IDR in 2025: the typical award held at 4 times the plan's own rate. UnitedHealth's went up.

IDR in 2025: UnitedHealth's typical arbitration award rose from 2.9 to 3.5 times its own in-network rate. Aetna's fell from 4.8 to 4.0.

Across all insurers, the typical award held at 4 times the plan's own rate. Underneath, the insurers moved in different directions. Of the four with the most disputes, UnitedHealth is the only one whose awards went up. On October 13, UnitedHealthcare's CEO called some of these awards excessive.

How IDR works: when an out-of-network provider and a plan can't agree on a bill, each side sends one number. The arbitrator must pick one. In 2025 the provider's number won 85.7% of the time.

The other two of the four: HCSC, the Blue plans of Texas, Illinois and three more states, 6.2 to 6.1. Cigna, 3.9 to 3.6.

If your company pays its own claims, awards on your employees' claims are paid from your plan, not the insurer's.

The typical award held. The number of disputes did not: 2.2 million disputed lines in 2024, 5.7 million in 2025.

Every IDR decision CMS has published, by insurer, code and state, is in our MCP. Ask it about your plan: vladahealth.com/data-access