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Medical Costs Payable (Notes)
 12 Months Ended
Dec. 31, 2023
Insurance [Abstract]  
Medical Costs Payable Medical Costs Payable
The following table shows the components of the change in medical costs payable for the years ended December 31:
(in millions)202320222021
Medical costs payable, beginning of period$29,056 $24,483 $21,872 
Acquisitions1 308 88 
Reported medical costs:
Current year242,734 211,252 188,631 
Prior years(840)(410)(1,720)
Total reported medical costs241,894 210,842 186,911 
Medical payments:
Payments for current year
(211,380)(184,049)(165,524)
Payments for prior years(27,176)(22,528)(18,864)
Total medical payments(238,556)(206,577)(184,388)
Medical costs payable, end of period$32,395 $29,056 $24,483 
For the years ended December 31, 2023 and 2022 , prior years’ medical cost reserve development included no individual factors that were significant. For the year ended December 31, 2021, prior years’ medical cost reserve development was primarily driven by lower than expected care activity and care patterns disrupted by COVID-19.
Medical costs payable included IBNR of $22.3 billion and $20.0 billion at December 31, 2023 and 2022, respectively. Substantially all of the IBNR balance as of December 31, 2023 relates to the current year.
The following is information about incurred and paid medical cost development as of December 31, 2023:
Net Incurred Medical Costs
 (in millions)For the Years Ended December 31,
Year20222023
2022$211,252 $210,476 
2023242,734 
Total$453,210 
Net Cumulative Medical Payments
 (in millions)For the Years Ended December 31,
Year20222023
2022$(184,049)$(209,564)
2023(211,380)
Total(420,944)
Net remaining outstanding liabilities prior to 2022129 
Total medical costs payable$32,395