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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Operating activities      
Net earnings $ 23,144 $ 20,639 $ 17,732
Noncash items:      
Depreciation and amortization 3,972 3,400 3,103
Deferred income taxes (245) (673) 130
Share-based compensation 1,059 925 800
Other, net (505) (331) (944)
Net change in other operating items, net of effects from acquisitions and changes in AARP balances:      
Accounts receivable (3,114) (2,523) (1,000)
Other assets (2,444) (1,374) (1,031)
Medical costs payable 3,482 4,053 2,701
Accounts payable and other liabilities 3,516 1,964 1,162
Unearned revenues 203 126 (310)
Cash flows from operating activities 29,068 26,206 22,343 Close
Investing activities      
Purchases of investments (18,314) (18,825) (17,139)
Sales of investments 7,307 5,907 7,045
Maturities of investments 9,230 6,081 8,251
Cash paid for acquisitions, net of cash assumed (10,136) (21,458) (4,821)
Purchases of property, equipment and capitalized software (3,386) (2,802) (2,454)
Cash received from dispositions 685 3,414 15
Other, net (960) (793) (1,269)
Cash flows used for investing activities (15,574) (28,476) (10,372) Close
Financing activities      
Common share repurchases (8,000) (7,000) (5,000)
Cash dividends paid (6,761) (5,991) (5,280)
Proceeds from common stock issuances 1,353 1,253 1,355
Repayments of long-term debt (2,125) (3,015) (3,150)
Proceeds from (repayments of) short-term borrowings, net 11 732 (1,302)
Proceeds from issuance of long-term debt 6,394 14,819 6,933
Customer funds administered (521) 5,548 622
Purchases of redeemable noncontrolling interests (730) (176) (1,338)
Other, net (1,150) (1,944) (295)
Cash flows (used for) from financing activities (11,529) 4,226 (7,455) Close
Effect of exchange rate changes on cash and cash equivalents 97 34 (62) Close
Increase in cash and cash equivalents 2,062 1,990 4,454 Close
Cash and cash equivalents, beginning of period 23,365 21,375 16,921
Cash and cash equivalents, end of period 25,427 23,365 21,375
Supplemental cash flow disclosures      
Cash paid for interest 3,035 1,945 1,653
Cash paid for income taxes $ 6,078 $ 5,222 $ 3,966