Vlada · Research · 2026-10-23 · comparative
IDR in 2025: the typical award held at 4 times the plan's own rate. UnitedHealth's went up.
In 2025, did federal IDR awards rise against the plan's own rate, and for which insurers?
| Federal IDR, 2024 and 2025 | 2024 | 2025 |
|---|---|---|
| All IDR5,719,896 lines in 2025 · provider won 86% | 4 | 4 |
| UnitedHealth (UNH)1,564,301 lines in 2025 · provider won 84% | 2.9 | 3.5 |
| HCSC1,215,224 lines in 2025 · provider won 89% | 6.2 | 6.1 |
| CVS / Aetna (CVS)884,034 lines in 2025 · provider won 90% | 4.8 | 4 |
| Cigna (CI)662,534 lines in 2025 · provider won 81% | 3.9 | 3.6 |
| Other named Blue plans366,955 lines in 2025 · provider won 80% | 4.1 | 6 |
| Elevance (ELV)246,628 lines in 2025 · provider won 87% | 3.5 | 3.7 |
| Centene (CNC)129,176 lines in 2025 · provider won 90% | 2.5 | 2.9 |
| Florida Blue73,113 lines in 2025 · provider won 97% | 3.1 | 3.2 |
| Oscar (OSCR)17,194 lines in 2025 · provider won 91% | 3.6 | 4.4 |
| Humana (HUM)2,986 lines in 2025 · provider won 72% | 3 | 3.6 |
Median of CMS's prevailing offer as a percent of the QPA, per decided line (payment determination for the provider or the plan), CMS analytics-eligible rows with a QPA percent, by year the dispute was decided; one decimal, half up · CMS Federal IDR Public Use Files 2024 Q1 to 2025 Q4 (posted July 22, 2026) · Athena becb8da2-693b-47b5-aecc-62129a3ae9c0 · 11 rows
The posted figure
Read with
- A line is one billed service in dispute, not a case or a patient. Only decided lines count: ineligible, withdrawn and settled disputes are not in them.
- The typical award is computed on lines that report the plan's rate as a percent: 82% of 2025 lines overall, less for some insurers. Line counts on the image are all decided lines.
- An award is the offer the arbitrator picked, not a record of what was paid.
- The plan's own rate (the QPA) is calculated and reported by the plan. CMS does not audit it in this file.
- Insurer is read from CMS's free-text plan name (queries/parent_by_year.sql), audited 2026-10-23. Bare Blue names that do not say which company, and unmatched names (including a bare 'United'), are left out, not guessed. Some small Blue subsidiaries are in the unmatched group.
- Not adjusted for state, service or plan type. An insurer's typical award moves when its mix of cases moves, and this card does not separate the two.
- Many of these awards are on fully insured plans, where the insurer pays. The post says a self-funded employer's plan pays awards on its own employees' claims, nothing broader.
- Humana and Oscar have few lines; read their dots as indications.
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