Portneuf Health and Regence Blue Shield Reach Agreement

POCATELLO — Portneuf Health and Regence Blue Shield of Idaho have finalized a long-term agreement that reinstates in-network access for Regence members at the Portneuf facility. This marks the end of a month-long dispute that had left many patients in southeastern Idaho facing higher out-of-pocket costs.

The agreement was announced on Saturday and will be retroactive to June 15, 2026. This date corresponds with when Portneuf was removed from Regence’s network after the expiration of their previous contract, which followed several months of negotiations centered on reimbursement rates, unpaid claims, and a trend of claim denials from insurers.

With the new deal, Regence members can once again receive care at in-network rates within the Portneuf Health System, including the Portneuf Medical Center. Since the agreement is retroactive, patients who received treatment at Portneuf while it was out of network can expect their claims to be adjusted to in-network rates, according to Regence.

Portneuf indicated that patients will need to take no action to benefit from this agreement, allowing them to continue seeing their current providers without disruptions.

“This agreement is an essential step forward for patients who count on our team for care,” stated Portneuf Health CEO Nate Carter. “It restores access to in-network services, offers patients and families more certainty, and lays the groundwork for quality care delivery in this area.”

Beyond restoring in-network access, the agreement also includes provisions designed to lessen barriers to care, decrease administrative burdens, and reduce payment denials, which have been focal points in prior disputes.

Mark Ruszczyk, president of Regence Blue Shield of Idaho, thanked Mr. Portneuf for the cooperation in reaching this agreement and acknowledged the Pocatello community for their patience during the negotiations.

“We appreciate Mr. Portneuf’s collaboration on an agreement that ensures our members maintain access to Portneuf Health’s in-network care,” Ruszczyk commented. “Our gratitude also goes to the Pocatello community for their understanding as we worked towards affordability for our members.”

This agreement concludes a dispute that became increasingly public around late April, when both parties began sharing differing views on the rupture. Mr. Portneuf alleged that Regence pays health systems at unreasonably low rates relative to other insurers, and accused Regence’s parent company, Cambia Health Solutions, of more than $30 million in unpaid claims and denying nearly 76 percent of claims that hospitals believed were validly filed.

On the other hand, Regence disputed these figures, suggesting they were misleading and pointing to the significant rate increase proposed by Portneuf’s parent company, Ardent Health. Initially, Ardent sought a 73% increase over seven years, later scaling it back to a 41.6% increase over five years, based on information from the Idaho Office of Group Insurance.

Details regarding specific terms that would ultimately bridge the gap were not made public in the news releases from either side on Saturday.

Patients who have questions regarding their specific insurance plan should directly contact Regence or visit their website. For other inquiries, it is advisable to reach out to your healthcare provider’s office.