A contract dispute between Portneuf Health and Regence BlueShield of Idaho has left roughly 5,700 people without in-network coverage at the Pocatello hospital system, with negotiations still unresolved after the agreement expired earlier this week.
The breakdown affects a broad cross-section of southeastern Idaho workers and families. Approximately 3,600 are enrolled in the state of Idaho employee health plan, and about 1,800 of those are Idaho State University employees based in Pocatello. Workers covered through Pocatello-Chubbuck School District 25 are also among those affected.
Portneuf CEO Details Financial Dispute
Portneuf Health CEO Nate Carter says the core of the dispute is straightforward: Regence is not paying the hospital what it is owed, and is offering rates well below what it pays other Idaho hospital systems.
“When they’re short paying us, that is just the opposite of what I would view competitive to be,” Carter said in a public statement. “They’re not treating us fairly.”
Carter also took direct aim at what he described as an inequitable payment structure, arguing that Regence pays Idaho hospitals differently based on geography or market position rather than a consistent standard. “Regence pays other Idaho-based hospitals and systems significantly more than they’ve offered to pay us, which is the definition of not being competitive,” he said.
According to Portneuf, Regence denies approximately 75 percent of the claims the hospital submits, and on the claims that are approved, Regence pays only around 78 cents on the dollar. The hospital says that pattern has resulted in $25 million in outstanding unpaid claims — a figure hospital leadership says is unsustainable for a regional health system serving eastern Idaho communities.
Regence insures between 12 and 15 percent of Portneuf’s total patient population, making it a significant but not dominant payer in the hospital’s revenue mix. Still, at the volume of patients involved, Portneuf CFO John Abreu has indicated the financial impact of the ongoing dispute is material to the hospital’s operations.
Timeline of Negotiations
Regence, represented by strategic communications manager Lou Riepl, has pushed back on the characterization that negotiations have been slow-walked. The insurer says it initiated contract discussions in December 2025. However, Portneuf’s Tennessee-based parent company, Ardent Health, did not submit its first formal rate proposal until March 2026 — roughly three months after Regence opened the negotiating process.
That timeline has become a point of contention between the two sides, with each characterizing the pace of talks differently. The contract expired this week without a new agreement in place, triggering the loss of in-network status for thousands of policyholders.
What Affected Patients Should Know
Despite the breakdown, Regence policyholders are not entirely without recourse. Emergency care at Portneuf will continue to be billed at in-network rates regardless of the contract status — a federal requirement under existing law. The financial exposure for patients comes primarily in non-emergency settings, where the absence of a contract could mean significantly higher out-of-pocket costs.
Some patients may also qualify for continuity of care protections, which allow those already mid-treatment to continue receiving care at in-network rates for a period after a contract lapses. Eligibility for those protections generally applies to patients dealing with serious or complex medical conditions, those currently receiving inpatient or institutional care, patients scheduled for non-elective surgeries, and those receiving pregnancy-related care.
Patients with Regence coverage who rely on Portneuf for ongoing care are encouraged to contact their insurer directly to determine whether continuity of care protections apply to their specific situation.
What Comes Next
As of this week, negotiations between Portneuf Health and Regence BlueShield of Idaho are ongoing, though no timeline for resolution has been announced by either party. Both sides have indicated a willingness to continue talks, but the $25 million in disputed claims and the disagreement over competitive rate benchmarking represent significant gaps to bridge. The longer the standoff continues, the greater the financial and logistical burden on affected employees across state government, Idaho State University, and the Pocatello-Chubbuck School District. For the latest updates on Idaho health and economy news, visit Idaho News.