldquoOur working experience with Siemens Financial Services has been very posi-tive The team is very knowledgeable not only as relates to putting the tax-exempt financing together but also of our business model and how we provide service to our patients This made it very easy for us to work to-gether Additionally their professional-ism and customer service exceeded our expectations We look forward to work-ing with them again in the futurerdquo

Janelle SpannExecutive Director North Oakland ndashNorth Macomb Imaging Inc

A summary of the benefits

Customer was able to achieve a lending rate which mir-rored what is available via the tax-exempt bond market in a more timely and efficient manner (as compared to issuing a bond)

The challenge

When North Oakland ndash North Macomb Imaging was planning to acquire a new MRI system from Siemens the top priori-ties were to finance not only the equip-ment but also the necessary structural changes Given the customerrsquos status as a non-profit entity North Oakland ndash North Macomb Imaging was interested in secur-ing tax-exempt financing

The solution

Siemens offers tax-exempt financing to qualifying non-profit organizations in the US and was able to offer an attractive tax-exempt financing package for North Oakland ndash North Macomb Imaging

North Oakland ndash North Macomb Imaging US

Tax-exempt solution for non-profit groups

North Oakland ndash North Macomb Imaging is jointly run by three non-profit hospitals For this reason it becomes even more important to finance capital expenditures in a way that conserves resources ndash particularly when major equipment like a new magnetic resonance imaging (MRI) system is needed

1716

Ministry of Health

ldquoWe are proud that Siemens Croatia is recognized as a quality partner and supplier of medical equipment with proven solutions for all healthcare areas With tailored financing solutions from Siemens Financial Services we are able to react more flexible to customer needs The state-of-the-art devices will now also be available to Croatian patientsrdquo

Mladen Fogec Siemens Croatia Country CEO

A summary of the benefits

The Ministry of Health (MOH) and the involved hospitals received state-of-the-art medical imaging technology

Extended warranty services assure best availability of the systems throughout the contract period and beyond

The MOH has one contract partner for the technical solution and for long-term financing and at the same time acquires ownership of the equipment

Through the long-term supplier loan the substantial investment does not cause immediate burden to the national healthcare budget Neither does the MOH have interest rate risk or foreign currency risks as the final price for medical equipment and services is covered by the financing costs

The challenge

All the tasks including delivery installa-tion and training as well as building adap-tations have to be completed within 240 days The Ministry of Health requested also a six-year warranty service The whole package had to be offered at a fixed price in local currency without cur-rency exchange clause and bankable col-laterals with extended yearly repayments over a period of six years

The solution

Due to many limitations the markets were not able to offer long-term refinanc-ing in local currency or hedging over one year So during the tendering phase Siemens Financial Services with its local and regional office was strongly involved in risk assessment structuring and pric-ing of the respective transactions based on sovereign risk

In the end Siemens could offer to the Ministry of Health the desired equipment and services as well as the long repay-ment period in form of a six-year supplier loan and fulfill the pre-defined conditions of the Ministry of Healthrsquos tender

Ministry of Health Croatia

State-of-the-art equipment for Croatian hospitals

The Croatian Ministry of Health has modernized and expanded the pool of equipment (four state-of-the-art Symbia TruePoint SPECTCT systems two 2-head gamma cameras four MAGNETOM Avanto 15 T scanners four ONCOR LINAC and three SOMATOM SENSATION OPEN CT simulators) in many of its public hospitals across the country to provide state-of-the-art medical and imaging services to the patients These tenders which were supervised by Transparency Interna-tional have generated one of the largest contracts for Siemens Healthcare in Central and Eastern Europe

1918

ldquoWe found a good partner in Siemens In addition to the equipment purchase the innovative concept is an important component of the agreement We decided to purchase the entire pack-age Only a few people can offer some-thing like this We wanted everything to come from a single sourcerdquo

Dr Heiner Meyer zu LoumlsebeckManaging Director of the Evangelisches Krankenhaus Bielefeld(Dr Heiner Meyer zu Loumlsebeck was Managing Director from September 2007 to mid-January 2012)

A summary of the benefits

Rent-and-invest solution with monthly flat-rate pay-ments covering equipment service financing training and upgrades

Planning security covering an extended period of time

Financing of the installment payment using ldquopay as you earnrdquo

Use of the latest technology without overburdening the budget and liquidity

Guaranteeing and increase of internal financing ability

The challenge

Together with the Betheler Krankenhaus Mara the maximum-care facility Evan-gelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia with approximately 1500 beds 30 departments and 4200 employees In addition it is the biggest employer in the city of Bielefeld As part of the scheduled expansion of the hos-pital and its radiology department EvKB was looking for a strategic partner who not only delivered innovative medical technology but could also help it gain a long-range competitive edge

The solution

Siemens devised an equipment availabil-ity model with integrated capital expen-diture financing and the hospital con-cluded a ten-year partnership agreement based on it The complete single-source solution creates a decade of planning security in terms of the use of state-of-the-art medical technology and the costs related to it

The project covers the planning delivery and implementation of more than 80 medical-equipment products for the next ten years The products include large-scale equipment like MRIs CTs and X-ray units as well as ultrasound systems

In addition to the investment volume the financing flat rate covered by the agreement covers consulting services training process optimization equipment maintenance and technical upgrades The parties to the contract have combined all of this into a package that will be covered by a flat monthly installment payment for a period of 120 months

Evangelisches Krankenhaus Bielefeld gGmbH Germany

Strategic partnership with flat-rate financing

The Evangelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia As part of a scheduled expansion of some departments ndash particularly radiology ndash the hospital entered into a strategic partnership with Siemens Thanks to this alliance the hospital has gained a long-range competitive edge created by innovative medical technology without taking on financial risks that are difficult to calculate

2120

ldquoRegent has worked successfully with members of the Siemens team on a number of debt financings over the past five years Their ability to under-write both de novo and turnaround sit-uations to assess the potential for a variety of facilities and to craft creative financing structures makes them good colleagues with whom to do businessrdquo

Michael KarnesCFO Regent Surgical Health

A summary of the benefits

Financing from Siemens enabled the customer to develop a new outpatient surgery facility

The community benefits from having access to an outpatient surgery center which is often viewed as a more effective option for certain types of procedures

The challenge

Since being established in 2001 Regent Surgical Health has set up 18 medical centers that the company continues to successfully run on its own The company also holds minority stakes in ambula-tory surgical centers in the United States that it operates jointly with local part-ners For a center that it was planning to build with 18 local private physicians in Anchorage the capital of Alaska Regent needed an end-to-end financing solution that covered development of a new facility and acquisition of equipment

The solution

Thanks to Siemensrsquo experience with the business model on which the ambulatory surgical centers are based Financial Services was able to devise and offer a comprehensive financing solution that met the needs of Regent and the physicians involved in the project

Regent Surgical Health US

Convincing single-source financing

Regent Surgical Health operates a number of ambulatory surgical centers and a specialty hospital in the United States The company is known for running sustainably efficient facilities and for offering a high degree of autonomy to the private physicians with whom it works locally To set up an ambulatory surgical center in Alaska Regent needed a comprehensive financing concept

2322

ldquoOur strategy of renting high-tech equipment for five years was served by the innovative solution offered by Financial Services As a result we can keep our cost structures competitive while delivering high-quality and dependable service to the communityrdquo

Professor Amarilio Vieira de Macedo NetoPresident of the Hospital de Clinicas de Porto Alegre

A summary of the benefits

The financing structure meets the customerrsquos needs without hurting the liquidity of Siemens Healthcare Diagnostics

The customer can adjust spendings on laboratory equipment and operations to their utilization rate and thus match them to the hospitalrsquos own growth

The challenge

Siemens Healthcare Diagnostics the worldrsquos largest company specializing in clinical diagnostics seemed like a logical partner for the university medical cen-ter in the southern Brazilian city With the necessity to increase its performance to attend the high daily demand HCPA invested in Siemens equipment But it was crucial to find a financing solution based on monthly installments

The solution

Working together Siemens Health-care Diagnostics and Financial Services devised a viable needs-based financing structure and found a suitable local partner the Gaap Locaccedilatildeo de Bens company It served as the purchaser of the equipment and rented it back to Siemens Healthcare Diagnostics The Siemens division then rented it to HCPA under the same terms The agreement runs for three years and includes an option for two additional years

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

The Hospital de Clinicas de Porto Alegre (HCPA) wanted to finance its laboratory equipment and operations on a usage basis instead of purchasing the equipment Siemens was not only able to supply the right solution for clinical diagnostics but also devised a usage-based financing structure ndash using an unconventional approach

2524

ldquoThe working relationship with Siemens is helping Chengdu Western Hospital better manage its rapid expansion Thanks to the financing provided by Siemens we can offer our patients world-class technology without having to assume the financial burden that would have been associated with a major investment in the equipment for our new facility This really helps us reach our growth objectives in an effec-tive economically healthy mannerrdquo

Hao Shi Quan President of Chengdu Western Hospital

A summary of the benefits

The hospitalrsquos growth target could be quickly met without the additional financial burden created by a loan

Fast decision-making process due to single-source financing and the option of flexibly incorporating the equipment of other providers

World-class medical technology meets the needs of customers and patients

The challenge

Chengdu is one of Chinarsquos most appeal-ing cities in which to live And one factor that makes it so attractive to its citizens is its state-of-the-art efficient healthcare system which includes Chengdu West-ern Hospital as a key component To meet the cityrsquos growing demands the health-care operator has made extensive capi-tal expenditures and expanded the facil-ityrsquos capacity from 200 to 800 beds The operatorrsquos objective was also to equip the newly erected facility with cutting-edge medical technology without over-burdening its already stretched financial resources

