v3.8.0.1
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Cash flows from operating activities:      
Net earnings $ 808 $ 561 $ 357
Adjustments to reconcile net earnings to net cash provided by operating activities      
Depreciation and amortization 361 278 111
Stock compensation expense 135 148 71
Debt extinguishment costs 0 (7) 0
Deferred income taxes (108) 92 (17)
Gain on contingent consideration (1) (5) (44)
Goodwill and intangible adjustment 0 0 38
Changes in assets and liabilities      
Premium and trade receivables (50) 74 (360)
Other assets (146) 167 (102)
Medical claims liabilities 359 145 536
Unearned revenue 19 43 (27)
Accounts payable and accrued expenses 53 402 39
Other long-term liabilities 68 (61) 51
Other operating activities, net (9) 14 5
Net cash provided by operating activities 1,489 1,851 658
Cash flows from investing activities:      
Capital expenditures (422) (306) (150)
Purchases of investments (2,704) (2,450) (1,321)
Sales and maturities of investments 1,899 1,656 669
Investments in acquisitions, net of cash acquired (50) (1,297) (18)
Other investing activities, net 12 0 7
Net cash used in investing activities (1,265) (2,397) (813)
Cash flows from financing activities:      
Proceeds from borrowings 1,400 8,946 1,925
Payment of long-term debt (1,353) (6,076) (1,583)
Common stock repurchases (65) (63) (53)
Purchase of noncontrolling interest (66) (14) 0
Debt issue costs (3) (76) (4)
Other financing activities, net 5 0 20
Net cash (used in) provided by financing activities (82) 2,717 305
Effect of exchange rate changes on cash and cash equivalents 0 (1) 0
Net increase in cash and cash equivalents 142 2,170 150
Cash and cash equivalents, beginning of period 3,930 1,760 1,610
Cash and cash equivalents, end of period 4,072 3,930 1,760
Supplemental disclosures of cash flow information:      
Interest paid 237 165 55
Income taxes paid 496 556 328
Equity issued in connection with acquisitions $ 0 $ 3,105 $ 12