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Medical Claims and Benefits Payable (Tables) | 12 Months Ended
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Dec. 31, 2023
Insurance [Abstract] |
Schedule of Liability for Unpaid Claims and Claims Adjustment Expense | The following table provides the details of our medical claims and benefits payable as of the dates indicated.
| December 31,
| 2023 |  | 2022 |  | 2021
| (In millions)
Fee-for-service claims incurred but not paid (“IBNP”) | $ | 2,901 |  |  | $ | 2,597 |  |  | $ | 2,486 |
Pharmacy payable | 202 |  |  | 206 |  |  | 219 |
Capitation payable | 100 |  |  | 94 |  |  | 82 |
Other | 1,001 |  |  | 631 |  |  | 576 |
Total | $ | 4,204 |  |  | $ | 3,528 |  |  | $ | 3,363 |
Schedule of Components of The Change in Medical Claims and Benefits Payable | The following tables present the components of the change in our medical claims and benefits payable for the periods indicated.
| Year Ended December 31, 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 | 23,749 |  |  | 3,802 |  |  | 1,545 |  |  | 29,096 |
Prior years | (395) |  |  | (11) |  |  | (21) |  |  | (427) |
Total medical care costs | 23,354 |  |  | 3,791 |  |  | 1,524 |  |  | 28,669 |
Payments for medical care costs related to: |  |  |  |  |  |  |
Current year | 20,999 |  |  | 3,293 |  |  | 1,323 |  |  | 25,615 |
Prior years | 2,069 |  |  | 431 |  |  | 234 |  |  | 2,734 |
Total paid | 23,068 |  |  | 3,724 |  |  | 1,557 |  |  | 28,349 |
Acquired balances, net of post-acquisition adjustments | 82 |  |  | 14 |  |  | — |  |  | 96 |
Change in non-risk and other provider payables | 261 |  |  | (1) |  |  | — |  |  | 260 |
Medical claims and benefits payable, ending balance | $ | 3,444 |  |  | $ | 532 |  |  | $ | 228 |  |  | $ | 4,204 |
| Year Ended December 31, 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 | 22,097 |  |  | 3,390 |  |  | 1,972 |  |  | 27,459 |
Prior years | (251) |  |  | (32) |  |  | (1) |  |  | (284) |
Total medical care costs | 21,846 |  |  | 3,358 |  |  | 1,971 |  |  | 27,175 |
Payments for medical care costs related to: |  |  |  |  |  |  |
Current year | 19,655 |  |  | 2,944 |  |  | 1,746 |  |  | 24,345 |
Prior years | 1,966 |  |  | 361 |  |  | 343 |  |  | 2,670 |
Total paid | 21,621 |  |  | 3,305 |  |  | 2,089 |  |  | 27,015 |
Acquired balances, net of post-acquisition adjustments | 12 |  |  | — |  |  | — |  |  | 12 |
Change in non-risk and other provider payables | (2) |  |  | (5) |  |  | — |  |  | (7) |
Medical claims and benefits payable, ending balance | $ | 2,815 |  |  | $ | 452 |  |  | $ | 261 |  |  | $ | 3,528 |
| 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 |
Schedule of Incurred and Paid Claims Development | The following tables provide information about our consolidated incurred and paid claims development as of December 31, 2023, 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 |  | 2021 |  | 2022 |  | 2023 |
|  | (Unaudited) |  | (Unaudited) |  |  |  |  |  |
|  | (In millions)
2021 |  | $ | 24,167 |  |  | $ | 23,979 |  |  | $ | 23,912 |  |  | $ | 18 |  |  | 133 |
2022 |  |  |  | 27,459 |  |  | 27,128 |  |  | 77 |  |  | 163 |
2023 |  |  |  |  |  | 29,096 |  |  | 2,803 |  |  | 153 |
|  |  |  |  |  | $ | 80,136 |  |  | $ | 2,898 |  |  |
Cumulative Paid Claims and Allocated Claims Adjustment Expenses |
Benefit Year |  | 2021 |  | 2022 |  | 2023 |
|  | (Unaudited) |  | (Unaudited) |  |  |
|  | (In millions) |
2021 |  | $ | 21,148 |  |  | $ | 23,871 |  |  | $ | 23,894 |  |
2022 |  |  |  | 24,345 |  |  | 27,051 |  |
2023 |  |  |  |  |  | 25,615 |  |
|  |  |  |  |  | $ | 76,560 |  |
Schedule of Reconciliation of Claims Development to Liability | The following table represents a reconciliation of claims development to the aggregate carrying amount of the liability for medical claims and benefits payable.
|  |  |  |  |  | 2023 |
|  |  |  |  |  | (In millions) |
Incurred claims and allocated claims adjustment expenses |  | $ | 80,136 |  |
Less: cumulative paid claims and allocated claims adjustment expenses |  | (76,560) |  |
All outstanding liabilities before 2021 |  | 3 |  |
Acquired balances |  | 96 |  |
Non-risk and other provider payables |  | 529 |  |
Medical claims and benefits payable |  | $ | 4,204 |  |

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- Definition Tabular disclosure of the activity in the reserve for settling insured claims and expenses incurred in the claims settlement process for the period. The estimated liability includes the amount of money that will be required for future payments of (a) claims that have been reported to the insurer, (b) claims related to insured events that have occurred but that have not been reported to the insurer as of the date the liability is estimated, and (c) claim adjustment expenses. Claim adjustment expenses include costs incurred in the claim settlement process such as legal fees; outside adjuster fees; and costs to record, process, and adjust claims. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Topic 944 -SubTopic 40 -Name Accounting Standards Codification -Section 50 -Paragraph 3 -Publisher FASB -URI https://asc.fasb.org//1943274/2147480081/944-40-50-3 + Details
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