Medical Liabilities (Details) - USD ($) $ in Thousands	3 Months Ended
Mar. 31, 2024	Mar. 31, 2023
Medical Liabilities [Roll Forward]
Medical liabilities, beginning of period	$ 106,657	$ 81,255
Acquired (see Note 3)	30,645	0
Components of medical care costs related to claims incurred:
Current period	235,237	223,713
Prior periods	(1,419)	(8,950)
Total medical care costs	233,818	214,763
Payments for medical care costs related to claims incurred:
Current period	(136,286)	(136,743)
Prior periods	(97,837)	(61,736)
Total paid	(234,123)	(198,479)
Adjustments	(503)	857
Medical liabilities, end of period	$ 136,494	$ 98,396

The amount needed to reflect the estimated ultimate cost of settling claims relating to insured events that have occurred on or before the balance sheet date, whether or not reported to the insurer at that date.

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Amount of increase (decrease) in the cost of settling unpaid claims after deduction of reinsurance recoveries related to the acquisition of a business. Includes, but is not limited to, claims which have been incurred but not reported.

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A roll forward is a reconciliation of a concept from the beginning of a period to the end of a period.

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Amount, after effects of reinsurance, of expense for claims incurred in the current reporting period and related claims settlement costs.

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