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Segments
 12 Months Ended
Dec. 31, 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, who is our chief operating decision maker, to review results, assess performance, and allocate resources. Such oversight and decision making includes, among others, pricing, approving capital expenditures, and identifying growth opportunities. 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.
Year Ended December 31, 2024
MedicaidMedicare MarketplaceOtherTotal
(In millions)
Revenue:
Premium revenue$30,579 $5,542 $2,506 $— $38,627 
Service revenue— — — 81 81 
Revenue from external customers30,579 5,542 2,506 81 38,708 
Other operating revenues (1)
1,942 
Total revenue40,650 
Operating Expenses:
Medical care costs27,600 4,939 1,889 — 34,428 
Cost of service revenue— — — 73 73 
Segment expenses27,600 4,939 1,889 73 34,501 
Other operating expenses (2)
4,442 
Operating income1,707 
Less: interest expense118 
Income before income tax expense$1,589 
Segment Margin:
Medical margin$2,979 $603 $617 $— $4,199 
Service margin— — — 8 8 
Year Ended December 31, 2023
MedicaidMedicare MarketplaceOtherTotal
(In millions)
Revenue:
Premium revenue$26,327 $4,179 $2,023 $— $32,529 
Service revenue— — — 76 76 
Revenue from external customers26,327 4,179 2,023 76 32,605 
Other operating revenues (1)
1,467 
Total revenue34,072 
Operating Expenses:
Medical care costs23,354 3,791 1,524 — 28,669 
Cost of service revenue— — — 67 67 
Segment expenses23,354 3,791 1,524 67 28,736 
Other operating expenses (2)
3,763 
Operating income1,573 
Less: interest expense109 
Income before income tax expense$1,464 
Segment Margin:
Medical margin$2,973 $388 $499 $— $3,860 
Service margin— — — 9 9 
Year Ended December 31, 2022
MedicaidMedicare MarketplaceOtherTotal
(In millions)
Revenue:
Premium revenue$24,827 $3,795 $2,261 $— $30,883 
Service revenue— — — 71 71 
Revenue from external customers24,827 3,795 2,261 71 30,954 
Other operating revenues (1)
1,020 
Total revenue31,974 
Operating Expenses:
Medical care costs21,846 3,358 1,971 — 27,175 
Cost of service revenue— — — 60 60 
Segment expenses21,846 3,358 1,971 60 27,235 
Other operating expenses (2)
3,566 
Operating income1,173 
Less: interest expense110 
Income before income tax expense$1,063 
Segment Margin:
Medical margin$2,981 $437 $290 $— $3,708 
Service margin— — — 11 11 
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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.