Medical Costs Payable (Notes)

12 Months Ended

Dec. 31, 2020

The following table shows the components of the change in medical costs payable for the years ended December 31:


(in millions)	2020		2019		2018
Medical costs payable, beginning of period	$	21,690	$	19,891	$	17,871
Acquisitions	316		679		339
Reported medical costs:
Current year	160,276		157,020		145,723
Prior years	(880)		(580)		(320)
Total reported medical costs	159,396		156,440		145,403
Medical payments:
Payments for current year	(139,974)		(137,155)		(127,155)
Payments for prior years	(19,556)		(18,165)		(16,567)
Total medical payments	(159,530)		(155,320)		(143,722)
Medical costs payable, end of period	$	21,872	$	21,690	$	19,891

For the years ended December 31, 2020 and 2019 medical cost reserve development was primarily driven by lower than expected health system utilization levels. For the year ended December 31, 2018, no individual factors significantly impacted medical cost reserve development. Medical costs payable included IBNR of $14.8 billion and $13.8 billion at December 31, 2020 and 2019, respectively. Substantially all of the IBNR balance as of December 31, 2020 relates to the current year.

The following is information about incurred and paid medical cost development as of December 31, 2020:


	Net Incurred Medical Costs
(in millions)	For the Years Ended December 31,
Year	2019		2020
2019	$	157,020	$	156,217
2020			160,276
Total			$	316,493

	Net Cumulative Medical Payments
(in millions)	For the Years Ended December 31,
Year	2019		2020
2019	$	(137,155)	$	(155,150)
2020			(139,974)
Total			(295,124)
Net remaining outstanding liabilities prior to 2019			503
Total medical costs payable			$	21,872