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Segment and Geographic Information | 9 Months Ended
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Sep. 30, 2024
Segment Reporting [Abstract] |
Segment and Geographic Information | NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION We operate in one line of business, which is operating hospitals and related health care entities. We operate in three geographically organized groups: the National, American and Atlantic Groups. At September 30, 2024, the National Group included 55 hospitals located in Alaska, California, Idaho, Indiana, Kentucky, Nevada, New Hampshire, North Carolina, Tennessee, Utah and Virginia; the American Group included 62 hospitals located in Colorado, central Kansas, Louisiana and Texas; and the Atlantic Group included 62 hospitals located in Florida, Georgia, northern Kansas, Missouri and South Carolina. We also operate eight hospitals in England, and these facilities are included in the Corporate and other group. NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued) Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, gains and losses 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 and losses of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters and nine months ended September 30, 2024 and 2023 are summarized in the following table (dollars in millions):
|  | Quarter |  |  | Nine Months |
|  | 2024 |  |  | 2023 |  |  | 2024 |  |  | 2023 |
Revenues: |  |  |  |  |  |  |  |  |  |  |  |
National Group |  | $ | 4,891 |  |  | $ | 4,352 |  |  | $ | 14,503 |  |  | $ | 13,340 |
American Group |  |  | 6,019 |  |  |  | 5,491 |  |  |  | 17,911 |  |  |  | 16,226 |
Atlantic Group |  |  | 5,578 |  |  |  | 5,470 |  |  |  | 16,974 |  |  |  | 15,617 |
Corporate and other |  |  | 999 |  |  |  | 900 |  |  |  | 2,930 |  |  |  | 2,482 |
|  | $ | 17,487 |  |  | $ | 16,213 |  |  | $ | 52,318 |  |  | $ | 47,665 |
Equity in (earnings) losses of affiliates: |  |  |  |  |  |  |  |  |  |  |  |
National Group |  | $ | — |  |  | $ | — |  |  | $ | 2 |  |  | $ | (2 | )
American Group |  |  | (18 | ) |  |  | (13 | ) |  |  | (49 | ) |  |  | (35 | )
Atlantic Group |  |  | — |  |  |  | — |  |  |  | (2 | ) |  |  | (2 | )
Corporate and other |  |  | 3 |  |  |  | (6 | ) |  |  | 36 |  |  |  | 45 |
|  | $ | (15 | ) |  | $ | (19 | ) |  | $ | (13 | ) |  | $ | 6 |
Adjusted segment EBITDA: |  |  |  |  |  |  |  |  |  |  |  |
National Group |  | $ | 1,087 |  |  | $ | 799 |  |  | $ | 3,259 |  |  | $ | 2,826 |
American Group |  |  | 1,378 |  |  |  | 1,210 |  |  |  | 4,118 |  |  |  | 3,662 |
Atlantic Group |  |  | 1,154 |  |  |  | 1,158 |  |  |  | 3,757 |  |  |  | 3,219 |
Corporate and other |  |  | (352 | ) |  |  | (287 | ) |  |  | (964 | ) |  |  | (599 | )
|  | $ | 3,267 |  |  | $ | 2,880 |  |  | $ | 10,170 |  |  | $ | 9,108 |
Depreciation and amortization: |  |  |  |  |  |  |  |  |  |  |  |
National Group |  | $ | 213 |  |  | $ | 206 |  |  | $ | 636 |  |  | $ | 621 |
American Group |  |  | 277 |  |  |  | 244 |  |  |  | 799 |  |  |  | 719 |
Atlantic Group |  |  | 271 |  |  |  | 249 |  |  |  | 790 |  |  |  | 735 |
Corporate and other |  |  | 81 |  |  |  | 70 |  |  |  | 231 |  |  |  | 213 |
|  | $ | 842 |  |  | $ | 769 |  |  | $ | 2,456 |  |  | $ | 2,288 |
Adjusted segment EBITDA |  | $ | 3,267 |  |  | $ | 2,880 |  |  | $ | 10,170 |  |  | $ | 9,108 |
Depreciation and amortization |  |  | 842 |  |  |  | 769 |  |  |  | 2,456 |  |  |  | 2,288 |
Interest expense |  |  | 515 |  |  |  | 483 |  |  |  | 1,533 |  |  |  | 1,447 |
Losses (gains) on sales of facilities |  |  | 4 |  |  |  | (2 | ) |  |  | (209 | ) |  |  | 12 |
Income before income taxes |  | $ | 1,906 |  |  | $ | 1,630 |  |  | $ | 6,390 |  |  | $ | 5,361 |

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