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LEASES
12 Months Ended
Dec. 31, 2023
Leases [Abstract]  
LEASES LEASES
    
    The Company determines if an arrangement is or contains a lease at contract inception. The Company leases office space, patient service centers, clinical laboratories, warehouses, logistic hubs and equipment primarily through operating leases, with a limited number of finance leases. A right-of-use asset, representing the underlying asset during the lease term, and a lease liability, representing the payment obligation arising from the lease, are recognized on the balance sheet at lease commencement based on the present value of the payment obligation. For operating leases, expense is recognized on a straight-line basis over the lease term. For finance leases, interest expense on the lease liability is recognized using the effective interest method and amortization of the right-of-use asset is recognized on a straight-line basis over the shorter of the estimated useful life of the asset or the lease term. Short-term leases with an initial term of 12 months or less are not recorded on the balance sheet; the Company recognizes lease expense for these leases on a straight-line basis over the lease term. For the years ended December 31, 2023, 2022, and 2021, lease expense associated with short-term leases was not material.

    The Company primarily uses its collateralized incremental borrowing rate in determining the present value of lease payments as the Company's leases generally do not provide an implicit rate. Such incremental borrowing rates, which take into account interest rates offered to companies that have similar credit ratings to the Company, are determined using a portfolio approach which groups the Company’s leases based on tenor.

    The Company has lease agreements with (i) right-of-use asset payments and (ii) non-lease components (i.e., payments related to maintenance fees, utilities, etc.) which have been combined and accounted for as a single lease component.

    The Company's leases have remaining terms of less than 1 year to 14 years, some of which include options to extend the leases for up to approximately 20 years. The Company's lease terms may include renewal options that are reasonably certain to be exercised and termination options that are reasonably certain not to be exercised. Certain leases also include options to purchase the leased property.

    Certain of the Company's lease agreements include rental payments adjusted periodically for inflation or a market rate which are included in the lease liabilities.

    The Company's assets and liabilities for its lease agreements as of December 31, 2023 and 2022 were as follows:

LeasesBalance Sheet Classification20232022
Assets
OperatingOperating lease right-of-use assets$602 $585 
FinanceProperty, plant and equipment, net (a)
Total lease assets$608 $594 
Liabilities
Current:
OperatingCurrent portion of long-term operating lease liabilities$153 $153 
FinanceCurrent portion of long-term debt
Non-current:
OperatingLong-term operating lease liabilities503 489 
FinanceLong-term debt
Total lease liabilities$663 $651 

(a) Finance lease assets as of December 31, 2023 and 2022 were recorded net of accumulated amortization of $5 million and $3 million, respectively.
    
    Components of lease cost for the years ended December 31, 2023, 2022 and 2021 were as follows:
Lease cost202320222021
Operating lease cost (a)$353 $345 $321 
Finance lease cost:
Amortization of leased assets2
Interest on lease liabilities— 1
Net lease cost$355 $348 $325 

(a) Includes short-term leases and variable lease costs (primarily usage-based maintenance fees and utilities related to real estate leases and certain equipment-related and vehicle-related costs) of $161 million, $160 million and $140 million for the years ended December 31, 2023, 2022 and 2021, respectively.
    
    The maturity of the Company's lease liabilities as of December 31, 2023 is as follows:
Maturity of lease liabilitiesOperating leasesFinance leasesTotal
2024$173 $$175 
2025145 147 
2026115 117 
202792 93 
202869 70 
Thereafter141 — 141 
Total lease payments735 743 
Less: Interest 79 80 
Present value of lease liabilities$656 $$663 
    
    Lease term and discount rate as of December 31, 2023 and 2022 were as follows:
Lease term and discount rate20232022
Weighted-average remaining lease term (years):
Operating leases66
Finance leases56
Weighted-average discount rate:
Operating leases4.0 %3.0 %
Finance leases2.4 %2.4 %

    The Company's discount rates for its operating leases were primarily determined using the Company's incremental borrowing rate.

