Segment and Geographic Information

9 Months Ended

Sep. 30, 2022

Segment Reporting [Abstract]

Segment and Geographic Information

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION

We operate in one line of business, which is operating hospitals and related health care entities. We operate in two geographically organized groups: the National and American Groups. The National Group includes 96 hospitals located in Alaska, California, Florida, Georgia, Idaho, Indiana, northern Kentucky, Nevada, New Hampshire, North Carolina, South Carolina, Utah and Virginia, and the American Group includes 79 hospitals located in Colorado, Kansas, southern Kentucky, Louisiana, Missouri, Tennessee and Texas. We also operate seven hospitals in England, and these facilities are included in the Corporate and other group.

Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, gains and losses on sales of facilities, losses on retirement of debt, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry, and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters and nine months ended September 30, 2022 and 2021 are summarized in the following table (dollars in millions):

	Quarter						Nine Months
	2022			2021			2022			2021
Revenues:
National Group	$	7,635		$	7,787		$	22,490		$	22,143
American Group		6,599			6,767			19,872			19,562
Corporate and other		737			722			2,374			1,983
	$	14,971		$	15,276		$	44,736		$	43,688
Losses (equity) in earnings of affiliates:
National Group	$	(1	)	$	(14	)	$	(3	)	$	(30	)
American Group		(13	)		(14	)		(31	)		(38	)
Corporate and other		4			(7	)		5			(10	)
	$	(10	)	$	(35	)	$	(29	)	$	(78	)
Adjusted segment EBITDA:
National Group	$	1,550		$	1,780		$	4,656		$	5,330
American Group		1,389			1,604			4,417			4,698
Corporate and other		(37	)		(160	)		(185	)		(533	)
	$	2,902		$	3,224		$	8,888		$	9,495
Depreciation and amortization:
National Group	$	369		$	343		$	1,088		$	1,005
American Group		309			295			914			884
Corporate and other		71			78			217			236
	$	749		$	716		$	2,219		$	2,125
Adjusted segment EBITDA	$	2,902		$	3,224		$	8,888		$	9,495
Depreciation and amortization		749			716			2,219			2,125
Interest expense		446			398			1,288			1,168
Losses (gains) on sales of facilities		3			(1,047	)		25			(1,057	)
Losses on retirement of debt		—			—			78			12
Income before income taxes	$	1,704		$	3,157		$	5,278		$	7,247