Quick Summary
- UnitedHealth Group says federal IDR costs are adding pressure to commercial health plan pricing
- CFO Wayne DeVeydt said the company is accounting for higher IDR awards as it sets 2027 rates
- UnitedHealth is calling for Congress to examine what it describes as problems with the current IDR system
- Federal data continue to show significant growth in dispute volume and a high provider success rate
- The comments highlight the growing debate over the future of the No Surprises Act arbitration process
UnitedHealth Points to IDR as a Growing Cost Pressure
UnitedHealth Group is raising new concerns about the cost of the federal Independent Dispute Resolution process under the No Surprises Act.
Speaking at the Wells Fargo Healthcare Conference in September, UnitedHealth Chief Financial Officer Wayne DeVeydt discussed several factors affecting the company’s commercial health insurance business, including Medicaid-related pressures, the continued movement of employers toward self-funded health plans, and increasing costs associated with IDR awards. UnitedHealth has made a replay of the September 9 conference available through its investor relations site.
DeVeydt said the company is incorporating the IDR costs it is currently experiencing into its pricing assumptions for 2027 commercial coverage. He also argued that those costs create additional affordability pressure for consumers.
UnitedHealth Calls for Greater Scrutiny
During the investor conference, DeVeydt said UnitedHealth wants Congress to examine how the IDR system is operating.
The company contends that some organizations are taking advantage of weaknesses in the current process and that high award amounts are creating additional costs for insurers and health plans.
These concerns reflect a broader disagreement between payers and providers over federal IDR. Insurers have argued that the system is receiving large numbers of disputes, including claims they believe may be ineligible, and that arbitration awards can substantially exceed typical in-network reimbursement.
Providers and physician organizations, meanwhile, have argued that strong provider outcomes reflect inadequate initial reimbursement offers and weaknesses in how payers present their cases during arbitration.
IDR Volume Continues to Grow
Federal data show that use of the IDR system continues to expand.
According to CMS, more than 2.1 million disputes were initiated during the first seven months of 2026 alone. Since the federal portal opened in April 2022, more than 7 million disputes had been initiated as of July 31, 2026.
Providers, facilities, and air ambulance providers also continue to prevail in most completed cases. During the first half of 2025, they won approximately 88% of payment determinations, and the prevailing offer exceeded the Qualifying Payment Amount in roughly 88% of cases.
Those results have become a central part of the debate over whether the system is functioning as Congress intended.
What This Means for Healthcare Providers
UnitedHealth’s comments suggest that IDR could face increased scrutiny as insurers, employers, providers, and policymakers debate its impact on reimbursement and health plan costs.
For providers, the federal IDR process remains an important mechanism for challenging inadequate out-of-network payments. However, continued pressure for legislative or regulatory changes makes it important to monitor developments closely.
How Patriot Group Can Help
Patriot Group helps healthcare providers evaluate eligible claims, navigate the federal IDR process, challenge inadequate reimbursement, and develop strategies for payer disputes.
As scrutiny of the IDR system increases, providers should be prepared for possible changes while continuing to protect their reimbursement rights under the current rules.
For questions about IDR, payer disputes, or revenue recovery, contact Thomas J. Force, Esq., President and Founder of Patriot Group, at TForce@patriotcompli.com or call (631) 870-4040.