The solution

For Chengdu Western Hospital Siemens put together a customized hire-purchase solution that helped support the hospi-talrsquos expansion strategy The financing agreement was arranged with a five-year term and enabled the hospital to acquire the latest medical technology from Siemens and other providers To obtain the required equipment the healthcare operator did not have to take out any new loans instead through the arrange-ment with Siemens the Chengdu West-ern Hospital was able to make the financ-ing payments from the income generated by the investment As a major portion of the technical equipment was made by Siemens Chengdu Western Hospital also benefited from the fast decision-making process facilitated by Siemensrsquo concept ldquotechnology and financing from a single sourcerdquo

Chengdu Western Hospital China

Rapid growth without side effects

As the rapidly expanding capital of the Chinese province of Sichuan the city of Chengdu needed state-of-the-art healthcare infrastructure To meet this need Chengdu Western Hospital launched a systematic expansion strategy To ensure that the goal is achieved efficiently the healthcare operator chose to finance the complete range of medical technology with Siemens

成都西区医院

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

1110

ldquoThe risk capital team at Financial Services is an important partner for us It not only invested in us but also introduced us to financing tools that optimized our net working capital and can make it easier for our customers to acquire our systemsrdquo

Greg M Ayers MD PhD CEO and President of ViewRay Inc

A summary of the benefits

Support of innovative technology to help cancer patients

Win-win situation for Siemens Healthcare and ViewRay

Comprehensive support for an up-and-coming company in the medical-technology industry Risk capital can be complemented by vendor finance tools

The challenge

Radiation therapy uses ionizing radiation to systematically fight tumors and halt their growth In the process healthy tissue should be protected from the unwanted effects of the radiation This aim is complicated by the fact that some organs move during the radiation treat-ment For this reason ViewRay set out to develop a system that facilitates the pre-cise management of the radiated region during the treatment

The solution

Using ViewRayrsquos system of MRI-guided radiation therapy the physician can con-tinuously monitor where the radiation is hitting the tumor or healthy tissue and thus aim its beam more precisely Siemens delivers not only the necessary MRI components and technical assis-tance but also financial support from Financial Servicesrsquo subsidiary Siemens Venture Capital (SVC) For this develop-mental work SVC provided ViewRay with risk capital

ViewRay Inc US

Risk capital for safe radiation therapy

The US company ViewRay Inc specializes in radiation therapy systems used to treat cancer With the strong support of Financial Services (Siemens Venture Capital) the company was able to develop an MRI-guided radiation therapy system

1312

ldquoThe distribution of the payments throughout the financing period and the holistic approach with a central contact person for the equipment reagents and financing really appealed to us because it was all so simple The Siemens solu-tion enabled our lab group to calmly and deliberately work on the expansion of our new test infrastructurerdquo

Franccedilois LeacuteonardCo-President Biosynergie

A summary of the benefits

60-month flexible finance arrangement

Transparent predictable and affordable payments

A holistic approach and streamlined processes with a central contact person

The challenge

Since France reorganized its regulatory frameworks for laboratories providers of laboratory and analysis services have been compelled to increase their opera-tional efficiency As this goal could not be achieved by Biosynergie by simply merging the previously autonomous labs the company wanted to acquire an analy-sis clinical chemistry and immunoassay platform for the entire laboratory group

The idea was to create one centralized platform that would cater for all labora-tory samples but a financing solution had to be found in order to make the investment viable

The solution

Siemens Healthcare Diagnostics offered Biosynergie a fully automated clinical chemistry and immunoassay system with an efficiency that facilitated economies of scale and thus more cost-effective operations on its previous setup To best address the needs of the lab group Siemens put together an all-inclusive package that included instruments main-tenance insurance and financing The financing covered a period of five years based on monthly payments aligned to the expected use of the system and the anticipated income generated An addi-tional agreement covering reagents was also arranged

Biosynergie France

Clearing the way with an ldquoall-inclusiverdquo offer

Biosynergie is a group of nine medical laboratories that joined together in 1994 in anticipation of regulatory changes Biosynergie selected an all-inclusive solution from Siemens when it decided to acquire a new joint analysis clinical chemistry and immunoassay platform

1514

ldquoOur working experience with Siemens Financial Services has been very posi-tive The team is very knowledgeable not only as relates to putting the tax-exempt financing together but also of our business model and how we provide service to our patients This made it very easy for us to work to-gether Additionally their professional-ism and customer service exceeded our expectations We look forward to work-ing with them again in the futurerdquo

Janelle SpannExecutive Director North Oakland ndashNorth Macomb Imaging Inc

A summary of the benefits

Customer was able to achieve a lending rate which mir-rored what is available via the tax-exempt bond market in a more timely and efficient manner (as compared to issuing a bond)

The challenge

When North Oakland ndash North Macomb Imaging was planning to acquire a new MRI system from Siemens the top priori-ties were to finance not only the equip-ment but also the necessary structural changes Given the customerrsquos status as a non-profit entity North Oakland ndash North Macomb Imaging was interested in secur-ing tax-exempt financing

The solution

Siemens offers tax-exempt financing to qualifying non-profit organizations in the US and was able to offer an attractive tax-exempt financing package for North Oakland ndash North Macomb Imaging

North Oakland ndash North Macomb Imaging US

Tax-exempt solution for non-profit groups

North Oakland ndash North Macomb Imaging is jointly run by three non-profit hospitals For this reason it becomes even more important to finance capital expenditures in a way that conserves resources ndash particularly when major equipment like a new magnetic resonance imaging (MRI) system is needed

1716

Ministry of Health

ldquoWe are proud that Siemens Croatia is recognized as a quality partner and supplier of medical equipment with proven solutions for all healthcare areas With tailored financing solutions from Siemens Financial Services we are able to react more flexible to customer needs The state-of-the-art devices will now also be available to Croatian patientsrdquo

Mladen Fogec Siemens Croatia Country CEO

A summary of the benefits

The Ministry of Health (MOH) and the involved hospitals received state-of-the-art medical imaging technology

Extended warranty services assure best availability of the systems throughout the contract period and beyond

The MOH has one contract partner for the technical solution and for long-term financing and at the same time acquires ownership of the equipment

Through the long-term supplier loan the substantial investment does not cause immediate burden to the national healthcare budget Neither does the MOH have interest rate risk or foreign currency risks as the final price for medical equipment and services is covered by the financing costs

The challenge

All the tasks including delivery installa-tion and training as well as building adap-tations have to be completed within 240 days The Ministry of Health requested also a six-year warranty service The whole package had to be offered at a fixed price in local currency without cur-rency exchange clause and bankable col-laterals with extended yearly repayments over a period of six years

The solution

Due to many limitations the markets were not able to offer long-term refinanc-ing in local currency or hedging over one year So during the tendering phase Siemens Financial Services with its local and regional office was strongly involved in risk assessment structuring and pric-ing of the respective transactions based on sovereign risk

In the end Siemens could offer to the Ministry of Health the desired equipment and services as well as the long repay-ment period in form of a six-year supplier loan and fulfill the pre-defined conditions of the Ministry of Healthrsquos tender

Ministry of Health Croatia

State-of-the-art equipment for Croatian hospitals

The Croatian Ministry of Health has modernized and expanded the pool of equipment (four state-of-the-art Symbia TruePoint SPECTCT systems two 2-head gamma cameras four MAGNETOM Avanto 15 T scanners four ONCOR LINAC and three SOMATOM SENSATION OPEN CT simulators) in many of its public hospitals across the country to provide state-of-the-art medical and imaging services to the patients These tenders which were supervised by Transparency Interna-tional have generated one of the largest contracts for Siemens Healthcare in Central and Eastern Europe

1918

ldquoWe found a good partner in Siemens In addition to the equipment purchase the innovative concept is an important component of the agreement We decided to purchase the entire pack-age Only a few people can offer some-thing like this We wanted everything to come from a single sourcerdquo

Dr Heiner Meyer zu LoumlsebeckManaging Director of the Evangelisches Krankenhaus Bielefeld(Dr Heiner Meyer zu Loumlsebeck was Managing Director from September 2007 to mid-January 2012)

A summary of the benefits

Rent-and-invest solution with monthly flat-rate pay-ments covering equipment service financing training and upgrades

Planning security covering an extended period of time

Financing of the installment payment using ldquopay as you earnrdquo

Use of the latest technology without overburdening the budget and liquidity

Guaranteeing and increase of internal financing ability

The challenge

Together with the Betheler Krankenhaus Mara the maximum-care facility Evan-gelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia with approximately 1500 beds 30 departments and 4200 employees In addition it is the biggest employer in the city of Bielefeld As part of the scheduled expansion of the hos-pital and its radiology department EvKB was looking for a strategic partner who not only delivered innovative medical technology but could also help it gain a long-range competitive edge

The solution

Siemens devised an equipment availabil-ity model with integrated capital expen-diture financing and the hospital con-cluded a ten-year partnership agreement based on it The complete single-source solution creates a decade of planning security in terms of the use of state-of-the-art medical technology and the costs related to it

The project covers the planning delivery and implementation of more than 80 medical-equipment products for the next ten years The products include large-scale equipment like MRIs CTs and X-ray units as well as ultrasound systems

In addition to the investment volume the financing flat rate covered by the agreement covers consulting services training process optimization equipment maintenance and technical upgrades The parties to the contract have combined all of this into a package that will be covered by a flat monthly installment payment for a period of 120 months

