10) REVENUE RECOGNITION

We recognize revenue when services/goods have been provided to patients/customers in an amount that reflects the consideration to which we expect to be entitled in exchange for those goods or services. Our estimate for amounts not expected to be collected based on historical experience will continue to be recognized as a reduction to net revenue. However, subsequent changes in estimate of collectability due to a change in the financial status of a payer, for example a bankruptcy, will be recognized as bad debt expense in operating charges.

The performance obligation is separately identifiable from other promises in the customer contract. As the performance obligations are met (i.e.: room, board, ancillary services, level of care), revenue is recognized based upon allocated transaction price. The transaction price is allocated to separate performance obligations based upon the relative standalone selling price. In instances where we determine there are multiple performance obligations across multiple months, the transaction price will be allocated by applying an estimated implicit and explicit rate to gross charges based on the separate performance obligations.

In assessing collectability, we have elected the portfolio approach. This portfolio approach is being used as we have large volume of similar contracts with similar classes of customers. We reasonably expect that the effect of applying a portfolio approach to a group of contracts would not differ materially from considering each contract separately. Management’s judgment to group the contracts by portfolio is based on the payment behavior expected in each portfolio category. As a result, aggregating all of the contracts (which are at the patient level) by the particular payer or group of payers, will result in the recognition of the same amount of revenue as applying the analysis at the individual patient level.

We group our revenues into categories based on payment behaviors. Each component has its own reimbursement structure which allows us to disaggregate the revenue into categories that share the nature and timing of payments. The other patient revenue consists primarily of self-pay, government-funded non-Medicaid, and other.

The following table disaggregates our revenue by major source for the years ended December 31, 2025, 2024 and 2023 (in thousands):

 

For the year ended December 31, 2025

 

 

Acute Care

 

 

Behavioral Health

 

 

Other

 

 

Total

 

Medicare

$

1,538,151

 

 

15

%

 

$

318,253

 

 

4

%

 

 

 

 

$

1,856,404

 

 

11

%

Managed Medicare

 

1,658,864

 

 

17

%

 

 

421,414

 

 

6

%

 

 

 

 

 

2,080,278

 

 

12

%

Medicaid

 

1,337,579

 

 

13

%

 

 

1,349,388

 

 

18

%

 

 

 

 

 

2,686,967

 

 

15

%

Managed Medicaid

 

685,083

 

 

7

%

 

 

1,797,518

 

 

24

%

 

 

 

 

 

2,482,601

 

 

14

%

Managed Care (HMO and PPOs)

 

3,257,367

 

 

33

%

 

 

1,644,729

 

 

22

%

 

 

 

 

 

4,902,096

 

 

28

%

UK Revenue

 

0

 

 

0

%

 

 

1,001,356

 

 

13

%

 

 

 

 

 

1,001,356

 

 

6

%

Other patient revenue and adjustments, net

 

584,535

 

 

6

%

 

 

655,743

 

 

9

%

 

 

 

 

 

1,240,278

 

 

7

%

Other non-patient revenue

 

864,328

 

 

9

%

 

 

237,099

 

 

3

%

 

 

13,422

 

 

 

1,114,849

 

 

6

%

Total Net Revenue

$

9,925,907

 

 

100

%

 

$

7,425,500

 

 

100

%

 

$

13,422

 

 

$

17,364,829

 

 

100

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For the year ended December 31, 2024

 

 

Acute Care

 

 

Behavioral Health

 

 

Other

 

 

Total

 

Medicare

$

1,363,090

 

 

15

%

 

$

306,035

 

 

4

%

 

 

 

 

$

1,669,125

 

 

11

%

Managed Medicare

 

1,480,707

 

 

17

%

 

 

403,198

 

 

6

%

 

 

 

 

 

1,883,905

 

 

12

%

Medicaid

 

1,113,070

 

 

12

%

 

 

1,138,960

 

 

17

%

 

 

 

 

 

2,252,030

 

 

14

%

Managed Medicaid

 

626,352

 

 

7

%

 

 

1,677,586

 

 

24

%

 

 

 

 

 

2,303,938

 

 

15

%

Managed Care (HMO and PPOs)

 

2,865,515

 

 

32

%

 

 

1,630,887

 

 

24

%

 

 

 

 

 

4,496,402

 

 

28

%

UK Revenue

 

0

 

 

0

%

 

 

880,148

 

 

13

%

 

 

 

 

 

880,148

 

 

6

%

Other patient revenue and adjustments, net

 

499,420

 

 

6

%

 

 

613,388

 

 

9

%

 

 

 

 

 

1,112,808

 

 

7

%

Other non-patient revenue

 

996,134

 

 

11

%

 

 

222,888

 

 

3

%

 

 

10,557

 

 

 

1,229,579

 

 

8

%

Total Net Revenue

$

8,944,288

 

 

100

%

 

$

6,873,090

 

 

100

%

 

$

10,557

 

 

$

15,827,935

 

 

100

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For the year ended December 31, 2023

 

 

Acute Care

 

 

Behavioral Health

 

 

Other

 

 

Total

 

Medicare

$

1,297,084

 

 

16

%

 

$

310,321

 

 

5

%

 

 

 

 

$

1,607,405

 

 

11

%

Managed Medicare

 

1,368,284

 

 

17

%

 

 

345,771

 

 

6

%

 

 

 

 

 

1,714,055

 

 

12

%

Medicaid

 

638,986

 

 

8

%

 

 

893,918

 

 

14

%

 

 

 

 

 

1,532,904

 

 

11

%

Managed Medicaid

 

716,380

 

 

9

%

 

 

1,574,281

 

 

25

%

 

 

 

 

 

2,290,661

 

 

16

%

Managed Care (HMO and PPOs)

 

2,658,890

 

 

33

%

 

 

1,552,304

 

 

25

%

 

 

 

 

 

4,211,194

 

 

29

%

UK Revenue

 

0

 

 

0

%

 

 

761,124

 

 

12

%

 

 

 

 

 

761,124

 

 

5

%

Other patient revenue and adjustments, net

 

452,781

 

 

6

%

 

 

528,422

 

 

9

%

 

 

 

 

 

981,203

 

 

7

%

Other non-patient revenue

 

948,997

 

 

12

%

 

 

224,780

 

 

4

%

 

 

9,653

 

 

 

1,183,430

 

 

8

%

Total Net Revenue

$

8,081,402

 

 

100

%

 

$

6,190,921

 

 

100

%

 

$

9,653

 

 

$

14,281,976

 

 

100

%

Historical Timeline

Fiscal YearFiled
2025Feb 25, 2026Showing above
2024Feb 26, 2025
2023Feb 27, 2024
2022Feb 27, 2023

About Revenue Disclosures

Revenue disclosures under ASC 606 explain how a company identifies performance obligations, allocates transaction prices, and determines when revenue is recognized. This section is essential for understanding whether reported revenue reflects genuine economic activity or aggressive accounting choices. Analysts examine the mix of point-in-time versus over-time recognition, which directly affects revenue timing and comparability.

Key signals: rising contract liabilities (deferred revenue) suggest strong future revenue visibility, while declining contract assets may indicate slowing project milestones. Watch for variable consideration estimates — rebates, returns, and performance bonuses that require management judgment. Significant changes in disaggregated revenue by geography or product line can reveal shifting business mix before it appears in headline numbers. Compare revenue growth against contract liability growth to assess sustainability, and scrutinize any changes in the timing of recognition that coincide with earnings pressure.