10/02/2025
SOUNDING THE ALARM TO NP PRACTICE OWNERS!
As a practice owner, you are providing great care in communities that value access to the care you provide. As the CEO and Co-Founder of the National Nurse Practitioner Entrepreneur Network (NNPEN), we value NP practice owners and are passionate about being a national organization voice for you. We also know all is local when it comes to issues in your day-to-day practice. NNPEN is connecting with business owners to get the word out about the collective power that leveraging NP practice owners affords. Our collective voices need to be heard loud and proud as the gap of providers widens, WE ARE THE SOLUTION!
Call to Action includes:
a.
1. **NP Directory**If you have not done so, please sign up for the NP Directory. This 501(c)(3) arm of NNPEN helps patients find you, allows you to connect with other NP practice owners for referrals and collaboration, and assists students in locating preceptors. As a 501(c)(3), the directory can also serve as a grant administrator, enabling you, as a for-profit entity, to apply for funds that can support your practice. Completing the registration takes only 3 minutes. Www.npdirectory.org
2. **Insurance Issues Survey**We are aware of ongoing issues with insurance companies denying empanelment and terminating contracts without cause. NNPEN is collecting data to capture the extent of these concerns. Please take a moment to complete the attached survey: https://forms.office.com/r/GM6dgEPCnF
3. * Government Shutdown**
Advisory for Nurse Practitioner (NP) Practice Owners
Implications of the Federal Government Shutdown
________________________________________
1. Claims Processing & Cash Flow
CMS claims will continue, but possible delays if staffing is reduced.
Backlogs could affect provider enrollment, appeals, and prior authorization functions.
Action Step: Monitor receivables closely, strengthen cash reserves, and prepare contingency billing workflows.
________________________________________
2. Telehealth Access & Reimbursement
COVID-era telehealth flexibilities expire Sept 30 unless CMS issues non-enforcement guidance.
Risk of losing reimbursement for:
o Home-based visits (patients may need to return to approved facilities)
o Audio-only visits
4. Action Step: Identify patients most affected, shift them to in-person visits where possible, and proactively communicate changes.
________________________________________
3. Medicaid Reimbursement Cuts
North Carolina: 3% cut to all Medicaid providers (effective Oct 1)
Idaho: 4% across-the-board Medicaid provider cut
Other states (WA, PA): considering reductions
Impact: Lower reimbursement directly threatens margins for NP-led practices.
Action Step: Review payer mix, adjust budgets, and explore alternate revenue sources (e.g., CCM, behavioral health codes, direct pay options).
________________________________________
4. Federal Workforce Instability
Shutdowns normally cause temporary furloughs, but leaked guidance suggests possible permanent layoffs (RIFs).
Expect slower CMS/HHS response times for:
o Provider enrollment & credentialing
o Appeals and audits
o Policy guidance and approvals
5. ________________________________________
5. Strategic & Advocacy Considerations
Revenue volatility and policy uncertainty discourage growth investment.
Patient access disruptions (especially telehealth) risk care gaps.
Advocacy opportunity: Position NP practice owners as essential safety-net providers maintaining continuity of care when systems face instability.
________________________________________
✅ Key Takeaways for NP Practice Owners
Monitor cash flow and receivables—prepare for delayed payments.
Transition telehealth patients where possible; update patient communication.
Anticipate Medicaid cuts—adjust budgets and diversify revenue.
Prepare for slower agency processing times.
Use this moment to advocate for the value of NP-owned practices in ensuring access and stability.
________________________________________
Prepared by: National Nurse Practitioner Entrepreneur Network (NNPEN)
Supporting NP entrepreneurs in navigating policy and payment uncertainty
Lastly, save the date for the NNPEN conference on April 9th and 10th, 2026, in Tampa, FL.
Let's move the healthcare needle forward together!
