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Segment and Geographic Information
 6 Months Ended
Jun. 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 98 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 82 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 gain
s
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 six months ended June 30, 2021 and 2020 are summarized in the following table (dollars in millions):
 
    
Quarter
     
Six Months
  
    
2021
     
2020
     
2021
     
2020
  
Revenues:
                                    
National Group
   
$
7,300
 
    $ 5,546     
$
14,356
 
    $ 12,020  
American Group
   
 
6,504
 
      5,103     
 
12,795
 
      10,847  
Corporate and other
   
 
631
 
      419     
 
1,261
 
      1,062  
    
 
 
     
 
 
     
 
 
     
 
 
  
    
$
14,435
 
    $ 11,068     
$
28,412
 
    $ 23,929  
    
 
 
     
 
 
     
 
 
     
 
 
  
Equity in earnings of affiliates:
                                    
National Group
   
$
(9
) 
    $ (4 )    
$
(16
) 
    $ (3 ) 
American Group
   
 
(12
) 
      (2 )    
 
(24
) 
      (11 ) 
Corporate and other
   
 
(1
) 
      5     
 
(3
) 
      6  
    
 
 
     
 
 
     
 
 
     
 
 
  
    
$
(22
) 
    $ (1 )    
$
(43
) 
    $ (8 ) 
    
 
 
     
 
 
     
 
 
     
 
 
  
Adjusted segment EBITDA:
                                    
National Group
   
$
1,845
 
    $ 1,485     
$
3,550
 
    $ 2,700  
American Group
   
 
1,593
 
      1,408     
 
3,094
 
      2,523  
Corporate and other
   
 
(219
) 
      (227 )    
 
(373
) 
      (357 ) 
    
 
 
     
 
 
     
 
 
     
 
 
  
    
$
3,219
 
    $ 2,666     
$
6,271
 
    $ 4,866  
    
 
 
     
 
 
     
 
 
     
 
 
  
Depreciation and amortization:
                                    
National Group
   
$
339
 
    $ 312     
$
662
 
    $ 618  
American Group
   
 
296
 
      295     
 
589
 
      582  
Corporate and other
   
 
77
 
      84     
 
158
 
      165  
    
 
 
     
 
 
     
 
 
     
 
 
  
    
$
712
 
    $ 691     
$
1,409
 
    $ 1,365  
    
 
 
     
 
 
     
 
 
     
 
 
  
Adjusted segment EBITDA
   
$
3,219
 
    $ 2,666     
$
6,271
 
    $ 4,866  
Depreciation and amortization
   
 
712
 
      691     
 
1,409
 
      1,365  
Interest expense
   
 
386
 
      388     
 
770
 
      816  
Losses (gains) on sales of facilities
   
 
(8
) 
      27     
 
(10
) 
      20  
Losses on retirement of debt
   
 
12
 
      —     
 
12
 
      295  
    
 
 
     
 
 
     
 
 
     
 
 
  
Income before income taxes
   
$
2,117
 
    $ 1,560     
$
4,090
 
    $ 2,370