These included a limit on excess revenues ("profits"), that $86 million in cost savings be passed on to consumers, and a prohibition on certain anti-competitive behaviors.

Both the Central Montana Surgery Center (an ambulatory care facility founded in 1996 by local Great Falls businessman Harold Poulsen) and the Great Falls Clinic (a physician-owned group practice founded in 1917) announced they intended to build outpatient surgery centers in the city.

[7] Both companies then altered their plans, saying they would build specialty surgical centers instead (as permission was not needed under the state's CON law).

[6] In early 1999, Benefis announced it was suffering serious financial losses that were imperiling its ability to provide health care.

[15] The agreement created a 50-50 for-profit partnership which marketed Benefis and the IPA to large employers and health care trusts.

[19][20] Benefis refused, and in 2004 Providence Services declined to issue a corporate bond that would have financed construction of a new cancer center in Great Falls.

[18] In early 2006, Benefis sought to stop the Great Falls Clinic from purchasing 20-bed Central Montana Surgical Hospital.

[22] The company said it would likely close its renal dialysis unit, suspend Mercy Flights, shutter its nursing home, and end outpatient psychiatric and chemical dependency services.

[20] Benefis was forced to make a donation of $10 million to cover goodwill, and repay loans made to the company by Providence Services.

[20] The same year, Benefis founded the Northcentral Montana Healthcare Alliance, a consortium of 14 hospitals and long-term care facilities whose goal was to promote the general economic well-being of its member institutions.

[34] On February 7, 2007, a Benefis Mercy Flight Beechcraft Super King Air 200 twin-engine fixed-wing aircraft crashed a short distance from Gallatin Field Airport (near Bozeman, Montana) around 9 p.m., killing the pilot, a registered nurse, and a paramedic.

[35] Members of the victims' families contended the contractor which operated the flight, Metro Aviation, failed to adhere to safety and training procedures.

In June 2007, Metro Aviation reached a confidential, out-of-court settlement with the family of paramedic Paul Erickson.

[36] In March 2007, Benefis and the Great Falls Clinic began exploring ways to collaborate in cardiac care.

[38] But although the talks continued into February 2010, the Clinic eventually rejected the confidential purchase price and terms offered by Benefis.

[42] In December, Benefis began construction, cost, and marketing studies aimed at building a continuous-case retirement community on 60 acres (24 ha) south of its east campus.

[45] Benefis began construction of a $17 million, four-story, 79,000 square feet (7,300 m2) medical office building next to the Orthopedic Center of Montana on its east campus in August 2010.

[51] Benefis also said that the cost of its long-term care cottages and assisted living housing, which began construction in November 2010, would be about $21.5 million.

[52] Benefis also said in April 2011 that it would spend $3.5 million to expand and renovate its Peak Health & Wellness facility, a for-profit joint venture with private investors.

[59] On April 2, 2007, Montana Governor Brian Schweitzer signed the legislation ending state oversight of Benefis through the COPA process.

[64] As of 2008, Benefis was considered the "sole community provider" by the Centers for Medicare and Medicaid Services, which resulted in a $1.5 million annual federal payment to the health system.

[57] If total hospital admissions at any other healthcare facility in the community rises above 8 percent, Benefis would be required to share that payment equally with the other provider(s).

[4] In July 2005, Benefis announced it was partnering with MedCath Corp. to construct an $11 million cardiac hospital on its east campus.

[70] Benefis disagreed with the report, noting that the document says the company broke even on Medicaid but that the hospital actually lost $3.2 million on providing the service.

[72] Based on the ratio of charity care to operating budget, Benefis ranked fourth-highest among nonprofit hospitals in the state.

However, Section 125 of the Medicare Improvement for Patients and Providers Act of 2008 (MIPPA) changed JCAHO's accreditation authority.

As of July 15, 2010, JCAHO had to seek approval from a federal agency, the Centers for Medicare & Medicaid (CMS), for it to retain its accrediting power.

[74] In January 2012, Benefis announced it would no longer seek accreditation by JCAHO, saving the hospital roughly $80,000 every three years.

[76] Benefis also won a Specialty Excellence Award recipient for its orthopedic, joint replacement, and stroke care.

[76] It also gave the hospital five-star ratings (for above-average patient outcomes) in the areas of bowel obstruction, pneumonia, respiratory failure, sepsis, and stroke.