The Clock is Ticking: Portneuf Health ‘committed’ to securing Regence deal ahead of June 15 deadline
POCATELLO, Idaho (KIFI) — The clock is ticking for thousands of southeast Idaho residents who could lose in-network access to Portneuf Medical Center and its affiliates by June 15, as contract negotiations between Portneuf Health and Regence BlueShield of Idaho remain at a standstill.
If a new agreement is not reached, patients with Regence insurance will face significantly higher out-of-pocket costs for non-emergency services, forcing many to either pay premium rates to keep their doctors or find other care options.
Portneuf: "Disruptive Practices" Blamed for Delay
Portneuf Health issued a press update on Monday, May 18, stating its commitment to securing a fair agreement that ensures continuous in-network access for Regence members. Portneuf has proposed a modest increase as part of a longer-term agreement, aiming to provide stability for patients and employers.
However, the healthcare provider indicated that key issues remain unresolved, including Regence's "disruptive practices" that lead to delayed and unpaid claims. In addition, the hospital says Regence's parent company — Cambia Health — owes Portneuf more than $30 million in unpaid claims.
Katie Damron Quayle, Director of Marketing for Portneuf Health, detailed the ongoing issues in the press release. "In addition to delayed and unpaid claims, Regence continues disruptive practices including denials, down-coding and repeated claim reprocessing that interfere with timely patient care and create unnecessary administrative burdens that increase costs," Quayle said.
Quayle added that these practices directly threaten Portneuf’s ability to sustain local access to care. The hospital also notes that Regence currently reimburses Portneuf substantially less than other major insurers in the market and less than it pays other Idaho health systems.
Portneuf’s negotiations are being led by its Tennessee-based parent company, Ardent Health.
Regence: Hospital Demanding "Unreasonable" Rate Increases
On the other side of the negotiations, Ryan Pharis, Vice President of Contracting for Regence BlueShield of Idaho, stated that the insurer is actively working towards an agreement.
Ryan Pharis, Vice President of Contracting for Regence, said the insurer is actively working toward a resolution but claims Ardent Health's financial demands are unrealistic.
“We're meeting regularly on a weekly basis with the teams over there to try to get a deal done,” Pharis said in an interview with Local News 8 earlier this month. “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.”
What's Next for Patients?
While Portneuf remains hopeful an agreement can still be reached, the healthcare provider has encouraged Regence members to visit portneuf.org/network-update for information about coverage options, continuity of care resources, and additional updates.