    See Note 10 for cash flow information on cash paid for amounts included in the measurement of lease liabilities and leased assets obtained in exchange for new operating lease liabilities for the years ended December 31, 2023, 2022 and 2021.
LEASES LEASES
    
    The Company determines if an arrangement is or contains a lease at contract inception. The Company leases office space, patient service centers, clinical laboratories, warehouses, logistic hubs and equipment primarily through operating leases, with a limited number of finance leases. A right-of-use asset, representing the underlying asset during the lease term, and a lease liability, representing the payment obligation arising from the lease, are recognized on the balance sheet at lease commencement based on the present value of the payment obligation. For operating leases, expense is recognized on a straight-line basis over the lease term. For finance leases, interest expense on the lease liability is recognized using the effective interest method and amortization of the right-of-use asset is recognized on a straight-line basis over the shorter of the estimated useful life of the asset or the lease term. Short-term leases with an initial term of 12 months or less are not recorded on the balance sheet; the Company recognizes lease expense for these leases on a straight-line basis over the lease term. For the years ended December 31, 2023, 2022, and 2021, lease expense associated with short-term leases was not material.

    The Company primarily uses its collateralized incremental borrowing rate in determining the present value of lease payments as the Company's leases generally do not provide an implicit rate. Such incremental borrowing rates, which take into account interest rates offered to companies that have similar credit ratings to the Company, are determined using a portfolio approach which groups the Company’s leases based on tenor.

    The Company has lease agreements with (i) right-of-use asset payments and (ii) non-lease components (i.e., payments related to maintenance fees, utilities, etc.) which have been combined and accounted for as a single lease component.

    The Company's leases have remaining terms of less than 1 year to 14 years, some of which include options to extend the leases for up to approximately 20 years. The Company's lease terms may include renewal options that are reasonably certain to be exercised and termination options that are reasonably certain not to be exercised. Certain leases also include options to purchase the leased property.

    Certain of the Company's lease agreements include rental payments adjusted periodically for inflation or a market rate which are included in the lease liabilities.

    The Company's assets and liabilities for its lease agreements as of December 31, 2023 and 2022 were as follows:

LeasesBalance Sheet Classification20232022
Assets
OperatingOperating lease right-of-use assets$602 $585 
FinanceProperty, plant and equipment, net (a)
Total lease assets$608 $594 
Liabilities
Current:
OperatingCurrent portion of long-term operating lease liabilities$153 $153 
FinanceCurrent portion of long-term debt
Non-current:
OperatingLong-term operating lease liabilities503 489 
FinanceLong-term debt
Total lease liabilities$663 $651 

(a) Finance lease assets as of December 31, 2023 and 2022 were recorded net of accumulated amortization of $5 million and $3 million, respectively.
    
    Components of lease cost for the years ended December 31, 2023, 2022 and 2021 were as follows:
Lease cost202320222021
Operating lease cost (a)$353 $345 $321 
Finance lease cost:
Amortization of leased assets2
Interest on lease liabilities— 1
Net lease cost$355 $348 $325 

(a) Includes short-term leases and variable lease costs (primarily usage-based maintenance fees and utilities related to real estate leases and certain equipment-related and vehicle-related costs) of $161 million, $160 million and $140 million for the years ended December 31, 2023, 2022 and 2021, respectively.
    
    The maturity of the Company's lease liabilities as of December 31, 2023 is as follows:
Maturity of lease liabilitiesOperating leasesFinance leasesTotal
2024$173 $$175 
2025145 147 
2026115 117 
202792 93 
202869 70 
Thereafter141 — 141 
Total lease payments735 743 
Less: Interest 79 80 
Present value of lease liabilities$656 $$663 
    
    Lease term and discount rate as of December 31, 2023 and 2022 were as follows:
Lease term and discount rate20232022
Weighted-average remaining lease term (years):
Operating leases66
Finance leases56
Weighted-average discount rate:
Operating leases4.0 %3.0 %
Finance leases2.4 %2.4 %

    The Company's discount rates for its operating leases were primarily determined using the Company's incremental borrowing rate.

    See Note 10 for cash flow information on cash paid for amounts included in the measurement of lease liabilities and leased assets obtained in exchange for new operating lease liabilities for the years ended December 31, 2023, 2022 and 2021.