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CONSOLIDATED STATEMENTS OF CASH FLOW - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020
Cash flows from operating activities |  |  |
Net income | $ 2,802 | $ 2,934 | $ 3,367
Adjustments to reconcile net income to net cash provided by operating activities: |  |  |
Gain on sale of KAH Hospice | (237) | 0 | 0
Loss (gain) on investment securities, net | 205 | 130 | (838)
Gain on Kindred at Home equity method investment | 0 | (1,129) | 0
Equity in net losses (earnings) | 4 | (65) | (74)
Stock-based compensation | 216 | 180 | 181
Depreciation | 749 | 640 | 528
Amortization | 96 | 73 | 88
Impairment of property and equipment | 248 | 0 | 0
(Benefit) provision for deferred income taxes | (100) | 15 | 195
Changes in operating assets and liabilities, net of effect of businesses acquired and dispositions: |  |  |
Receivables | (54) | (280) | (85)
Other assets | (463) | (491) | (581)
Benefits payable | 975 | 104 | 2,139
Other liabilities | 44 | 176 | 599
Unearned revenues | 32 | (65) | 71
Other, net | 70 | 40 | 49
Net cash provided by operating activities | 4,587 | 2,262 | 5,639
Cash flows from investing activities |  |  |
Proceeds from sale of KAH Hospice, net | 2,701 | 0 | 0
Acquisitions, net of cash and cash equivalents acquired | (337) | (4,187) | (709)
Purchases of property and equipment, net | (1,120) | (1,316) | (964)
Purchases of investment securities | (6,049) | (7,197) | (9,125)
Maturities of investment securities | 1,365 | 2,597 | 4,986
Proceeds from sales of investment securities | 2,434 | 3,547 | 2,747
Net cash used in investing activities | (1,006) | (6,556) | (3,065)
Cash flows from financing activities |  |  |
Receipts (withdrawals) from contract deposits, net | 1,993 | (306) | (939)
Proceeds from issuance of senior notes, net | 1,982 | 2,984 | 1,088
Repayment of senior notes | (1,000) | 0 | (400)
(Repayments) proceeds from issuance of commercial paper, net | (376) | 352 | 295
Proceeds from term loan | 0 | 2,500 | 1,000
Repayment of term loan | (2,000) | (2,078) | (1,000)
Debt issue costs | (6) | (31) | 0
Common stock repurchases | (2,096) | (79) | (1,820)
Dividends paid | (392) | (354) | (323)
Change in book overdraft | (28) | 6 | 95
Other, net | 9 | 21 | 49
Net cash (used in) provided by financing activities | (1,914) | 3,015 | (1,955)
Increase (decrease) in cash and cash equivalents | 1,667 | (1,279) | 619
Cash and cash equivalents at beginning of period | 3,394 | 4,673 | 4,054
Cash and cash equivalents at end of period | 5,061 | 3,394 | 4,673
Supplemental cash flow disclosures: |  |  |
Interest payments | 354 | 285 | 258
Income tax payments, net | 758 | 227 | 1,132
Details of businesses acquired in purchase transactions: |  |  |
Fair value of assets acquired, net of cash acquired | 460 | 9,804 | 819
Less: Fair value of liabilities assumed | (70) | (3,235) | (110)
Less: Noncontrolling interests acquired | (53) | (22) | 0
Less: Remeasured existing Kindred at Home equity method investment | 0 | (2,360) | 0
Cash paid for acquired businesses, net of cash acquired | $ 337 | $ 4,187 | $ 709

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