Segment and Geographic Information (Tables)

6 Months Ended

Jun. 30, 2025

Segment Reporting [Abstract]

Schedule of Geographic Distributions of Revenues, Equity in Earnings or Losses of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization

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