Pay vs Performance Disclosure - USD ($) | 4 Months Ended | 8 Months Ended | 12 Months Ended |
Dec. 31, 2021 | Aug. 31, 2021 | Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 |
Pay vs Performance Disclosure [Table] | | | | | |
Pay vs Performance [Table Text Block] | | | Pay Versus Performance In Exchange pay Average Average Value of Initial Fixed Year Summary ($) (1) Summary (1) Compensation ($) (1)(2) Compensation (1)(2) Table Total for Non-PEO ($) (1) Compensation Non-PEO ($) (1)(2) Company ($) Peer ($) Net ($MM) (4) Adjusted ($MM) (5) 2022 11,047,128 — (9,106,588 ) — 6,921,122 1,325,894 128.29 140.29 411 3,469 2021 21,153,672 18,666,160 50,394,322 34,148,681 4,786,880 11,458,403 214.80 143.09 1,476 3,483 2020 — 16,675,529 — 16,079,648 4,996,930 5,700,379 105.00 113.45 768 3,146 (1) Mr. Rittenmeyer served as our principal executive officer (PEO) during 2020 and 2021 until he was succeeded by Dr. Sutaria on September 1, 2021, who served as our PEO for the remainder of 2021 and 2022. The Non-PEO (2) The amounts shown as Compensation Actually Paid have been calculated in accordance with Item 402(v) of Regulation S-K and do not reflect the total compensation actually realized or received by the Company’s NEOs. In accordance with these rules, these amounts reflect total compensation as set forth in the Summary Compensation Table for each year, adjusted as shown below. Equity values are calculated in accordance with FASB ASC Topic 718, and the valuation assumptions used to calculate fair values did not materially differ from those disclosed at the time of the grant. Mr. Rittenmeyer 2021 2020 Summary Compensation Table Total 18,666,160 16,675,529 Less, value of Stock Awards and Option Awards reported in Summary Compensation Table (10,000,013 ) (10,000,021 ) Plus, year-end 7,728,528 10,446,087 Plus, year over year change in fair value of outstanding and unvested equity awards granted in prior years 5,462,459 239,051 Plus, fair value as of vesting date of equity awards granted and vested in the year 6,317,870 2,699,468 Plus (less), year over year change in fair value of equity awards granted in prior years that vested in the year 5,973,677 (3,980,466 ) Compensation Actually Paid to Mr. Rittenmeyer 34,148,681 16,079,648 Dr. Sutaria 2022 2021 Summary Compensation Table Total 11,047,128 21,153,672 Less, value of Stock Awards and Option Awards reported in Summary Compensation Table (6,847,258 ) (15,000,119 ) Plus, year-end 5,227,267 20,942,669 Plus (less), year over year change in fair value of outstanding and unvested equity awards granted in prior years (17,620,981 ) 22,242,975 Plus (less), year over year change in fair value of equity awards granted in prior years that vested in the year (912,744 ) 1,055,125 Compensation Actually Paid to Dr. Sutaria (9,106,588 ) 50,394,322 Average Non-PEO 2022 2021 2020 Summary Compensation Table Total 6,921,122 4,786,880 4,996,930 Less, value of Stock Awards and Option Awards reported in Summary Compensation Table (2,506,876) (1,475,070 ) (2,175,033 ) Less, Change in Pension Value reported in Summary Compensation Table -0- (655,283 ) (565,660 ) Plus, year-end 731,847 3,148,375 4,098,316 Plus (less), year over year change in fair value of outstanding and unvested equity awards granted in prior years (4,075,913 ) 4,639,027 317,308 Plus, fair value as of vesting date of equity awards granted and vested in the year 1,109,226 289,836 -0- Plus (less), year over year change in fair value of equity awards granted in prior years that vested in the year (853,512 ) 724,638 (593,527 ) Plus (less), fair value at last day of prior year of equity awards forfeited during the year -0- -0- (377,955) Plus, pension service cost for services rendered during the year -0- -0- -0- Plus, prior pension service cost or credit associated with any plan amendments or initiations during the year for services rendered during prior years. -0- -0- -0- Compensation Actually Paid to Average Non-PEO 1,325,894 11,458,403 5,700,379 (3) Amounts in these columns assume $100 was invested for the cumulative period from December 31, 2019 through the end of the listed fiscal year, in either the Company or the S&P 500 Health Care Index (the Company’s peer group), as applicable, and reinvestment of the pre-tax (4) Reflects the Company’s net income, as reported in the Company’s Annual Report on Form 10-K (5) We determined Adjusted EBITDA to be the most important financial performance measure used to link Company performance to Compensation Actually Paid to our PEO and other NEOs in 2022. This performance measure may not have been the most important financial performance measure for years 2021 and 2020 and we may determine that a different financial performance measure to be the most important measure in future years. Adjusted EBITDA, a non-GAAP non-GAAP 10-K | | |
