Segment Information

9 Months Ended

Sep. 30, 2023

Segment Reporting [Abstract]

Segment Information

Segment Information

In the first quarter of 2023, and in conjunction with the Company's updated strategic plan, executive leadership realignment, and corresponding 2023 divestitures, the Company revised the way it manages the business, evaluates performance, and allocates resources, resulting in an updated segment structure comprised of (1) a Medicaid segment, (2) a Medicare segment, (3) a Commercial segment and (4) an Other segment. Prior year information has been adjusted to reflect the change in segment reporting.

The Medicaid, Medicare, and Commercial segments represent the government-sponsored or subsidized programs under which the Company offers managed healthcare services. The Other segment includes the Company's pharmacy operations, vision and dental services, clinical healthcare, behavioral health, international operations, and corporate management companies, among others.

Factors used in determining the reportable business segments include the nature of operating activities, the existence of separate senior management teams, and the type of information presented to the Company's chief operating decision-maker to evaluate all results of operations. The Company does not report total assets by segment since this is not a metric used to allocate resources or evaluate segment performance.

Segment information for the three months ended September 30, 2023, is as follows ($ in millions):

		Medicaid		Medicare		Commercial		Other/Eliminations		Consolidated Total
Premium		$	21,619	$	5,430	$	6,451	$	366	$	33,866
Service		—		—		2		1,099		1,101
Premium and service revenues		21,619		5,430		6,453		1,465		34,967
Premium tax		3,075		—		—		—		3,075
Total external revenues		24,694		5,430		6,453		1,465		38,042
Internal revenues		—		—		—		3,978		3,978
Eliminations		—		—		—		(3,978)		(3,978)
Total revenues		$	24,694	$	5,430	$	6,453	$	1,465	$	38,042
Medical costs		$	19,607	$	4,462	$	5,089	$	321	$	29,479
Cost of services		$	—	$	—	$	—	$	856	$	856
Gross margin (1)		$	2,012	$	968	$	1,364	$	288	$	4,632
(1)	Gross margin represents premium and service revenues less medical costs and cost of services.

Segment information for the three months ended September 30, 2022, is as follows ($ in millions):

		Medicaid		Medicare		Commercial		Other/Eliminations		Consolidated Total
Premium		$	21,154	$	5,639	$	4,291	$	764	$	31,848
Service		—		—		1		1,877		1,878
Premium and service revenues		21,154		5,639		4,292		2,641		33,726
Premium tax		2,139		—		—		—		2,139
Total external revenues		23,293		5,639		4,292		2,641		35,865
Internal revenues		—		—		—		6,420		6,420
Eliminations		—		—		—		(6,420)		(6,420)
Total revenues		$	23,293	$	5,639	$	4,292	$	2,641	$	35,865
Medical costs		$	19,075	$	4,730	$	3,613	$	693	$	28,111
Cost of services		$	—	$	—	$	—	$	1,571	$	1,571
Gross margin (1)		$	2,079	$	909	$	679	$	377	$	4,044
(1)	Gross margin represents premium and service revenues less medical costs and cost of services.

Segment information for the nine months ended September 30, 2023, is as follows ($ in millions):

		Medicaid		Medicare		Commercial		Other/Eliminations		Consolidated Total
Premium		$	65,741	$	16,971	$	17,437	$	1,255	$	101,404
Service		—		—		2		3,351		3,353
Premium and service revenues		65,741		16,971		17,439		4,606		104,757
Premium tax		9,782		—		—		—		9,782
Total external revenues		75,523		16,971		17,439		4,606		114,539
Internal revenues		—		—		—		11,634		11,634
Eliminations		—		—		—		(11,634)		(11,634)
Total revenues		$	75,523	$	16,971	$	17,439	$	4,606	$	114,539
Medical costs		$	59,076	$	14,354	$	13,738	$	1,092	$	88,260
Cost of services		$	2	$	—	$	—	$	2,601	$	2,603
Gross margin (1)		$	6,663	$	2,617	$	3,701	$	913	$	13,894
(1)	Gross margin represents premium and service revenues less medical costs and cost of services.

Segment information for the nine months ended September 30, 2022, is as follows ($ in millions):

		Medicaid		Medicare		Commercial		Other/Eliminations		Consolidated Total
Premium		$	62,763	$	17,035	$	12,977	$	2,472	$	95,247
Service		(1)		—		2		6,678		6,679
Premium and service revenues		62,762		17,035		12,979		9,150		101,926
Premium tax		7,060		—		—		—		7,060
Total external revenues		69,822		17,035		12,979		9,150		108,986
Internal revenues		—		—		—		18,856		18,856
Eliminations		—		—		—		(18,856)		(18,856)
Total revenues		$	69,822	$	17,035	$	12,979	$	9,150	$	108,986
Medical costs		$	56,108	$	14,602	$	10,416	$	2,135	$	83,261
Cost of services		$	—	$	—	$	—	$	5,658	$	5,658
Gross margin (1)		$	6,654	$	2,433	$	2,563	$	1,357	$	13,007
(1)	Gross margin represents premium and service revenues less medical costs and cost of services.