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Segments
 12 Months Ended
Dec. 31, 2023
Segment Reporting [Abstract]  
Segments Segments
We currently have four reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. Our reportable segments are consistent with how we currently manage the business and view the markets we serve.
The Medicaid, Medicare, and Marketplace segments represent the government-funded or sponsored programs under which we offer managed healthcare services. The Other segment, which is insignificant to our consolidated results of operations, includes long-term services and supports consultative services in Wisconsin.
The key metrics used to assess the performance of our Medicaid, Medicare, and Marketplace segments are premium revenue, medical margin and medical care ratio (“MCR”). MCR represents the amount of medical care costs as a percentage of premium revenue. Therefore, the underlying medical margin, or the amount earned by the Medicaid, Medicare, and Marketplace segments after medical costs are deducted from premium revenue, represents the most important measure of earnings reviewed by management, and is used by our chief executive officer to review results, assess performance, and allocate resources. The key metric used to assess the performance of our Other segment is service margin. The service margin is equal to service revenue minus cost of service revenue. We do not report total assets by segment since this is not a metric used to assess segment performance or allocate resources.
The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented.
Year Ended December 31,
202320222021
(In millions)
Total revenue:
Medicaid$27,707 $25,783 $21,231 
Medicare4,227 3,824 3,379 
Marketplace2,062 2,296 3,091 
Other76 71 70 
Consolidated$34,072 $31,974 $27,771 
The following table reconciles margin by segment to consolidated income before income tax expense:
Year Ended December 31,
202320222021
(In millions)
Margin:
Medicaid$2,973 $2,981 $2,322 
Medicare388 437 430 
Marketplace499 290 399 
Other9 11 14 
Total margin3,869 3,719 3,165 
Add: other operating revenues (1)
1,467 1,020 846 
Less: other operating expenses (2)
(3,763)(3,566)(2,991)
Operating income1,573 1,173 1,020 
Less: other expenses, net (3)
109 110 145 
Income before income tax expense$1,464 $1,063 $875 
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(1)Other operating revenues include premium tax revenue, investment income and certain other revenue.
(2)Other operating expenses include general and administrative expenses, premium tax expenses, depreciation and amortization, impairment, and certain other operating expenses.
(3)Other expenses, net include interest expense and non-operating other expenses.