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Physicians, health care services contribute billions to Idaho's economy, new report shows

Economic analysis comes weeks before state Legislature convenes, when medical education debate is likely to resume

December 15, 2025

By: Kyle Pfannenstiel, Idaho Capital Sun

In Idaho, doctors and a flurry of health care services contribute billions to the state's economy, a new economic report found.

Commissioned by the Idaho Medical Association and the Idaho Coalition for Safe Healthcare Foundation, the report comes weeks before the Idaho Legislature will convene for the 2026 session. And the report's findings could come in handy for some policy debates in the Statehouse, as state lawmakers will likely resume heated talks about how medical education can help alleviate the state's severe doctor shortage.

"We just thought this was a great opportunity at this moment, especially as our state Legislature has been talking about the physician workforce and what does it take to maintain and grow what we have," Idaho Medical Association CEO Susie Keller told the Idaho Capital Sun in an interview. "And so having this kind of information, I think, really shows what a worthwhile investment it is for the state of Idaho to put state dollars into funding residency training, for instance."

This spring, after blowback over a bill that could have ended Idaho's partnership with the University of Washington Medical school through WWAMI, the Legislature passed a bill to direct the state to explore adding more state-funded seats for Idaho students in other programs.

Key takeaway is "physicians matter," economist says

Services by doctors alone contributed $2.3 billion in output or sales, out of the health care sector's $10.4 billion overall economic activity in the state, according to the report by University of Idaho economist Steven Peterson.

The key takeaway from the study is that "physicians matter," Peterson told the Sun in an interview.

"They matter in two ways. One is they make us healthier, or help heal us from our ailments," he said. "But the other part of this -- and I don't know that people fully realize this -- is how important the offices and the services they offer are a part of the regional economy."

Each year, a doctor in Idaho generates $1.34 million in economic activity, and generates more than $46,000 in state and local taxes, the report found. READ MORE

Congress races against the clock to avert skyrocketing health care costs for millions

December 14, 2025

By: Alison Main, CNN

Lawmakers are scrambling to address skyrocketing health care costs in the final days before Congress leaves Washington for the holidays, with enhanced tax credits that make insurance premiums more affordable for millions of Americans set to expire at the end of the month.

After the Senate failed to advance health care plans spearheaded by each party last week, it's the House's turn to take up proposals with similarly uncertain outcomes.

Speaker Mike Johnson has vowed to hold a vote on a Republican-led bill released last week, which includes provisions to lower premiums for certain Affordable Care Act enrollees through a cost-sharing reduction program. The plan would not extend the Covid-era subsidies due to lapse at the end of this month.

GOP leaders are also expected to allow an amendment to extend the ACA credits to come to the floor, as swing-state Republicans like Rep. Brian Fitzpatrick of Pennsylvania seek to force a vote on the issue. The legislative path to passing a short-term extension of the expiring subsidies before both chambers depart on Friday until early January seems all but impossible.

Even if health care legislation were to pass the House, it would face a Senate that failed to garner 60 votes to advance bills, including a three-year ACA subsidy extension last week, and a president who has made clear he favors funneling federal aid directly to patients through health savings accounts, also known as HSAs. READ MORE

What Idaho Practices Need to Know: 2026 New Medicare Advantage Referral Rules

Significant changes to Medicare Advantage (MA) referral requirements are underway, and expectations are not consistent particularly when comparing two major Idaho payors - Blue Cross of Idaho (BCI) and UnitedHealthcare (UHC). Practices can no longer rely on assumptions and must verify the specific insurance product policy before determining whether a referral is required.

Blue Cross of Idaho just published an updated policy MAPAP310 – Medicare Advantage Referral Requirements that applies to all of its Medicare Advantage plans. In short:

• Referrals are required for any specialty or ancillary care outside of routine primary care. This applies to all BCI MA plans.
• Members must have an in-network PCP (family practice, general practice, internal medicine, OBGYN, or pediatrics), and the PCP must submit referrals before the member sees a specialist. Retroactive referrals are not allowed.
• Referrals must be submitted electronically via the BCI provider portal.
• Referrals issued are valid for 12 months, reducing administrative burden over time when appropriate.
• Specialists and ancillary providers must confirm a referral is on file before seeing the patient.
• There are exceptions (emergent/urgent care, behavioral health, preventive services, routine wellness services, certain equipment/services), but the key rule is that most specialty referrals now require documented PCP authorization. See all the exceptions HERE.
• If the patient has been established with a specialist, BCI will still require a new referral authorization for 2026. Note, a 90 day grace period will apply starting January 1, 2026 in order to get referrals in place. Visit HERE to submit a new referral.

UnitedHealthcare national policy around MA plan referrals is a big shift for how specialists and PCPs interact.

• Effective Jan. 1, 2026, most UnitedHealthcare Medicare Advantage HMO and HMO-POS plans will require a referral from the PCP before accessing certain specialist services in outpatient, office, or home settings. See policy HERE.
• This is not a broad referral requirement for all services, but rather for specific specialty care areas and again varies by product (HMO/HMO-POS vs PPO/SNPs).
• UHC's official guidance also includes a grace period through April 30, 2026. Providers are encouraged to begin submitting referrals for services on/after Jan. 1, 2026, and UHC will not deny claims through April 30, 2026 for lack of referrals.

We recommend practices visit payor sites for which they are participating with MA plans to organize referral processes and be attentive to grace periods for established patients.

Idaho Rural Workforce Support Forum

Save the Date!

The Idaho Academy of Family Physicians is offering the first of four planned virtual forums for rural healthcare providers and health systems. In the IAFP's recent survey, with results from 21 of Idaho's Critical Access Hospitals, 90% of respondents indicated interest in these forums. Both administrators and all types of medical providers are encouraged to attend.

January 8, 2026

5:00 PM Pt / 6:00 PM MT

Topic: Obstacles and Solutions for Nursing Staffing

Dr. Peter Crane, a family physician in Montpelier, ID will facilitate a conversation about how nurse staffing issues impact workforce and care delivery in Idaho and support sharing solutions to this issue.

CLICK HERE to pre-register for this virtual forum

Questions? Contact liz@idahoafp.org