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Reserves for Claims and Performance-Based Arrangements (Tables)
12 Months Ended
Dec. 31, 2020
Insurance [Abstract]  
Activity in claims reserves
Activity in reserves for claims and performance-based arrangements for the years ended December 31, 2020 and 2019, was as follows (in thousands):
For the Year Ended December 31,
20202019
Services (1)(2)
True Health (2)
Total
Services (1)
True Health (2)
Total
Beginning balance$54,510 $6,640 $61,150 $17,715 $9,880 $27,595 
Incurred costs related to current year420,597 89,008 509,605 $267,064 $136,303 $403,367 
Incurred costs related to prior year2,878 799 3,677 (334)(529)(863)
Paid costs related to current year464,571 79,640 544,211 220,050 61,621 281,671 
Paid costs related to prior year9,598 6,949 16,547 8,165 8,092 16,257 
Change during the year(50,694)3,218 (47,476)38,515 66,061 104,576 
Impact of consolidation on reserves for claims and performance-based arrangements164,297 — 164,297 — — — 
Other adjustments (3)
10,714 — 10,714 (1,720)(69,301)(71,021)
Ending balance$178,827 $9,858 $188,685 $54,510 $6,640 $61,150 

(1)    Costs incurred to provide specialty care management and EVH Passport are recorded within cost of revenue in our statement of operations. EVH Passport operations are not included in 2019 activity.
(2)    There is no single or common claim frequency metric used in the health care industry. The Company believes a relevant metric for its health insurance business is the number of customers for whom an insured medical claim was paid. The number of claims processed for the Services and True Health segments for years ended December 31, 2020 and 2019 were 2,279,228 and 317,187, respectively.
(3)    Other adjustments to reserves for claims and performance-based arrangements for Services reflect changes in accrual for amounts payable to facilities and amounts owed to our payer partners for claims paid on our behalf. Other adjustments related to EVH Passport and our True Health segment represent premiums received less administrative expenses related to the reinsurance agreements. Refer to Note 10 for additional information about the reinsurance agreements.