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v3.23.2

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions | 6 Months Ended
--- | ---
Jun. 30, 2023 | Jun. 30, 2022
Cash flows from operating activities: |  |
Net income | $ 2,955 | $ 2,844
Increase (decrease) in cash from operating assets and liabilities: |  |
Accounts receivable | 306 | (547)
Inventories and other assets | (301) | (462)
Accounts payable and accrued expenses | (505) | (818)
Depreciation and amortization | 1,519 | 1,470
Income taxes | 3 | 121
Losses on sales of facilities | 14 | 22
Losses on retirement of debt | 0 | 78
Amortization of debt issuance costs and discounts | 17 | 15
Share-based compensation | 133 | 171
Other | 137 | 81
Net cash provided by operating activities | 4,278 | 2,975
Cash flows from investing activities: |  |
Purchase of property and equipment | (2,438) | (1,941)
Acquisition of hospitals and health care entities | (124) | (116)
Sales of hospitals and health care entities | 172 | 20
Change in investments | (16) | (2)
Other | (2) | (11)
Net cash used in investing activities | (2,408) | (2,050)
Cash flows from financing activities: |  |
Issuance of long-term debt | 3,218 | 5,966
Net change in revolving credit facilities | (1,840) | 930
Repayment of long-term debt | (608) | (2,690)
Distributions to noncontrolling interests | (342) | (333)
Payment of debt issuance costs | (30) | (53)
Payment of dividends | (339) | (337)
Repurchase of common stock | (1,761) | (4,783)
Other | (221) | (201)
Net cash used in financing activities | (1,923) | (1,501)
Effect of exchange rate changes on cash and cash equivalents | 7 | (17)
Change in cash and cash equivalents | (46) | (593)
Cash and cash equivalents at beginning of period | 908 | 1,451
Cash and cash equivalents at end of period | 862 | 858
Interest payments | 925 | 777
Income tax payments, net | $ 773 | $ 609

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