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CONSOLIDATED STATEMENTS OF CASH FLOW - USD ($)
 12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Cash flows from operating activities      
Net income $ 1,214,000,000 $ 2,484,000,000 $ 2,802,000,000
Adjustments to reconcile net income to net cash provided by operating activities:      
Gain on sale of Gentiva Hospice 0 0 (237,000,000)
(Gain) loss on investment securities, net (24,000,000) 54,000,000 205,000,000
Equity in net losses 94,000,000 63,000,000 4,000,000
Stock-based compensation 207,000,000 175,000,000 216,000,000
Depreciation 908,000,000 850,000,000 749,000,000
Amortization 60,000,000 67,000,000 96,000,000
Impairment of property and equipment 237,000,000 206,000,000 248,000,000
Impairment of indefinite-lived intangible assets 200,000,000 55,000,000 0
Deferred income taxes (192,000,000) (167,000,000) (100,000,000)
Changes in operating assets and liabilities, net of effect of businesses acquired and dispositions:      
Receivables (669,000,000) (337,000,000) (54,000,000)
Other assets 1,003,000,000 (1,318,000,000) (463,000,000)
Benefits payable 199,000,000 915,000,000 975,000,000
Other liabilities (373,000,000) 841,000,000 44,000,000
Unearned revenues (6,000,000) (20,000,000) 32,000,000
Other, net 108,000,000 113,000,000 70,000,000
Net cash provided by operating activities 2,966,000,000 3,981,000,000 4,587,000,000
Cash flows from investing activities      
Proceeds from sale of Gentiva Hospice, net 0 0 2,701,000,000
Acquisitions, net of cash and cash equivalents acquired (89,000,000) (233,000,000) (337,000,000)
Purchases of property and equipment (575,000,000) (1,004,000,000) (1,137,000,000)
Proceeds from sale of property and equipment 7,000,000 210,000,000 17,000,000
Changes in securities lending collateral receivable (418,000,000) 0 0
Purchases of investment securities (8,185,000,000) (7,552,000,000) (6,049,000,000)
Proceeds from maturities of investment securities 2,982,000,000 1,292,000,000 1,365,000,000
Proceeds from sales of investment securities 3,376,000,000 3,795,000,000 2,434,000,000
Other (50,000,000) 0 0
Net cash used in investing activities (2,952,000,000) (3,492,000,000) (1,006,000,000)
Cash flows from financing activities      
(Payments) receipts from contract deposits, net (1,933,000,000) 828,000,000 1,993,000,000
Proceeds from issuance of senior notes, net 2,232,000,000 2,544,000,000 1,982,000,000
Repayment of senior notes (1,107,000,000) (1,832,000,000) (1,000,000,000)
(Repayments) proceeds from issuance of commercial paper, net (907,000,000) 211,000,000 (376,000,000)
Proceeds from short-term borrowings 0 100,000,000 0
Repayment of short-term borrowings 0 (100,000,000) 0
Repayment of term loan 0 (500,000,000) (2,000,000,000)
Debt issue costs (7,000,000) (7,000,000) (6,000,000)
Common stock repurchases (817,000,000) (1,573,000,000) (2,096,000,000)
Dividends paid (431,000,000) (431,000,000) (392,000,000)
Changes in securities lending payable 418,000,000 0 0
Changes in rebate factor payable 123,000,000 0 0
Change in book overdraft 50,000,000 55,000,000 (28,000,000)
Other, net (108,000,000) (151,000,000) 9,000,000
Net cash used in financing activities (2,487,000,000) (856,000,000) (1,914,000,000)
(Decrease) increase in cash and cash equivalents (2,473,000,000) (367,000,000) 1,667,000,000
Cash and cash equivalents at beginning of period 4,694,000,000 5,061,000,000 3,394,000,000
Cash and cash equivalents at end of period 2,221,000,000 4,694,000,000 5,061,000,000
Supplemental cash flow disclosures:      
Interest payments 584,000,000 394,000,000 354,000,000
Income tax payments, net 570,000,000 997,000,000 758,000,000
Details of businesses acquired in purchase transactions:      
Fair value of assets acquired, net of cash acquired 124,000,000 462,000,000 460,000,000
Less: Fair value of liabilities assumed (35,000,000) (234,000,000) (70,000,000)
Less: Noncontrolling interests acquired 0 5,000,000 (53,000,000)
Cash paid for acquired businesses, net of cash acquired $ 89,000,000 $ 233,000,000 $ 337,000,000