Goodwill and Other Intangible Assets (Tables)

12 Months Ended

Sep. 30, 2024

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Changes in the Carrying Value of Goodwill

The following is a summary of the changes in the carrying value of goodwill, by reportable segment, for fiscal 2024 and 2023:

(in thousands)	U.S. Healthcare Solutions		International Healthcare Solutions		Total
Goodwill as of September 30, 2022	$	6,280,240	$	2,223,646	$	8,503,886
Goodwill recognized in connection with acquisitions	—		1,026,440		1,026,440
Goodwill derecognized in connection with divestiture	—		(14,424)		(14,424)
Foreign currency translation	2,177		56,038		58,215
Goodwill as of September 30, 2023	6,282,417		3,291,700		9,574,117
Purchase accounting adjustments	—		(12,904)		(12,904)
Goodwill recognized in connection with acquisitions	—		18,712		18,712
Goodwill impairment	—		(418,000)		(418,000)
Foreign currency translation	2,748		153,354		156,102
Goodwill as of September 30, 2024	$	6,285,165	$	3,032,862	$	9,318,027

The carrying values of goodwill as of September 30, 2024 and 2023 are net of the following accumulated impairments:

(in thousands)	U.S. Healthcare Solutions		International Healthcare Solutions
Accumulated impairment losses as of September 30, 2024	$	—	$	493,936
Accumulated impairment losses as of September 30, 2023	$	—	$	75,936

Schedule of Other Intangible Assets - Indefinite-lived

The following is a summary of other intangible assets:

	September 30, 2024							September 30, 2023
(dollars in thousands)	Weighted Average Remaining Useful Life	Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount		Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount
Indefinite-lived trade name		$	17,000	$	—	$	17,000	$	17,000	$	—	$	17,000
Finite-lived:
Customer relationships	13 years	5,090,864		(1,536,081)		3,554,783		4,845,091		(1,213,200)		3,631,891
Trade names and other	5 years	1,259,954		(830,691)		429,263		1,224,795		(441,903)		782,892
Total other intangible assets		$	6,367,818	$	(2,366,772)	$	4,001,046	$	6,086,886	$	(1,655,103)	$	4,431,783

Schedule of Other Intangible Assets - Finite-lived

The following is a summary of other intangible assets:

	September 30, 2024							September 30, 2023
(dollars in thousands)	Weighted Average Remaining Useful Life	Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount		Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount
Indefinite-lived trade name		$	17,000	$	—	$	17,000	$	17,000	$	—	$	17,000
Finite-lived:
Customer relationships	13 years	5,090,864		(1,536,081)		3,554,783		4,845,091		(1,213,200)		3,631,891
Trade names and other	5 years	1,259,954		(830,691)		429,263		1,224,795		(441,903)		782,892
Total other intangible assets		$	6,367,818	$	(2,366,772)	$	4,001,046	$	6,086,886	$	(1,655,103)	$	4,431,783