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Medical Expenses Payable
12 Months Ended
Dec. 31, 2025
Insurance [Abstract]  
Medical Expenses Payable Medical Expenses Payable
The following table is a detail of medical expenses payable as of December 31, 2025 and 2024:
 December 31,
2025
December 31,
2024
Claims incurred but not paid$297,368 $168,357 
Capitation and risk-sharing payable85,083 52,016 
Other92,118 69,415 
Medical expenses payable$474,569 $289,788 
Each period, we re-examine previously established outstanding claims reserve estimates based on actual claims submissions and other changes in facts and circumstances. As more complete claim information becomes available, we adjust the amount of the estimates and include the changes in estimates in claim costs in the period in which the change is identified. Substantially, all of the total claims paid by us are known and settled within the first year from the date of service, and substantially, all remaining claim amounts are paid within a three-year period.
The following table presents components of the change in medical expenses payable as of December 31, 2025, 2024, and 2023 :
 December 31,
2025
December 31,
2024
December 31,
2023
Claims incurred but not paid - beginning balance$168,357 $95,664 $88,813 
Incurred related to:
Current year1,136,448 832,819 492,315 
Prior years(25,389)(9,245)(14,555)
Total incurred, net of reinsurance1,111,059 823,574 477,760 
Payments related to:
Current year848,206 670,471 400,465 
Prior years133,842 80,410 70,444 
Total payments, net of reinsurance982,048 750,881 470,909 
Claims incurred but not paid - ending balance297,368 168,357 95,664 
Capitation payable, risk-sharing payable, and other177,201 121,431 109,735 
Total medical expenses payable$474,569 $289,788 $205,399 
We re-examine previously established outstanding claims reserve estimates based on actual claims submissions and other changes in facts and circumstances. We recognized a favorable prior year development, excluding provision for adverse deviation, of $20,243, $7,052, and $10,996 for the years ended December 31, 2025, 2024, and 2023, respectively. The favorable prior year development incurred in 2025, 2024 and 2023 was primarily due to better-than-expected claims recoveries and actual claims expense being less than expected.
The following tables provide information about incurred and paid claims development as of December 31, 2025:
Cumulative Incurred Claims, Net of Reinsurance For the Years Ended December 31,
202320242025
Claims Incurred Year(in thousands)
2023$492,315 482,279 480,412 
2024832,819 809,297 
20251,136,448 
Total$2,426,157 
 Cumulative Claims Paid, Net of Reinsurance For the Years Ended December 31,
Cumulative Number of
Paid Claims(1)
202320242025
Claims Incurred Year(in thousands)
2023$400,465 479,148 478,999 540,426
2024670,471 804,462 1,036,274
2025848,206 1,268,147
Total$2,131,667 
(1) Cumulative number of paid claims are presented in whole amounts
Substantially all of the claims incurred but not paid as of December 31, 2025 relate to the current year.
There is no single or common claim frequency metric used in the health care industry. We believe a relevant metric for our health insurance business is the cumulative number of claims paid for each incurred year. Claims that did not result in a liability are not included in the frequency metric.