Segment and Geographic Information

6 Months Ended

Jun. 30, 2023

Segment Reporting [Abstract]

Segment and Geographic Information

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION

Effective January 1, 2023, we reorganized our operations from two geographically organized groups into three geographically organized groups: the National, American and Atlantic Groups. The National Group includes 57 hospitals located in Alaska, California, Idaho, Indiana, Kentucky, Nevada, New Hampshire, North Carolina, Tennessee, Utah and Virginia, the American Group includes 56 hospitals located in Colorado, central Kansas, Louisiana and Texas, and the Atlantic Group includes 62 hospitals located in Florida, Georgia, northern Kansas, Missouri and South Carolina. The seven hospitals we operate in England remain in the Corporate and other group. Prior periods presented have been restated according to the new organizational structure.

Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, gains and losses on sales of facilities, losses on retirement of debt, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters and six months ended June 30, 2023 and 2022 are summarized in the following table (dollars in millions):

	Quarter						Six Months
	2023			2022			2023			2022
Revenues:
National Group	$	4,372		$	4,088		$	8,988		$	8,290
Atlantic Group		5,038			4,700			10,147			9,386
American Group		5,536			5,205			10,735			10,411
Corporate and other		915			827			1,582			1,678
	$	15,861		$	14,820		$	31,452		$	29,765
Equity in losses (earnings) of affiliates:
National Group	$	(1	)	$	(1	)	$	(2	)	$	(1	)
Atlantic Group		(1	)		(1	)		(2	)		(1	)
American Group		(10	)		(9	)		(22	)		(18	)
Corporate and other		19			3			51			1
	$	7		$	(8	)	$	25		$	(19	)
Adjusted segment EBITDA:
National Group	$	878		$	867		$	2,027		$	1,822
Atlantic Group		975			969			2,061			1,819
American Group		1,319			1,338			2,452			2,654
Corporate and other		(116	)		(132	)		(312	)		(309	)
	$	3,056		$	3,042		$	6,228		$	5,986
Depreciation and amortization:
National Group	$	208		$	194		$	415		$	391
Atlantic Group		247			233			486			455
American Group		238			233			475			465
Corporate and other		70			78			143			159
	$	763		$	738		$	1,519		$	1,470
Adjusted segment EBITDA	$	3,056		$	3,042		$	6,228		$	5,986
Depreciation and amortization		763			738			1,519			1,470
Interest expense		485			434			964			842
Losses (gains) on sales of facilities		(1	)		32			14			22
Losses on retirement of debt		—			78			—			78
Income before income taxes	$	1,809		$	1,760		$	3,731		$	3,574