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Medical Claims and Benefits Payable | 12 Months Ended
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Dec. 31, 2021
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,
| 2021 |  | 2020 |  | 2019
| (In millions)
Fee-for-service claims incurred but not paid (“IBNP”) | $ | 2,486 |  |  | $ | 1,647 |  |  | $ | 1,406 |
Pharmacy payable | 219 |  |  | 157 |  |  | 126 |
Capitation payable | 82 |  |  | 70 |  |  | 55 |
Other | 576 |  |  | 528 |  |  | 267 |
Magellan Complete Care acquisition opening balance | — |  |  | 294 |  |  | — |
Total | $ | 3,363 |  |  | $ | 2,696 |  |  | $ | 1,854 |
“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 $226 million, $235 million and $132 million, as of December 31, 2021, 2020, and 2019, respectively. The following tables present the components of the change in our medical claims and benefits payable for the periods indicated, with the prior periods recast to conform to current year presentation.
| Year Ended December 31, 2021
| Medicaid |  | Medicare |  | Marketplace |  | Consolidated
| (In millions)
Medical claims and benefits payable, beginning balance | $ | 2,129 |  |  | $ | 392 |  |  | $ | 175 |  |  | $ | 2,696 |
Components of medical care costs related to: |  |  |  |  |  |  |
Current year | 18,321 |  |  | 2,970 |  |  | 2,652 |  |  | 23,943 |
Prior years | (182) |  |  | (39) |  |  | (18) |  |  | (239) |
Total medical care costs | 18,139 |  |  | 2,931 |  |  | 2,634 |  |  | 23,704 |
Payments for medical care costs related to: |  |  |  |  |  |  |
Current year | 16,284 |  |  | 2,573 |  |  | 2,291 |  |  | 21,148 |
Prior years | 1,601 |  |  | 340 |  |  | 139 |  |  | 2,080 |
Total paid | 17,885 |  |  | 2,913 |  |  | 2,430 |  |  | 23,228 |
Acquired balances, net of post-acquisition adjustments | 205 |  |  | (8) |  |  | — |  |  | 197 |
Change in non-risk and other provider payables | (8) |  |  | 2 |  |  | — |  |  | (6) |
Medical claims and benefits payable, ending balance | $ | 2,580 |  |  | $ | 404 |  |  | $ | 379 |  |  | $ | 3,363 |
| Year Ended December 31, 2020
| Medicaid |  | Medicare |  | Marketplace |  | Consolidated
| (In millions)
Medical claims and benefits payable, beginning balance | $ | 1,465 |  |  | $ | 267 |  |  | $ | 122 |  |  | $ | 1,854 |
Components of medical care costs related to: |  |  |  |  |  |  |
Current year | 12,545 |  |  | 2,189 |  |  | 1,205 |  |  | 15,939 |
Prior years | (84) |  |  | (28) |  |  | (7) |  |  | (119) |
Total medical care costs | 12,461 |  |  | 2,161 |  |  | 1,198 |  |  | 15,820 |
Payments for medical care costs related to: |  |  |  |  |  |  |
Current year | 10,940 |  |  | 1,884 |  |  | 1,047 |  |  | 13,871 |
Prior years | 1,176 |  |  | 233 |  |  | 98 |  |  | 1,507 |
Total paid | 12,116 |  |  | 2,117 |  |  | 1,145 |  |  | 15,378 |
Acquired balances, net of post-acquisition adjustments | 215 |  |  | 79 |  |  | — |  |  | 294 |
Change in non-risk and other provider payables | 104 |  |  | 2 |  |  | — |  |  | 106 |
Medical claims and benefits payable, ending balance | $ | 2,129 |  |  | $ | 392 |  |  | $ | 175 |  |  | $ | 2,696 |
| Year Ended December 31, 2019
| Medicaid |  | Medicare |  | Marketplace |  | Consolidated
| (In millions)
Medical claims and benefits payable, beginning balance | $ | 1,554 |  |  | $ | 253 |  |  | $ | 154 |  |  | $ | 1,961 |
Components of medical care costs related to: |  |  |  |  |  |  |
Current year | 11,191 |  |  | 1,934 |  |  | 1,051 |  |  | 14,176 |
Prior years | (222) |  |  | (21) |  |  | (28) |  |  | (271) |
Total medical care costs | 10,969 |  |  | 1,913 |  |  | 1,023 |  |  | 13,905 |
Payments for medical care costs related to: |  |  |  |  |  |  |
Current year | 9,936 |  |  | 1,676 |  |  | 942 |  |  | 12,554 |
Prior years | 1,145 |  |  | 224 |  |  | 113 |  |  | 1,482 |
