Nurse Practitioners Are Opening Direct Care Offices, Bypassing Need for Health Insurance
- In states that allow nurse practitioners to practice independently, some NPs are opening direct primary care (DPC) offices.
- DPC offices operate under a membership model, with members paying for access to the office and set, standard prices for services, tests, and imaging.
- Over 2,300 DPC offices are currently in the U.S.
As rising costs of healthcare premiums are leaving many Americans facing tough challenges about how to approach healthcare coverage, some practitioners are turning to a new model: direct primary care practices.
Direct primary care offices allow patients to pay directly for services, bypassing insurance altogether. Most operate with a monthly membership fee for access and set, standardized pricing for all services for members.
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In rural areas, direct primary care models can be especially helpful, and in states that allow independent practice, nurse practitioners are stepping in with solutions. For instance, in the rugged mountains of northwest Colorado, Family Nurse Practitioner (FNP) Alina Love-Moore runs Love Wellness Ltd., a membership-based direct primary care (DPC) practice.
“Direct primary care takes insurance out of the equation for routine care, which means patients get more access, more time, and more transparency,” Love-Moore told a local news outlet, adding that most of her patients have appointments that are 30 minutes or more.
What Is Direct Primary Care?
You might’ve heard of DPC—it’s been picking up steam nationally as both patients and providers look for alternatives to the fast-paced, volume-driven world of traditional healthcare.
According to the Direct Primary Care Coalition, there are now over 2,300 DPC practices across the country, with rural areas seeing a particularly rapid expansion.
Love-Moore’s practice embodies everything DPC proponents tout as benefits of the model: straightforward pricing, better access, and personalized care.
In Love-Moore's office, here’s how it works: patients pay a monthly fee—$95 for adults, $25 for kids, or $225 for an entire household— that covers unlimited visits. No co-pays, no deductibles, no insurance red tape. Her practice also caps enrollment at 400 patients, both because she's the sole provider and to ensure that everyone gets the attention they deserve.
Patients like Hayden resident Brandon Lehman say it’s exactly what they’ve been searching for. “Having her sit down and talk about things and work in a proactive way is nice for what I was looking for,” he shares.
Another patient, Gabriel Elkinton, loves the “whole health approach” that focuses on identifying and addressing root causes. “After our first meet-and-greet, I’ve been really pleased with the care I’ve been given,” he says.
From Business Major to Nurse Practitioner: Love-Moore’s Unique Journey
Nurses come to this profession from every walk of life, and Love-Moore’s story is no exception. She initially earned a bachelor’s degree in international business but felt called to healthcare after her brother’s battle with cancer. That calling led her to pursue multiple nursing degrees, ultimately becoming a family nurse practitioner in 2017.
Over the past 13 years, she’s gained experience in some of the toughest and most rewarding areas of nursing—hospice care, rural health clinics, veterans’ healthcare, senior living, and correctional facilities. All of this experience built the foundation for her holistic, patient-centered approach to care. In 2021, she opened her first DPC practice in Elizabeth, Colorado, before relocating to the Yampa Valley in 2025 to bring her services to another underserved area.
Her practice attracts a diverse patient population, with roughly one-third of patients uninsured, another third carrying high-deductible insurance plans, and the rest using medical-sharing programs. This mix shows how DPC can fill critical gaps for the underinsured while also appealing to those with coverage who want a different approach to care.
A Nursing Model Built for Real-World Needs
For nurses dreaming about starting their own innovative practice, Love-Moore’s approach offers some great takeaways. First, accessibility is key. Her practice emphasizes same-day or next-day appointments and allows patients to connect through HIPAA-compliant telehealth, phone, or even text.
Love-Moore has tailored her services to meet the unique needs of her community. While she doesn’t provide obstetric care, she offers support for new mothers, like answering infant care questions, a huge help in a region with limited pediatric resources.
Continuity of care is another hallmark of her practice. Sandy Gress, a former patient from Love-Moore’s first clinic in Elizabeth, says her entire family benefited from this approach.
“We feel very fortunate, very blessed to have found her,” Gress shares. “She works hard to not just fix the symptoms but to look for causes.”
What Can Nurses Learn From Love-Moore’s Model?
Here’s the big takeaway: nurse-led practices like this are reshaping what healthcare can look like, especially in areas hit hardest by provider shortages. Not all states allow NPs to practice independently, but in states that do, NPs like Love-Moore could look into starting their own direct care models. (Another unstated benefit is that not dealing with insurance allows practitioners to bypass medical coders and billers too.)
Love-Moore’s DPC model prioritizes the nurse-patient relationship, focusing on preventive care and holistic health, which aligns perfectly with nursing’s core values. While there is some controversy over DCP models, proponents say it can be a win-win for patients and providers alike, especially in today's shifting landscape of high health insurance costs.
The DPCC states that direct care models provide a pathway to the "future" of healthcare:
"The DPCC believes Americans of all ages and incomes should have access to high-functioning, affordable, comprehensive, accessible, personal primary care. We think a pivotal part of the effort to promote choice and competition is to place a greater emphasis on primary care and preventative services by putting patients back in control of their care with the assistance of a trusted personal primary care physician who knows the patient, and therefore can be that patient's guide through the often complicated and expensive healthcare system."
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