A Missouri DPC Doctor Went to Washington for Rural Hospitals. Now He's Opening a Second Clinic.

Practice Spotlight by DPC Insider
#DPC practice#rural healthcare#Missouri#rural hospitals#practice expansion
Sources: Healthspan expanding direct primary care to Canton, Missouri · Lewistown, Missouri's Dr. Aaron Neisen travels to Washington, D.C. to champion rural hospitals · Sen. Hawley Introduces Rural Hospital Emergency Room Funding Bill · EXCLUSIVE: Hawley pushes new legislation to save rural emergency rooms from 'breakneck' closures · Lewis County Scoop Business Spotlight - Healthspan DPC

Dr. Aaron Neisen works two jobs that don’t usually overlap. Some days he’s in the emergency department at Scotland County Hospital in Memphis, Missouri, one of just five rural hospitals in the state that still delivers babies. Other days he sees patients at Healthspan DPC, the direct primary care clinic he co-founded in La Belle, a northeast Missouri town of about 600.

Last month, he added a trip to Washington.

From the ER to the Senate

Neisen joined Republican Sen. Josh Hawley at a press conference on June 24 to support the Rural Hospital Emergency Room Guarantee Act, a bipartisan bill co-sponsored by Democratic Sen. Maggie Hassan of New Hampshire. He went at the invitation of Scotland County Hospital and the Missouri Hospital Association to tell lawmakers what it looks like when rural hospitals run out of money.

The data behind his trip is stark. Nearly 200 rural hospitals have closed since 2005. Twelve of those were in Missouri. About half of the state’s remaining rural hospitals operate at a loss, and roughly one in five face immediate risk of shutting down. When a rural ER closes, patients may drive over an hour for emergency care.

The bill would create a 10-year funding stream, providing eligible hospitals at least $1 million per year in baseline support with additional dollars based on geography, patient volume and financial need. Hospitals on the brink could receive one-time emergency payments of up to $250,000.

Neisen told Muddy River News that rural hospitals across the state are making hard calls about which units to cut. Labor and delivery are often first.

Building the Other Half

Two weeks after his D.C. trip, Neisen and co-founder Matt Scoggin, a family nurse practitioner, announced that Healthspan DPC is expanding to Canton, Missouri. The second location is expected to open in early September.

The La Belle clinic opened in September 2024. Memberships run $80 a month for individuals and $150 to $200 for families. That covers unlimited office visits, same-day or next-day scheduling, initial appointments of 60 to 90 minutes, discounted labs and wholesale medications.

“The reason that primary care exists is to keep things from snowballing,” Neisen told the Lewis County Scoop. Scoggin put it more plainly: “It’s easier on patients. Same-day appointments. When you’re sick, you get in.”

Healthspan also works with local and large employers to offer DPC coverage alongside or in place of traditional insurance. That employer angle fits a national pattern: employer-sponsored memberships now make up the majority of DPC enrollment across the country.

Two Problems, One Doctor

Neisen’s split schedule makes the link between DPC and the rural healthcare crisis hard to miss. He sees the emergency cases that show up because someone couldn’t get a primary care appointment. He also sees what happens when primary care works: patients who manage chronic conditions early and stay out of the ER for things that could have been caught months before.

Northeast Missouri puts both problems in the same frame. The region has limited primary care access, long drives to the nearest specialist and hospitals that can’t cover their costs. An $80/month DPC clinic won’t close every gap. But it puts a provider within reach for people who might otherwise skip routine care until something breaks.

What This Means

The rural healthcare crisis usually lands as either a policy story in Washington or a practice story in a small town. Neisen is in both at the same time.

For DPC physicians thinking about rural markets, Healthspan is a useful reference point. La Belle has about 600 residents. Canton is bigger but still rural. The $80/month pricing and employer partnerships suggest the model can work in areas where traditional healthcare has pulled back.

For those watching the Rural Hospital Emergency Room Guarantee Act, the bill has bipartisan support and real numbers behind the problem. Whether it moves through Congress this session is an open question. But the argument Neisen made in Washington, that DPC and rural hospital funding address different parts of the same access problem, is one worth tracking as the bill advances.