| Fiscal period | 2024 | 2023 | 2022 | 2021 | 2020 | 2019 | 2018 | 2017 | 2016 | 2015 |
|---|
| Period End Date | 12/31/2024 | 12/31/2023 | 12/31/2022 | 12/31/2021 | 12/31/2020 | 12/31/2019 | 12/31/2018 | 12/31/2017 | 12/31/2016 | 12/31/2015 |
|---|
| NET OPERATING REVENUES | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Patient service operating revenues | 12,260.38 | 11,574.94 | 11,176.46 | 11,213.51 | 11,039.71 | 10,918.42 | 10,709.98 | 10,093.67 | 10,354.16 | 9,480.28 |
| Less: Provision for uncollectible accounts related to patient service operating revenues | -- | -- | -- | -- | (13.46) | (21.72) | (49.59) | (485.40) | (451.35) | (427.86) |
| HCP capitated revenues | -- | -- | -- | -- | -- | -- | -- | -- | 3,518.68 | 3,509.10 |
| Other revenues | 555.18 | 565.21 | 433.43 | 405.28 | 524.35 | 491.77 | 744.46 | 1,268.36 | 1,323.62 | 1,220.32 |
| Total Revenues | 12,815.55 | 12,140.15 | 11,609.89 | 11,618.80 | 11,550.60 | 11,388.48 | 11,404.85 | 10,876.63 | 14,745.11 | 13,781.84 |
| Patient care costs | 8,598.52 | 8,319.72 | 8,209.55 | 7,972.41 | 7,988.61 | 7,914.49 | 8,195.51 | 7,640.01 | 10,646.74 | 9,824.83 |
| Depreciation and amortization | 723.86 | 745.44 | 732.60 | 680.62 | 630.44 | 615.15 | 591.04 | 559.91 | 720.25 | 638.02 |
| Goodwill impairment charge | -- | 26.08 | -- | -- | -- | 124.89 | 3.11 | 36.20 | 296.41 | 210.23 |
| General and Administrative | 1,538.34 | 1,473.98 | 1,355.20 | 1,195.34 | 1,247.58 | 1,103.31 | 1,135.45 | 1,064.03 | 1,592.70 | 1,452.14 |
| Valuation gain on Alliance and Product Supply Agreement | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Provision for uncollectible accounts | -- | -- | -- | -- | -- | -- | 7.30 | 7.03 | (11.68) | (9.24) |
| Impairments and valuation adjustments | -- | -- | -- | -- | -- | -- | (17.34) | (295.23) | -- | -- |
| Equity investment income | 26.19 | 27.86 | 26.52 | 26.94 | 26.92 | 12.68 | (4.48) | (8.64) | 13.04 | 18.33 |
| Legal proceeding contingency accrual and related expenses | -- | -- | -- | -- | -- | -- | -- | -- | -- | (495.00) |
| Contingent earn-out obligation adjustment | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Minority interests and equity income | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Gain on changes in ownership interests, net | 109.47 | -- | -- | -- | (16.25) | -- | 60.60 | 6.27 | 404.17 | -- |
| Gain on settlement, net | -- | -- | -- | -- | -- | -- | -- | 526.83 | -- | -- |
| Total operating expenses and charges | 10,725.07 | 10,537.36 | 10,270.83 | 9,821.43 | 9,855.97 | 9,745.16 | 9,879.03 | 9,063.88 | 12,850.56 | 12,611.14 |
| Operating Income / (Loss) | 2,090.48 | 1,602.78 | 1,339.06 | 1,797.37 | 1,694.64 | 1,643.32 | 1,525.82 | 1,812.76 | 1,894.54 | 1,170.70 |
| Minority interests and equity income, net | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Other income (loss) net | (69.81) | (19.18) | (15.77) | 6.38 | 16.76 | 29.35 | 10.09 | 17.67 | 8.73 | 8.89 |
| Refinancing Charges | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Debt expense | (470.47) | (398.55) | (357.02) | (285.25) | (304.11) | (443.82) | (487.44) | (430.63) | (414.38) | (408.38) |
| Swap valuation gains | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Debt refinancing and redemption charges | -- | -- | -- | -- | (89.02) | (33.40) | -- | -- | -- | (48.07) |
| Debt extinguishment and modification costs | (19.81) | (7.96) | -- | -- | -- | -- | -- | -- | -- | -- |
