Segment and Geographic Information

9 Months Ended

Sep. 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 57 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 nine months ended September 30, 2023 and 2022 are summarized in the following table (dollars in millions):

	Quarter						Nine Months
	2023			2022			2023			2022
Revenues:
National Group	$	4,352		$	4,092		$	13,340		$	12,382
Atlantic Group		5,470			4,951			15,617			14,337
American Group		5,491			5,117			16,226			15,528
Corporate and other		900			811			2,482			2,489
	$	16,213		$	14,971		$	47,665		$	44,736
Equity in (earnings) losses of affiliates:
National Group	$	—		$	—		$	(2	)	$	(1	)
Atlantic Group		—			(1	)		(2	)		(2	)
American Group		(13	)		(13	)		(35	)		(31	)
Corporate and other		(6	)		4			45			5
	$	(19	)	$	(10	)	$	6		$	(29	)
Adjusted segment EBITDA:
National Group	$	799		$	780		$	2,826		$	2,602
Atlantic Group		1,158			1,014			3,219			2,833
American Group		1,210			1,178			3,662			3,832
Corporate and other		(287	)		(70	)		(599	)		(379	)
	$	2,880		$	2,902		$	9,108		$	8,888
Depreciation and amortization:
National Group	$	206		$	207		$	621		$	598
Atlantic Group		249			231			735			686
American Group		244			236			719			701
Corporate and other		70			75			213			234
	$	769		$	749		$	2,288		$	2,219
Adjusted segment EBITDA	$	2,880		$	2,902		$	9,108		$	8,888
Depreciation and amortization		769			749			2,288			2,219
Interest expense		483			446			1,447			1,288
Losses (gains) on sales of facilities		(2	)		3			12			25
Losses on retirement of debt		—			—			—			78
Income before income taxes	$	1,630		$	1,704		$	5,361		$	5,278