After falling out, East Idaho hospital reaches deal to re-join network for health insurer

The fallout also spurred the attention of state lawmakers, who assembled a new working group to study the practices of health insurance companies that spent much of its first meeting last week focused on the insurer. 

The in-network agreement is retroactive until June 15, when the two split, the hospital and insurer say. 

The deal “includes reimbursement updates that support the long-term sustainability of care delivery,” the two businesses said in a news release. The contract also lasts until 2029, Regence spokesperson Lou Riepl said in an emailed statement. 

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Regence BlueShield of Idaho President Mark Ruszczyk thanked the hospital for its “willingness to work with us on” the agreement.

“We are also grateful to the Pocatello community for its patience as we advocated for affordability on behalf of our members and customers,” he said. “Members who received care while Portneuf Health was out of network can be assured those claims will be covered at in-network rates.”

Portneuf Health CEO Nate Carter said hospital officials believe terms in the deal that improve operations “will help create a better experience for patients and caregivers moving forward.”

“This agreement is an important step forward for patients who rely on our teams for care,” he said in a written statement. “It restores in-network access, provides greater certainty for patients and families, and establishes a foundation that supports the long-term delivery of high-quality care in our region.”

But the insurer and the hospital didn’t release much more specific information about the new deal — including whether it could affect premiums for state employees. 

“While we don’t disclose the specific financial terms of our provider contracts, what we can say is that both sides were able to reach compromises in key areas that were important to each, such as access to affordable health care for Regence members and reduction in administrative burden for Portneuf Medical Center,” said Riepl, who is with Regence.

But Portneuf Health spokesperson Katie Damron said the agreement “addresses our concerns of high denial rates and outstanding unpaid claims, as well as provides reimbursements on par with the market.”

When news about their contract dispute became public in May, Regence argued the for-profit owner of the hospital was asking for an unreasonable pay increase. But the hospital said Regence denied the vast majority of its claims. 

Last week, Faith Knowlton, who leads the state office that oversees the contract between the health insurer and the state, told state lawmakers serving on the new panel that if Regence had accepted the hospital owners’ terms for a reimbursement rate increase, monthly premiums for all state employees and their family members on the plan would’ve jumped.

The hospital could not be reached for comment on terms of the deal.

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