Yes, but with tele health you don't necessarily have to live where you work. Thus, my clients are in Washington state and my house in Florida. Thus, I have the advantage of my 28K per month in earnings integrated with the cost of living of Florida. There is no reason that "NP" owned businesses could not propagate this dynamic and offer partners the option of 1099, PLLC, or W-2 (obviously at different percentage levels to reflect the differences in cost/benefits, and taxes paid by the company). However, with such a company the emphasis would be on maximizing the pay/benefits of the workers rather than enriching the owner. Thus, at "Dr. C's" in Florida (the place that offered me 100K with benefits) she lives in a 10 Million dollar home in Florida and has other homes in Puerto Rico and elsewhere. Indeed, at her practice even the MD psychiatrists still only earned about 160-180K (still alot more than the NP's) and were expected to see about 25-30 patients per day. My approach would even pay many MD's more than they earn in typical Florida (and other states in the South) MD owned practices.