Medical Claims and Related Payables

12 Months Ended

Dec. 31, 2024


NOTE 9. Medical Claims and Related Payables

Medical claims and related payables include estimates for amounts owed for claims incurred for services provided to members by various providers. Changes in amounts reported for medical claims related to prior years result from claims being paid at amounts different than originally estimated. Liabilities are continually reviewed and re-estimated as information regarding actual claim payments becomes known. This information is compared to the originally established

liability at year end. The following table presents the components of changes in medical claims and related payables (in thousands):


	December 31,
	2024		2023		2022
Medical claims and related payables, beginning of the year	$	723,071	$	339,749	$	239,014
Components of incurred costs related to:
Current year	5,798,709		3,956,874		2,084,009
Prior years	43,821		51,785		9,851
Discontinued operations - current year	—		263,214		303,365
Discontinued operations - prior years	—		7,008		2,607
	5,842,530		4,278,881		2,399,832
Claims paid related to:
Current year	(4,878,351)		(3,237,050)		(1,792,303)
Prior years	(768,856)		(344,269)		(200,668)
Discontinued operations - current year	—		(263,215)		(258,733)
Discontinued operations - prior years	—		(51,025)		(47,393)
	(5,647,207)		(3,895,559)		(2,299,097)
Medical claims and related payables, end of the year	$	918,394	$	723,071	$	339,749

Beginning and ending balances of medical claims and related payables disclosed above for December 31, 2022, include $44.1 million and $45.9 million, respectively, that are presented as current liabilities held for sale and discontinued operations. Ending balance of medical claims and related payables disclosed above for December 31, 2024 and 2023, includes $13.3 million and $14.7 million, respectively, that is recoverable from other parties under risk sharing arrangements and is presented as prepaid expenses and other current assets, net in the consolidated balance sheets.

During 2023, the Company experienced an increase in medical claims expenses attributable to higher-than-expected utilization. The increase in medical service utilization trends became visible during the fourth quarter of 2023 as a result of additional updated information provided by the Company’s payors. For the three months ended December 31, 2023, the Company recognized $1.16 billion of medical claims expense.