Segment Reporting

9 Months Ended

Sep. 30, 2021

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. 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 the three and nine months ended September 30, 2021 and September 30, 2020:

(In thousands)	Domestic		International		Other		Total
Three Months Ended 2021
Revenues	$	1,285,488	$	182,488	$	—	$	1,467,976
Costs of revenue	222,665		28,446		—		251,111
Operating expenses	580,535		70,472		340,935		991,942
Total costs and expenses	803,200		98,918		340,935		1,243,053
Operating earnings (loss)	$	482,288	$	83,570	$	(340,935)	$	224,923

(In thousands)	Domestic		International		Other		Total
Three Months Ended 2020
Revenues	$	1,230,769	$	137,904	$	—	$	1,368,673
Costs of revenue	219,938		11,951		—		231,889
Operating expenses	566,777		58,626		316,430		941,833
Total costs and expenses	786,715		70,577		316,430		1,173,722
Gain on sale of businesses	—		—		216,869		216,869
Operating earnings (loss)	$	444,054	$	67,327	$	(99,561)	$	411,820

(In thousands)	Domestic		International		Other		Total
Nine Months Ended 2021
Revenues	$	3,774,507	$	538,002	$	—	$	4,312,509
Costs of revenue	660,584		82,508		—		743,092
Operating expenses	1,797,466		206,794		1,072,616		3,076,876
Total costs and expenses	2,458,050		289,302		1,072,616		3,819,968
Operating earnings (loss)	$	1,316,457	$	248,700	$	(1,072,616)	$	492,541

(In thousands)	Domestic		International		Other		Total
Nine Months Ended 2020
Revenues	$	3,645,397	$	465,366	$	—	$	4,110,763
Costs of revenue	638,284		59,984		—		698,268
Operating expenses	1,724,545		182,594		985,131		2,892,270
Total costs and expenses	2,362,829		242,578		985,131		3,590,538
Gain on sale of businesses	—		—		216,869		216,869
Operating earnings (loss)	$	1,282,568	$	222,788	$	(768,262)	$	737,094