August 1, 2025

Peer-Reviewed Study Confirms OB/GYNs Leaving Idaho Obstetrics in Wake of Dobbs

A comprehensive peer-reviewed study examining the evolving state of maternal healthcare in Idaho has been published in the Journal of the American Medical Association (JAMA). The study, entitled "Change in Number of OB/GYN Physicians Practicing Obstetrics After the Dobbs Decision," highlights the sharp decline in the number of OB/GYNs available to provide care to Idahoans, even as the patient population is booming.

The study shows that between August 2022, when Idaho's abortion ban went into effect, and December 2024, Idaho had a net loss of 35% (94 of 268) OB/GYN physicians who stopped practicing obstetrics, left the state, closed their practices within the state, or retired. This net loss takes into account 20 new OB/GYN physicians recruited into Idaho during that timeframe. Had these physicians not been successfully recruited -- an increasingly challenging prospect -- the picture would be even more grim: a total loss of 43% (114 of 268) of OB/GYN physicians no longer providing obstetrical care since the ban.

Decisions regarding practice alterations are multi-factorial, but it is no coincidence that not one of the twenty-two physicians who left Idaho to practice elsewhere moved to a state with similarly restrictive or punitive abortion policies. Five went to Washington; three each to Minnesota, Nevada, Oregon, and Utah; two to Colorado; and one each to Illinois, Maine, Montana, and New York. In a time when the entire country is facing a shortage of maternal care specialists, Idaho significantly lags behind other states in its ability to keep and recruit OB/GYNs.

Idaho can ill afford these departures. Limiting access to maternal healthcare services disproportionately affects a broad swath of outlying Idaho communities, including low-income and rural residents. At the conclusion of the study, 85% of Idaho's OB/GYNs practicing obstetrics were concentrated in Idaho's 7 most populated counties. In the remaining counties, 23 OB/GYNs practicing obstetrics served a population of 569,000 Idahoans.

"We have fantastic doctors and healthcare teams caring for women in Idaho, but we are at the point where strain on the maternal workforce is impacting patients, especially in our rural communities. And that means patients struggle to get the care they need, when they need it, where they need it," said Dr. Megan Kasper, an OB/GYN and President Elect of IMA in response to the study. "We need to make common sense changes to our law to ensure Idahoans have access to maternal health care now and in the future."

The study, conducted by J. Edward McEachern, MD; T. Allen Traylor, MPH, and Deb Roman, DO, is unique in that it does not rely on large data sets and data extrapolation to guide conclusions. Rather, it provides an actual one-to-one accounting of each individual OB/GYN who has entered or left practice in Idaho during the study period. IMA thanks the study authors for their work on this compelling evidence of the impacts of Idaho's criminalization of medicine on access to care statewide. IMA hopes the study will equip policymakers, healthcare providers, and the public with the insights needed to protect and improve care for women and families by offering a clear, evidence-based picture of Idaho's maternal health system.

Proposed 2026 Medicare Physician Payment Rule Would Redistribute Pay Across Specialties and Practice Types

Overall, most physicians would see a conversion factor increase of 3.3% in 2026, while qualifying physicians in advanced alternative payment models (APM) would see an increase of 3.8% in 2026, under the 2026 Medicare Physician Payment Schedule proposed rule released on July 14.

These increases are primarily due to action by Congress to provide a temporary, one-year 2.5% pay boost for physicians. However, these updates would be offset by a proposed negative 2.5% "efficiency adjustment" that would be applied to all non-time-based services, including 8,961 physician services, and cuts to payments for physician services provided in the hospital or ambulatory surgery center (ASC) due to the Centers for Medicare & Medicaid Services' (CMS) belief that those physicians no longer maintain a separate office with separate overhead and non-clinical staff expenses.

As detailed by the AMA in response to a similar discussion by the Medicare Payment Advisory Commission (MedPAC), there are concerns that reducing physician payments for services provided in the facility setting could result in unintended consequences, including further exacerbating consolidation. Furthermore, the "efficiency adjustment" would reduce overall payment by 1% and only specialties that perform a more significant amount of telehealth services, which are excluded from the "efficiency adjustment" would see an increase of at least 1%.

Other notable proposals include:

• CMS proposes to accept nearly 90% of the AMA/Specialty Society RVS Update Committee's (RUC's) relative value recommendations for 2026.
• Following ongoing advocacy by the AMA not to increase the Merit-based Incentive Payment System (MIPS) performance threshold, CMS proposed to maintain the threshold to avoid a MIPS penalty of up to 9% at 75 points for the next three years.
• CMS is proposing to implement a new payment model in 2027 in select geographic areas that would be mandatory for physicians who treat patients with heart failure or low back pain.

The AMA has developed a detailed summary and a brief summary of the proposed rule and will share draft recommendations with the Federation before they are due to CMS on Sept. 12, 2025.

Submit Your Resolution for the IMA House of Delegates

Proposed resolutions for the the 133rd IMA Annual Meeting and House of Delegates (HOD) are now being accepted. The HOD is an annual meeting of physician members from around the state and is the official policymaking body where IMA policy is debated and voted on. These policies go into the IMA Health Policy Manual, and guide the IMA's lobby team in the upcoming legislative session.

This year's Annual Meeting is October 10-12 at the beautiful Sun Valley Resort.

What is a Resolution?

A resolution is the vehicle used to propose an official policy for adoption, directive for action, or both, by the Idaho Medical Association (IMA) House of Delegates (HOD). To learn more about the required elements of a resolution, review our Resolution Fact Sheet.

Who can submit a resolution?

Resolutions may come from an individual IMA member, committee, Board of Trustees, a local or specialty society or an outside physician entity or association.

How do I submit a Resolution?

To better streamline our resolution process, resolutions must be submitted through our online Resolution Submission Form. This tool will walk resolution authors through the steps and required elements needed to create a full and complete resolution.

THE DEADLINE TO SUBMIT RESOLUTIONS IS AUGUST 20!

The IMA Annual Meeting is the perfect time to catch up with medical professionals from across the state and help set the 2026 IMA legislative agenda at the House of Delegates sessions. The Annual Meeting also features CME opportunities, family-friendly activities and a chance to see the latest innovations, products and offerings from regional and national vendors.

For information about the IMA Annual Meeting, click here.

Grant Applications Open: Rural Health Care Access & Rural Physician Incentive Program