Nurse Practitioner-Owned Clinic Struggles With Lowest Rates In US

WESLEY CHAPEL, FL — Wiregrass Direct Primary Care, one of the largest independent nurse practitioner-owned and operated clinics in Florida, is facing a critical financial challenge due to the lowest reimbursement rates in the United States.

Despite providing essential healthcare services to the community, the clinic is grappling with reimbursement rates that fall far below the cost of providing care, placing a significant strain on its ability to maintain operations.

The clinic, led by dedicated nurse practitioners committed to delivering high-quality, patient-centered care, is facing a pervasive issue in the healthcare industry: insurance companies' failure to recognize nurse practitioners as primary caregivers and billers. This oversight results in reimbursement rates that are significantly lower than those received by physician-led practices, creating an unsustainable financial burden for nurse practitioner-owned clinics like Wiregrass Direct Primary Care.

"Most items used in our office, including durable medical equipment, medications administered in-office, IUDs, Nexplanon devices, and more, are reimbursed at rates below our actual costs," explains Michael Ipock, CEO at Wiregrass Direct Primary Care. "This disparity in reimbursement stems from the practice of billing incident-to services using the physician's National Provider Identifier (NPI), despite regulations prohibiting this practice unless the physician is physically present."

While Wiregrass Direct Primary Care employs one physician, the physician is not always on-site, requiring nurse practitioners to handle billing responsibilities while providing care to patients. This practice necessitates additional training and expertise among nurse practitioners, who must operate at the physician level rather than as "mid-level" providers. However, despite their expanded roles and responsibilities, nurse practitioners continue to face reimbursement rates that are approximately 40% lower than the average provider in the Tampa Bay Region.

"This discrepancy in reimbursement not only poses financial challenges for nurse practitioner-owned clinics but also exacerbates the shortage of primary care providers in communities," Michael Ipock continues. "Many healthcare professionals are opting for specialties over primary care due to higher reimbursements and increased liabilities associated with insurance companies."

Wiregrass Direct Primary Care is calling for greater awareness and recognition of the vital role nurse practitioners play in healthcare delivery. Despite recent legislative efforts, such as the signing of bill SB 7016 by Governor Ron DeSantis, which allocated $717 million in spending to address healthcare shortages in Florida by simply attracting physician residents to move to Florida, nurse practitioners remain unrecognized as primary care providers by insurance companies.

"We urge policymakers and insurance carriers to recognize nurse practitioners as primary care providers and to equitably reimburse them for the essential services they provide," Michael Ipock emphasizes. "Addressing this disparity in reimbursement is critical to ensuring access to quality healthcare for all individuals."

Wiregrass Direct Primary Care is committed to raising awareness within the community and the medical community at large about the challenges faced by nurse practitioner-owned clinics and advocating for policy changes that promote equitable reimbursement and access to care.
For more information or media inquiries, please contact:

Michael Ipock
CEO
Wiregrass Direct Primary Care
813-999-0505
wiregrassdpc@gmail.com