Evangelisches Krankenhaus Bielefeld gGmbH Germany

Strategic partnership with flat-rate financing

The Evangelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia As part of a scheduled expansion of some departments ndash particularly radiology ndash the hospital entered into a strategic partnership with Siemens Thanks to this alliance the hospital has gained a long-range competitive edge created by innovative medical technology without taking on financial risks that are difficult to calculate

2120

ldquoRegent has worked successfully with members of the Siemens team on a number of debt financings over the past five years Their ability to under-write both de novo and turnaround sit-uations to assess the potential for a variety of facilities and to craft creative financing structures makes them good colleagues with whom to do businessrdquo

Michael KarnesCFO Regent Surgical Health

A summary of the benefits

Financing from Siemens enabled the customer to develop a new outpatient surgery facility

The community benefits from having access to an outpatient surgery center which is often viewed as a more effective option for certain types of procedures

The challenge

Since being established in 2001 Regent Surgical Health has set up 18 medical centers that the company continues to successfully run on its own The company also holds minority stakes in ambula-tory surgical centers in the United States that it operates jointly with local part-ners For a center that it was planning to build with 18 local private physicians in Anchorage the capital of Alaska Regent needed an end-to-end financing solution that covered development of a new facility and acquisition of equipment

The solution

Thanks to Siemensrsquo experience with the business model on which the ambulatory surgical centers are based Financial Services was able to devise and offer a comprehensive financing solution that met the needs of Regent and the physicians involved in the project

Regent Surgical Health US

Convincing single-source financing

Regent Surgical Health operates a number of ambulatory surgical centers and a specialty hospital in the United States The company is known for running sustainably efficient facilities and for offering a high degree of autonomy to the private physicians with whom it works locally To set up an ambulatory surgical center in Alaska Regent needed a comprehensive financing concept

2322

ldquoOur strategy of renting high-tech equipment for five years was served by the innovative solution offered by Financial Services As a result we can keep our cost structures competitive while delivering high-quality and dependable service to the communityrdquo

Professor Amarilio Vieira de Macedo NetoPresident of the Hospital de Clinicas de Porto Alegre

A summary of the benefits

The financing structure meets the customerrsquos needs without hurting the liquidity of Siemens Healthcare Diagnostics

The customer can adjust spendings on laboratory equipment and operations to their utilization rate and thus match them to the hospitalrsquos own growth

The challenge

Siemens Healthcare Diagnostics the worldrsquos largest company specializing in clinical diagnostics seemed like a logical partner for the university medical cen-ter in the southern Brazilian city With the necessity to increase its performance to attend the high daily demand HCPA invested in Siemens equipment But it was crucial to find a financing solution based on monthly installments

The solution

Working together Siemens Health-care Diagnostics and Financial Services devised a viable needs-based financing structure and found a suitable local partner the Gaap Locaccedilatildeo de Bens company It served as the purchaser of the equipment and rented it back to Siemens Healthcare Diagnostics The Siemens division then rented it to HCPA under the same terms The agreement runs for three years and includes an option for two additional years

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

The Hospital de Clinicas de Porto Alegre (HCPA) wanted to finance its laboratory equipment and operations on a usage basis instead of purchasing the equipment Siemens was not only able to supply the right solution for clinical diagnostics but also devised a usage-based financing structure ndash using an unconventional approach

2524

ldquoThe working relationship with Siemens is helping Chengdu Western Hospital better manage its rapid expansion Thanks to the financing provided by Siemens we can offer our patients world-class technology without having to assume the financial burden that would have been associated with a major investment in the equipment for our new facility This really helps us reach our growth objectives in an effec-tive economically healthy mannerrdquo

Hao Shi Quan President of Chengdu Western Hospital

A summary of the benefits

The hospitalrsquos growth target could be quickly met without the additional financial burden created by a loan

Fast decision-making process due to single-source financing and the option of flexibly incorporating the equipment of other providers

World-class medical technology meets the needs of customers and patients

The challenge

Chengdu is one of Chinarsquos most appeal-ing cities in which to live And one factor that makes it so attractive to its citizens is its state-of-the-art efficient healthcare system which includes Chengdu West-ern Hospital as a key component To meet the cityrsquos growing demands the health-care operator has made extensive capi-tal expenditures and expanded the facil-ityrsquos capacity from 200 to 800 beds The operatorrsquos objective was also to equip the newly erected facility with cutting-edge medical technology without over-burdening its already stretched financial resources

The solution

For Chengdu Western Hospital Siemens put together a customized hire-purchase solution that helped support the hospi-talrsquos expansion strategy The financing agreement was arranged with a five-year term and enabled the hospital to acquire the latest medical technology from Siemens and other providers To obtain the required equipment the healthcare operator did not have to take out any new loans instead through the arrange-ment with Siemens the Chengdu West-ern Hospital was able to make the financ-ing payments from the income generated by the investment As a major portion of the technical equipment was made by Siemens Chengdu Western Hospital also benefited from the fast decision-making process facilitated by Siemensrsquo concept ldquotechnology and financing from a single sourcerdquo

Chengdu Western Hospital China

Rapid growth without side effects

As the rapidly expanding capital of the Chinese province of Sichuan the city of Chengdu needed state-of-the-art healthcare infrastructure To meet this need Chengdu Western Hospital launched a systematic expansion strategy To ensure that the goal is achieved efficiently the healthcare operator chose to finance the complete range of medical technology with Siemens

成都西区医院

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

1312

ldquoThe distribution of the payments throughout the financing period and the holistic approach with a central contact person for the equipment reagents and financing really appealed to us because it was all so simple The Siemens solu-tion enabled our lab group to calmly and deliberately work on the expansion of our new test infrastructurerdquo

Franccedilois LeacuteonardCo-President Biosynergie

A summary of the benefits

60-month flexible finance arrangement

Transparent predictable and affordable payments

A holistic approach and streamlined processes with a central contact person

The challenge

Since France reorganized its regulatory frameworks for laboratories providers of laboratory and analysis services have been compelled to increase their opera-tional efficiency As this goal could not be achieved by Biosynergie by simply merging the previously autonomous labs the company wanted to acquire an analy-sis clinical chemistry and immunoassay platform for the entire laboratory group

The idea was to create one centralized platform that would cater for all labora-tory samples but a financing solution had to be found in order to make the investment viable

The solution

Siemens Healthcare Diagnostics offered Biosynergie a fully automated clinical chemistry and immunoassay system with an efficiency that facilitated economies of scale and thus more cost-effective operations on its previous setup To best address the needs of the lab group Siemens put together an all-inclusive package that included instruments main-tenance insurance and financing The financing covered a period of five years based on monthly payments aligned to the expected use of the system and the anticipated income generated An addi-tional agreement covering reagents was also arranged

Biosynergie France

Clearing the way with an ldquoall-inclusiverdquo offer

Biosynergie is a group of nine medical laboratories that joined together in 1994 in anticipation of regulatory changes Biosynergie selected an all-inclusive solution from Siemens when it decided to acquire a new joint analysis clinical chemistry and immunoassay platform

1514

ldquoOur working experience with Siemens Financial Services has been very posi-tive The team is very knowledgeable not only as relates to putting the tax-exempt financing together but also of our business model and how we provide service to our patients This made it very easy for us to work to-gether Additionally their professional-ism and customer service exceeded our expectations We look forward to work-ing with them again in the futurerdquo

Janelle SpannExecutive Director North Oakland ndashNorth Macomb Imaging Inc

A summary of the benefits

Customer was able to achieve a lending rate which mir-rored what is available via the tax-exempt bond market in a more timely and efficient manner (as compared to issuing a bond)

The challenge

When North Oakland ndash North Macomb Imaging was planning to acquire a new MRI system from Siemens the top priori-ties were to finance not only the equip-ment but also the necessary structural changes Given the customerrsquos status as a non-profit entity North Oakland ndash North Macomb Imaging was interested in secur-ing tax-exempt financing

The solution

Siemens offers tax-exempt financing to qualifying non-profit organizations in the US and was able to offer an attractive tax-exempt financing package for North Oakland ndash North Macomb Imaging

North Oakland ndash North Macomb Imaging US

Tax-exempt solution for non-profit groups

North Oakland ndash North Macomb Imaging is jointly run by three non-profit hospitals For this reason it becomes even more important to finance capital expenditures in a way that conserves resources ndash particularly when major equipment like a new magnetic resonance imaging (MRI) system is needed

1716

Ministry of Health

ldquoWe are proud that Siemens Croatia is recognized as a quality partner and supplier of medical equipment with proven solutions for all healthcare areas With tailored financing solutions from Siemens Financial Services we are able to react more flexible to customer needs The state-of-the-art devices will now also be available to Croatian patientsrdquo

Mladen Fogec Siemens Croatia Country CEO

A summary of the benefits

The Ministry of Health (MOH) and the involved hospitals received state-of-the-art medical imaging technology

Extended warranty services assure best availability of the systems throughout the contract period and beyond

The MOH has one contract partner for the technical solution and for long-term financing and at the same time acquires ownership of the equipment

Through the long-term supplier loan the substantial investment does not cause immediate burden to the national healthcare budget Neither does the MOH have interest rate risk or foreign currency risks as the final price for medical equipment and services is covered by the financing costs

The challenge

All the tasks including delivery installa-tion and training as well as building adap-tations have to be completed within 240 days The Ministry of Health requested also a six-year warranty service The whole package had to be offered at a fixed price in local currency without cur-rency exchange clause and bankable col-laterals with extended yearly repayments over a period of six years

