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SEGMENT REPORTING | 12 Months Ended
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Dec. 31, 2024
Segment Reporting [Abstract] |
SEGMENT REPORTING | SEGMENT REPORTING Our chief operating decision maker ("CODM"), who is also our CEO, evaluates the financial performance of our segments based upon their respective revenue and segmented internal profit and loss statements prepared on a basis not consistent with GAAP. The CODM considers actual to budget and current year actual to prior year actual for revenue and other profit and loss measures on a monthly basis for evaluating performance of each segment and making decisions about allocating capital and other resources to each segment. We do not report balance sheet information by segment since it is not reviewed by our CODM to evaluate segment performance or to make resource allocation decisions. In the first quarter of 2024, we revised our reportable segments to combine our eRad business, which was included in the Imaging Center segment, with our former AI segment to form a new Digital Health reportable segment. Prior period amounts were adjusted retrospectively to reflect the change in reportable segment. Accordingly, our reportable segments currently are our Imaging Center segment and our Digital Health segment. Our Imaging Center segment provides physicians with imaging capabilities to facilitate the diagnosis and treatment of diseases and disorders. Services include magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), nuclear medicine, mammography, ultrasound, diagnostic radiology (X-ray), fluoroscopy and other related procedures. The vast majority of our centers offer multi-modality imaging services, a strategy that diversifies revenue streams, reduces exposure to reimbursement changes and provides patients and referring physicians one location to serve the needs of multiple procedures. Our Digital Health segment develops and deploys clinical applications to enhance interpretation of medical images and improve patient outcomes with an emphasis on brain, breast, prostate, and pulmonary diagnostics. Included in the segment is our eRad subsidiary, which designs the underlying critical scheduling, data storage and retrieval systems necessary for imaging center operation. In the normal course of business, our Imaging Center and Digital Health segments enter into transactions with each other. While intersegment transactions are treated like third-party transactions to determine segment performance, the revenues recognized by a segment and expenses incurred by the counterparty are eliminated in consolidation and do not affect consolidated results. The following tables reflect certain financial data for each reportable segment:
Year Ended December 31, 2024 |  |  |
| Imaging Center | Digital health | Total
Revenues from external customers | $ | 1,792,319 |  | $ | 37,345 |  | $ | 1,829,664 |
Intersegment revenues | — |  | 28,361 |  | 28,361 |
| $ | 1,792,319 |  | $ | 65,706 |  | $ | 1,858,025 |
Reconciliation of revenue |  |  |
Elimination of intersegment revenues |  |  | (28,361) |
Total consolidated revenues |  |  | $ | 1,829,664 |
Less: |  |  |
Other segment items* | $ | 1,542,274 |  | $ | 40,753 |  | $ | 1,583,027 |
Segment profit (loss) | 250,045 |  | (3,408) |  | 246,637 |
Reconciliation of segment profit |  |  |
Depreciation and amortization |  |  | (137,838) |
Loss on sale and disposal of equipment and other |  |  | (2,276) |
Severance costs |  |  | (1,902) |
Interest expense |  |  | (79,849) |
Equity in earnings of joint ventures |  |  | 14,472 |
Non-cash change in fair value of interest rate swaps |  |  | (8,006) |
Debt restructuring and extinguishment expenses |  |  | (11,292) |
Other income |  |  | 24,916 |
Income before income taxes |  |  | $ | 44,862 |
*Other segment items include operating expenses, inclusive of cost of operations and lease abandonment charges.
Year Ended December 31, 2023 |  |  |
| Imaging Center | Digital health | Total
Revenues from external customers | $ | 1,590,564 |  | $ | 26,066 |  | $ | 1,616,630 |
Intersegment revenues | — |  | 23,510 |  | 23,510 |
| 1,590,564 |  | 49,576 |  | 1,640,140 |
Reconciliation of revenue |  |  |
Elimination of intersegment revenues |  |  | (23,510) |
Total consolidated revenues |  |  | $ | 1,616,630 |
Less: |  |  |
Other segment items* | $ | 1,381,847 |  | $ | 18,538 |  | $ | 1,400,385 |
Segment profit (loss) | 208,717 |  | 7,528 |  | 216,245 |
Reconciliation of segment profit |  |  |
Depreciation and amortization |  |  | (128,391) |
Loss on sale and disposal of equipment and other |  |  | (2,187) |
Severance costs |  |  | (3,778) |
Interest expense |  |  | (64,483) |
Equity in earnings of joint ventures |  |  | 6,427 |
Non-cash change in fair value of interest rate swaps |  |  | (8,185) |
Debt restructuring and extinguishment expenses |  |  | — |
Other income |  |  | 6,354 |
Gain on contribution of imaging centers into joint venture |  |  | 16,808 |
Income before income taxes |  |  | $ | 38,810 |
*Other segment items include operating expenses, inclusive of cost of operations and lease abandonment charges.
Year Ended December 31, 2022 |  |  |
| Imaging Center | Digital health | Total
Revenues from external customers | $ | 1,413,419 |  | $ | 16,642 |  | $ | 1,430,061 |
Intersegment revenues | — |  | 21,416 |  | 21,416 |
| 1,413,419 |  | 38,058 |  | 1,451,477 |
Reconciliation of revenue |  |  |
Elimination of intersegment revenues |  |  | (21,416) |
Total consolidated revenues |  |  | $ | 1,430,061 |
Less: |  |  |
Other segment items* | $ | 1,246,701 |  | $ | 17,645 |  | $ | 1,264,346 |
Segment profit (loss) | 166,718 |  | (1,003) |  | 165,715 |
Reconciliation of segment profit |  |  |
Depreciation and amortization |  |  | (115,877) |
Loss on sale and disposal of equipment and other |  |  | (2,529) |
Severance costs |  |  | (946) |
Interest expense |  |  | (50,841) |
Equity in earnings of joint ventures |  |  | 10,390 |
Non-cash change in fair value of interest rate swaps |  |  | 39,621 |
Debt restructuring and extinguishment expenses |  |  | (731) |
Other income |  |  | (1,833) |
Income before income taxes |  |  | $ | 42,969 |
*Other segment items include operating expenses, inclusive of cost of operations and lease abandonment charges. Substantially all of our property, equipment and right-of-use assets were located in the United States as of December 31, 2024 and 2023. Service revenue attributed to countries that represent a significant portion of consolidated service revenue are as follows (in thousands):
| 2024 |  | 2023 |  | 2022
United States | $ | 1,802,422 |  |  | $ | 1,599,745 |  |  | $ | 1,423,232 |
United Kingdom | 24,359 |  |  | 14,245 |  |  | 4,432 |
Other countries | 2,883 |  |  | 2,640 |  |  | 2,397 |
Total | $ | 1,829,664 |  |  | $ | 1,616,630 |  |  | $ | 1,430,061 |

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- Definition The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments. + References Reference 1: http://www.xbrl.org/2003/role/exampleRef -Topic 280 -SubTopic 10 -Name Accounting Standards Codification -Section 55 -Paragraph 48 -Publisher FASB -URI https://asc.fasb.org/1943274/2147482785/280-10-55-48 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Topic 280 -SubTopic 10 -Name Accounting Standards 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