Company Selected Measure Name | | | Adjusted EBITDA | | |
Named Executive Officers, Footnote [Text Block] | | | Mr. Rittenmeyer served as our principal executive officer (PEO) during 2020 and 2021 until he was succeeded by Dr. Sutaria on September 1, 2021, who served as our PEO for the remainder of 2021 and 2022. The Non-PEO | | |
Peer Group Issuers, Footnote [Text Block] | | | Amounts in these columns assume $100 was invested for the cumulative period from December 31, 2019 through the end of the listed fiscal year, in either the Company or the S&P 500 Health Care Index (the Company’s peer group), as applicable, and reinvestment of the pre-tax | | |
Adjustment To PEO Compensation, Footnote [Text Block] | | | Mr. Rittenmeyer 2021 2020 Summary Compensation Table Total 18,666,160 16,675,529 Less, value of Stock Awards and Option Awards reported in Summary Compensation Table (10,000,013 ) (10,000,021 ) Plus, year-end 7,728,528 10,446,087 Plus, year over year change in fair value of outstanding and unvested equity awards granted in prior years 5,462,459 239,051 Plus, fair value as of vesting date of equity awards granted and vested in the year 6,317,870 2,699,468 Plus (less), year over year change in fair value of equity awards granted in prior years that vested in the year 5,973,677 (3,980,466 ) Compensation Actually Paid to Mr. Rittenmeyer 34,148,681 16,079,648 Dr. Sutaria 2022 2021 Summary Compensation Table Total 11,047,128 21,153,672 Less, value of Stock Awards and Option Awards reported in Summary Compensation Table (6,847,258 ) (15,000,119 ) Plus, year-end 5,227,267 20,942,669 Plus (less), year over year change in fair value of outstanding and unvested equity awards granted in prior years (17,620,981 ) 22,242,975 Plus (less), year over year change in fair value of equity awards granted in prior years that vested in the year (912,744 ) 1,055,125 Compensation Actually Paid to Dr. Sutaria (9,106,588 ) 50,394,322 | | |
Non-PEO NEO Average Total Compensation Amount | | | $ 6,921,122 | $ 4,786,880 | $ 4,996,930 |
Non-PEO NEO Average Compensation Actually Paid Amount | | | $ 1,325,894 | 11,458,403 | 5,700,379 |
Adjustment to Non-PEO NEO Compensation Footnote [Text Block] | | | Average Non-PEO 2022 2021 2020 Summary Compensation Table Total 6,921,122 4,786,880 4,996,930 Less, value of Stock Awards and Option Awards reported in Summary Compensation Table (2,506,876) (1,475,070 ) (2,175,033 ) Less, Change in Pension Value reported in Summary Compensation Table -0- (655,283 ) (565,660 ) Plus, year-end 731,847 3,148,375 4,098,316 Plus (less), year over year change in fair value of outstanding and unvested equity awards granted in prior years (4,075,913 ) 4,639,027 317,308 Plus, fair value as of vesting date of equity awards granted and vested in the year 1,109,226 289,836 -0- Plus (less), year over year change in fair value of equity awards granted in prior years that vested in the year (853,512 ) 724,638 (593,527 ) Plus (less), fair value at last day of prior year of equity awards forfeited during the year -0- -0- (377,955) Plus, pension service cost for services rendered during the year -0- -0- -0- Plus, prior pension service cost or credit associated with any plan amendments or initiations during the year for services rendered during prior years. -0- -0- -0- Compensation Actually Paid to Average Non-PEO 1,325,894 11,458,403 5,700,379 | | |
Compensation Actually Paid vs. Total Shareholder Return [Text Block] | | | Company vs Peer Group TSR and Compensation Actually Paid vs Company TSR | | |
Compensation Actually Paid vs. Net Income [Text Block] | | | Compensation | | |
Compensation Actually Paid vs. Company Selected Measure [Text Block] | | | Compensation Actually Paid vs Adjusted EBITDA | | |
Total Shareholder Return Vs Peer Group [Text Block] | | | Company vs Peer Group TSR and Compensation Actually Paid vs Company TSR | | |
Tabular List [Table Text Block] | | | Financial Performance Measures The following list presents the financial performance measures that the Company has determined represent the most important in linking “Compensation Actually Paid” to our PEO and the other NEOs for 2022 to Company performance. These measures are not ranked. • Adjusted EBITDA; • Adjusted Free Cash Flow (FCF) less cash distributions paid to noncontrolling interest (NCI) reflected on the Company’s consolidated statements of cash flow; and • Adjusted Diluted Earnings Per Share. See Appendix A for definitions of each of these non-GAAP | | |
Total Shareholder Return Amount | | | $ 128.29 | 214.8 | 105 |
Peer Group Total Shareholder Return Amount | | | 140.29 | 143.09 | 113.45 |
Net Income (Loss) | | | $ 411,000,000 | $ 1,476,000,000 | $ 768,000,000 |
