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Medical Claims and Benefits Payable
12 Months Ended
Dec. 31, 2020
Insurance [Abstract]  
Medical Claims and Benefits Payable Medical Claims and Benefits Payable
The following table provides the details of our medical claims and benefits payable as of the dates indicated.
December 31,
202020192018
(In millions)
Fee-for-service claims incurred but not paid (“IBNP”)$1,647 $1,406 $1,562 
Pharmacy payable157 126 115 
Capitation payable70 55 52 
Other528 267 232 
Magellan Complete Care294 — — 
Total$2,696 $1,854 $1,961 
“Other” medical claims and benefits payable include amounts payable to certain providers for which we act as an intermediary on behalf of various government agencies without assuming financial risk. Such receipts and payments do not impact our consolidated statements of income. Non-risk provider payables amounted to $235 million, $132 million and $107 million, as of December 31, 2020, 2019, and 2018, respectively.
The following table presents the components of the change in our medical claims and benefits payable for the periods indicated. The amounts presented for “Components of medical care costs related to: Prior years” represent the amount by which our original estimate of medical claims and benefits payable at the beginning of the year were more than the actual liabilities, based on information (principally the payment of claims) developed since those liabilities were first reported.
Year Ended December 31,
202020192018
(In millions)
Medical claims and benefits payable, beginning balance$1,854 $1,961 $2,192 
Components of medical care costs related to:
Current year15,939 14,176 15,478 
Prior years (1)
(119)(271)(341)
Total medical care costs15,820 13,905 15,137 
Payments for medical care costs related to:
Current year13,871 12,554 13,671 
Prior years1,507 1,482 1,710 
Total paid15,378 14,036 15,381 
Acquisition - Magellan Complete Care294 — — 
Change in non-risk and other provider payables106 24 13 
Medical claims and benefits payable, ending balance$2,696 $1,854 $1,961 
________________
(1)December 31, 2018, includes the 2018 benefit of the 2017 Marketplace CSR reimbursement of $81 million.
Our estimates of medical claims and benefits payable recorded at December 31, 2020, 2019 and 2018 developed favorably by approximately $119 million, $271 million and $341 million in 2020, 2019 and 2018, respectively.
The favorable prior year development recognized in 2020 was primarily due to lower than expected utilization of medical services by our Medicaid members, and improved operating performance. Consequently, the ultimate costs recognized in 2020 were lower than our original estimates in 2019, which was not discernible until additional information was provided, and as claims payments were processed.
The favorable prior year development recognized in 2019 was primarily due to lower than expected utilization of medical services by our Medicaid members, and improved operating performance. Consequently, the ultimate costs recognized in 2019 were lower than our original estimates in 2018, which was not discernible until additional information was provided, and as claims payments were processed.
The favorable prior year development recognized in 2018 includes a benefit of approximately $81 million in reduced medical care costs relating to Marketplace CSR subsidies for 2017 dates of service. The remainder of the favorable
prior period development was primarily due to lower than expected utilization of medical services by our Medicaid and Marketplace members and improved operating performance. Consequently, the ultimate costs recognized in 2018 were lower than our original estimates in 2017, which was not discernible until additional information was provided, and as claims payments were processed.
The following tables provide information about incurred and paid claims development as of December 31, 2020, as well as cumulative claims frequency and the total of incurred but not paid claims liabilities. The cumulative claim frequency is measured by claim event, and includes claims covered under capitated arrangements.
Incurred Claims and Allocated Claims Adjustment ExpensesTotal IBNPCumulative number of reported claims
Benefit Year201820192020
(Unaudited)(Unaudited)
(In millions)
2018$15,478 $15,245 $15,233 $11 110 
201914,176 14,083 27 100 
202015,939 1,593 93 
$45,255 $1,631 
Cumulative Paid Claims and Allocated Claims Adjustment Expenses
Benefit Year201820192020
(Unaudited)(Unaudited)
(In millions)
2018$13,752 $15,220 $15,222 
201912,554 14,056 
202013,871 
$43,149 
The following table represents a reconciliation of claims development to the aggregate carrying amount of the liability for medical claims and benefits payable.
2020
(In millions)
Incurred claims and allocated claims adjustment expenses
$45,255 
Less: cumulative paid claims and allocated claims adjustment expenses
(43,149)
All outstanding liabilities before 201816 
Magellan Complete Care294 
Non-risk and other provider payables280 
Medical claims and benefits payable$2,696