The solution

Due to many limitations the markets were not able to offer long-term refinanc-ing in local currency or hedging over one year So during the tendering phase Siemens Financial Services with its local and regional office was strongly involved in risk assessment structuring and pric-ing of the respective transactions based on sovereign risk

In the end Siemens could offer to the Ministry of Health the desired equipment and services as well as the long repay-ment period in form of a six-year supplier loan and fulfill the pre-defined conditions of the Ministry of Healthrsquos tender

Ministry of Health Croatia

State-of-the-art equipment for Croatian hospitals

The Croatian Ministry of Health has modernized and expanded the pool of equipment (four state-of-the-art Symbia TruePoint SPECTCT systems two 2-head gamma cameras four MAGNETOM Avanto 15 T scanners four ONCOR LINAC and three SOMATOM SENSATION OPEN CT simulators) in many of its public hospitals across the country to provide state-of-the-art medical and imaging services to the patients These tenders which were supervised by Transparency Interna-tional have generated one of the largest contracts for Siemens Healthcare in Central and Eastern Europe

1918

ldquoWe found a good partner in Siemens In addition to the equipment purchase the innovative concept is an important component of the agreement We decided to purchase the entire pack-age Only a few people can offer some-thing like this We wanted everything to come from a single sourcerdquo

Dr Heiner Meyer zu LoumlsebeckManaging Director of the Evangelisches Krankenhaus Bielefeld(Dr Heiner Meyer zu Loumlsebeck was Managing Director from September 2007 to mid-January 2012)

A summary of the benefits

Rent-and-invest solution with monthly flat-rate pay-ments covering equipment service financing training and upgrades

Planning security covering an extended period of time

Financing of the installment payment using ldquopay as you earnrdquo

Use of the latest technology without overburdening the budget and liquidity

Guaranteeing and increase of internal financing ability

The challenge

Together with the Betheler Krankenhaus Mara the maximum-care facility Evan-gelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia with approximately 1500 beds 30 departments and 4200 employees In addition it is the biggest employer in the city of Bielefeld As part of the scheduled expansion of the hos-pital and its radiology department EvKB was looking for a strategic partner who not only delivered innovative medical technology but could also help it gain a long-range competitive edge

The solution

Siemens devised an equipment availabil-ity model with integrated capital expen-diture financing and the hospital con-cluded a ten-year partnership agreement based on it The complete single-source solution creates a decade of planning security in terms of the use of state-of-the-art medical technology and the costs related to it

The project covers the planning delivery and implementation of more than 80 medical-equipment products for the next ten years The products include large-scale equipment like MRIs CTs and X-ray units as well as ultrasound systems

In addition to the investment volume the financing flat rate covered by the agreement covers consulting services training process optimization equipment maintenance and technical upgrades The parties to the contract have combined all of this into a package that will be covered by a flat monthly installment payment for a period of 120 months

Evangelisches Krankenhaus Bielefeld gGmbH Germany

Strategic partnership with flat-rate financing

The Evangelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia As part of a scheduled expansion of some departments ndash particularly radiology ndash the hospital entered into a strategic partnership with Siemens Thanks to this alliance the hospital has gained a long-range competitive edge created by innovative medical technology without taking on financial risks that are difficult to calculate

2120

ldquoRegent has worked successfully with members of the Siemens team on a number of debt financings over the past five years Their ability to under-write both de novo and turnaround sit-uations to assess the potential for a variety of facilities and to craft creative financing structures makes them good colleagues with whom to do businessrdquo

Michael KarnesCFO Regent Surgical Health

A summary of the benefits

Financing from Siemens enabled the customer to develop a new outpatient surgery facility

The community benefits from having access to an outpatient surgery center which is often viewed as a more effective option for certain types of procedures

The challenge

Since being established in 2001 Regent Surgical Health has set up 18 medical centers that the company continues to successfully run on its own The company also holds minority stakes in ambula-tory surgical centers in the United States that it operates jointly with local part-ners For a center that it was planning to build with 18 local private physicians in Anchorage the capital of Alaska Regent needed an end-to-end financing solution that covered development of a new facility and acquisition of equipment

The solution

Thanks to Siemensrsquo experience with the business model on which the ambulatory surgical centers are based Financial Services was able to devise and offer a comprehensive financing solution that met the needs of Regent and the physicians involved in the project

Regent Surgical Health US

Convincing single-source financing

Regent Surgical Health operates a number of ambulatory surgical centers and a specialty hospital in the United States The company is known for running sustainably efficient facilities and for offering a high degree of autonomy to the private physicians with whom it works locally To set up an ambulatory surgical center in Alaska Regent needed a comprehensive financing concept

2322

ldquoOur strategy of renting high-tech equipment for five years was served by the innovative solution offered by Financial Services As a result we can keep our cost structures competitive while delivering high-quality and dependable service to the communityrdquo

Professor Amarilio Vieira de Macedo NetoPresident of the Hospital de Clinicas de Porto Alegre

A summary of the benefits

The financing structure meets the customerrsquos needs without hurting the liquidity of Siemens Healthcare Diagnostics

The customer can adjust spendings on laboratory equipment and operations to their utilization rate and thus match them to the hospitalrsquos own growth

The challenge

Siemens Healthcare Diagnostics the worldrsquos largest company specializing in clinical diagnostics seemed like a logical partner for the university medical cen-ter in the southern Brazilian city With the necessity to increase its performance to attend the high daily demand HCPA invested in Siemens equipment But it was crucial to find a financing solution based on monthly installments

The solution

Working together Siemens Health-care Diagnostics and Financial Services devised a viable needs-based financing structure and found a suitable local partner the Gaap Locaccedilatildeo de Bens company It served as the purchaser of the equipment and rented it back to Siemens Healthcare Diagnostics The Siemens division then rented it to HCPA under the same terms The agreement runs for three years and includes an option for two additional years

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

The Hospital de Clinicas de Porto Alegre (HCPA) wanted to finance its laboratory equipment and operations on a usage basis instead of purchasing the equipment Siemens was not only able to supply the right solution for clinical diagnostics but also devised a usage-based financing structure ndash using an unconventional approach

2524

ldquoThe working relationship with Siemens is helping Chengdu Western Hospital better manage its rapid expansion Thanks to the financing provided by Siemens we can offer our patients world-class technology without having to assume the financial burden that would have been associated with a major investment in the equipment for our new facility This really helps us reach our growth objectives in an effec-tive economically healthy mannerrdquo

Hao Shi Quan President of Chengdu Western Hospital

A summary of the benefits

The hospitalrsquos growth target could be quickly met without the additional financial burden created by a loan

Fast decision-making process due to single-source financing and the option of flexibly incorporating the equipment of other providers

World-class medical technology meets the needs of customers and patients

The challenge

Chengdu is one of Chinarsquos most appeal-ing cities in which to live And one factor that makes it so attractive to its citizens is its state-of-the-art efficient healthcare system which includes Chengdu West-ern Hospital as a key component To meet the cityrsquos growing demands the health-care operator has made extensive capi-tal expenditures and expanded the facil-ityrsquos capacity from 200 to 800 beds The operatorrsquos objective was also to equip the newly erected facility with cutting-edge medical technology without over-burdening its already stretched financial resources

The solution

For Chengdu Western Hospital Siemens put together a customized hire-purchase solution that helped support the hospi-talrsquos expansion strategy The financing agreement was arranged with a five-year term and enabled the hospital to acquire the latest medical technology from Siemens and other providers To obtain the required equipment the healthcare operator did not have to take out any new loans instead through the arrange-ment with Siemens the Chengdu West-ern Hospital was able to make the financ-ing payments from the income generated by the investment As a major portion of the technical equipment was made by Siemens Chengdu Western Hospital also benefited from the fast decision-making process facilitated by Siemensrsquo concept ldquotechnology and financing from a single sourcerdquo

Chengdu Western Hospital China

Rapid growth without side effects

As the rapidly expanding capital of the Chinese province of Sichuan the city of Chengdu needed state-of-the-art healthcare infrastructure To meet this need Chengdu Western Hospital launched a systematic expansion strategy To ensure that the goal is achieved efficiently the healthcare operator chose to finance the complete range of medical technology with Siemens

成都西区医院

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

1514

ldquoOur working experience with Siemens Financial Services has been very posi-tive The team is very knowledgeable not only as relates to putting the tax-exempt financing together but also of our business model and how we provide service to our patients This made it very easy for us to work to-gether Additionally their professional-ism and customer service exceeded our expectations We look forward to work-ing with them again in the futurerdquo

Janelle SpannExecutive Director North Oakland ndashNorth Macomb Imaging Inc

A summary of the benefits

Customer was able to achieve a lending rate which mir-rored what is available via the tax-exempt bond market in a more timely and efficient manner (as compared to issuing a bond)

The challenge

When North Oakland ndash North Macomb Imaging was planning to acquire a new MRI system from Siemens the top priori-ties were to finance not only the equip-ment but also the necessary structural changes Given the customerrsquos status as a non-profit entity North Oakland ndash North Macomb Imaging was interested in secur-ing tax-exempt financing

The solution

Siemens offers tax-exempt financing to qualifying non-profit organizations in the US and was able to offer an attractive tax-exempt financing package for North Oakland ndash North Macomb Imaging

North Oakland ndash North Macomb Imaging US

Tax-exempt solution for non-profit groups

North Oakland ndash North Macomb Imaging is jointly run by three non-profit hospitals For this reason it becomes even more important to finance capital expenditures in a way that conserves resources ndash particularly when major equipment like a new magnetic resonance imaging (MRI) system is needed

