136: Expanding Access to Primary Care: Nurse Practitioners
51 min
Can Nurse Practitioners Solve the Primary Care Access Crisis Through Practice Ownership?
Primary care is getting harder to access. More than 100 million Americans lack a usual source of primary care because of provider shortages where they live. And the problem isn't confined to rural areas. Massachusetts has more physicians per person than any other state, yet in a 2025 survey of 15 large metro areas, new patients in Boston waited longer for an appointment than in any other city surveyed.
Nurse practitioners are already filling that gap. There are now more than 461,000 licensed NPs in the United States, delivering nearly a billion patient visits a year, and they tend to live and work in the communities that other providers have never ventured into. What many of them lack is the infrastructure to open and sustain a practice of their own: billing, insurance contracts, technology, and data.
In this episode, guest host Dr. Wendy L. Wright, a family nurse practitioner who owns her own clinic in Amherst, New Hampshire, talks with three colleagues from Duet, a company built around NP practice owners that brings nurse practitioners together with entrepreneurs, investors, and business operators. They discuss why this moment matters, what makes ownership possible, what changes when nurse practitioners get credit for the care they already deliver, and where an NP might begin when starting their own clinic.
About See You Now Podcast
SEE YOU NOW is a podcast that shines a light on the real people changing the status quo in health: from nurses working in labor and delivery, with infectious diseases, and in hospice; to nurse allies in politics, business and tech. Created in collaboration with Johnson & Johnson and the American Nurses Association.
For more nursing innovation resources from ANA, visit https://www.nursingworld.org/practice-policy/innovation/resources.
Have questions or feedback for the SEE YOU NOW team? Future episode ideas? Contact us at hello@seeyounowpodcast.com.
Resources
Learn more and get started
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Duet and its NP-ACO program
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Nurse Practitioner Entrepreneur Program, powered by Duke Health and sponsored by Johnson & Johnson. See the program overview and the 2024-2025 cohort.
Primary care access
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Closing the Primary Care Gap, National Association of Community Health Centers and HealthLandscape at the AAFP
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2025 Survey of Physician Appointment Wait Times, AMN Healthcare
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Physicians per capita by state, from AAMC data
The NP workforce and scope of practice
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National Nurse Practitioner Week resource guide, AANP, for current workforce and visit figures
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State Practice Environment map, AANP, for full practice authority by state
NP practice ownership
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Nurse Practitioner Entrepreneurs: An Untapped Primary Care Lifeline, JAMA Health Forum, January 2026
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Reimagining primary care delivery: Evaluation of nurse practitioner-owned primary care practices, Journal of the American Association of Nurse Practitioners, February 2026, co-authored by Alicia Korpi Ortiz and Wendy Wright
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Physician Practice Characteristics in 2024, American Medical Association, on the decline in physician practice ownership
Payment and value-based care
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42 CFR 414.56, the federal rule setting Medicare payment for NP services at 85% of the physician fee schedule
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Post COVID-19 Reimbursement Parity for Nurse Practitioners, Online Journal of Issues in Nursing
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New Hampshire SB 556, prohibiting carriers from setting payment based solely on APRN licensure, effective January 1, 2025
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States leading efforts to increase primary care spending, Milbank Memorial Fund
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Outcomes of primary care delivery by nurse practitioners: utilization, cost, and quality of care, Health Services Research
