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Segment and Geographic Information
 9 Months Ended
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