1716

Ministry of Health

ldquoWe are proud that Siemens Croatia is recognized as a quality partner and supplier of medical equipment with proven solutions for all healthcare areas With tailored financing solutions from Siemens Financial Services we are able to react more flexible to customer needs The state-of-the-art devices will now also be available to Croatian patientsrdquo

Mladen Fogec Siemens Croatia Country CEO

A summary of the benefits

The Ministry of Health (MOH) and the involved hospitals received state-of-the-art medical imaging technology

Extended warranty services assure best availability of the systems throughout the contract period and beyond

The MOH has one contract partner for the technical solution and for long-term financing and at the same time acquires ownership of the equipment

Through the long-term supplier loan the substantial investment does not cause immediate burden to the national healthcare budget Neither does the MOH have interest rate risk or foreign currency risks as the final price for medical equipment and services is covered by the financing costs

The challenge

All the tasks including delivery installa-tion and training as well as building adap-tations have to be completed within 240 days The Ministry of Health requested also a six-year warranty service The whole package had to be offered at a fixed price in local currency without cur-rency exchange clause and bankable col-laterals with extended yearly repayments over a period of six years

The solution

Due to many limitations the markets were not able to offer long-term refinanc-ing in local currency or hedging over one year So during the tendering phase Siemens Financial Services with its local and regional office was strongly involved in risk assessment structuring and pric-ing of the respective transactions based on sovereign risk

In the end Siemens could offer to the Ministry of Health the desired equipment and services as well as the long repay-ment period in form of a six-year supplier loan and fulfill the pre-defined conditions of the Ministry of Healthrsquos tender

Ministry of Health Croatia

State-of-the-art equipment for Croatian hospitals

The Croatian Ministry of Health has modernized and expanded the pool of equipment (four state-of-the-art Symbia TruePoint SPECTCT systems two 2-head gamma cameras four MAGNETOM Avanto 15 T scanners four ONCOR LINAC and three SOMATOM SENSATION OPEN CT simulators) in many of its public hospitals across the country to provide state-of-the-art medical and imaging services to the patients These tenders which were supervised by Transparency Interna-tional have generated one of the largest contracts for Siemens Healthcare in Central and Eastern Europe

1918

ldquoWe found a good partner in Siemens In addition to the equipment purchase the innovative concept is an important component of the agreement We decided to purchase the entire pack-age Only a few people can offer some-thing like this We wanted everything to come from a single sourcerdquo

Dr Heiner Meyer zu LoumlsebeckManaging Director of the Evangelisches Krankenhaus Bielefeld(Dr Heiner Meyer zu Loumlsebeck was Managing Director from September 2007 to mid-January 2012)

A summary of the benefits

Rent-and-invest solution with monthly flat-rate pay-ments covering equipment service financing training and upgrades

Planning security covering an extended period of time

Financing of the installment payment using ldquopay as you earnrdquo

Use of the latest technology without overburdening the budget and liquidity

Guaranteeing and increase of internal financing ability

The challenge

Together with the Betheler Krankenhaus Mara the maximum-care facility Evan-gelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia with approximately 1500 beds 30 departments and 4200 employees In addition it is the biggest employer in the city of Bielefeld As part of the scheduled expansion of the hos-pital and its radiology department EvKB was looking for a strategic partner who not only delivered innovative medical technology but could also help it gain a long-range competitive edge

The solution

Siemens devised an equipment availabil-ity model with integrated capital expen-diture financing and the hospital con-cluded a ten-year partnership agreement based on it The complete single-source solution creates a decade of planning security in terms of the use of state-of-the-art medical technology and the costs related to it

The project covers the planning delivery and implementation of more than 80 medical-equipment products for the next ten years The products include large-scale equipment like MRIs CTs and X-ray units as well as ultrasound systems

In addition to the investment volume the financing flat rate covered by the agreement covers consulting services training process optimization equipment maintenance and technical upgrades The parties to the contract have combined all of this into a package that will be covered by a flat monthly installment payment for a period of 120 months

Evangelisches Krankenhaus Bielefeld gGmbH Germany

Strategic partnership with flat-rate financing

The Evangelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia As part of a scheduled expansion of some departments ndash particularly radiology ndash the hospital entered into a strategic partnership with Siemens Thanks to this alliance the hospital has gained a long-range competitive edge created by innovative medical technology without taking on financial risks that are difficult to calculate

2120

ldquoRegent has worked successfully with members of the Siemens team on a number of debt financings over the past five years Their ability to under-write both de novo and turnaround sit-uations to assess the potential for a variety of facilities and to craft creative financing structures makes them good colleagues with whom to do businessrdquo

Michael KarnesCFO Regent Surgical Health

A summary of the benefits

Financing from Siemens enabled the customer to develop a new outpatient surgery facility

The community benefits from having access to an outpatient surgery center which is often viewed as a more effective option for certain types of procedures

The challenge

Since being established in 2001 Regent Surgical Health has set up 18 medical centers that the company continues to successfully run on its own The company also holds minority stakes in ambula-tory surgical centers in the United States that it operates jointly with local part-ners For a center that it was planning to build with 18 local private physicians in Anchorage the capital of Alaska Regent needed an end-to-end financing solution that covered development of a new facility and acquisition of equipment

The solution

Thanks to Siemensrsquo experience with the business model on which the ambulatory surgical centers are based Financial Services was able to devise and offer a comprehensive financing solution that met the needs of Regent and the physicians involved in the project

Regent Surgical Health US

Convincing single-source financing

Regent Surgical Health operates a number of ambulatory surgical centers and a specialty hospital in the United States The company is known for running sustainably efficient facilities and for offering a high degree of autonomy to the private physicians with whom it works locally To set up an ambulatory surgical center in Alaska Regent needed a comprehensive financing concept

2322

ldquoOur strategy of renting high-tech equipment for five years was served by the innovative solution offered by Financial Services As a result we can keep our cost structures competitive while delivering high-quality and dependable service to the communityrdquo

Professor Amarilio Vieira de Macedo NetoPresident of the Hospital de Clinicas de Porto Alegre

A summary of the benefits

The financing structure meets the customerrsquos needs without hurting the liquidity of Siemens Healthcare Diagnostics

The customer can adjust spendings on laboratory equipment and operations to their utilization rate and thus match them to the hospitalrsquos own growth

The challenge

Siemens Healthcare Diagnostics the worldrsquos largest company specializing in clinical diagnostics seemed like a logical partner for the university medical cen-ter in the southern Brazilian city With the necessity to increase its performance to attend the high daily demand HCPA invested in Siemens equipment But it was crucial to find a financing solution based on monthly installments

The solution

Working together Siemens Health-care Diagnostics and Financial Services devised a viable needs-based financing structure and found a suitable local partner the Gaap Locaccedilatildeo de Bens company It served as the purchaser of the equipment and rented it back to Siemens Healthcare Diagnostics The Siemens division then rented it to HCPA under the same terms The agreement runs for three years and includes an option for two additional years

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

The Hospital de Clinicas de Porto Alegre (HCPA) wanted to finance its laboratory equipment and operations on a usage basis instead of purchasing the equipment Siemens was not only able to supply the right solution for clinical diagnostics but also devised a usage-based financing structure ndash using an unconventional approach

2524

ldquoThe working relationship with Siemens is helping Chengdu Western Hospital better manage its rapid expansion Thanks to the financing provided by Siemens we can offer our patients world-class technology without having to assume the financial burden that would have been associated with a major investment in the equipment for our new facility This really helps us reach our growth objectives in an effec-tive economically healthy mannerrdquo

Hao Shi Quan President of Chengdu Western Hospital

A summary of the benefits

The hospitalrsquos growth target could be quickly met without the additional financial burden created by a loan

Fast decision-making process due to single-source financing and the option of flexibly incorporating the equipment of other providers

World-class medical technology meets the needs of customers and patients

The challenge

Chengdu is one of Chinarsquos most appeal-ing cities in which to live And one factor that makes it so attractive to its citizens is its state-of-the-art efficient healthcare system which includes Chengdu West-ern Hospital as a key component To meet the cityrsquos growing demands the health-care operator has made extensive capi-tal expenditures and expanded the facil-ityrsquos capacity from 200 to 800 beds The operatorrsquos objective was also to equip the newly erected facility with cutting-edge medical technology without over-burdening its already stretched financial resources

The solution

For Chengdu Western Hospital Siemens put together a customized hire-purchase solution that helped support the hospi-talrsquos expansion strategy The financing agreement was arranged with a five-year term and enabled the hospital to acquire the latest medical technology from Siemens and other providers To obtain the required equipment the healthcare operator did not have to take out any new loans instead through the arrange-ment with Siemens the Chengdu West-ern Hospital was able to make the financ-ing payments from the income generated by the investment As a major portion of the technical equipment was made by Siemens Chengdu Western Hospital also benefited from the fast decision-making process facilitated by Siemensrsquo concept ldquotechnology and financing from a single sourcerdquo

Chengdu Western Hospital China

Rapid growth without side effects

As the rapidly expanding capital of the Chinese province of Sichuan the city of Chengdu needed state-of-the-art healthcare infrastructure To meet this need Chengdu Western Hospital launched a systematic expansion strategy To ensure that the goal is achieved efficiently the healthcare operator chose to finance the complete range of medical technology with Siemens

