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NET OPERATING REVENUES | 9 Months Ended
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Sep. 30, 2025
Revenue from Contract with Customer [Abstract] |
NET OPERATING REVENUES | NET OPERATING REVENUES Net operating revenues for our Hospital Operations and Ambulatory Care segments primarily consist of net patient service revenues, principally for patients covered by Medicare, Medicaid, and managed care and other health plans, as well as certain uninsured patients under our Compact with Uninsured Patients and other uninsured discount and charity programs. Net operating revenues for our Hospital Operations segment also include revenues from providing revenue cycle management and value‑based care services to hospitals, health systems, physician practices, employers and other clients, as well as income recognized under grant programs. The table below presents our sources of net operating revenues:
|  | Three Months Ended September 30, |  | Nine Months Ended September 30,
|  | 2025 |  | 2024 |  | 2025 |  | 2024
Hospital Operations: |  |  |  |  |  |  |  |
Net patient service revenues from hospitals and related outpatient facilities: |  |  |  |  |  |  |  |
Medicare |  | $ | 512 |  |  | $ | 504 |  |  | $ | 1,590 |  |  | $ | 1,632 |
Medicaid |  | 404 |  |  | 342 |  |  | 1,163 |  |  | 1,123 |
Managed care |  | 2,374 |  |  | 2,425 |  |  | 7,197 |  |  | 7,464 |
Uninsured |  | 15 |  |  | 10 |  |  | 50 |  |  | 40 |
Indemnity and other |  | 157 |  |  | 148 |  |  | 395 |  |  | 439 |
Total |  | 3,462 |  |  | 3,429 |  |  | 10,395 |  |  | 10,698 |
Other revenues(1) |  | 552 |  |  | 558 |  |  | 1,649 |  |  | 1,629 |
Total Hospital Operations |  | 4,014 |  |  | 3,987 |  |  | 12,044 |  |  | 12,327 |
Ambulatory Care |  | 1,275 |  |  | 1,139 |  |  | 3,739 |  |  | 3,275 |
Net operating revenues |  | $ | 5,289 |  |  | $ | 5,126 |  |  | $ | 15,783 |  |  | $ | 15,602 |
(1) | Primarily revenue from physician practices and revenue cycle management.
Adjustments for prior‑year cost reports and related valuation allowances, principally related to Medicare and Medicaid, increased revenues in the nine months ended September 30, 2025 by $24 million, but did not result in a change in revenues during the nine months ended September 30, 2024. Estimated cost report settlements receivable, net of payables and valuation allowances, were included in accounts receivable in the accompanying Condensed Consolidated Balance Sheets (see Note 2). We believe that we have made adequate provision for any adjustments that may result from the final determination of amounts earned under all the above arrangements with Medicare and Medicaid. The table below presents the composition of net operating revenues for our Ambulatory Care segment:
|  | Three Months Ended September 30, |  | Nine Months Ended September 30,
|  | 2025 |  | 2024 |  | 2025 |  | 2024
Net patient service revenues |  | $ | 1,222 |  |  | $ | 1,098 |  |  | $ | 3,579 |  |  | $ | 3,152 |
Other revenues(1) |  | 53 |  |  | 41 |  |  | 160 |  |  | 123 |
Net operating revenues |  | $ | 1,275 |  |  | $ | 1,139 |  |  | $ | 3,739 |  |  | $ | 3,275 |
(1) | Primarily revenue from management fees and other sources.
Performance Obligations The following table presents revenue from revenue cycle management services that is expected to be recognized in the future related to performance obligations that are unsatisfied, or partially unsatisfied, at the end of the reporting period:
|  |  |  | Three Months Ending |  | Years Ending |  | Later Years
|  |  |  |  |  | December 31, |
|  | Total |  | 2025 |  | 2026 |  | 2027 |  | 2028 |  | 2029 |
Performance obligations |  | $ | 5,128 |  |  | $ | 180 |  |  | $ | 720 |  |  | $ | 719 |  |  | $ | 718 |  |  | $ | 718 |  |  | $ | 2,073 |
The amounts in the table primarily consist of revenue cycle management fixed fees, which are typically recognized ratably as the performance obligation is satisfied. The estimated revenue does not include volume‑ or contingency‑based contracts, variable‑based escalators, performance incentives, penalties or other variable consideration that is considered constrained. Our contract with Catholic Health Initiatives (“CHI”), now known as CommonSpirit Health and the minority interest holder in our Conifer Health Solutions, LLC joint venture, represents the majority of the fixed‑fee revenue related to remaining performance obligations. Our contract term with CHI is scheduled to end on December 31, 2032.

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- Definition The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 7 -Publisher FASB -URI https://asc.fasb.org/1943274/2147479806/606-10-50-7 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 9 -Publisher FASB -URI https://asc.fasb.org/1943274/2147479806/606-10-50-9 Reference 3: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 10 -Publisher FASB -URI https://asc.fasb.org/1943274/2147479806/606-10-50-10 Reference 4: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 15 -Publisher FASB -URI https://asc.fasb.org/1943274/2147479806/606-10-50-15 Reference 5: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 12 -Subparagraph (a) -Publisher FASB -URI https://asc.fasb.org/1943274/2147479806/606-10-50-12 Reference 6: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 12 -Subparagraph (b) -Publisher FASB -URI https://asc.fasb.org/1943274/2147479806/606-10-50-12 Reference 7: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 12 -Subparagraph (c) -Publisher FASB -URI https://asc.fasb.org/1943274/2147479806/606-10-50-12 Reference 8: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 12 -Subparagraph (d) -Publisher FASB -URI https://asc.fasb.org/1943274/2147479806/606-10-50-12 Reference 9: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 12 -Subparagraph (e) -Publisher FASB -URI https://asc.fasb.org/1943274/2147479806/606-10-50-12 Reference 10: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 13 -Subparagraph (b)(2) -Publisher FASB -URI https://asc.fasb.org/1943274/2147479806/606-10-50-13 Reference 11: http://www.xbrl.org/2003/role/disclosureRef -Name Accounting Standards Codification -Topic 606 -Publisher FASB -URI https://asc.fasb.org/606/tableOfContent + Details
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