NOTE 11 — 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 88 hospitals located in Alaska, California, Florida, southern Georgia, Idaho, Indiana, northern Kentucky, Nevada, New Hampshire, South Carolina, Utah and Virginia, and the American Group includes 84 hospitals located in Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Mississippi, Missouri, Tennessee and Texas. We also operate six 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 on sales of facilities, 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 six months ended June 30, 2018 and 2017 are summarized in the following table (dollars in millions):


	Quarter						Six Months
	2018			2017			2018			2017
Revenues:
National Group	$	5,609		$	5,160		$	11,177		$	10,308
American Group		5,390			5,093			10,717			10,088
Corporate and other		530			480			1,058			960

	$	11,529		$	10,733		$	22,952		$	21,356

Equity in earnings of affiliates:
National Group	$	(2	)	$	(4	)	$	(4	)	$	(9	)
American Group		(10	)		(10	)		(19	)		(18	)
Corporate and other		5			1			7			4

	$	(7	)	$	(13	)	$	(16	)	$	(23	)

Adjusted segment EBITDA:
National Group	$	1,284		$	1,162		$	2,466		$	2,293
American Group		1,147			1,040			2,178			2,047
Corporate and other		(204	)		(112	)		(299	)		(245	)

	$	2,227		$	2,090		$	4,345		$	4,095

Depreciation and amortization:
National Group	$	232		$	217		$	457		$	431
American Group		255			238			507			476
Corporate and other		75			66			151			135

	$	562		$	521		$	1,115		$	1,042

Adjusted segment EBITDA	$	2,227		$	2,090		$	4,345		$	4,095
Depreciation and amortization		562			521			1,115			1,042
Interest expense		436			411			867			830
Gains on sales of facilities		(9	)		(2	)		(414	)		(3	)

Income before income taxes	$	1,238		$	1,160		$	2,777		$	2,226