Company Selected Measure Amount | | | 3,469,000,000 | 3,483,000,000 | 3,146,000,000 |
Measure [Axis]: 1 | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Measure Name | | | Adjusted EBITDA | | |
Non-GAAP Measure Description [Text Block] | | | Adjusted EBITDA, a non-GAAP non-GAAP 10-K | | |
Measure [Axis]: 2 | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Measure Name | | | Adjusted Free Cash Flow (FCF) less cash distributions paid to noncontrolling interest (NCI) reflected on the Company’s consolidated statements of cash flow | | |
Measure [Axis]: 3 | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Measure Name | | | Adjusted Diluted Earnings Per Share | | |
Dr. Sutaria [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
PEO Total Compensation Amount | | | $ 11,047,128 | $ 21,153,672 | |
PEO Actually Paid Compensation Amount | | | $ (9,106,588) | 50,394,322 | |
PEO Name | Dr. Sutaria | | Dr. Sutaria | | |
Mr. Rittenmeyer [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
PEO Total Compensation Amount | | | | 18,666,160 | $ 16,675,529 |
PEO Actually Paid Compensation Amount | | | | 34,148,681 | $ 16,079,648 |
PEO Name | | Mr. Rittenmeyer | | | Mr. Rittenmeyer |
PEO [Member] | Dr. Sutaria [Member] | Value of Stock Awards and Option Awards reported in SCT [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | $ (6,847,258) | (15,000,119) | |
PEO [Member] | Dr. Sutaria [Member] | YearEnd Fair Value Of Outstanding And Unvested Equity Awards Granted In The Year [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | 5,227,267 | 20,942,669 | |
PEO [Member] | Dr. Sutaria [Member] | Year Over Year Change In Fair Value Of Outstanding And Unvested Equity Awards Granted In Prior Years [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | (17,620,981) | 22,242,975 | |
PEO [Member] | Dr. Sutaria [Member] | Year Over Year Change In Fair Value Of Equity Awards Granted In Prior Years That Vested In The Year [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | (912,744) | 1,055,125 | |
PEO [Member] | Mr. Rittenmeyer [Member] | Value of Stock Awards and Option Awards reported in SCT [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | | (10,000,013) | $ (10,000,021) |
PEO [Member] | Mr. Rittenmeyer [Member] | YearEnd Fair Value Of Outstanding And Unvested Equity Awards Granted In The Year [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | | 7,728,528 | 10,446,087 |
PEO [Member] | Mr. Rittenmeyer [Member] | Year Over Year Change In Fair Value Of Outstanding And Unvested Equity Awards Granted In Prior Years [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | | 5,462,459 | 239,051 |
PEO [Member] | Mr. Rittenmeyer [Member] | Fair Value As Of Vesting Date Of Equity Awards Granted And Vested In The Year [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | | 6,317,870 | 2,699,468 |
PEO [Member] | Mr. Rittenmeyer [Member] | Year Over Year Change In Fair Value Of Equity Awards Granted In Prior Years That Vested In The Year [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | | 5,973,677 | (3,980,466) |
Non-PEO NEO [Member] | Value of Stock Awards and Option Awards reported in SCT [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | (2,506,876) | (1,475,070) | (2,175,033) |
Non-PEO NEO [Member] | YearEnd Fair Value Of Outstanding And Unvested Equity Awards Granted In The Year [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | 731,847 | 3,148,375 | 4,098,316 |
Non-PEO NEO [Member] | Year Over Year Change In Fair Value Of Outstanding And Unvested Equity Awards Granted In Prior Years [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | (4,075,913) | 4,639,027 | 317,308 |
Non-PEO NEO [Member] | Fair Value As Of Vesting Date Of Equity Awards Granted And Vested In The Year [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | 1,109,226 | 289,836 | 0 |
Non-PEO NEO [Member] | Year Over Year Change In Fair Value Of Equity Awards Granted In Prior Years That Vested In The Year [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | (853,512) | 724,638 | (593,527) |
Non-PEO NEO [Member] | Change In Pension Value Reported In SCT [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | 0 | (655,283) | (565,660) |
Non-PEO NEO [Member] | Fair Value At Last Day Of Prior Year Of Equity Awards Forfeited During The Year [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | 0 | 0 | (377,955) |
Non-PEO NEO [Member] | Pension Service Cost For Services Rendered During The Year [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | 0 | 0 | 0 |
Non-PEO NEO [Member] | Prior Pension Service Cost Or Credit Associated With Any Plan Amendments Or Initiations During The Year For Services Rendered During Prior Years [Member] | | | | | |
Pay vs Performance Disclosure [Table] | | | | | |
Adjustment to Compensation Amount | | | $ 0 | $ 0 | $ 0 |