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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2022
Sep. 30, 2021
Cash flows from operating activities    
Net income $ 2,820 $ 2,947
Adjustments to reconcile net income to net cash provided by (used in) operating activities:    
Gain on sale of KAH Hospice (240) 0
Loss on investment securities, net 136 18
Gain on Kindred at Home equity method investment 0 (1,129)
Equity in net earnings (1) (69)
Stock-based compensation 173 132
Depreciation 555 468
Amortization 73 51
Impairment on property and equipment 144 0
Deferred income taxes (33) 0
Changes in operating assets and liabilities, net of effect of businesses acquired and disposed:    
Receivables 11 (294)
Other assets (465) (476)
Benefits payable 948 573
Other liabilities (195) 207
Unearned revenues 5,758 (84)
Other 30 14
Net cash provided by operating activities 9,714 2,358
Cash flows from investing activities    
Proceeds from sale of KAH Hospice, net 2,708 0
Acquisitions, net of cash and cash equivalents acquired (293) (3,959)
Purchases of property and equipment, net (862) (945)
Purchases of investment securities (4,740) (6,573)
Proceeds from maturities of investment securities 1,214 2,103
Proceeds from sales of investment securities 1,979 2,920
Net cash provided by (used in) investing activities 6 (6,454)
Cash flows from financing activities    
Receipts from contract deposits, net 3,787 605
Proceeds from issuance of senior notes, net 744 2,984
(Repayments) proceeds from issuance of commercial paper, net (660) 193
Proceeds from term loan 0 500
Repayment of term loan (2,000) (150)
Debt issue costs (2) (29)
Change in book overdraft (89) (80)
Common stock repurchases (1,032) (36)
Dividends paid (291) (263)
Other (13) 3
Net cash provided by financing activities 444 3,727
Increase (decrease) in cash and cash equivalents 10,164 (369)
Cash and cash equivalents at beginning of period 3,394 4,673
Cash and cash equivalents at end of period 13,558 4,304
Supplemental cash flow disclosures:    
Interest payments 256 183
Income tax payments, net 751 219
Details of businesses acquired in purchase transactions:    
Fair value of assets acquired, net of cash and cash equivalents acquired 411 9,572
Less: Fair value of liabilities assumed (65) (3,231)
Less: Noncontrolling interests acquired (53) (22)
Less: Remeasured existing Kindred at Home equity method investment 0 (2,360)
Cash paid for acquired businesses, net of cash and cash equivalents acquired $ 293 $ 3,959