The following table is a detail of medical expenses payable as of June 30, 2021 and December 31, 2020:


	June 30, 2021		December 31, 2020
Claims incurred but not paid	$	77,374	$	82,391
Capitation payable, risk-sharing payable, and other		59,104		30,214
	$	136,478	$	112,605

Each period, we re-examine previously established outstanding claims reserve estimates based on actual claims submissions and other changes in facts and circumstances. As more complete claim information becomes available, we adjust the amount of the estimates and include the changes in estimates in claim costs in the period in which the change is identified. Substantially, all of the total claims paid by us are known and settled within the first year from the date of service, and substantially, all remaining claim amounts are paid within a three-year period.

The following table presents components of the change in medical expenses payable as of June 30, 2021 and 2020:


	June 30, 2021			June 30, 2020
Claims incurred but not paid - beginning balance	$	82,391		$	83,939
Incurred related to:
Current year		164,620			136,119
Prior years		(3,016	)		(13,244	)
Total incurred, net of reinsurance		161,604			122,875
Payments related to:
Current year		100,606			83,536
Prior years		66,015			54,199
Total payments, net of reinsurance		166,621			137,735
Claims incurred but not paid - ending balance		77,374			69,079
Other medical expenses payable		59,104			35,957
Total medical expenses payable	$	136,478		$	105,036

In March 2020, the COVID-19 outbreak was declared a pandemic. The COVID-19 virus disproportionately impacts older adults, especially those with chronic illnesses, which describes many of the seniors we serve. For the three months ended March 31, 2021, we experienced higher claims costs due to COVID-19 related inpatient admissions. However, for the three months ended June 30, 2021, we saw a decline in COVID-related utilization as vaccination rates improved across our senior population, which was partially offset by higher spend related to non-COVID-19 care as general healthcare utilization trended towards pre-pandemic levels. While COVID had a less significant impact on our second quarter medical expense relative to our first quarter medical expense, we remain cautious of the potential impact of the Delta variant in the future. Cumulatively, the six months incurred claims increased in 2021 due to higher membership. The ultimate impact of COVID-19 to us and our financial condition is presently unknown and we continue to monitor the impact of COVID-19 on our claims reserve estimate.

We re-examine previously established outstanding claims reserve estimates based on actual claims submissions and other changes in facts and circumstances. We recognized an unfavorable prior year development, excluding provision for adverse deviation, of $935 and $1,335 in the three and six months ended June 30, 2021, respectively.