Segment Reporting

3 Months Ended

Mar. 31, 2021

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 months ended March 31, 2021 and March 31, 2020:

(In thousands)	Domestic		International		Other		Total
Three Months Ended 2021
Revenues	$	1,221,992	$	165,786	$	—	$	1,387,778
Costs of revenue	205,694		24,962		—		230,656
Operating expenses	560,562		61,614		316,888		939,064
Total costs and expenses	766,256		86,576		316,888		1,169,720
Operating earnings (loss)	$	455,736	$	79,210	$	(316,888)	$	218,058

(In thousands)	Domestic		International		Other		Total
Three Months Ended 2020
Revenues	$	1,246,415	$	165,326	$	—	$	1,411,741
Costs of revenue	228,567		25,849		—		254,416
Operating expenses	570,094		66,555		342,300		978,949
Total costs and expenses	798,661		92,404		342,300		1,233,365
Operating earnings (loss)	$	447,754	$	72,922	$	(342,300)	$	178,376