The Company utilizes operating and finance leases for the use of certain hospitals, medical office buildings, and medical equipment. All lease agreements generally require the Company to pay maintenance, repairs, property taxes and insurance costs, which are variable amounts based on actual costs incurred during each applicable period. Such costs are not included in the determination of the ROU asset or lease liability. Variable lease cost also includes escalating rent payments that are not fixed at commencement but are based on an index that is determined in future periods over the lease term based on changes in the Consumer Price Index or other measures of cost inflation. Most leases include one or more options to renew the lease at the end of the initial term, with renewal terms that generally extend the lease at the then market rate of rental payment. Certain leases also include an option to buy the underlying asset at or a short time prior to the termination of the lease. All such options are at the Company’s discretion and are evaluated at the commencement of the lease, with only those that are reasonably certain of exercise included in determining the appropriate lease term. The Company has elected to account for COVID-19 related concessions as though the enforceable rights and

obligations for those concessions are explicit within the underlying contract. During the year ended December 31, 2020, concessions of approximately $7 million were recognized as a reduction to variable rent expense.

The components of lease cost and rent expense for the year ended December 31, 2020 and 2019 are as follows (in millions):

	Year Ended December 31,
Lease Cost	2020			2019
Operating lease cost:
Operating lease cost	$	203		$	194
Short-term rent expense		104			114
Variable lease cost		26			18
Sublease income		(6	)		(5	)
Total operating lease cost	$	327		$	321
Finance lease cost:
Amortization of right-of-use assets	$	10		$	12
Interest on finance lease liabilities		8			7
Total finance lease cost	$	18		$	19

Supplemental balance sheet information related to leases was as follows (in millions):

	Balance Sheet Classification	December 31, 2020			December 31, 2019
Operating Leases:
Operating Lease ROU Assets	Other assets, net	$	642		$	607

Finance Leases:
Finance Lease ROU Assets	Property and equipment
	Land and improvements	$	8		$	8
	Buildings and improvements		134			154
	Equipment and fixtures		8			11
	Property and equipment		150			173
	Less accumulated depreciation and amortization		(46	)		(56	)
	Property and equipment, net	$	104		$	117

Current finance lease liabilities	Current maturities of long-term debt	$	5		$	6
Long-term finance lease liabilities	Long-term debt		74			107

Supplemental cash flow information related to leases for the year ended December 31, 2020 and 2019 are as follows (in millions):

	Year Ended December 31,
Cash flow information	2020			2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases (1)	$	188		$	167
Operating cash flows from finance leases		8			7
Financing cash flows from finance leases		7			9
Right-of-use assets obtained in exchange for new finance lease liabilities		22			2
Right-of-use assets obtained in exchange for new operating lease liabilities		150			122
Weighted-average remaining lease term:
Operating leases	7 years			6 years
Finance leases	19 years			20 years
Weighted-average discount rate:
Operating leases		9.0	%		9.1	%
Finance leases		8.4	%		5.6	%

On September 19, 2019, the Company completed the sale and leaseback of four medical office buildings for net proceeds of $56 million to Carter Validus Mission Critical REIT II, Inc. The buildings, with a combined total of 285,337 square feet, are located in three states and support a wide array of diagnostic, medical and surgical services in an outpatient setting for the respective nearby hospitals. Based on the Company’s assessment of the control transfer principle in these leased buildings, the transaction did not qualify for sale treatment and the related leases have been recorded as financing obligations in long-term debt in the Company’s consolidated balance sheet at December 31, 2019. In addition, on December 18, 2019, the Company completed the sale and leaseback of one medical office building for net proceeds of approximately $4 million to an affiliate of Catalyst Healthcare Real Estate. The 30,000 square foot building is located in Arkansas and supports a wide array of diagnostic, medical and surgical services in an outpatient setting for the nearby hospital. Based on the Company’s assessment of the control transfer principle in this leased building, the transaction does not qualify for sale treatment and the related lease has been recorded as a financing obligation in long-term debt in the accompanying consolidated balance sheet at December 31, 2019.

Commitments relating to noncancellable operating and finance leases and financing obligations for each of the next five years and thereafter are as follows (in millions):

							Financing
Year Ending December 31,	Operating			Finance			Obligations
2021	$	193		$	10		$	12
2022		161			9			12
2023		127			8			13
2024		93			8			13
2025		77			8			13
Thereafter		253			150			103
Total minimum future payments		904			193			166
Less: Imputed interest		(238	)		(114	)		(6	)
Total liabilities		666			79			160
Less: Current portion		(142	)		(5	)		(2	)
Long-term liabilities	$	524		$	74		$	158

As of December 31, 2020, there were approximately $17 million of assets underlying approved but pending leases that have not yet commenced, primarily for medical equipment.