NOTE 14 — 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. At December 31, 2018, the National Group included 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 included 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, legal claim benefits, 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, depreciation and amortization, assets and goodwill and other intangible assets are summarized in the following table (dollars in millions):


	For the Years Ended December 31,
	2018			2017			2016
Revenues:
National Group	$	22,581		$	20,772		$	19,845
American Group		21,959			20,912			19,670
Corporate and other		2,137			1,930			1,975

	$	46,677		$	43,614		$	41,490

Equity in earnings of affiliates:
National Group	$	(4	)	$	(21	)	$	(20	)
American Group		(40	)		(37	)		(38	)
Corporate and other		15			13			4

	$	(29	)	$	(45	)	$	(54	)

Adjusted segment EBITDA:
National Group	$	4,980		$	4,600		$	4,565
American Group		4,593			4,231			4,173
Corporate and other		(624	)		(598	)		(520	)

	$	8,949		$	8,233		$	8,218

Depreciation and amortization:
National Group	$	946		$	867		$	806
American Group		1,027			986			908
Corporate and other		305			278			252

	$	2,278		$	2,131		$	1,966


	For the Years Ended December 31,
	2018			2017			2016
Adjusted segment EBITDA	$	8,949		$	8,233		$	8,218
Depreciation and amortization		2,278			2,131			1,966
Interest expense		1,755			1,690			1,707
Gains on sales of facilities		(428	)		(8	)		(23	)
Losses on retirement of debt		9			39			4
Legal claim benefits		—			—			(246	)

Income before income taxes	$	5,335		$	4,381		$	4,810


	December 31,
	2018			2017			2016
Assets:
National Group	$	14,839		$	13,097		$	12,320
American Group		19,122			18,136			16,208
Corporate and other		5,246			5,360			5,230

	$	39,207		$	36,593		$	33,758


	National Group			American Group			Corporate and Other			Total
Goodwill and other intangible assets:
Balance at December 31, 2015	$	1,481		$	4,638		$	612		$	6,731
Acquisitions		—			33			8			41
Foreign currency translation, amortization and other		(23	)		(10	)		(35	)		(68	)

Balance at December 31, 2016		1,458			4,661			585			6,704
Acquisitions		19			612			62			693
Foreign currency translation, amortization and other		(3	)		(8	)		8			(3	)

Balance at December 31, 2017		1,474			5,265			655			7,394
Acquisitions		132			504			—			636
Foreign currency translation, amortization and other		(9	)		(40	)		(28	)		(77	)

Balance at December 31, 2018	$	1,597		$	5,729		$	627		$	7,953