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 85 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, 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, 2018 and 2017 are summarized in the following table (dollars in millions):


	Quarter						Nine Months
	2018			2017			2018			2017
Revenues:
National Group	$	5,542		$	5,036		$	16,719		$	15,344
American Group		5,396			5,180			16,113			15,268
Corporate and other		513			480			1,571			1,440

	$	11,451		$	10,696		$	34,403		$	32,052

Equity in earnings of affiliates:
National Group	$	(1	)	$	(8	)	$	(5	)	$	(17	)
American Group		(10	)		(9	)		(29	)		(27	)
Corporate and other		2			4			9			8

	$	(9	)	$	(13	)	$	(25	)	$	(36	)

Adjusted segment EBITDA:
National Group	$	1,127		$	975		$	3,593		$	3,268
American Group		1,072			930			3,250			2,977
Corporate and other		(103	)		(129	)		(402	)		(374	)

	$	2,096		$	1,776		$	6,441		$	5,871

Depreciation and amortization:
National Group	$	245		$	219		$	702		$	650
American Group		258			251			765			727
Corporate and other		79			69			230			204

	$	582		$	539		$	1,697		$	1,581

Adjusted segment EBITDA	$	2,096		$	1,776		$	6,441		$	5,871
Depreciation and amortization		582			539			1,697			1,581
Interest expense		442			427			1,309			1,257
Gains on sales of facilities		(6	)		(7	)		(420	)		(10	)
Losses on retirement of debt		9			39			9			39

Income before income taxes	$	1,069		$	778		$	3,846		$	3,004