zimmer biomet holdings , inc .
2018 form 10-k annual report ( 8 ) we have incurred other various expenses from specific events or projects that we consider highly variable or have a significant impact to our operating results that we have excluded from our non-gaap financial measures .
this includes legal entity and operational restructuring as well as our costs of complying with our dpa with the u.s .
government related to certain fcpa matters involving biomet and certain of its subsidiaries .
under the dpa , which has a three-year term , we are subject to oversight by an independent compliance monitor , which monitorship commenced in july 2017 .
the excluded costs include the fees paid to the independent compliance monitor and to external legal counsel assisting in the matter .
( 9 ) represents the tax effects on the previously specified items .
the tax effect for the u.s .
jurisdiction is calculated based on an effective rate considering federal and state taxes , as well as permanent items .
for jurisdictions outside the u.s. , the tax effect is calculated based upon the statutory rates where the items were incurred .
( 10 ) the 2016 period includes negative effects from finalizing the tax accounts for the biomet merger .
under the applicable u.s .
gaap rules , these measurement period adjustments are recognized on a prospective basis in the period of change .
( 11 ) the 2017 tax act resulted in a net favorable provisional adjustment due to the reduction of deferred tax liabilities for unremitted earnings and revaluation of deferred tax liabilities to a 21 percent rate , which was partially offset by provisional tax charges related to the toll charge provision of the 2017 tax act .
in 2018 , we finalized our estimates of the effects of the 2017 tax act based upon final guidance issued by u.s .
tax authorities .
( 12 ) other certain tax adjustments in 2018 primarily related to changes in tax rates on deferred tax liabilities recorded on intangible assets recognized in acquisition-related accounting and adjustments from internal restructuring transactions that provide us access to offshore funds in a tax efficient manner .
in 2017 , other certain tax adjustments relate to tax benefits from lower tax rates unrelated to the impact of the 2017 tax act , net favorable resolutions of various tax matters and net favorable adjustments from internal restructuring transactions .
the 2016 adjustment primarily related to a favorable adjustment to certain deferred tax liabilities recognized as part of acquisition-related accounting and favorable resolution of certain tax matters with taxing authorities offset by internal restructuring transactions that provide us access to offshore funds in a tax efficient manner .
( 13 ) diluted share count used in adjusted diluted eps : year ended december 31 , 2018 .

year endeddecember 31 2018
diluted shares
203.5
dilutive shares assuming net earnings
1.5
adjusted diluted shares
205.0

liquidity and capital resources cash flows provided by operating activities were $ 1747.4 million in 2018 compared to $ 1582.3 million and $ 1632.2 million in 2017 and 2016 , respectively .
the increase in operating cash flows in 2018 compared to 2017 was driven by additional cash flows from our sale of accounts receivable in certain countries , lower acquisition and integration expenses and lower quality remediation expenses , as well as certain significant payments made in the 2017 period .
in the 2017 period , we made payments related to the u.s .
durom cup settlement program , and we paid $ 30.5 million in settlement payments to resolve previously-disclosed fcpa matters involving biomet and certain of its subsidiaries as discussed in note 19 to our consolidated financial statements included in item 8 of this report .
the decline in operating cash flows in 2017 compared to 2016 was driven by additional investments in inventory , additional expenses for quality remediation and the significant payments made in the 2017 period as discussed in the previous sentence .
these unfavorable items were partially offset by $ 174.0 million of incremental cash flows in 2017 from our sale of accounts receivable in certain countries .
cash flows used in investing activities were $ 416.6 million in 2018 compared to $ 510.8 million and $ 1691.5 million in 2017 and 2016 , respectively .
instrument and property , plant and equipment additions reflected ongoing investments in our product portfolio and optimization of our manufacturing and logistics network .
in 2018 , we entered into receive-fixed-rate , pay-fixed-rate cross-currency interest rate swaps .
our investing cash flows reflect the net cash inflows from the fixed- rate interest rate receipts/payments , as well as the termination of certain of these swaps that were in a gain position in the year .
the 2016 period included cash outflows for the acquisition of ldr holding corporation ( 201cldr 201d ) and other business acquisitions .
additionally , the 2016 period reflects the maturity of available-for-sale debt securities .
as these investments matured , we used the cash to pay off debt and have not reinvested in any additional debt securities .
cash flows used in financing activities were $ 1302.2 million in 2018 .
our primary use of available cash in 2018 was for debt repayment .
we received net proceeds of $ 749.5 million from the issuance of additional senior notes and borrowed $ 400.0 million from our multicurrency revolving facility to repay $ 1150.0 million of senior notes that became due on april 2 , 2018 .
we subsequently repaid the $ 400.0 million of multicurrency revolving facility borrowings .
also in 2018 , we borrowed another $ 675.0 million under a new u.s .
term loan c and used the cash proceeds along with cash generated from operations throughout the year to repay an aggregate of $ 835.0 million on u.s .
term loan a , $ 450.0 million on u.s .
term loan b , and we subsequently repaid $ 140.0 million on u.s .
term loan c .
overall , we had approximately $ 1150 million of net principal repayments on our senior notes and term loans in 2018 .
in 2017 , our primary use of available cash was also for debt repayment compared to 2016 when we were not able to repay as much debt due to financing requirements to complete the ldr and other business acquisitions .
additionally in 2017 , we had net cash inflows of $ 103.5 million on factoring programs that had not been remitted to the third party .
in 2018 , we had net cash outflows related to these factoring programs as we remitted the $ 103.5 million and collected only $ 66.8 million which had not yet been remitted by the end of the year .
since our factoring programs started at the end of 2016 , we did not have similar cash flows in that year .
in january 2019 , we borrowed an additional $ 200.0 million under u.s .
term loan c and used those proceeds , along with cash on hand , to repay the remaining $ 225.0 million outstanding under u.s .
term loan b .
in february , may , august and december 2018 , our board of directors declared cash dividends of $ 0.24 per share .
we expect to continue paying cash dividends on a quarterly basis ; however , future dividends are subject to approval of the board of directors and may be adjusted as business needs or market conditions change .
as further discussed in note 11 to our consolidated financial statements , our debt facilities restrict the payment of dividends in certain circumstances. .

Question: what was the percentage change in cash flows used in investing activities from 2016 to 2017?
Answer: -70%

Question: what is the percent change in cash flows provided by operating activities between 2017 and 2016?
Answer: -3%

Question: what is the percent change in cash flows provided by operating activities between 2018 and 2017?
Answer: -9%

Question: what was the percentage change in cash flows used in investing activities from 2017 to 2018?
Answer: -18%