Lessons Learned From Nurse Practitioner Independent Practice

A Conversation With a Nurse Practitioner Entrepreneur

Joyce A. Hahn, PhD, RN, NEA-BC, FNAP; Wesley Cook, APRN, FNP-BC, CPSN


Nurs Econ. 2018;36(1):18-22. 

In This Article

Developing a Business Model

JH: Can you speak to your original business model?

WC: I formed DPC as a limited liability company in the summer of 2016 to address what I observed and the literature confirmed is a significant access-to-care problem – the needs of patients bound to their homes and facilities. Because the clinical aesthetics practice offers high-profitability without a huge investment of time per encounter, I focused DPC on the needs of financially disadvantaged seniors, focusing on areas of town that needed help absent an ability to pay. I also added the consulting arm so I could finance the operation from locum tenens work while the patient panels build to a critical mass. The work is challenging and rewarding, if exhausting.

Especially challenging has been empaneling myself with commercial payers. Centers for Medicare & Medicaid Services (CMS) are delighted to have providers. The process is mostly streamlined and regulations concerning NP provider status are clearly established. But, the business model would have been unsuccessful without accepting reimbursement from both public and commercial insurance products. Even CMS contracts with commercial payers to deliver their products now. So, I embarked on a somewhat frustrating but ultimately worthy journey to gain provider status with the major commercial payers in the DC marketplace. While I was ultimately successful in gaining provider status with most commercial payers, I certainly learned many lessons along the way, lessons that would have changed the way I approached the process from the beginning.