Segment and Geographic Information

9 Months Ended

Sep. 30, 2021

Segment Reporting [Abstract]

Segment and Geographic Information

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 96 hospitals located in Alaska, California, Florida, southern Georgia, Idaho, Indiana, northern Kentucky, Nevada, New Hampshire, North Carolina, South Carolina, Utah and Virginia, and the American Group includes 80 hospitals located in Colorado, northern Georgia, 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, losses and 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, 2021 and 2020 are summarized in the following table (dollars in millions):

	Quarter						Nine Months
	2021			2020			2021			2020
Revenues:
National Group	$	7,787		$	6,633		$	22,143		$	18,653
American Group		6,767			6,073			19,562			16,920
Corporate and other		722			605			1,983			1,667
	$	15,276		$	13,311		$	43,688		$	37,240
Equity in earnings of affiliates:
National Group	$	(14	)	$	(23	)	$	(30	)	$	(26	)
American Group		(14	)		(15	)		(38	)		(26	)
Corporate and other		(7	)		(2	)		(10	)		4
	$	(35	)	$	(40	)	$	(78	)	$	(48	)
Adjusted segment EBITDA:
National Group	$	1,780		$	1,128		$	5,330		$	3,828
American Group		1,604			1,130			4,698			3,653
Corporate and other		(160	)		(205	)		(533	)		(562	)
	$	3,224		$	2,053		$	9,495		$	6,919
Depreciation and amortization:
National Group	$	343		$	312		$	1,005		$	930
American Group		295			286			884			868
Corporate and other		78			96			236			261
	$	716		$	694		$	2,125		$	2,059
Adjusted segment EBITDA	$	3,224		$	2,053		$	9,495		$	6,919
Depreciation and amortization		716			694			2,125			2,059
Interest expense		398			385			1,168			1,201
Losses (gains) on sales of facilities		(1,047	)		(14	)		(1,057	)		6
Losses on retirement of debt		—			—			12			295
Income before income taxes	$	3,157		$	988		$	7,247		$	3,358