Accrued Professional Liabilities

9 Months Ended

Sep. 30, 2016

The Company maintains professional liability insurance policies with third-party insurers generally on a claims-made basis, subject to self-insured retention, exclusions and other restrictions. A substantial portion of the professional liability loss risks are being provided by a third-party insurer, which is fully reinsured by the Company's wholly-owned captive insurance subsidiary. The Company records an estimate of liabilities for self-insured amounts and claims incurred but not reported based on an actuarial valuation using historical loss patterns, which are not discounted.

At September 30, 2016 and December 31, 2015, the Company's accrued professional liabilities are presented in the accompanying consolidated balance sheets as a component of other accrued liabilities and other long-term liabilities as follows (in thousands):



	September 30, 2016		December 31, 2015
Estimated losses under self-insured programs	$	34,019	$	30,748
Incurred but not reported losses	40,038		36,166
Total accrued professional liabilities	74,057		66,914
Less estimated losses payable within one year	15,346		14,362
Total	$	58,711	$	52,552

The changes to the Company's estimated losses under self-insured programs as of September 30, 2016 were as follows (in thousands):



Balance at December 31, 2015	$	66,914
Assumed liabilities through acquisitions	379
Provision related to current period reserves	15,398
Payments for current period reserves	(1,070		)
Benefit related to changes in prior period reserves	(249		)
Payments for prior period reserves	(8,423		)
Other, net including post-acquisition adjustments	1,108
Balance at September 30, 2016	$	74,057