Segment and Geographic Information

3 Months Ended

Mar. 31, 2021

Segment Reporting [Abstract]

Segment and Geographic Information

NOTE 11 — SEGMENT AND GEOGRAPHIC INFORMATION

We operate in one line of business, which is operating hospitals and related health care entities. We operate in two geographically organized groups: the National and American Groups. The National Group includes 97 hospitals located in Alaska, California, Florida, southern Georgia, Idaho, Indiana, northern Kentucky, Nevada, New Hampshire, North Carolina, South Carolina, Utah and Virginia, and the American Group includes 82 hospitals located in Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Missouri, Tennessee and Texas. We also operate seven hospitals in England, and these facilities are included in the Corporate and other group.  

Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, 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, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters ended March 31, 2021 and 2020 are summarized in the following table (dollars in millions): 

	2021		2020
Revenues:
National Group	$	7,056	$	6,474
American Group		6,291		5,744
Corporate and other		630		643
	$	13,977	$	12,861

		2021			2020
Equity in earnings of affiliates:
National Group	$	(7	)	$	1
American Group		(12	)		(9	)
Corporate and other		(2	)		1
	$	(21	)	$	(7	)
Adjusted segment EBITDA:
National Group	$	1,705		$	1,215
American Group		1,501			1,115
Corporate and other		(154	)		(130	)
	$	3,052		$	2,200
Depreciation and amortization:
National Group	$	323		$	306
American Group		293			287
Corporate and other		81			81
	$	697		$	674
Adjusted segment EBITDA	$	3,052		$	2,200
Depreciation and amortization		697			674
Interest expense		384			428
Gains on sales of facilities		(2	)		(7	)
Losses on retirement of debt		—			295
Income before income taxes	$	1,973		$	810