In the changing U.S. healthcare scene, the role of Nurse Practitioners (NPs) is expanding. By 2024, their ranks have grown to more than 385,000, with a notable growth in NP entrepreneurship —a development supported by regulatory changes that offer more practice independence. Our report examines this trend, focusing on the types of businesses NPs establish and where they're most prevalent.
To provide a comprehensive analysis, we analyzed the LinkedIn profiles of 46,036 Nurse Practitioners, with a focus on those who self-reported as founders or owners of businesses. This analysis reveals trends in NP entrepreneurship, including preferred states and cities and the types of businesses that are most common among NPs.
Our analysis reveals a clear pattern in the landscape of Nurse Practitioner (NP) entrepreneurship across the United States: states characterized by lower population densities, along with the legal autonomy for NPs to practice independently and a lower ratio of physicians per capita, encourage NP entrepreneurship.
As an example, Pennsylvania with required NP physician collaboration and high amount of physicians per capita shows 0.8% of NPs founding businesses whereas North Dakota with NP autonomy and much fewer physicians per capita shows 5% of NPs founding businesses.
In terms of absolute numbers, Florida leads with 60 NP founders, whereas Oklahoma did not report any NP founders within our dataset. Notably, Montana stands out as the sole state where over 5% of NPs identify as founders, indicating a distinct trend where the majority of states report less than 2% of their NPs as business owners.
The leading states for Nurse Practitioner (NP) entrepreneurship are predominantly found in the West—Montana, North Dakota, Idaho, Oregon, and Wyoming. These states share common traits that foster a conducive environment for NP-led businesses: they offer full practice autonomy to NPs and have a lower density of physicians per capita, indicating unmet medical needs. In these states, a significant proportion of NP practices, 26%, focus on primary care. This trend likely reflects the NPs' role in addressing the healthcare gap in regions with limited access to medical doctors.
The states presenting the greatest challenges for Nurse Practitioner (NP) entrepreneurship include New York, California, Illinois, Pennsylvania, and Alabama. These regions are characterized by a higher number of physicians, and all these states restrict NPs' ability to practice independently to some degree. This regulatory landscape appears to influence the type of businesses NPs establish, with the majority (54%) of NP-owned practices focusing on Aesthetics, Wellness, or IV Hydration services—areas likely chosen for their higher income potential. Conversely, only 16% of NP practices in these states are in primary care, suggesting that regulatory and competitive barriers might steer NPs towards niche markets.
States allowing independent practice see double the rate of NP entrepreneurs compared to those requiring supervision. In independent practice states, 2.79% of NPs are founders or owners, whereas in non-independent practice states, the rate is 1.45%.
Vast differences exist in NP entrepreneurship rates across cities. Predominantly, cities in states supporting independent practice top the list, with notable exceptions such as Charlotte and Charleston. There are some stark contrasts comparing cities on the top and the bottom of the list. There are an equal number of NP founders in Bismarck, ND as in Chicago, IL, while Chicago has 30x more NPs. Additionally, Colorado Springs, CO has more NP founders than Los Angeles, CA.
In 2024, the most common businesses owned by Nurse Practitioners were in psychiatry, aesthetics, and primary care, accounting for 50-60% of all NP-owned practices. This trend is likely influenced by the high earning potential in these specialties. Online forums and influencers often cite incomes of approximately $250k annually for psychiatry NPs and $200-250k for those in aesthetics. Additionally, many Nurse Practitioners in primary care are adopting the Direct Primary Care model. This cash-based approach sidesteps insurance complexities and can lead to more predictable, and possibly higher, compensation. Companies of these specialities have developed "business in a box" platforms to help NPs start their own practices. For more info, read our healthcare "business in a box" platform analysis.
Recent data indicates a possible surge in Nurse Practitioners starting primary care practices, with 31% of businesses founded in the past year being in primary care, compared to 16% historically. While the data is limited, it suggests a noteworthy trend towards an increased focus on primary care among NP entrepreneurs.
To investigate Nurse Practitioners' entrepreneurial trends, we gathered data from LinkedIn, targeting profiles that listed educational backgrounds relevant to the NP field. We searched for a range of titles, from 'Family Nurse Practitioner' to 'Doctor of Nursing Practice' and their common abbreviations like FNP, PMHNP, and DNP. This approach resulted in a pool of 46,036 NP profiles. From there, we honed in on profiles where 'founder' or 'owner' was specified in the job title, identifying a group of NPs who had ventured into business ownership. This selection formed the basis for the trend analysis presented in our report.
Sources: LinkedIn, AAMC State Physician Workforce Data Report, 2010 United States Census
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