| Income (loss) before income taxes | 1,530.39 | 1,177.09 | 966.28 | 1,518.49 | 1,318.26 | 1,195.44 | 1,048.48 | 1,399.79 | 1,488.90 | 723.14 |
| Current- Foreign | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Current: Federal | 253.50 | 200.07 | 201.93 | 216.54 | 47.17 | 208.34 | 140.06 | 330.19 | 337.18 | 183.26 |
| Current: State | 52.41 | 38.37 | 55.59 | 15.60 | 21.44 | 58.03 | 32.99 | 47.23 | 48.77 | 30.77 |
| Deferred: Federal | (47.72) | (40.23) | (66.40) | 59.53 | 198.62 | 44.26 | 52.03 | (98.76) | 93.21 | 88.72 |
| Deferred: State | (2.86) | 0.37 | (12.29) | 5.34 | 27.21 | (25.84) | 21.10 | 37.35 | (27.76) | (8.31) |
| Deferred: International | (7.22) | 0.54 | 3.00 | (4.53) | 2.01 | (20.71) | 4.66 | 4.43 | 2.49 | 0.43 |
| Current: International | 31.53 | 21.01 | 16.25 | 14.25 | 17.48 | 15.55 | 7.56 | 3.42 | 1.93 | 0.86 |
| Provision for Income Taxes - Total | 279.66 | 220.12 | 198.09 | 306.73 | 313.93 | 279.63 | 258.40 | 323.86 | 455.81 | 295.73 |
| Income Tax: Discontinued operations | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Income tax: Loss on discontinued operations | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Income from Continuing Operations | 1,250.74 | 956.98 | 768.19 | 1,211.76 | 1,004.33 | 915.81 | 790.08 | 1,075.93 | 1,033.08 | 427.41 |
| Gain on disposal of discontinued operations, net of tax | -- | -- | 13.45 | -- | -- | 105.48 | (457.04) | -- | -- | -- |
| Income from operations of discontinued operations, net of tax | -- | -- | -- | -- | (9.65) | -- | -- | (245.37) | -- | -- |
| Income Before Extraordinary Income & Accounting Change | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Extraordinary gain (loss) related to early extinguishment of debt, net | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Consolidated Net Income (Loss) | 1,250.74 | 956.98 | 781.64 | 1,211.76 | 994.68 | 1,021.29 | 333.04 | 830.56 | 1,033.08 | 427.41 |
| Less- Net income attributable to noncontrolling interests | 314.40 | 265.44 | 221.24 | 233.31 | 221.04 | 210.31 | 173.65 | 166.94 | 153.21 | 157.68 |
| Net Income (Loss) Available to Common Shareholders | 936.34 | 691.54 | 560.40 | 978.45 | 773.64 | 810.98 | 159.39 | 663.62 | 879.87 | 269.73 |
| Earnings per share from continuing operations | 11.02 | 7.62 | 5.88 | 9.30 | 6.54 | 4.61 | 3.66 | 4.78 | -- | 1.27 |
| Basic income from discontinuing operations per share | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Extraordinary gain (loss), net of tax | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Net Earnings Per Share (Basic) | 11.02 | 7.62 | 6.03 | 9.30 | 6.46 | 5.29 | 0.93 | 3.52 | 4.36 | 1.27 |
| Earnings per share from continuing operations | 10.73 | 7.42 | 5.71 | 8.90 | 6.39 | 4.60 | 3.62 | 4.71 | -- | 1.25 |
| Diluted income from discontinuing operations per share | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Extraordinary gain (loss), net of tax | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| Net Earnings Per Share (Diluted) | 10.73 | 7.42 | 5.85 | 8.90 | 6.31 | 5.27 | 0.92 | 3.47 | 4.29 | 1.25 |
| Weighted Average Shares Outstanding (Basic) | 84.99 | 90.79 | 92.99 | 105.23 | 119.80 | 153.18 | 170.79 | 188.63 | 201.64 | 211.87 |
| Weighted Average Shares Outstanding (Diluted) | 87.27 | 93.18 | 95.83 | 109.95 | 122.62 | 153.81 | 172.37 | 191.35 | 204.91 | 216.25 |