Contract issues between Portneuf Medical Center and Regence BlueShield of Idaho could cost 5,700 patients their health care

POCATELLO, Idaho (KIFI)– Several thousand southeast Idaho residents could lose in-network access to Portneuf Medical Center, along with their affiliates —Pocatello Health Services, PHS Ambulatory Services, and Portneuf Ambulatory Surgical Center — this June as contract negotiations with Regence BlueShield of Idaho fail to produce an agreement.

The dispute centers on a disagreement over costs. Portneuf Medical Center is operated by Ardent Health, a Tennessee-based company that is leading negotiations on the hospital’s behalf.

Ryan Pharis, Vice President of Contracting for Regence BlueShield of Idaho, says that the insurer is actively negotiating to reach an agreement by the deadline. However, the insurance provider claims Ardent is seeking unreasonable price hikes.

"We're meeting regularly on a weekly basis with the teams over there to try to get a deal done," Pharis said. "We are really working to provide access to affordable care for the people of Pocatello. (But) when Ardent Health is asking for rate increases twice the cost of inflation, despite its financials showing that they're making double-digit margins, that makes it really tough."

On the other side, the Portneuf Medical Center issued a statement saying that the disagreement extends beyond standard contract negotiations. The hospital stated that Regence "currently reimburses Portneuf substantially less than other major insurers in our market and less than it pays many other Idaho health systems."

What This Means for Patients

If an agreement is not reached, patients with Regence BlueShield insurance could face substantially higher out-of-pocket costs for most non-emergency services. This could lead some patients to either pay more to continue receiving care from their current providers or seek treatment elsewhere within the insurer’s network.

Pharis assured that there are options in place to protect members if Portneuf moves out of network.

"Members will still have access to the facilities and providers at an out-of-network top share," Pharis explained. "Emergent and urgent services will be covered. Members are protected from balanced billing by the federal "No Surprises Act." Continuity of care for members that meet continuity of care criteria will be covered for an additional 90 days, and Regents will work diligently with members to find alternative care options."

Portneuf Medical Center serves as a primary source of care. If the facility moves out of network, patients with Regence BlueShield insurance could face significantly higher out-of-pocket costs for most non-emergency services. That shift could force some patients to either pay more to continue care with their current providers or seek treatment elsewhere within the insurer’s network.

Should Portneuf Medical Center and its affiliates leave the Regence BlueShield of Idaho network, in-network alternatives for most Regence plans include:

• Bingham Memorial Hospital 
• Caribou Medical Center 
• Mountain View Hospital 
• Idaho Falls Community Hospital 
• Grove Creek Medical Center
• Bingham Memorial Clinics 
• MVH PIC (Physicians Immediate Care) 
• Brandon A West Clinic 
• Health West 
• Family Practice Group

Local News 8 reached out to both Portneuf Medical Center and Ardent Health for a statement, but as of publishing, has not received a response.