GOODWILL AND OTHER INTANGIBLE ASSETS
The following table presents information on changes in the carrying amount of goodwill for each of our segments:
December 31,
 20252024
Hospital Operations  
Goodwill at beginning of period, net of accumulated impairment losses$2,697 $3,119 
Goodwill acquired during the year, including purchase price allocation adjustments— 42 
Goodwill related to assets held for sale and disposed— (464)
Goodwill at end of period, net of accumulated impairment losses$2,697 $2,697 
Ambulatory Care
Goodwill at beginning of period7,994 $7,188 
Goodwill acquired during the year, including purchase price allocation adjustments507 927 
Goodwill related to assets held for sale and disposed or deconsolidated facilities— (121)
Goodwill at end of period8,501 $7,994 
Total Goodwill$11,198 $10,691 
There were $2.430 billion of accumulated impairment losses related to the goodwill of our Hospital Operations segment at both December 31, 2025 and 2024. There were no accumulated goodwill impairment losses related to our Ambulatory Care segment in either period.
The following table presents information regarding other intangible assets, which were included in the accompanying Consolidated Balance Sheets:
 Gross
Carrying
Amount
Accumulated
Amortization
Net Book
Value
At December 31, 2025:   
Other intangible assets with finite useful lives:
Capitalized software costs$1,511 $(1,166)$345 
Contracts241 (148)93 
Other42 (14)28 
Other intangible assets with finite lives1,794 (1,328)466 
Other intangible assets with indefinite useful lives:
Trade names105 — 105 
Contracts773 — 773 
Other— 
Other intangible assets with indefinite lives882 — 882 
Total other intangible assets, net$2,676 $(1,328)$1,348 
At December 31, 2024:
Other intangible assets with finite useful lives:
Capitalized software costs$1,469 $(1,075)$394 
Contracts241 (135)106 
Other96 (78)18 
Other intangible assets with finite lives1,806 (1,288)518 
Other intangible assets with indefinite useful lives:
Trade names105 — 105 
Contracts769 — 769 
Other— 
Other intangible assets with indefinite lives879 — 879 
Total other intangible assets, net$2,685 $(1,288)$1,397 
Estimated future amortization of intangible assets with finite useful lives at December 31, 2025 was as follows:
 TotalYears Ending December 31,Later Years
 20262027202820292030
Amortization of intangible assets$466 $106 $114 $82 $58 $43 $63 
We recognized amortization expense of $166 million, $172 million and $174 million during the years ended December 31, 2025, 2024 and 2023, respectively.

Historical Timeline

Fiscal YearFiled
2025Feb 17, 2026Showing above
2024Feb 18, 2025
2023Feb 16, 2024
2022Feb 21, 2023
2021Feb 18, 2022
2020Feb 19, 2021
2019Feb 24, 2020
2018Feb 25, 2019
2017Feb 26, 2018
2016Feb 27, 2017
2015Feb 22, 2016

About Goodwill & Intangibles Disclosures

Goodwill and intangible asset disclosures reveal the premium paid in acquisitions and how management assesses whether that premium retains its value. Since goodwill is no longer amortized under US GAAP, the annual impairment test is the only mechanism that adjusts carrying values downward — making the assumptions behind that test critically important for investors.

Key signals: a history of goodwill impairments suggests management consistently overpays for acquisitions. Watch the gap between reporting unit fair value and carrying amount — when fair value exceeds carrying amount by less than 10-20%, a small decline in business performance could trigger a write-down. For finite-lived intangibles, examine useful life assumptions across customer relationships, technology, and trade names; aggressive estimates inflate near-term earnings. Compare total intangibles-to-total-assets ratios against peers to assess acquisition dependency. Rising goodwill as a percentage of equity can signal balance sheet fragility.