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Goodwill and Other Intangible Assets
 12 Months Ended
Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill and Other Intangible Assets Goodwill and Other Intangible Assets
As of each balance sheet date, other intangible assets consisted of the following:
As of December 31,
20222021
(in thousands)Weighted-average amortization periodGross
Carrying
Amount		Accumulated
Amortization		Net
Carrying
Value		Gross
Carrying
Amount		Accumulated
Amortization		Net
Carrying
Value
Customer relationships15 years$4,178,280 $(1,810,880)$2,367,400 $4,178,280 $(1,531,679)$2,646,601 
Provider network15 years896,800 (392,599)504,201 896,800 (332,812)563,988 
Technology5 years6,350 (2,752)3,598 6,350 (1,482)4,868 
Trade names9 years2,670 (668)2,002 2,670 (390)2,280 
Trade namesIndefinite63,000 — 63,000 67,300 — 67,300 
Total$5,147,100 $(2,206,899)$2,940,201 $5,151,400 $(1,866,363)$3,285,037 
The estimated aggregate amortization expense for each of the five succeeding years is $340.0 million per year.
The goodwill arose from the acquisition of the Company in 2016 by Holdings, the HST acquisition in 2020 and the DHP acquisition in 2021. The carrying value of goodwill was $3,705.2 million and $4,363.1 million as of December 31, 2022 and 2021, respectively.
In the year ended December 31, 2022, the Company recorded impairment losses of $657.9 million related to the goodwill and $4.3 million related to the indefinite-lived trade names. No impairment losses had been recorded in previous years. Impairment losses are included in Loss on impairment of goodwill and intangible assets in the accompanying consolidated statements of (loss) income and comprehensive (loss) income.
In the quantitative impairment test of goodwill performed in the year ended December 31, 2022, we calculate the estimated enterprise fair value of the reporting unit using a (i) discounted cash flow analysis, (ii) forecasted EBITDA trading multiples for comparable publicly traded companies and (iii) historical EBITDA multiples for comparable acquisitions, giving equal weight to the three approaches. Assumptions used in the discounted cash flow analysis include forecasted revenues, terminal growth rate, forecasted expenses and the discount rate. The fair value measurements are based on significant unobservable inputs, and thus represent Level 3 inputs.
Qualitative impairment assessments were performed for the years ended December 31, 2021 and 2020.
Goodwill for the years ended December 31, 2022 and 2021 are as follows:
(in thousands)20222021
Beginning balance, January 1$4,363,070 $4,257,336 
Acquisitions— 108,435 
Measurement period adjustments51 (2,701)
Loss on impairment (657,922)— 
Ending balance, December 31$3,705,199 $4,363,070