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v3.25.2

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 | 6 Months Ended |
--- | --- | --- | ---
Jun. 30, 2025 | Jun. 30, 2024 | Jun. 30, 2025 | Jun. 30, 2024 | Dec. 31, 2024
Segment Reporting Information [Line Items] |  |  |  |  |
Revenues | $ 18,605 | $ 17,492 | $ 36,926 | $ 34,831 |
Salaries and benefits | 8,138 | 7,685 | 16,135 | 15,392 |
Supplies | 2,844 | 2,634 | 5,608 | 5,305 |
Other operating expenses | 3,793 | 3,623 | 7,638 | 7,229 |
Equity in losses (earnings) of affiliates | (19) | 0 | (37) | 2 |
Depreciation and amortization | 863 | 819 | 1,723 | 1,614 |
Interest expense | 568 | 506 | 1,115 | 1,018 |
Losses (gains) on sales of facilities | 3 | (12) | 2 | (213) |
Income before income taxes | 2,415 | 2,237 | 4,742 | 4,484 |
Assets | 59,536 |  | 59,536 |  | $ 59,513
Operating Segments [Member] |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Adjusted segment EBITDA | 4,201 | 3,805 | 8,213 | 7,429 |
Eliminations and Reconciling Items [Member] |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Corporate and Other | 352 | 255 | 631 | 526 |
Depreciation and amortization | 863 | 819 | 1,723 | 1,614 |
Interest expense | 568 | 506 | 1,115 | 1,018 |
Losses (gains) on sales of facilities | 3 | (12) | 2 | (213) |
Income before income taxes | 2,415 | 2,237 | 4,742 | 4,484 |
National Group [Member] | Operating Segments [Member] |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Revenues | 5,200 | 4,856 | 10,265 | 9,691 |
Salaries and benefits | 1,919 | 1,869 | 3,878 | 3,759 |
Supplies | 755 | 693 | 1,496 | 1,398 |
Other operating expenses | 1,255 | 1,204 | 2,488 | 2,398 |
Equity in losses (earnings) of affiliates |  | 3 |  | 2 |
Operating expenses | 3,929 | 3,769 | 7,862 | 7,557 |
Adjusted segment EBITDA | 1,271 | 1,087 | 2,403 | 2,134 |
Depreciation and amortization | 223 | 211 | 449 | 423 |
Assets | 13,139 |  | 13,139 |  | 12,855
Atlantic Group [Member] | Operating Segments [Member] |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Revenues | 6,122 | 5,881 | 12,289 | 11,691 |
Salaries and benefits | 2,246 | 2,149 | 4,462 | 4,310 |
Supplies | 935 | 884 | 1,849 | 1,793 |
Other operating expenses | 1,590 | 1,544 | 3,166 | 3,026 |
Equity in losses (earnings) of affiliates | (1) | (1) | (2) | (2) |
Operating expenses | 4,770 | 4,576 | 9,475 | 9,127 |
Adjusted segment EBITDA | 1,352 | 1,305 | 2,814 | 2,564 |
Depreciation and amortization | 275 | 261 | 549 | 519 |
Assets | 17,365 |  | 17,365 |  | 17,168
American Group [Member] | Operating Segments [Member] |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Revenues | 6,493 | 6,043 | 12,824 | 12,027 |
Salaries and benefits | 2,216 | 2,110 | 4,412 | 4,229 |
Supplies | 1,067 | 978 | 2,087 | 1,958 |
Other operating expenses | 1,649 | 1,560 | 3,360 | 3,140 |
Equity in losses (earnings) of affiliates | (17) | (18) | (31) | (31) |
Operating expenses | 4,915 | 4,630 | 9,828 | 9,296 |
Adjusted segment EBITDA | 1,578 | 1,413 | 2,996 | 2,731 |
Depreciation and amortization | 277 | 267 | 556 | 522 |
Assets | 20,900 |  | 20,900 |  | 20,714
Corporate and Other [Member] |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Revenues | 790 | 712 | 1,548 | 1,422 |
Depreciation and amortization | 88 | $ 80 | 169 | $ 150 |
Assets | $ 8,132 |  | $ 8,132 |  | $ 8,776

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