成都西区医院

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

1716

Ministry of Health

ldquoWe are proud that Siemens Croatia is recognized as a quality partner and supplier of medical equipment with proven solutions for all healthcare areas With tailored financing solutions from Siemens Financial Services we are able to react more flexible to customer needs The state-of-the-art devices will now also be available to Croatian patientsrdquo

Mladen Fogec Siemens Croatia Country CEO

A summary of the benefits

The Ministry of Health (MOH) and the involved hospitals received state-of-the-art medical imaging technology

Extended warranty services assure best availability of the systems throughout the contract period and beyond

The MOH has one contract partner for the technical solution and for long-term financing and at the same time acquires ownership of the equipment

Through the long-term supplier loan the substantial investment does not cause immediate burden to the national healthcare budget Neither does the MOH have interest rate risk or foreign currency risks as the final price for medical equipment and services is covered by the financing costs

The challenge

All the tasks including delivery installa-tion and training as well as building adap-tations have to be completed within 240 days The Ministry of Health requested also a six-year warranty service The whole package had to be offered at a fixed price in local currency without cur-rency exchange clause and bankable col-laterals with extended yearly repayments over a period of six years

The solution

Due to many limitations the markets were not able to offer long-term refinanc-ing in local currency or hedging over one year So during the tendering phase Siemens Financial Services with its local and regional office was strongly involved in risk assessment structuring and pric-ing of the respective transactions based on sovereign risk

In the end Siemens could offer to the Ministry of Health the desired equipment and services as well as the long repay-ment period in form of a six-year supplier loan and fulfill the pre-defined conditions of the Ministry of Healthrsquos tender

Ministry of Health Croatia

State-of-the-art equipment for Croatian hospitals

The Croatian Ministry of Health has modernized and expanded the pool of equipment (four state-of-the-art Symbia TruePoint SPECTCT systems two 2-head gamma cameras four MAGNETOM Avanto 15 T scanners four ONCOR LINAC and three SOMATOM SENSATION OPEN CT simulators) in many of its public hospitals across the country to provide state-of-the-art medical and imaging services to the patients These tenders which were supervised by Transparency Interna-tional have generated one of the largest contracts for Siemens Healthcare in Central and Eastern Europe

1918

ldquoWe found a good partner in Siemens In addition to the equipment purchase the innovative concept is an important component of the agreement We decided to purchase the entire pack-age Only a few people can offer some-thing like this We wanted everything to come from a single sourcerdquo

Dr Heiner Meyer zu LoumlsebeckManaging Director of the Evangelisches Krankenhaus Bielefeld(Dr Heiner Meyer zu Loumlsebeck was Managing Director from September 2007 to mid-January 2012)

A summary of the benefits

Rent-and-invest solution with monthly flat-rate pay-ments covering equipment service financing training and upgrades

Planning security covering an extended period of time

Financing of the installment payment using ldquopay as you earnrdquo

Use of the latest technology without overburdening the budget and liquidity

Guaranteeing and increase of internal financing ability

The challenge

Together with the Betheler Krankenhaus Mara the maximum-care facility Evan-gelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia with approximately 1500 beds 30 departments and 4200 employees In addition it is the biggest employer in the city of Bielefeld As part of the scheduled expansion of the hos-pital and its radiology department EvKB was looking for a strategic partner who not only delivered innovative medical technology but could also help it gain a long-range competitive edge

The solution

Siemens devised an equipment availabil-ity model with integrated capital expen-diture financing and the hospital con-cluded a ten-year partnership agreement based on it The complete single-source solution creates a decade of planning security in terms of the use of state-of-the-art medical technology and the costs related to it

The project covers the planning delivery and implementation of more than 80 medical-equipment products for the next ten years The products include large-scale equipment like MRIs CTs and X-ray units as well as ultrasound systems

In addition to the investment volume the financing flat rate covered by the agreement covers consulting services training process optimization equipment maintenance and technical upgrades The parties to the contract have combined all of this into a package that will be covered by a flat monthly installment payment for a period of 120 months

Evangelisches Krankenhaus Bielefeld gGmbH Germany

Strategic partnership with flat-rate financing

The Evangelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia As part of a scheduled expansion of some departments ndash particularly radiology ndash the hospital entered into a strategic partnership with Siemens Thanks to this alliance the hospital has gained a long-range competitive edge created by innovative medical technology without taking on financial risks that are difficult to calculate

2120

ldquoRegent has worked successfully with members of the Siemens team on a number of debt financings over the past five years Their ability to under-write both de novo and turnaround sit-uations to assess the potential for a variety of facilities and to craft creative financing structures makes them good colleagues with whom to do businessrdquo

Michael KarnesCFO Regent Surgical Health

A summary of the benefits

Financing from Siemens enabled the customer to develop a new outpatient surgery facility

The community benefits from having access to an outpatient surgery center which is often viewed as a more effective option for certain types of procedures

The challenge

Since being established in 2001 Regent Surgical Health has set up 18 medical centers that the company continues to successfully run on its own The company also holds minority stakes in ambula-tory surgical centers in the United States that it operates jointly with local part-ners For a center that it was planning to build with 18 local private physicians in Anchorage the capital of Alaska Regent needed an end-to-end financing solution that covered development of a new facility and acquisition of equipment

The solution

Thanks to Siemensrsquo experience with the business model on which the ambulatory surgical centers are based Financial Services was able to devise and offer a comprehensive financing solution that met the needs of Regent and the physicians involved in the project

Regent Surgical Health US

Convincing single-source financing

Regent Surgical Health operates a number of ambulatory surgical centers and a specialty hospital in the United States The company is known for running sustainably efficient facilities and for offering a high degree of autonomy to the private physicians with whom it works locally To set up an ambulatory surgical center in Alaska Regent needed a comprehensive financing concept

2322

ldquoOur strategy of renting high-tech equipment for five years was served by the innovative solution offered by Financial Services As a result we can keep our cost structures competitive while delivering high-quality and dependable service to the communityrdquo

Professor Amarilio Vieira de Macedo NetoPresident of the Hospital de Clinicas de Porto Alegre

A summary of the benefits

The financing structure meets the customerrsquos needs without hurting the liquidity of Siemens Healthcare Diagnostics

The customer can adjust spendings on laboratory equipment and operations to their utilization rate and thus match them to the hospitalrsquos own growth

The challenge

Siemens Healthcare Diagnostics the worldrsquos largest company specializing in clinical diagnostics seemed like a logical partner for the university medical cen-ter in the southern Brazilian city With the necessity to increase its performance to attend the high daily demand HCPA invested in Siemens equipment But it was crucial to find a financing solution based on monthly installments

The solution

Working together Siemens Health-care Diagnostics and Financial Services devised a viable needs-based financing structure and found a suitable local partner the Gaap Locaccedilatildeo de Bens company It served as the purchaser of the equipment and rented it back to Siemens Healthcare Diagnostics The Siemens division then rented it to HCPA under the same terms The agreement runs for three years and includes an option for two additional years

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

The Hospital de Clinicas de Porto Alegre (HCPA) wanted to finance its laboratory equipment and operations on a usage basis instead of purchasing the equipment Siemens was not only able to supply the right solution for clinical diagnostics but also devised a usage-based financing structure ndash using an unconventional approach

2524

ldquoThe working relationship with Siemens is helping Chengdu Western Hospital better manage its rapid expansion Thanks to the financing provided by Siemens we can offer our patients world-class technology without having to assume the financial burden that would have been associated with a major investment in the equipment for our new facility This really helps us reach our growth objectives in an effec-tive economically healthy mannerrdquo

Hao Shi Quan President of Chengdu Western Hospital

A summary of the benefits

The hospitalrsquos growth target could be quickly met without the additional financial burden created by a loan

Fast decision-making process due to single-source financing and the option of flexibly incorporating the equipment of other providers

World-class medical technology meets the needs of customers and patients

The challenge

Chengdu is one of Chinarsquos most appeal-ing cities in which to live And one factor that makes it so attractive to its citizens is its state-of-the-art efficient healthcare system which includes Chengdu West-ern Hospital as a key component To meet the cityrsquos growing demands the health-care operator has made extensive capi-tal expenditures and expanded the facil-ityrsquos capacity from 200 to 800 beds The operatorrsquos objective was also to equip the newly erected facility with cutting-edge medical technology without over-burdening its already stretched financial resources

The solution

For Chengdu Western Hospital Siemens put together a customized hire-purchase solution that helped support the hospi-talrsquos expansion strategy The financing agreement was arranged with a five-year term and enabled the hospital to acquire the latest medical technology from Siemens and other providers To obtain the required equipment the healthcare operator did not have to take out any new loans instead through the arrange-ment with Siemens the Chengdu West-ern Hospital was able to make the financ-ing payments from the income generated by the investment As a major portion of the technical equipment was made by Siemens Chengdu Western Hospital also benefited from the fast decision-making process facilitated by Siemensrsquo concept ldquotechnology and financing from a single sourcerdquo

Chengdu Western Hospital China

Rapid growth without side effects

As the rapidly expanding capital of the Chinese province of Sichuan the city of Chengdu needed state-of-the-art healthcare infrastructure To meet this need Chengdu Western Hospital launched a systematic expansion strategy To ensure that the goal is achieved efficiently the healthcare operator chose to finance the complete range of medical technology with Siemens

成都西区医院

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

1918

ldquoWe found a good partner in Siemens In addition to the equipment purchase the innovative concept is an important component of the agreement We decided to purchase the entire pack-age Only a few people can offer some-thing like this We wanted everything to come from a single sourcerdquo

