Medical Costs Payable (Notes)

12 Months Ended

Dec. 31, 2022

Insurance [Abstract]

Medical Costs Payable

Medical Costs Payable

The following table shows the components of the change in medical costs payable for the years ended December 31:

(in millions)	2022		2021		2020
Medical costs payable, beginning of period	$	24,483	$	21,872	$	21,690
Acquisitions	308		88		316
Reported medical costs:
Current year	211,252		188,631		160,276
Prior years	(410)		(1,720)		(880)
Total reported medical costs	210,842		186,911		159,396
Medical payments:
Payments for current year	(184,049)		(165,524)		(139,974)
Payments for prior years	(22,528)		(18,864)		(19,556)
Total medical payments	(206,577)		(184,388)		(159,530)
Medical costs payable, end of period	$	29,056	$	24,483	$	21,872

For the year ended December 31, 2022, prior year’s medical cost reserve development included no individual factors that were significant. For the years ended December 31, 2021 and 2020, prior years’ medical cost reserve development was primarily driven by lower than expected care activity. Additionally, prior years’ medical cost reserve development in the year ended December 31, 2021 was driven by care patterns disrupted by COVID-19.

Medical costs payable included IBNR of $20.0 billion and $17.1 billion at December 31, 2022 and 2021, respectively. Substantially all of the IBNR balance as of December 31, 2022 relates to the current year.

The following is information about incurred and paid medical cost development as of December 31, 2022:

	Net Incurred Medical Costs
(in millions)	For the Years Ended December 31,
Year	2021		2022
2021	$	188,631	$	188,407
2022			211,252
Total			$	399,659
	Net Cumulative Medical Payments
(in millions)	For the Years Ended December 31,
Year	2021		2022
2021	$	(165,524)	$	(186,944)
2022			(184,049)
Total			(370,993)
Net remaining outstanding liabilities prior to 2021			390
Total medical costs payable			$	29,056