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v3.25.2

Long-term debt (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended |  |
--- | --- | --- | --- | ---
Jun. 30, 2025 | Jun. 30, 2025 | May 23, 2025 | Dec. 31, 2024
Debt Instrument [Line Items] |  |  |  |
Total debt principal outstanding | $ 10,330,478 | $ 10,330,478 |  | $ 9,511,106
Discount Premium And Deferred Financing Costs | (69,231) | (69,231) |  | (64,336)
Carrying amount of long-term debt, net of unamortized discounts, premiums and deferred financing costs | 10,261,247 | 10,261,247 |  | 9,446,770
Less current portion | (182,442) | (182,442) |  | (270,867)
Total long-term debt | $ 10,078,805 | $ 10,078,805 |  | 9,175,903
Long-term debt, weighted average interest rate, at point in time | 5.73% | 5.73% |  |
Revolving line of credit |  |  |  |
Debt Instrument [Line Items] |  |  |  |
Secured Debt | $ 0 | $ 0 |  | 0
Revolving line of credit, fair value of amount outstanding | $ 0 | $ 0 |  |
Debt Instrument, Maturity Date |  | Apr. 28, 2028 |  |
Weighted Average |  |  |  |
Debt Instrument [Line Items] |  |  |  |
Debt Instrument, Interest Rate During Period | 5.71% | 5.66% |  |
4.625% Senior Notes |  |  |  |
Debt Instrument [Line Items] |  |  |  |
Senior Notes | $ 2,750,000 | $ 2,750,000 |  | 2,750,000
Debt Instrument, Fair Value Disclosure | $ 2,633,125 | $ 2,633,125 |  |
Debt Instrument, Maturity Date |  | Jun. 01, 2030 |  |
Debt, Interest Rate, at Point in Time | 4.625% | 4.625% |  |
3.75% Senior Notes |  |  |  |
Debt Instrument [Line Items] |  |  |  |
Senior Notes | $ 1,500,000 | $ 1,500,000 |  | 1,500,000
Debt Instrument, Fair Value Disclosure | $ 1,362,225 | $ 1,362,225 |  |
Debt Instrument, Maturity Date |  | Feb. 15, 2031 |  |
Debt, Interest Rate, at Point in Time | 3.75% | 3.75% |  |
6.875% Senior Notes |  |  |  |
Debt Instrument [Line Items] |  |  |  |
Senior Notes | $ 1,000,000 | $ 1,000,000 |  | 1,000,000
Debt Instrument, Fair Value Disclosure | $ 1,035,000 | $ 1,035,000 |  |
Debt Instrument, Maturity Date |  | Sep. 01, 2032 |  |
Debt, Interest Rate, at Point in Time | 6.875% | 6.875% |  |
Acquisition obligations and other notes payable |  |  |  |
Debt Instrument [Line Items] |  |  |  |
Acquisition obligations and other notes payable | $ 51,276 | $ 51,276 |  | 56,483
Long-term debt, weighted average interest rate, at point in time | 5.41% | 5.41% |  |
Acquisition obligations and other notes payable, fair value | $ 51,276 | $ 51,276 |  |
Debt instrument, maturity date, description |  | 2025-2038 |  |
Financing lease obligations |  |  |  |
Debt Instrument [Line Items] |  |  |  |
Financing lease obligations | $ 201,413 | $ 201,413 |  | 216,401
Finance lease, weighted average discount rate, percent | 4.54% | 4.54% |  |
Debt instrument, maturity date, description |  | 2026-2039 |  |
Change Healthcare Temporary Funding Assistance |  |  |  |
Debt Instrument [Line Items] |  |  |  |
CHC Temporary Funding Assistance | $ 0 | $ 0 |  | 92,777
CHC Temporary Funding Assistance, Fair Value | 0 | 0 |  |
6.75% Senior Notes |  |  |  |
Debt Instrument [Line Items] |  |  |  |
Senior Notes | 1,000,000 | 1,000,000 | $ 1,000,000 |
Debt Instrument, Fair Value Disclosure | $ 1,032,500 | $ 1,032,500 |  |
Debt Instrument, Maturity Date |  | Jul. 15, 2033 |  |
Debt, Interest Rate, at Point in Time | 6.75% | 6.75% | 6.75% |
Term Loan A-1 |  |  |  |
Debt Instrument [Line Items] |  |  |  |
Secured Debt | $ 2,199,840 | $ 2,199,840 |  | 2,259,295
Debt Instrument, Fair Value Disclosure | 2,202,590 | 2,202,590 |  |
Debt Instrument, Periodic Payment, Principal |  | $ 59,455 |  |
Debt Instrument, Maturity Date |  | Apr. 28, 2028 |  |
Term Loan B-1 |  |  |  |
Debt Instrument [Line Items] |  |  |  |
Secured Debt | 1,627,949 | $ 1,627,949 |  | $ 1,636,150
Debt Instrument, Fair Value Disclosure | $ 1,636,089 | 1,636,089 |  |
Debt Instrument, Periodic Payment, Principal |  | $ 8,201 |  |
Debt Instrument, Maturity Date |  | May 09, 2031 |  |
Term Loan B-1 | SOFR |  |  |  |
Debt Instrument [Line Items] |  |  |  |
Debt Instrument, Description of Variable Rate Basis | SOFR + 2.00% |  |  |
Term Loan A-1 and Revolver | SOFR |  |  |  |
Debt Instrument [Line Items] |  |  |  |
Debt Instrument, Description of Variable Rate Basis |  | Base +1.75% |  |
Term Loan A-1 and Revolver | Adjusted Rate |  |  |  |
Debt Instrument [Line Items] |  |  |  |
Debt Instrument, Basis Spread on Variable Rate |  | 0.10% |  |

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