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v3.19.2

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions | 6 Months Ended
--- | ---
Jun. 30, 2019 | Jun. 30, 2018
Cash flows from operating activities: |  |
Net income | $ 2,108 | $ 2,248
Increase (decrease) in cash from operating assets and liabilities: |  |
Accounts receivable | (174) | (233)
Inventories and other assets | (231) | (200)
Accounts payable and accrued expenses | (238) | 31
Depreciation and amortization | 1,255 | 1,115
Income taxes | 27 | 118
Gains on sales of facilities | (17) | (414)
Amortization of debt issuance costs and discounts | 16 | 15
Share-based compensation | 158 | 134
Other | 67 | 51
Net cash provided by (used in) operating activities | 2,971 | 2,865
Cash flows from investing activities: |  |
Purchase of property and equipment | (1,745) | (1,574)
Acquisition of hospitals and health care entities | (1,504) | (538)
Disposal of hospitals and health care entities | 41 | 799
Change in investments | 59 | 23
Other | 36 | (25)
Net cash used in investing activities | (3,113) | (1,315)
Cash flows from financing activities: |  |
Issuances of long-term debt | 6,451 |
Net change in revolving bank credit facilities | (3,040) | 210
Repayment of long-term debt | (98) | (101)
Distributions to noncontrolling interests | (247) | (185)
Payment of debt issuance costs | (63) | (2)
Payment of cash dividends | (278) | (245)
Repurchases of common stock | (520) | (893)
Other | (135) | (192)
Net cash provided by (used in) financing activities | 2,070 | (1,408)
Effect of exchange rate changes on cash and cash equivalents |  | (6)
Change in cash and cash equivalents | 1,928 | 136
Cash and cash equivalents at beginning of period | 502 | 732
Cash and cash equivalents at end of period | 2,430 | 868
Interest payments | 910 | 873
Income tax payments, net | $ 523 | $ 411

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