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Health Care Costs Payable
 9 Months Ended
Sep. 30, 2024
Health Care And Other Insurance Liabilities [Abstract]  
Health Care Costs Payable Health Care Costs Payable
The following table shows the components of the change in health care costs payable during the nine months ended September 30, 2024 and 2023:
Nine Months Ended
September 30,
In millions20242023
Health care costs payable, beginning of the period$12,049 $10,142 
Less: Reinsurance recoverables5 5 
Less: Impact of discount rate on long-duration insurance reserves (1)
(23)8 
Health care costs payable, beginning of the period, net12,067 10,129 
Acquisitions, net— 1,098 
Add: Components of incurred health care costs
  Current year85,541 64,183 
  Prior years(845)(679)
Total incurred health care costs (2)
84,696 63,504 
Less: Claims paid
  Current year71,356 52,952 
  Prior years10,886 9,207 
Total claims paid82,242 62,159 
Health care costs payable, end of the period, net14,521 12,572 
Add: Premium deficiency reserve670 — 
Add: Reinsurance recoverables65 4 
Add: Impact of discount rate on long-duration insurance reserves (1)
(19)(26)
Health care costs payable, end of the period$15,237 $12,550 
_____________________________________________
(1)Reflects the difference between the current discount rate and the locked-in discount rate on long-duration insurance reserves which is recorded within accumulated other comprehensive income (loss) on the unaudited condensed consolidated balance sheets.
(2)Total incurred health care costs for the nine months ended September 30, 2024 and 2023 in the table above exclude $70 million and $62 million, respectively, of health care costs recorded in the Health Care Benefits segment that are included in other insurance liabilities on the unaudited condensed consolidated balance sheets and $142 million and $163 million, respectively, of health care costs recorded in the Corporate/Other segment that are included in other insurance liabilities on the unaudited condensed consolidated balance sheets. Total incurred health care costs for the nine months ended September 30, 2024 also exclude $670 million for premium deficiency reserves related to the Company’s Medicare, individual exchange and Medicaid product lines.

The Company’s estimates of prior years’ health care costs payable decreased by $845 million and $679 million, respectively, in the nine months ended September 30, 2024 and 2023, because claims were settled for amounts less than originally estimated (i.e., the amount of claims incurred was lower than originally estimated), primarily due to lower health care cost trends as well as the actual claim submission time being faster than originally assumed (i.e., the Company’s completion factors were higher than originally assumed) in estimating health care costs payable at the end of the prior year.

At September 30, 2024, the Company’s liabilities for the ultimate cost of (i) services rendered to the Company’s Insured members but not yet reported to the Company and (ii) claims which have been reported to the Company but not yet paid (collectively, “IBNR”) plus expected development on reported claims totaled approximately $11.0 billion. Substantially all of the Company’s liabilities for IBNR plus expected development on reported claims at September 30, 2024 related to the current year.