v3.25.2
Provider Liability
6 Months Ended
Jun. 30, 2025
Liability for Unpaid Claims and Claims Adjustment Expense, Activity in Liability [Abstract]  
Provider Liability Provider Liability
Provider liability represents costs payable to physicians, hospitals and other ancillary providers, including both Privia physicians (and their related physician practices), and providers the Company has contracted with through payer partners. Those costs include amounts that have not yet been paid for physician guaranteed payments and other required distributions pursuant to the service agreements as well as medical claims costs for services provided to attributed beneficiaries for which the Company is financially responsible under at-risk Capitated revenue arrangements whether paid directly by the Company or indirectly by payers with whom the Company has contracted. Provider expenses are recognized in the period in which services are provided and include estimates of claims that have been incurred but have either not yet been received, processed, or paid and as such, not reported.
Provider liability estimates are developed using actuarial methods commonly used by health insurance actuaries that include a number of factors and assumptions including medical service utilization trends, changes in membership, observed medical cost trends, historical claim payment patterns and other factors.
Each period, the Company re-examines previously established provider liability estimates based on actual claim submissions and other changes in facts and circumstances. As more complete claims information becomes available, the Company adjusts its estimates and recognizes those changes in estimates in the period in which the change is identified. The difference between the estimated liability
and the actual settlements of claims is recognized in the period in which the claims are settled. The Company’s provider liability balance represents management’s best estimate of its liability for unpaid provider expenses as of June 30, 2025 and 2024. The Company uses judgment to determine the appropriate assumptions for developing the required estimates.
The Company’s liabilities for unpaid medical claims under at-risk capitation arrangements, which are included in provider liability in the Company’s condensed consolidated balance sheets, were as follows:
June 30,
(Dollars in Thousands)20252024
Balance, beginning of period $66,355 $67,138 
Incurred health care costs
Current year144,840 104,610 
Prior years(555)3,305 
Total claims incurred$144,285 $107,915 
Claims Paid
Current year(63,025)(47,979)
Prior years(47,959)(52,877)
Total claims paid$(110,984)$(100,856)
Balance, end of period $99,656 $74,197