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Segment Reporting
6 Months Ended
Jun. 30, 2020
Segment Reporting [Abstract]  
Segment Reporting Segment Reporting
We have two operating segments, Domestic and International. Revenues are derived primarily from the sale of clinical, financial and administrative information solutions and services. The cost of revenues includes the cost of third-party consulting services, computer hardware, devices and sublicensed software purchased from manufacturers for delivery to clients. It also includes the cost of hardware maintenance and sublicensed software support subcontracted to the manufacturers. Operating expenses incurred by the geographic business segments consist of sales and client service expenses including salaries of sales and client service personnel, expenses associated with our managed services business, marketing expenses, communications expenses and unreimbursed travel expenses. "Other" includes expenses that have not been allocated to the operating segments, such as software development, general and administrative expenses, certain organizational restructuring and other expense, share-based compensation expense, and certain amortization and depreciation. Performance of the segments is assessed at the operating earnings level by our chief operating decision maker, who is our Chief Executive Officer. Items such as interest, income taxes, capital expenditures and total assets are managed at the consolidated level and thus are not included in our operating segment disclosures. Accounting policies for each of the reportable segments are the same as those used on a consolidated basis.

The following table presents a summary of our operating segments and other expense for the three and six months ended June 30, 2020 and June 29, 2019:
(In thousands)DomesticInternationalOtherTotal
Three Months Ended 2020
Revenues$1,168,213  $162,136  $—  $1,330,349  
Costs of revenue189,779  22,184  —  211,963  
Operating expenses587,674  57,413  326,401  971,488  
Total costs and expenses
777,453  79,597  326,401  1,183,451  
Operating earnings (loss)$390,760  $82,539  $(326,401) $146,898  

(In thousands)DomesticInternationalOtherTotal
Three Months Ended 2019
Revenues$1,266,112  $164,949  $—  $1,431,061  
Costs of revenue243,926  24,747  —  268,673  
Operating expenses605,636  73,258  352,377  1,031,271  
Total costs and expenses
849,562  98,005  352,377  1,299,944  
Operating earnings (loss)$416,550  $66,944  $(352,377) $131,117  

(In thousands)DomesticInternationalOtherTotal
Six Months Ended 2020
Revenues$2,414,628  $327,462  $—  $2,742,090  
Costs of revenue418,346  48,033  —  466,379  
Operating expenses1,157,768  123,968  668,701  1,950,437  
Total costs and expenses
1,576,114  172,001  668,701  2,416,816  
Operating earnings (loss)$838,514  $155,461  $(668,701) $325,274  
(In thousands)DomesticInternationalOtherTotal
Six Months Ended 2019
Revenues$2,496,942  $323,996  $—  $2,820,938  
Costs of revenue472,485  49,392  —  521,877  
Operating expenses1,177,654  141,427  650,919  1,970,000  
Total costs and expenses
1,650,139  190,819  650,919  2,491,877  
Operating earnings (loss)$846,803  $133,177  $(650,919) $329,061