Dr Heiner Meyer zu LoumlsebeckManaging Director of the Evangelisches Krankenhaus Bielefeld(Dr Heiner Meyer zu Loumlsebeck was Managing Director from September 2007 to mid-January 2012)

A summary of the benefits

Rent-and-invest solution with monthly flat-rate pay-ments covering equipment service financing training and upgrades

Planning security covering an extended period of time

Financing of the installment payment using ldquopay as you earnrdquo

Use of the latest technology without overburdening the budget and liquidity

Guaranteeing and increase of internal financing ability

The challenge

Together with the Betheler Krankenhaus Mara the maximum-care facility Evan-gelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia with approximately 1500 beds 30 departments and 4200 employees In addition it is the biggest employer in the city of Bielefeld As part of the scheduled expansion of the hos-pital and its radiology department EvKB was looking for a strategic partner who not only delivered innovative medical technology but could also help it gain a long-range competitive edge

The solution

Siemens devised an equipment availabil-ity model with integrated capital expen-diture financing and the hospital con-cluded a ten-year partnership agreement based on it The complete single-source solution creates a decade of planning security in terms of the use of state-of-the-art medical technology and the costs related to it

The project covers the planning delivery and implementation of more than 80 medical-equipment products for the next ten years The products include large-scale equipment like MRIs CTs and X-ray units as well as ultrasound systems

In addition to the investment volume the financing flat rate covered by the agreement covers consulting services training process optimization equipment maintenance and technical upgrades The parties to the contract have combined all of this into a package that will be covered by a flat monthly installment payment for a period of 120 months

Evangelisches Krankenhaus Bielefeld gGmbH Germany

Strategic partnership with flat-rate financing

The Evangelisches Krankenhaus Bielefeld (EvKB) is one of the largest medical centers in the northwestern German state of North Rhine-Westphalia As part of a scheduled expansion of some departments ndash particularly radiology ndash the hospital entered into a strategic partnership with Siemens Thanks to this alliance the hospital has gained a long-range competitive edge created by innovative medical technology without taking on financial risks that are difficult to calculate

2120

ldquoRegent has worked successfully with members of the Siemens team on a number of debt financings over the past five years Their ability to under-write both de novo and turnaround sit-uations to assess the potential for a variety of facilities and to craft creative financing structures makes them good colleagues with whom to do businessrdquo

Michael KarnesCFO Regent Surgical Health

A summary of the benefits

Financing from Siemens enabled the customer to develop a new outpatient surgery facility

The community benefits from having access to an outpatient surgery center which is often viewed as a more effective option for certain types of procedures

The challenge

Since being established in 2001 Regent Surgical Health has set up 18 medical centers that the company continues to successfully run on its own The company also holds minority stakes in ambula-tory surgical centers in the United States that it operates jointly with local part-ners For a center that it was planning to build with 18 local private physicians in Anchorage the capital of Alaska Regent needed an end-to-end financing solution that covered development of a new facility and acquisition of equipment

The solution

Thanks to Siemensrsquo experience with the business model on which the ambulatory surgical centers are based Financial Services was able to devise and offer a comprehensive financing solution that met the needs of Regent and the physicians involved in the project

Regent Surgical Health US

Convincing single-source financing

Regent Surgical Health operates a number of ambulatory surgical centers and a specialty hospital in the United States The company is known for running sustainably efficient facilities and for offering a high degree of autonomy to the private physicians with whom it works locally To set up an ambulatory surgical center in Alaska Regent needed a comprehensive financing concept

2322

ldquoOur strategy of renting high-tech equipment for five years was served by the innovative solution offered by Financial Services As a result we can keep our cost structures competitive while delivering high-quality and dependable service to the communityrdquo

Professor Amarilio Vieira de Macedo NetoPresident of the Hospital de Clinicas de Porto Alegre

A summary of the benefits

The financing structure meets the customerrsquos needs without hurting the liquidity of Siemens Healthcare Diagnostics

The customer can adjust spendings on laboratory equipment and operations to their utilization rate and thus match them to the hospitalrsquos own growth

The challenge

Siemens Healthcare Diagnostics the worldrsquos largest company specializing in clinical diagnostics seemed like a logical partner for the university medical cen-ter in the southern Brazilian city With the necessity to increase its performance to attend the high daily demand HCPA invested in Siemens equipment But it was crucial to find a financing solution based on monthly installments

The solution

Working together Siemens Health-care Diagnostics and Financial Services devised a viable needs-based financing structure and found a suitable local partner the Gaap Locaccedilatildeo de Bens company It served as the purchaser of the equipment and rented it back to Siemens Healthcare Diagnostics The Siemens division then rented it to HCPA under the same terms The agreement runs for three years and includes an option for two additional years

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

The Hospital de Clinicas de Porto Alegre (HCPA) wanted to finance its laboratory equipment and operations on a usage basis instead of purchasing the equipment Siemens was not only able to supply the right solution for clinical diagnostics but also devised a usage-based financing structure ndash using an unconventional approach

2524

ldquoThe working relationship with Siemens is helping Chengdu Western Hospital better manage its rapid expansion Thanks to the financing provided by Siemens we can offer our patients world-class technology without having to assume the financial burden that would have been associated with a major investment in the equipment for our new facility This really helps us reach our growth objectives in an effec-tive economically healthy mannerrdquo

Hao Shi Quan President of Chengdu Western Hospital

A summary of the benefits

The hospitalrsquos growth target could be quickly met without the additional financial burden created by a loan

Fast decision-making process due to single-source financing and the option of flexibly incorporating the equipment of other providers

World-class medical technology meets the needs of customers and patients

The challenge

Chengdu is one of Chinarsquos most appeal-ing cities in which to live And one factor that makes it so attractive to its citizens is its state-of-the-art efficient healthcare system which includes Chengdu West-ern Hospital as a key component To meet the cityrsquos growing demands the health-care operator has made extensive capi-tal expenditures and expanded the facil-ityrsquos capacity from 200 to 800 beds The operatorrsquos objective was also to equip the newly erected facility with cutting-edge medical technology without over-burdening its already stretched financial resources

The solution

For Chengdu Western Hospital Siemens put together a customized hire-purchase solution that helped support the hospi-talrsquos expansion strategy The financing agreement was arranged with a five-year term and enabled the hospital to acquire the latest medical technology from Siemens and other providers To obtain the required equipment the healthcare operator did not have to take out any new loans instead through the arrange-ment with Siemens the Chengdu West-ern Hospital was able to make the financ-ing payments from the income generated by the investment As a major portion of the technical equipment was made by Siemens Chengdu Western Hospital also benefited from the fast decision-making process facilitated by Siemensrsquo concept ldquotechnology and financing from a single sourcerdquo

Chengdu Western Hospital China

Rapid growth without side effects

As the rapidly expanding capital of the Chinese province of Sichuan the city of Chengdu needed state-of-the-art healthcare infrastructure To meet this need Chengdu Western Hospital launched a systematic expansion strategy To ensure that the goal is achieved efficiently the healthcare operator chose to finance the complete range of medical technology with Siemens

成都西区医院

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

2120

ldquoRegent has worked successfully with members of the Siemens team on a number of debt financings over the past five years Their ability to under-write both de novo and turnaround sit-uations to assess the potential for a variety of facilities and to craft creative financing structures makes them good colleagues with whom to do businessrdquo

Michael KarnesCFO Regent Surgical Health

A summary of the benefits

Financing from Siemens enabled the customer to develop a new outpatient surgery facility

The community benefits from having access to an outpatient surgery center which is often viewed as a more effective option for certain types of procedures

The challenge

Since being established in 2001 Regent Surgical Health has set up 18 medical centers that the company continues to successfully run on its own The company also holds minority stakes in ambula-tory surgical centers in the United States that it operates jointly with local part-ners For a center that it was planning to build with 18 local private physicians in Anchorage the capital of Alaska Regent needed an end-to-end financing solution that covered development of a new facility and acquisition of equipment

The solution

Thanks to Siemensrsquo experience with the business model on which the ambulatory surgical centers are based Financial Services was able to devise and offer a comprehensive financing solution that met the needs of Regent and the physicians involved in the project

Regent Surgical Health US

Convincing single-source financing

Regent Surgical Health operates a number of ambulatory surgical centers and a specialty hospital in the United States The company is known for running sustainably efficient facilities and for offering a high degree of autonomy to the private physicians with whom it works locally To set up an ambulatory surgical center in Alaska Regent needed a comprehensive financing concept

2322

ldquoOur strategy of renting high-tech equipment for five years was served by the innovative solution offered by Financial Services As a result we can keep our cost structures competitive while delivering high-quality and dependable service to the communityrdquo

Professor Amarilio Vieira de Macedo NetoPresident of the Hospital de Clinicas de Porto Alegre

A summary of the benefits

The financing structure meets the customerrsquos needs without hurting the liquidity of Siemens Healthcare Diagnostics

The customer can adjust spendings on laboratory equipment and operations to their utilization rate and thus match them to the hospitalrsquos own growth

The challenge

Siemens Healthcare Diagnostics the worldrsquos largest company specializing in clinical diagnostics seemed like a logical partner for the university medical cen-ter in the southern Brazilian city With the necessity to increase its performance to attend the high daily demand HCPA invested in Siemens equipment But it was crucial to find a financing solution based on monthly installments

The solution

Working together Siemens Health-care Diagnostics and Financial Services devised a viable needs-based financing structure and found a suitable local partner the Gaap Locaccedilatildeo de Bens company It served as the purchaser of the equipment and rented it back to Siemens Healthcare Diagnostics The Siemens division then rented it to HCPA under the same terms The agreement runs for three years and includes an option for two additional years

