SEGMENT INFORMATION
 3 Months Ended
Mar. 31, 2018
Segment Reporting [Abstract]  
SEGMENT INFORMATION
SEGMENT INFORMATION
 
Our business consists of our Hospital Operations and other segment, our Ambulatory Care segment and our Conifer segment. The factors for determining the reportable segments include the manner in which management evaluates operating performance combined with the nature of the individual business activities.
 
Our Hospital Operations and other segment is comprised of our acute care and specialty hospitals, ancillary outpatient facilities, urgent care centers, microhospitals and physician practices. At March 31, 2018, our subsidiaries operated 69 hospitals (certain of which are classified as held for sale, as described in Note 4), serving primarily urban and suburban communities in 11 states.
 
Our Ambulatory Care segment is comprised of the operations of our USPI joint venture and our nine Aspen facilities in the United Kingdom, which are classified as held for sale in the accompanying Condensed Consolidated Balance Sheets at
March 31, 2018 and December 31, 2017. At March 31, 2018, our USPI joint venture had interests in 251 ambulatory surgery centers, 34 urgent care centers, 23 imaging centers and 21 surgical hospitals in 27 states. At March 31, 2018, we owned 80.0% of our USPI joint venture.
 
Our Conifer segment provides healthcare business process services in the areas of hospital and physician revenue cycle management and value-based care solutions to healthcare systems, as well as individual hospitals, physician practices, self-insured organizations, health plans and other entities. At March 31, 2018, Conifer provided services to approximately 800 Tenet and non-Tenet hospitals and other clients nationwide. In 2012, we entered into agreements documenting the terms and conditions of various services Conifer provides to Tenet hospitals, as well as certain administrative services our Hospital Operations and other segment provides to Conifer. The pricing terms for the services provided by each party to the other under these contracts were based on estimated third-party pricing terms in effect at the time the agreements were signed. At March 31, 2018, we owned 76.2% of Conifer Health Solutions, LLC, which is the principal subsidiary of Conifer Holdings, Inc.
 
The following tables include amounts for each of our reportable segments and the reconciling items necessary to agree to amounts reported in the accompanying Condensed Consolidated Balance Sheets and Condensed Consolidated Statements of Operations:
 
 
March 31, 2018
 
December 31, 2017
Assets:
 
 

 
 

Hospital Operations and other
 
$
16,271

 
$
16,466

Ambulatory Care
 
5,811

 
5,822

Conifer
 
1,102

 
1,097

Total 
 
$
23,184

 
$
23,385


 
 
Three Months Ended
March 31,
 
 
2018
 
2017
Capital expenditures:
 
 

 
 

Hospital Operations and other
 
$
120

 
$
183

Ambulatory Care
 
15

 
11

Conifer
 
8

 
4

Total 
 
$
143

 
$
198

 
 
 
 
 
Net operating revenues:
 
 

 
 

Hospital Operations and other total prior to inter-segment eliminations(1)
 
$
3,947

 
$
4,115

Ambulatory Care
 
498

 
455

Conifer
 
 

 
 

Tenet
 
150

 
159

Other customers
 
254

 
243

Total Conifer
 
404

 
402

Inter-segment eliminations
 
(150
)
 
(159
)
Total 
 
$
4,699

 
$
4,813

 
 
 
 
 
Equity in earnings of unconsolidated affiliates:
 
 

 
 

Hospital Operations and other
 
$
(2
)
 
$
2

Ambulatory Care
 
27

 
27

Total 
 
$
25

 
$
29

 
 
 
 
 
Adjusted EBITDA(2):
 
 

 
 

Hospital Operations and other(2)
 
$
402

 
$
309

Ambulatory Care
 
165

 
153

Conifer
 
98

 
65

Total 
 
$
665

 
$
527

 
 
 
 
 
Depreciation and amortization:
 
 

 
 

Hospital Operations and other
 
$
175

 
$
187

Ambulatory Care
 
17

 
22

Conifer
 
12

 
12

Total 
 
$
204

 
$
221


 
 
Three Months Ended March 31,
 
 
2018
 
2017
Adjusted EBITDA(2)
 
$
665

 
$
527

Loss from divested and closed businesses
(i.e., the Company’s health plan businesses)
 
(1
)
 
(16
)
Depreciation and amortization
 
(204
)
 
(221
)
Impairment and restructuring charges, and acquisition-related costs
 
(47
)
 
(33
)
Litigation and investigation costs
 
(6
)
 
(5
)
Interest expense
 
(255
)
 
(258
)
Loss from early extinguishment of debt
 
(1
)
 
—

Other non-operating expense, net
 
(1
)
 
(5
)
Gains on sales, consolidation and deconsolidation of facilities
 
110

 
15

Income from continuing operations, before income taxes
 
$
260

 
$
4


(1)
Hospital Operations and other revenues includes health plan revenues of $6 million for the three months ended March 31, 2018 and $65 million for the three months ended March 31, 2017, respectively.
(2)
Hospital Operations and other Adjusted EBITDA excludes health plan EBITDA of $(1) million for the three months ended March 31, 2018 and $(16) million for the three months ended March 31, 2017.