Contract Dispute Leaves Many Without Coverage
POCATELLO – A breakdown in contract negotiations between Portneuf Health and Regence Blue Cross of Idaho has left thousands in East Idaho without in-network insurance after their existing contract expired earlier this week.
Policyholders with Regence are now faced with tough choices: drive out of town for non-routine medical care, switch to a different insurance provider, or hope for a swift resolution as negotiations continue.
A significant number of those affected work for the state of Idaho. According to the Idaho Department of Group Health Insurance, around 3,600 state employees enrolled in the health plan find themselves in this predicament.
“This is certainly a challenging situation for everyone involved. The Group Insurance Office is hopeful that a solution will be reached soon,” stated a message sent to those impacted on Monday.
About half of the affected employees, roughly 1,800, are affiliated with Idaho State University in Pocatello. Lou Rieple, Regence’s strategic communications manager, noted that this also includes workers from the Pocatello-Chubuck School District 25.
Regence estimates that the contract expiration has impacted around 5,700 individuals in total.
On a positive note, both Portneuf Health and Regence have indicated that discussions are still ongoing.
“We’re committed to ensuring that care remains local and accessible for the community,” said a press release from Portneuf Health.
Regence has pinpointed Ardent Health, Portneuf’s parent company based in Tennessee, as its negotiation partner.
“We recognize the difficulties this situation causes for our members, and we’re dedicated to resuming discussions with Ardent Health to return Portneuf Medical Center and its providers to our network,” a Regence statement added.
Negotiation Details
Negotiations have reportedly been underway since late last year. According to Rieple, Regence began talks in December 2025, receiving an initial proposal from Ardent Health in March 2026.
Rieple mentioned that Regence BlueShield’s vice president of contracting for Idaho and their director of provider contracting are overseeing these negotiations, both based in the state.
Carter, the CEO of Portneuf Health, shared that he and CFO John Abreu lead the negotiations with support from Ardent Health’s team, revealing that the management staff from Portneuf also works for Ardent.
Financial Disputes
Carter has pointed out that Regence covers an important portion of Portneuf’s patients—about 12 to 15 percent of the total patient volume. He noted that Regence has denied approximately 75% of claims and only paid 78% of what is owed.
This has led to an estimated $25 million in unpaid bills that Regence owes to Portneuf, according to Carter.
“They’re underpaying us, which doesn’t align with what I’d consider competitive. It feels unfair,” he remarked.
Carter expressed that the process is straining Portneuf’s operations. “The administrative burden of their payment methods is overwhelming for us,” he said.
On the other hand, Regence claims that Portneuf ignored a proposal to increase payments.
“They chose to walk away from a competitive, multi-year offer,” a release from Regence stated. “Our proposed agreement would have adequately covered the cost of treating Regence patients.”
Carter contradicts this, saying, “Regence is paying significantly more to other Idaho-based hospitals. That’s why their offer isn’t competitive.”
Regence expressed disappointment over the current situation, emphasizing their goal to provide affordable, quality health care.
Options for Policyholders
Portneuf clarified that emergency care will still be available for those insured through Regence at in-network rates, but non-emergency services might incur higher out-of-pocket costs.
The health provider added that some patients may qualify for “continuing medical protection” and encouraged calls to their support line for more details.
Eligible conditions for continued care include:
- Serious or complex conditions
- Ongoing institutional or inpatient care
- Scheduled non-elective surgery
- Pregnancy-related medical care
- Terminal illness
Portneuf has a complete list of accepted insurances on its website, and staff are prepared to help patients transition their care. Medical records can be accessed via MyChart or through direct calls.
Additionally, Regence has provided a list of facilities and online providers available to its network members.
Concerns About Out-of-Town Care
Carter expressed concerns regarding Regence’s suggestion for members to seek care outside their community, stating, “Asking residents of Pocatello to drive to Idaho Falls is unreasonable for medical care.”
Moving Towards Resolution
Both Portneuf Health and Regence maintain that negotiations are still in progress.
“There are multiple calls and counter-offers happening daily as both parties aim to resolve this,” Rieple noted.
Carter shared that he had actually just completed an hour-long call with Regence representatives and that more discussions were scheduled for later that same day.
“We’re still in the thick of it,” he remarked.
When asked about potential pathways to an agreement, Rieple commented, “Finding common ground through understanding each other’s needs is essential for reaching an agreement.”
