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Goodwill and Intangible Assets (Tables) | 12 Months Ended
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Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract] |
Schedule of changes In goodwill by operating segment | The following table summarizes the changes in goodwill by operating segment ($ in millions):
| Managed Care |  | Specialty Services |  | Total
Balance as of December 31, 2016 | $ | 4,015 |  |  | $ | 697 |  |  | $ | 4,712 |
Acquisitions and purchase accounting adjustments | — |  |  | 37 |  |  | 37 |
Balance as of December 31, 2017 | 4,015 |  |  | 734 |  |  | 4,749 |
Acquisitions and purchase accounting adjustments | 1,671 |  |  | 595 |  |  | 2,266 |
Balance as of December 31, 2018 | $ | 5,686 |  |  | $ | 1,329 |  |  | $ | 7,015 |
Schedule of intangible assets | Intangible assets at December 31, consist of the following ($ in millions):
|  |  |  |  | Weighted Average Life in Years
| 2018 |  | 2017 |  | 2018 |  | 2017
Purchased contract rights | $ | 1,173 |  |  | $ | 1,173 |  |  | 12.6 |  | 12.6
Provider contracts | 311 |  |  | 274 |  |  | 12.3 |  | 11.9
Customer relationships | 769 |  |  | 22 |  |  | 10.9 |  | 8.2
Trade names | 361 |  |  | 162 |  |  | 15.2 |  | 9.6
Developed technologies | 180 |  |  | 109 |  |  | 5.2 |  | 5.0
Other Intangibles | 5 |  |  | 7 |  |  | 2.7 |  | 2.8
Intangible assets | 2,799 |  |  | 1,747 |  |  | 11.9 |  | 11.6
Less accumulated amortization: |  |  |  |  |  |  |
Purchased contract rights | (283 | ) |  | (188 | ) |  |  |  |
Provider contracts | (90 | ) |  | (66 | ) |  |  |  |
Customer relationships | (57 | ) |  | (21 | ) |  |  |  |
Trade names | (55 | ) |  | (34 | ) |  |  |  |
Developed technologies | (72 | ) |  | (40 | ) |  |  |  |
Other Intangibles | (3 | ) |  | — |  |  |  |  |
Total accumulated amortization | (560 | ) |  | (349 | ) |  |  |  |
Intangible assets, net | $ | 2,239 |  |  | $ | 1,398 |  |  |  |  |
Schedule of future amortization expenses | Estimated total amortization expense related to intangible assets for each of the five succeeding fiscal years is as follows ($ in millions):
Year |  | Expense
2019 |  | $ | 252 |
2020 |  | 244 |
2021 |  | 223 |
2022 |  | 217 |
2023 |  | 214 |

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