Capitol Letters: Iowa ranks first in physician salaries

State Rep. Megan Jones

Recently, Physician Side Gigs released its average physician salaries by state, with comparisons to cost of living. In this report, Iowa ranks first in the nation with an average salary of $464,000 a year. Additionally, in comparing cost of living between states and salaries, Iowa ranks seventh.

This information builds on the work the legislature did this session to continuously improve Iowa’s health care workforce. Even with high national rankings in health care affordability, access and quality, Iowa still ranks 44th per capita for physicians. The legislature focused on growing and training our own that want to practice in rural areas, creating more training opportunities, and decreasing administrative burden on health care providers. All the bills below passed both chambers and were signed by the Governor in 2025.

Governor Health Care Bill — HF 972 does the following:

• Require DHHS to request federal approval for a health care hub-and-spoke partnership funding model to establish regional collaboration between health care providers in rural areas
• Consolidated five health care loan repayment programs into one called the Health Care Professional Incentive Program within DHHS that will award loan forgiveness or bonuses based on high-need health care professions in shortage areas. Provides for transition of funds to continue to support those with existing awards.
• Repeal existing residency and fellowship programs, with transition provisions, and converts those programs to the Medicaid graduate medical education efforts. The Governor has said that this will create a projected 115 new residency slots at our 14 training hospitals and will bring 460 new physicians to Iowa in four years.
• Eliminates the Health Facilities Council and replaces it with DHHS as the decision maker regarding certificate of need
• Requires DHHS to bid out the Iowa Health Information Network

University of Iowa Health Care — HF516 focuses our state institution and medical school on growing the physician workforce for the entire state. This bill requires the University of Iowa medical school and dental school to have at least 80% of their students be residents of Iowa, as well as priority admission to residents of Iowa who apply to these programs. This bill also requires specific questions regarding upbringing and intent to practice in Iowa by applicants for these programs as well as residency programs at UIHC. This bill requires an annual report by UI regarding the same schools and UIHC medical residencies demographic information.

• This bill requires the University of Iowa Hospital and Clinics to offer an interview for the medical residencies of some of the most-needed specialties in Iowa to those with an Iowa connection.
• This bill codifies requirements that were placed into session law in 2019 in House File 532. Additionally, it adds fellowships to the requirement that UIHC prioritize Iowans.

- Requires medical residencies at the University of Iowa Hospitals and Clinic to give priority to applicants that have an Iowa connection (resident of Iowa, went to undergrad in Iowa, or medical school in Iowa).

- Requires primary care residencies (family medicine, OB, psych, and internal medicine) at UIHC to provide the opportunity to participate in a rural rotation to expose those medical residents to rural areas of Iowa.

Assaults on Health Care Providers — HF310 expands the health care provider definition under the code chapter that provides enhanced penalties for assaulting a person engaged in certain occupations.

Prior Authorization — HF303 came from the Iowa Medical Society to set up timelines for determination from health insurers on prior authorizations, requires insurers to review health care services that require prior auth, requires reporting to IID regarding PAs and allows IID to investigate complaints.

Credentialing Timeline — HF875 provides a timeline for an insurer to respond to a provider seeking to be credentialed in-network and to provide a reason for denial.

Residency Start-Up Funds — HF1049 provides $2.3 million additional funds to start-up graduate medical education efforts in the Medicaid GME program. These funds will bring 20 new residency programs online in Iowa to train Iowa’s doctors.

Physician Assistant Compact — HF300 adds Iowa to the interstate license for Physician Assistants Compact. 16 states currently have enacted this compact (Including Nebraska, Minnesota and Wisconsin). The compact is effective and is now in the implementation process which will take 18 to 24 months.

Loan Forgiveness — SF647 consolidated health care loan forgiveness programs into one program and increased funding from $4.2 million to almost $8 million.

Contact Rep. Megan Jones by email: megan.jones@legis.iowa.gov.