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Segments
 9 Months Ended
Sep. 30, 2024
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.
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
(In millions)
Total revenue:
Medicaid$8,263 $6,976 $23,896 $20,282 
Medicare1,385 1,046 4,301 3,157 
Marketplace672 507 1,894 1,528 
Other20 19 60 57 
Consolidated$10,340 $8,548 $30,151 $25,024 
The following table reconciles margin by segment to consolidated income before income tax expense:
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
(In millions)
Margin:
Medicaid$730 $752 $2,188 $2,242 
Medicare142 78 522 317 
Marketplace179 104 509 393 
Other 1 2 5 7 
Total margin 1,052 936 3,224 2,959 
Add: other operating revenues (1)
626 289 1,447 800 
Less: other operating expenses (2)
(1,211)(866)(3,344)(2,502)
Operating income467 359 1,327 1,257 
Less: interest expense29 27 84 82 
Income before income tax expense$438 $332 $1,243 $1,175 
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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, and certain other operating expenses.