POCATELLO — Portneuf Medical Center is now out of network with Regence BlueShield of Idaho.

The two sides failed to reach a contract agreement before a June 15 deadline, a breakdown that could mean significantly higher out-of-pocket costs for thousands of Southeast Idaho residents who carry Regence insurance.

The split ends months of increasingly public negotiations over reimbursement rates, unpaid claims and what PMC has described as a pattern of claim denials by the insurer.

“Portneuf Health is now out of network with Regence BlueShield of Idaho following the expiration of our current agreement on June 15, 2026, despite months of good faith negotiations,” PMC said in a statement Monday.

Regence, though, tells a different story about how things fell apart.

In a post to its newsroom blog Monday, the insurer said it made a competitive multi-year offer to Ardent Health — PMC’s Tennessee-based parent company — that would have covered the cost of care for Regence patients. Ardent walked away from it, Regence said.

“This is not the outcome we had worked toward,” Regence wrote. “We are disappointed in Ardent Health’s response; however, we need to stand up for affordability for our employer group customers and members.”

Regence also issued a statement to the Idaho State Journal Monday afternoon saying negotiations are continuing at an accelerated pace.

“Regence customer service is — as always — available to answer questions about coverage for ongoing care, emergency services and alternative provider options,” Regence said in the statement. “As an Idaho not-for-profit insurer, we remain committed to ensuring any new agreement respects the healthcare affordability needs of our members, while fairly compensating the systems and professionals that provide care.”

The dispute has been building publicly since late April, when both sides went public with sharply different accounts of what was driving the breakdown.

PMC contends Regence reimburses the health system at unfairly low rates compared to other insurers and other Idaho health systems.

It has also accused Regence’s Portland, Oregon-based parent company, Cambia Health Solutions, of owing more than $30 million in unpaid claims and denying nearly 76 percent of claims the hospital says it appropriately submits.

Regence has called those figures misleading and out of context. The real issue, the insurer says, is the rate increases Ardent has demanded.

The Idaho Office of Group Insurance last month said that Ardent initially sought a 73 percent increase over seven years. Its most recent proposal was a 41.6 percent increase over five years — more than double the rate of inflation, Regence said.

“Rather than negotiating healthcare prices that truly reflect the cost of care for Regence members, they seem to be negotiating prices to bolster their profit margin,” Regence said last month.

PMC has pushed back hard on that framing, saying it proposed a modest, single-digit rate increase as part of a longer-term deal.

Here’s what Regence members need to know right now.

Despite the contract lapsing, a 30-day continuation of services clause means Regence members can still access Portneuf facilities and providers at in-network rates through July 14 without risk of balance billing. That gives members time to find a new in-network provider if needed.

Emergency care is not affected. Federal law requires emergency services to be covered at in-network rates regardless of contract status. Members who are pregnant or in active treatment for serious conditions may also qualify for continuity of care protections — Regence says those members should call 1-888-675-6570 to confirm eligibility.

For non-emergency care after July 14, Regence has identified in-network alternatives.

Hospital options include Bingham Memorial Hospital in Blackfoot, Caribou Medical Center in Soda Springs, Mountain View Hospital and Idaho Falls Community Hospital in Idaho Falls and Mountain River Birthing Center in Blackfoot.

Pocatello-area clinic options include Bingham Memorial Clinics, MVH Physicians Immediate Care, Brandon A. West Clinic, Primary Care Specialists, Health West in Chubbuck and Intermountain Medical Clinic.

Several virtual care providers are also available in the Regence network, including telehealth options for behavioral health, physical therapy and substance use disorder treatment.

PMC, meanwhile, said it remains at the table. The health system pointed to recent regional investments — a new Chubbuck urgent care clinic, an expanded small baby unit, cardiovascular service growth and multiple national surgical accreditations — as evidence it is committed to keeping advanced care local.

“Portneuf continues to actively work toward a resolution that ensures patients can access high-quality care close to home,” PMC said.

Updates from PMC are available at portneuf.org/network-update. Regence members with questions can call the number on the back of their member ID card or visit regence.com.