Medical Claims and Benefits Payable

6 Months Ended

Jun. 30, 2022

Other Liabilities Disclosure [Abstract]

Medical Claims and Benefits Payable

Medical Claims and Benefits Payable

The following table provides the details of our medical claims and benefits payable as of the dates indicated:

	June 30, 2022		December 31, 2021
	(In millions)
Claims incurred but not paid (“IBNP”)	$	2,719	$	2,486
Pharmacy payable	229		219
Capitation payable	94		82
Other	733		576
Total	$	3,775	$	3,363

“Other” medical claims and benefits payable include amounts payable to certain providers for which we act as an intermediary on behalf of various government agencies without assuming financial risk. Such receipts and payments do not impact our consolidated statements of income. Non-risk provider payables amounted to $229 million and $226 million as of June 30, 2022, and December 31, 2021, respectively.

The following tables present the components of the change in our medical claims and benefits payable for the periods indicated. The amounts presented for “Components of medical care costs related to: Prior years” represent the amount by which our original estimate of medical claims and benefits payable at the beginning of the year varied from the actual liabilities, based on information (principally the payment of claims) developed since those liabilities were first reported.

	Six Months Ended June 30, 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	11,059		1,681		1,006		13,746
Prior years	(243)		(33)		(35)		(311)
Total medical care costs	10,816		1,648		971		13,435
Payments for medical care costs related to:
Current year	8,532		1,270		820		10,622
Prior years	1,801		330		280		2,411
Total paid	10,333		1,600		1,100		13,033
Acquired balances, net of post-acquisition adjustments	7		—		—		7
Change in non-risk and other provider payables	3		—		—		3
Medical claims and benefits payable, ending balance	$	3,073	$	452	$	250	$	3,775

	Six Months Ended June 30, 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	8,869		1,459		1,158		11,486
Prior years	(150)		(24)		(19)		(193)
Total medical care costs	8,719		1,435		1,139		11,293
Payments for medical care costs related to:
Current year	7,043		1,111		869		9,023
Prior years	1,491		330		128		1,949
Total paid	8,534		1,441		997		10,972
Acquired balances, net of post-acquisition adjustments	(19)		(7)		—		(26)
Change in non-risk and other provider payables	(48)		(1)		—		(49)
Medical claims and benefits payable, ending balance	$	2,247	$	378	$	317	$	2,942

Our estimates of medical claims and benefits payable recorded at December 31, 2021, and 2020 developed favorably by approximately $311 million and $193 million as of June 30, 2022, and 2021, respectively.

The favorable prior year development recognized in the six months ended June 30, 2022 was primarily due to lower than expected utilization of medical services by our members and improved operating performance. Consequently, the ultimate costs recognized in 2022, as claims payments were processed, were lower than our estimates in 2021.