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Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings or Losses of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization (Detail) - USD ($)
$ in Millions
 3 Months Ended 12 Months Ended
Mar. 31, 2025
Mar. 31, 2024
Dec. 31, 2024
Segment Reporting Information [Line Items]      
Revenues $ 18,321 $ 17,339  
Salaries and benefits 7,997 7,707  
Supplies 2,764 2,671  
Other operating expenses 3,845 3,606  
Equity in earnings of affiliates (18) 2  
Depreciation and amortization 860 795  
Interest expense 547 512  
Gains on sales of facilities (1) (201)  
Income before income taxes 2,327 2,247  
Assets 59,798   $ 59,513
Operating Segments [Member]      
Segment Reporting Information [Line Items]      
Adjusted segment EBITDA 4,012 3,624  
Eliminations and Reconciling Items [Member]      
Segment Reporting Information [Line Items]      
Corporate and Other 279 271  
Depreciation and amortization 860 795  
Interest expense 547 512  
Gains on sales of facilities (1) (201)  
Income before income taxes 2,327 2,247  
National Group [Member] | Operating Segments [Member]      
Segment Reporting Information [Line Items]      
Revenues 5,065 4,835 4,835
Salaries and benefits 1,959   1,890
Supplies 741   705
Other operating expenses 1,233   1,194
Equity in earnings of affiliates   (1)
Operating expenses 3,933   3,788
Adjusted segment EBITDA 1,132 1,047 1,047
Depreciation and amortization 226 212  
Assets 13,407   12,855
Atlantic Group [Member] | Operating Segments [Member]      
Segment Reporting Information [Line Items]      
Revenues 6,167 5,810 5,810
Salaries and benefits 2,216   2,161
Supplies 914   909
Other operating expenses 1,576   1,482
Equity in earnings of affiliates (1)   (1)
Operating expenses 4,705   4,551
Adjusted segment EBITDA 1,462 1,259 1,259
Depreciation and amortization 274 258  
Assets 17,654   17,168
American Group [Member] | Operating Segments [Member]      
Segment Reporting Information [Line Items]      
Revenues 6,331 5,984 5,984
Salaries and benefits 2,196   2,119
Supplies 1,020   980
Other operating expenses 1,711   1,580
Equity in earnings of affiliates (14)   (13)
Operating expenses 4,913   4,666
Adjusted segment EBITDA 1,418 1,318 1,318
Depreciation and amortization 279 255  
Assets 20,614   20,714
Corporate and Other [Member]      
Segment Reporting Information [Line Items]      
Revenues 758 710  
Depreciation and amortization 81 $ 70  
Assets $ 8,123   $ 8,776