Yes it matters -- the extent varies by several factors.
Applications & Impact
In many contexts using stochastic process-based models, one is well-served to use time-varying models to capture the time-dependent behavior of the system. And sometimes close enough, $I(t)\approx 1$ is good enough.
In healthcare, appointment-based systems often see underdispersion, $I(t) < 1$, which implies staffing models would over staff if an NHPP arrival process was used, even if it captured the deterministic time-dependent behavior. This happens because the model would overestimate the stochastic variability properly about that time-dependent fluctuation. The literature reports appointment-based dispersion levels of $(0.4-0.6)$.
Also in healthcare, emergency rooms often see overdispersion, $I(t) > 1$, as well as some call centers. In this setting, a staffing model would underestimate the requirements to meet a desired performance, or Quality of Service (QoS), target. The literature reports levels $(1.5-2.5)$ as being significant.
Quality of Service (QoS)
How much one should concern oneself with this also depends on the QoS target. If the QoS target is very high, then the level of control required to meet that may require accounting for the dispersion. In low QoS systems, this is less likely to cause problems.
Summary
1. Focus on the time-dependent nature of your arrival process. This is more important to get right than the dispersion.
2. Estimate your dispersion to understand the potential bias of your model. More complexity may not be required, even if the model isn't spot on.
3. If you're quality of service target is high (high performance), then you may want to consider dispersion in the arrival process.
4. Add in dispersion if necessary.