Medical Claims and Benefits Payable

9 Months Ended

Sep. 30, 2023

Other Liabilities Disclosure [Abstract]

The following table provides the details of our medical claims and benefits payable as of the dates indicated:


	September 30, 2023		December 31, 2022

	(In millions)
Claims incurred but not paid (“IBNP”)	$	2,915	$	2,597
Pharmacy payable	197		206
Capitation payable	92		94
Other	1,031		631
Total	$	4,235	$	3,528

“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 $554 million and $228 million as of September 30, 2023, and December 31, 2022, respectively.

The following tables present 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 varied from the actual liabilities, based on information (principally the payment of claims) developed since those liabilities were first reported.


	Nine Months Ended September 30, 2023
	Medicaid		Medicare		Marketplace		Consolidated

	(In millions)
Medical claims and benefits payable, beginning balance	$	2,815	$	452	$	261	$	3,528
Components of medical care costs related to:
Current year	17,630		2,811		1,132		21,573
Prior years	(327)		(6)		(25)		(358)
Total medical care costs	17,303		2,805		1,107		21,215
Payments for medical care costs related to:
Current year	14,961		2,340		927		18,228
Prior years	2,074		424		209		2,707
Total paid	17,035		2,764		1,136		20,935
Acquired balances, net of post-acquisition adjustments	83		13		—		96
Change in non-risk and other provider payables	335		(4)		—		331
Medical claims and benefits payable, ending balance	$	3,501	$	502	$	232	$	4,235


	Nine Months Ended September 30, 2022
	Medicaid		Medicare		Marketplace		Consolidated

	(In millions)
Medical claims and benefits payable, beginning balance	$	2,580	$	404	$	379	$	3,363
Components of medical care costs related to:
Current year	16,520		2,525		1,476		20,521
Prior years	(282)		(38)		(18)		(338)
Total medical care costs	16,238		2,487		1,458		20,183
Payments for medical care costs related to:
Current year	14,133		2,103		1,302		17,538
Prior years	1,861		337		283		2,481
Total paid	15,994		2,440		1,585		20,019
Acquired balances, net of post-acquisition adjustments	8		—		—		8
Change in non-risk and other provider payables	91		(4)		—		87
Medical claims and benefits payable, ending balance	$	2,923	$	447	$	252	$	3,622

Our estimates of medical claims and benefits payable recorded at December 31, 2022, and 2021 developed favorably by approximately $358 million and $338 million as of September 30, 2023, and 2022, respectively.

The favorable prior year development recognized in the nine months ended September 30, 2023 was primarily due to lower than expected utilization of medical services by our members and improved operating performance. Consequently, the ultimate costs recognized in 2023, as claims payments were processed, were lower than our estimates in 2022.