Segment Reporting

12 Months Ended

Dec. 31, 2020

Segment Reporting [Abstract]

Segment Reporting

Segment ReportingWe have two operating segments, Domestic and International. Revenues are derived primarily from the sale of clinical, financial and administrative information solutions and services. The cost of revenues includes the cost of third-party consulting services, computer hardware, devices and sublicensed software purchased from manufacturers for delivery to clients. It also includes the cost of hardware maintenance and sublicensed software support subcontracted to the manufacturers. Operating expenses incurred by the geographic business segments consist of sales and client service expenses including salaries of sales and client service personnel, expenses associated with our managed services business, marketing expenses, communications expenses and unreimbursed travel expenses. "Other" includes expenses that have not been allocated to the operating segments, such as software development, general and administrative expenses, certain organizational restructuring and other expense, share-based compensation expense, and certain amortization and depreciation. "Other" also includes gains or losses recognized on the divestiture of businesses. Performance of the segments is assessed at the operating earnings level by our chief operating decision maker, who is our Chief Executive Officer. Items such as interest, income taxes, capital expenditures and total assets are managed at the consolidated level and thus are not included in our operating segment disclosures. Accounting policies for each of the reportable segments are the same as those used on a consolidated basis.

The following table presents a summary of our operating segments and other expense for 2020, 2019 and 2018:

(In thousands)	Domestic		International		Other		Total
2020
Revenues	$	4,879,769	$	626,019	$	—	$	5,505,788
Costs of revenue	854,574		78,367		—		932,941
Operating expenses	2,339,624		242,991		1,296,188		3,878,803
Total costs and expenses	3,194,198		321,358		1,296,188		4,811,744
Gain on sale of businesses	—		—		220,523		220,523
Operating earnings (loss)	$	1,685,571	$	304,661	$	(1,075,665)	$	914,567

(In thousands)	Domestic		International		Other		Total
2019
Revenues	$	5,038,127	$	654,471	$	—	$	5,692,598
Costs of revenue	967,035		104,006		—		1,071,041
Operating expenses	2,398,422		276,914		1,345,552		4,020,888
Total costs and expenses	3,365,457		380,920		1,345,552		5,091,929
Operating earnings (loss)	$	1,672,670	$	273,551	$	(1,345,552)	$	600,669

(In thousands)	Domestic		International		Other		Total
2018
Revenues	$	4,730,266	$	636,059	$	—	$	5,366,325
Costs of revenue	827,904		109,444		—		937,348
Operating expenses	2,164,465		321,116		1,168,611		3,654,192
Total costs and expenses	2,992,369		430,560		1,168,611		4,591,540
Operating earnings (loss)	$	1,737,897	$	205,499	$	(1,168,611)	$	774,785