Segment and Geographic Information

6 Months Ended

Jun. 30, 2025

Segment Reporting [Abstract]

Segment and Geographic Information

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION

We operate in one line of business, which is operating hospitals and related health care entities. We operate in three geographically organized groups: the National, Atlantic and American Groups. At June 30, 2025, the National Group included 54 hospitals located in Alaska, California, Idaho, Indiana, Kentucky, Nevada, New Hampshire, North Carolina, Tennessee, Utah and Virginia, the Atlantic Group included 63 hospitals located in Florida, Georgia, Northern Kansas, Missouri and South Carolina, and the American Group included 66 hospitals located in Colorado, Central Kansas, Louisiana and Texas. The eight hospitals we operate in England are included in the Corporate and other group.

Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses and gains 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, salaries and benefits, supplies, other operating expenses, equity in earnings of affiliates, adjusted segment EBITDA, depreciation and amortization and assets that are provided to the Chief Operating Decision Maker, which is the Chief Executive Officer, are summarized in the following tables (dollars in millions) and represent the operating segments for the quarters and six months ended June 30, 2025 and 2024 and assets at June 30, 2025 and December 31, 2024:

	Quarter								Six Months
	2025
	National Group		Atlantic Group			American Group			National Group		Atlantic Group			American Group
Revenues	$	5,200	$	6,122		$	6,493		$	10,265	$	12,289		$	12,824
Salaries and benefits		1,919		2,246			2,216			3,878		4,462			4,412
Supplies		755		935			1,067			1,496		1,849			2,087
Other operating expenses		1,255		1,590			1,649			2,488		3,166			3,360
Equity in earnings of affiliates		—		(1	)		(17	)		—		(2	)		(31	)
		3,929		4,770			4,915			7,862		9,475			9,828
Adjusted segment EBITDA	$	1,271	$	1,352		$	1,578		$	2,403	$	2,814		$	2,996

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

	Quarter								Six Months
	2024
	National Group		Atlantic Group			American Group			National Group		Atlantic Group			American Group
Revenues	$	4,856	$	5,881		$	6,043		$	9,691	$	11,691		$	12,027
Salaries and benefits		1,869		2,149			2,110			3,759		4,310			4,229
Supplies		693		884			978			1,398		1,793			1,958
Other operating expenses		1,204		1,544			1,560			2,398		3,026			3,140
Equity in losses (earnings) of affiliates		3		(1	)		(18	)		2		(2	)		(31	)
		3,769		4,576			4,630			7,557		9,127			9,296
Adjusted segment EBITDA	$	1,087	$	1,305		$	1,413		$	2,134	$	2,564		$	2,731

	Quarter					Six Months
	2025		2024			2025		2024
Adjusted segment EBITDA:
National Group	$	1,271	$	1,087		$	2,403	$	2,134
Atlantic Group		1,352		1,305			2,814		2,564
American Group		1,578		1,413			2,996		2,731
		4,201		3,805			8,213		7,429
Adjustments to reconcile Total Adjusted segment   EBITDA to consolidated Income before income taxes:
Corporate and Other		352		255			631		526
Depreciation and amortization		863		819			1,723		1,614
Interest expense		568		506			1,115		1,018
Losses (gains) on sales of facilities		3		(12	)		2		(213	)
Income before income taxes	$	2,415	$	2,237		$	4,742	$	4,484

	Quarter				Six Months
	2025		2024		2025		2024
Revenues:
National Group	$	5,200	$	4,856	$	10,265	$	9,691
Atlantic Group		6,122		5,881		12,289		11,691
American Group		6,493		6,043		12,824		12,027
Corporate and other		790		712		1,548		1,422
	$	18,605	$	17,492	$	36,926	$	34,831
Depreciation and amortization:
National Group	$	223	$	211	$	449	$	423
Atlantic Group		275		261		549		519
American Group		277		267		556		522
Corporate and other		88		80		169		150
	$	863	$	819	$	1,723	$	1,614

	June 30, 2025		December 31, 2024
Assets:
National Group	$	13,139	$	12,855
Atlantic Group		17,365		17,168
American Group		20,900		20,714
Corporate and other		8,132		8,776
	$	59,536	$	59,513