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

The Hospital de Clinicas de Porto Alegre (HCPA) wanted to finance its laboratory equipment and operations on a usage basis instead of purchasing the equipment Siemens was not only able to supply the right solution for clinical diagnostics but also devised a usage-based financing structure ndash using an unconventional approach

2524

ldquoThe working relationship with Siemens is helping Chengdu Western Hospital better manage its rapid expansion Thanks to the financing provided by Siemens we can offer our patients world-class technology without having to assume the financial burden that would have been associated with a major investment in the equipment for our new facility This really helps us reach our growth objectives in an effec-tive economically healthy mannerrdquo

Hao Shi Quan President of Chengdu Western Hospital

A summary of the benefits

The hospitalrsquos growth target could be quickly met without the additional financial burden created by a loan

Fast decision-making process due to single-source financing and the option of flexibly incorporating the equipment of other providers

World-class medical technology meets the needs of customers and patients

The challenge

Chengdu is one of Chinarsquos most appeal-ing cities in which to live And one factor that makes it so attractive to its citizens is its state-of-the-art efficient healthcare system which includes Chengdu West-ern Hospital as a key component To meet the cityrsquos growing demands the health-care operator has made extensive capi-tal expenditures and expanded the facil-ityrsquos capacity from 200 to 800 beds The operatorrsquos objective was also to equip the newly erected facility with cutting-edge medical technology without over-burdening its already stretched financial resources

The solution

For Chengdu Western Hospital Siemens put together a customized hire-purchase solution that helped support the hospi-talrsquos expansion strategy The financing agreement was arranged with a five-year term and enabled the hospital to acquire the latest medical technology from Siemens and other providers To obtain the required equipment the healthcare operator did not have to take out any new loans instead through the arrange-ment with Siemens the Chengdu West-ern Hospital was able to make the financ-ing payments from the income generated by the investment As a major portion of the technical equipment was made by Siemens Chengdu Western Hospital also benefited from the fast decision-making process facilitated by Siemensrsquo concept ldquotechnology and financing from a single sourcerdquo

Chengdu Western Hospital China

Rapid growth without side effects

As the rapidly expanding capital of the Chinese province of Sichuan the city of Chengdu needed state-of-the-art healthcare infrastructure To meet this need Chengdu Western Hospital launched a systematic expansion strategy To ensure that the goal is achieved efficiently the healthcare operator chose to finance the complete range of medical technology with Siemens

成都西区医院

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

2322

ldquoOur strategy of renting high-tech equipment for five years was served by the innovative solution offered by Financial Services As a result we can keep our cost structures competitive while delivering high-quality and dependable service to the communityrdquo

Professor Amarilio Vieira de Macedo NetoPresident of the Hospital de Clinicas de Porto Alegre

A summary of the benefits

The financing structure meets the customerrsquos needs without hurting the liquidity of Siemens Healthcare Diagnostics

The customer can adjust spendings on laboratory equipment and operations to their utilization rate and thus match them to the hospitalrsquos own growth

The challenge

Siemens Healthcare Diagnostics the worldrsquos largest company specializing in clinical diagnostics seemed like a logical partner for the university medical cen-ter in the southern Brazilian city With the necessity to increase its performance to attend the high daily demand HCPA invested in Siemens equipment But it was crucial to find a financing solution based on monthly installments

The solution

Working together Siemens Health-care Diagnostics and Financial Services devised a viable needs-based financing structure and found a suitable local partner the Gaap Locaccedilatildeo de Bens company It served as the purchaser of the equipment and rented it back to Siemens Healthcare Diagnostics The Siemens division then rented it to HCPA under the same terms The agreement runs for three years and includes an option for two additional years

Hospital de Clinicas de Porto Alegre (HCPA) Brazil

Making the impossible possible

The Hospital de Clinicas de Porto Alegre (HCPA) wanted to finance its laboratory equipment and operations on a usage basis instead of purchasing the equipment Siemens was not only able to supply the right solution for clinical diagnostics but also devised a usage-based financing structure ndash using an unconventional approach

2524

ldquoThe working relationship with Siemens is helping Chengdu Western Hospital better manage its rapid expansion Thanks to the financing provided by Siemens we can offer our patients world-class technology without having to assume the financial burden that would have been associated with a major investment in the equipment for our new facility This really helps us reach our growth objectives in an effec-tive economically healthy mannerrdquo

Hao Shi Quan President of Chengdu Western Hospital

A summary of the benefits

The hospitalrsquos growth target could be quickly met without the additional financial burden created by a loan

Fast decision-making process due to single-source financing and the option of flexibly incorporating the equipment of other providers

World-class medical technology meets the needs of customers and patients

The challenge

Chengdu is one of Chinarsquos most appeal-ing cities in which to live And one factor that makes it so attractive to its citizens is its state-of-the-art efficient healthcare system which includes Chengdu West-ern Hospital as a key component To meet the cityrsquos growing demands the health-care operator has made extensive capi-tal expenditures and expanded the facil-ityrsquos capacity from 200 to 800 beds The operatorrsquos objective was also to equip the newly erected facility with cutting-edge medical technology without over-burdening its already stretched financial resources

The solution

For Chengdu Western Hospital Siemens put together a customized hire-purchase solution that helped support the hospi-talrsquos expansion strategy The financing agreement was arranged with a five-year term and enabled the hospital to acquire the latest medical technology from Siemens and other providers To obtain the required equipment the healthcare operator did not have to take out any new loans instead through the arrange-ment with Siemens the Chengdu West-ern Hospital was able to make the financ-ing payments from the income generated by the investment As a major portion of the technical equipment was made by Siemens Chengdu Western Hospital also benefited from the fast decision-making process facilitated by Siemensrsquo concept ldquotechnology and financing from a single sourcerdquo

Chengdu Western Hospital China

Rapid growth without side effects

As the rapidly expanding capital of the Chinese province of Sichuan the city of Chengdu needed state-of-the-art healthcare infrastructure To meet this need Chengdu Western Hospital launched a systematic expansion strategy To ensure that the goal is achieved efficiently the healthcare operator chose to finance the complete range of medical technology with Siemens

成都西区医院

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

2524

ldquoThe working relationship with Siemens is helping Chengdu Western Hospital better manage its rapid expansion Thanks to the financing provided by Siemens we can offer our patients world-class technology without having to assume the financial burden that would have been associated with a major investment in the equipment for our new facility This really helps us reach our growth objectives in an effec-tive economically healthy mannerrdquo

Hao Shi Quan President of Chengdu Western Hospital

A summary of the benefits

The hospitalrsquos growth target could be quickly met without the additional financial burden created by a loan

Fast decision-making process due to single-source financing and the option of flexibly incorporating the equipment of other providers

World-class medical technology meets the needs of customers and patients

The challenge

Chengdu is one of Chinarsquos most appeal-ing cities in which to live And one factor that makes it so attractive to its citizens is its state-of-the-art efficient healthcare system which includes Chengdu West-ern Hospital as a key component To meet the cityrsquos growing demands the health-care operator has made extensive capi-tal expenditures and expanded the facil-ityrsquos capacity from 200 to 800 beds The operatorrsquos objective was also to equip the newly erected facility with cutting-edge medical technology without over-burdening its already stretched financial resources

The solution

For Chengdu Western Hospital Siemens put together a customized hire-purchase solution that helped support the hospi-talrsquos expansion strategy The financing agreement was arranged with a five-year term and enabled the hospital to acquire the latest medical technology from Siemens and other providers To obtain the required equipment the healthcare operator did not have to take out any new loans instead through the arrange-ment with Siemens the Chengdu West-ern Hospital was able to make the financ-ing payments from the income generated by the investment As a major portion of the technical equipment was made by Siemens Chengdu Western Hospital also benefited from the fast decision-making process facilitated by Siemensrsquo concept ldquotechnology and financing from a single sourcerdquo

Chengdu Western Hospital China

Rapid growth without side effects

As the rapidly expanding capital of the Chinese province of Sichuan the city of Chengdu needed state-of-the-art healthcare infrastructure To meet this need Chengdu Western Hospital launched a systematic expansion strategy To ensure that the goal is achieved efficiently the healthcare operator chose to finance the complete range of medical technology with Siemens

成都西区医院

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

2726

The best recommendation your own

In the end all of the examples in this brochure illustrate one point efficient financing concepts that lay the founda-tion for customized financing solutions Solutions that we jointly developed with our customers ndash for their success

And perhaps in the near future for your success too Benefit from the flexibility of our financing portfolio and our ability to develop customer-specific solutions that pave the way for investing in state-of-the-art technologies and sustainable infrastructure

Turn to us for your next investment or financing project See for yourself how the financing solutions from Siemens Financial Services can also help increase your competitiveness and expand your business success

Siemens Financial Services GmbH

Phone +49 89 636-30049 Fax +49 89 636-30047

E-Mail marketingsfssiemenscom Internet wwwsiemenscomfinance

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH

Publisher

Siemens Financial Services GmbH Strategic Development (SD) 80200 Munich Germany

Phone +49 89 636-30049 E-Mail marketingsfssiemenscom

siemenscomfinance

This brochure contains only general non-binding information Its contents are based on information available at the time of publication and can change at any time without prior notice The con-tents of this brochure in no way represent an offer to conclude a contract

All products and solutions offered in this brochure are subject to the legal require-ments of the respective country

copy 2016 Siemens Financial Services GmbH