Why is self-funded healthcare plan network evaluation important?

Carrier negotiated rates are increasing across the board and have been for a while; that’s no secret.

But at a handful of major hospitals around the country, average carrier rates are actually falling.

Specialized treatment centers seem to be seeing the biggest rate decreases. At the Memorial Hospital For Cancer And Allied Diseases in New York, Blue Cross Blue Shield rates dropped by 36.2% in the six months between October 2025 and March 2026.

The Adventhealth Lab system in Florida and the City of Hope Cancer Center in Atlanta returned BCBS decreases of 24.2% and 17.3%, respectively. 

Blue Cross Blue Shield rates fell at 13 of the 62 major providers surveyed, and the carrier also returned the largest hospital rate declines. However, UnitedHealthcare rates dropped at 18 hospitals – 7.2% being the biggest change across the 6 month period. We also measured a large hospital rate decrease from Aetna, 12.9%; Cigna’s biggest decrease came in at 6.2%.   

Even with these declines, overall rates continue to balloon. Aetna, Blue Cross Blue Shield, Cigna and UnitedHealthcare all returned increases at the vast majority of the hospitals surveyed, with median increases from 0.8% (United) to 7.4% (Aetna). UnitedHealthcare rates rose by an average of 1.8%, while BCBS rose by 2.9%.

Aetna rates rose at 50 of the providers surveyed. For self-funded employers and plan sponsors with Aetna-administered benefits, that gap translates directly into higher claim costs, particularly for high-volume inpatient and outpatient procedures at the facilities their members use most. Aetna’s biggest increase of nearly 79% happened at Cedars-Sinai Marina Spine Center; the next largest, 44.6%, happened at Stanford Health Care in California. Five additional providers returned rates increases of more than 20%. Compare that to Cigna, where rates at three hospitals rose by more than 20%. (Two rose by that much for BCBS, and one for United.)

The takeaway? Network evaluation is more important than ever before. In a world of rising healthcare rates, you have to know where to look to tap into savings.  

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