Originally posted on IdahoEdNews.org on November 25, 2025

MERIDIAN, ID – The price tag for the Idaho College of Osteopathic Medicine is unknown, but consultants say the state should pursue buying it anyway.

The consultants say it would make more sense for Idaho to purchase ICOM than to build a medical school from scratch.

The Meridian-based ICOM remains a private, for-profit college, for now. But ICOM’s owners are expected to sell at some point, and Idaho State University has made no secret of its interest in buying the school. The consultant’s report — commissioned by Idaho State, at a public cost of $100,000 — lands squarely on the side of an acquisition, calling it a “historic opportunity” for the state.

“By transitioning the Idaho College of Osteopathic Medicine into a publicly owned and governed medical school within Idaho State University, Idaho will gain direct control over its physician pipeline for the first time,” according to the report, which was submitted to Idaho State last week.

Idaho State President Robert Wagner said the report validates the university’s interest in a purchase.

“I think the report definitely shows there is potential,” Wagner told Idaho Education News in an interview Monday. “I believe this report takes us one step along that process.”

‘The benefits … begin immediately’

As state leaders hope to address Idaho’s chronic physician’s shortage, ICOM has become a focal point in the debate.

In the short run, Idaho could subsidize medical school seats at ICOM, cutting into the college’s $67,490-a-year tuition cost. Idaho subsidizes 50 medical school seats per year through the University of Washington and the University of Utah, allowing Idaho students to pay in-state tuition at the two out-of-state schools. Idaho offers no subsidies to ICOM students.

Acquiring ICOM, however, would be a long-term move.

But after a five-year transition period, a newly acquired ICOM would yield dividends quickly, according to the report from Tripp Umbach, the Kansas City, Mo.-based firm working on Idaho State’s behalf.

“Because ICOM is already an accredited, fully operational medical school producing Idaho-trained physicians today, the benefits to the state begin immediately,” according to the report. “In contrast, a newly constructed medical school would not produce graduates — and therefore not contribute new doctors to the Idaho workforce — for roughly a decade.”

Tripp Umbach studied two long-term alternatives — buying ICOM, or starting a state medical school from the ground up. The consultants attached a placeholder price tag to both options: $250 million. They said an ICOM purchase would pay for itself within three years and produce 525 practicing Idaho physicians within 20 years. During that same time, a built-from-scratch medical school would produce 225 practicing doctors.

Costs are unknown — and they might stay that way

In June, Tripp Umbach consultants laid out an outline for their study — and said they would complete a cost assessment by August. But their study contains no hard cost figures, using $250 million as a ballpark estimate. A second firm, Chicago-based Huron Consulting, is working on a fair-market report.

The June outline was preliminary, Wagner said, and cost analysis is not one of Tripp Umbach’s areas of expertise. So Idaho State assigned the fair-market assessment to a second firm.

“We of course know that a valuation is needed,” Wagner said.

But when that study is done, even Wagner might not see the bottom line.

Huron is working under a non-disclosure agreement. Idaho State and State Board of Education officials cannot sign such an agreement, Wagner said, so they might not have access to the fair-market study.

While the potential costs are unknown, and they might stay that way, they would be a major consideration in any debate about acquiring ICOM. Purchasing a medical school, and placing it under state jurisdiction, could well be the largest single transaction in Idaho higher education history. To date, lawmakers have had no substantive discussions about how Idaho would bankroll an ICOM purchase — or where the money would come from.

Pros and cons — and the risks from a purchase

ICOM owners have been closed-lipped about a possible sale, but college President Tracy Farnsworth has said a sale will likely occur at some point. A sale could mean a variety of different purchase options — with pros and cons for the state.

The best option, according to the Tripp Umbach report, is for the state to buy ICOM itself. “All fiscal benefits would remain with the state, and such ‘profit’ could be used to pay down debt service on the purchase, support scholarships, and potentially fund (graduate medical education) expansion.”

Partnering with a private buyer would provide fewer financial benefits to the state, the report said. If another private buyer swoops in, and operates ICOM on its own, this would put Idaho at risk, and could punch a hole in the state’s physician pipeline. “Another private owner could elect to downsize, relocate, or even close the college if profitability declines or market conditions change,” the report said.

A purchase carries risk, the consultants noted.

Some states, like Oklahoma and West Virginia, have successfully acquired private medical schools and assumed operations. Other state acquisitions have fallen through, however.

And there are other potential pitfalls. A rigid, public medical school might outlast Idaho’s current physicians’ shortage, flooding the market in some fields and some regions of the state. Idaho students might prefer an established, “brand-name” medical school or a school in a metropolitan area. In lean years, a medical school would compete with K-12 and other state programs for scarce revenue. “A state-owned medical school can become a recurring budget line, politically vulnerable to cuts.”

‘It can be part of the solution’

Opened in 2018, ICOM is located adjacent to Idaho State’s Meridian campus, and has operated in a partnership with Idaho State since its inception. The schools have multiple operating partnerships, and two university officials, including Wagner, sit on ICOM’s board of trustees.

Idaho State has been looking at an ICOM purchase for at least a year; EdNews reported first on a possible purchase in November 2024. Both publicly and privately, Wagner has spoken of the potential of ownership.

“We’re fully committed to working with you, our legislative partners and others across the state to help solve Idaho’s physician shortage,” Wagner said in an April 21 email to Rep. Dustin Manwaring, R-Pocatello, obtained by EdNews through a public records request. “That includes moving forward with ICOM a way that is open, transparent and responsive to legislative input.”

On Monday, Wagner declined to speculate on what may occur next legislative session. But he said the study should help inform the State Board’s discussions and the Legislature’s discussions of ICOM.

“ICOM is not the solution … (but) it can be part of the solution for the state,” Wagner said.

 Click here for more of Idaho EdNews’ in-depth coverage of the medical education debate.