Week 2: Lessons from Dr. Levi

This week I continued working at the practice, did more research, and conducted my first formal interview with Dr. Levi, who owns and operates three pediatric clinics in NYC.

Dr. Levi has been running her practice for 15 years across three locations with four doctors on staff. Here are the three biggest takeaways:

1. Medicaid dominance creates real financial pressure. Medicaid is a government insurance program that covers low-income patients, and it typically reimburses doctors at much lower rates than private insurance. About 80% of Dr. Levi’s patients are on Medicaid, and she confirmed that these reimbursement rates heavily affect her bottom line. Since Medicaid pays significantly less than private insurance for the same services, practices like hers are doing the same work but bringing in way less money for it. With profit margins at around 15% on roughly $400,000 in annual revenue, there is not much room for error. Despite this, Dr. Levi has never once turned away a patient based on their insurance type.
2. NYC rent is a serious threat to independent practices. At $8,000 per location per month, rent is one of her biggest expenses, and Dr. Levi said that rising costs make it very hard to keep profit margins from shrinking. She ruled out Manhattan entirely, as it is financially unsustainable. This connects to a broader pattern City Limits recently reported -as commercial rents in Brooklyn have risen as much as 40% in a single year in some neighborhoods, small businesses across the city are being squeezed out (citylimits). Independent medical practices face the exact same pressure.
3. Serving the underserved is a deliberate choice. Dr. Levi speaks Russian, Georgian, English, and Spanish, and she intentionally opens her practices in neighborhoods where language barriers make quality care hard to access. Even though out-of-pocket patients would be more profitable for the practice, she has no interest in shifting away from Medicaid because she believes it is her responsibility to serve the people who need it most. Even knowing that hospital systems get reimbursed at rates five times higher than independent practices for the same services, she has no plans to abandon the communities she has spent 15 years building relationships with.

Next week I plan to continue analyzing sources and reaching out to  billing companies for their perspectives.

Thanks for reading, see you in the next one!

Works cited 

Roberts, B. (2026, March 11). How NYC’s Housing Crisis is Squeezing its Small Businesses – City Limits. City Limits. https://citylimits.org/how-nycs-housing-crisis-is-squeezing-its-small-businesses/