Total paid | 11,081 |  |  | 1,900 |  |  | 1,055 |  |  | 14,036 |
Acquired balances, net of post-acquisition adjustments | — |  |  | — |  |  | — |  |  | — |
Change in non-risk and other provider payables | 23 |  |  | 1 |  |  | — |  |  | 24 |
Medical claims and benefits payable, ending balance | $ | 1,465 |  |  | $ | 267 |  |  | $ | 122 |  |  | $ | 1,854 |
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 varied from the actual liabilities, based on information (principally the payment of claims) developed since those liabilities were first reported. Our estimates of medical claims and benefits payable recorded at December 31, 2021, 2020 and 2019 developed favorably by approximately $239 million, $119 million and $271 million in 2021, 2020 and 2019, respectively. The favorable prior year development recognized in 2021 was primarily due to lower than expected utilization of medical services by our Medicaid members, and to a lesser extent our Medicare and Marketplace members, and improved operating performance. Consequently, the ultimate costs recognized in 2021 were lower than our original estimates in 2020, which was not discernible until additional information was provided, and as claims payments were processed. 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 following tables provide information about our consolidated incurred and paid claims development as of December 31, 2021, as well as cumulative claims frequency and the total of incurred but not paid claims liabilities. The pattern of incurred and paid claims development is consistent across each of our segments. The cumulative claim frequency is measured by claim event, and includes claims covered under capitated arrangements.
Incurred Claims and Allocated Claims Adjustment Expenses |  | Total IBNP |  | Cumulative number of reported claims
Benefit Year |  | 2019 |  | 2020 |  | 2021 |
|  | (Unaudited) |  | (Unaudited) |  |  |  |  |  |
|  | (In millions)
2019 |  | $ | 14,176 |  |  | $ | 14,083 |  |  | $ | 14,040 |  |  | $ | 12 |  |  | 105 |
2020 |  |  |  | 16,233 |  |  | 16,056 |  |  | 52 |  |  | 140 |
2021 |  |  |  |  |  | 23,943 |  |  | 2,416 |  |  | 181 |
|  |  |  |  |  | $ | 54,039 |  |  | $ | 2,480 |  |  |
Cumulative Paid Claims and Allocated Claims Adjustment Expenses |
Benefit Year |  | 2019 |  | 2020 |  | 2021 |
|  | (Unaudited) |  | (Unaudited) |  |  |
|  | (In millions) |
2019 |  | $ | 12,554 |  |  | $ | 14,056 |  |  | $ | 14,028 |  |
2020 |  |  |  | 13,871 |  |  | 16,004 |  |
2021 |  |  |  |  |  | 21,148 |  |
|  |  |  |  |  | $ | 51,180 |  |
The following table represents a reconciliation of claims development to the aggregate carrying amount of the liability for medical claims and benefits payable.
|  |  |  |  |  | 2021 |
|  |  |  |  |  | (In millions) |
Incurred claims and allocated claims adjustment expenses |  | $ | 54,039 |  |
Less: cumulative paid claims and allocated claims adjustment expenses |  | (51,180) |  |
All outstanding liabilities before 2019 |  | 6 |  |
Acquired balances |  | 224 |  |
Non-risk and other provider payables |  | 274 |  |
Medical claims and benefits payable |  | $ | 3,363 |  |

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- Definition The entire disclosure for insurance products considered to be short-duration contracts because the contract provides insurance protection for a fixed period of short duration and enables the insurer to cancel the contract or to adjust the provisions of the contract at the end of any contract period, such as adjusting the amount of premiums charged or coverage provided, and on contracts on which amounts are paid but insurance risk is not transferred. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 944 -URI http://asc.fasb.org/topic&trid=2303980 + Details
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