I just checked the notes from last month's annual wellness visit. I'm healthy, so it was pretty perfunctory and I…
News 5/7/25
Top News
CareCloud reports Q1 results: revenue up 6%, EPS –$0.04 versus – $0.10. Shares rose 26% Tuesday, valuing the company at $93 million.
The company said last week that its newly created, 50-member AI team will have 500 employees by the end of the year.
Reader Comments
From Nasty Parts: “Re: Epic. Are they getting too big, a la UnitedHealth Group? Smaller software vendors are constantly squeezed by Epic invading their solution, or telling prospects that Epic’s basic system is good enough or that they have a solution on the product roadmap. I think UHG will be broken up at some point and Epic will have 75% of the market in 6-7 years. Are we allowing a monopoly to be created?” Epic, unlike UnitedHealth Group, is giving the market what it wants. The alternative to “allowing” a monopoly is “disallowing” it, for which no legal or practical grounds exist. It’s hard to justify interfering with buyer preference in the absence of consumer harm. My take:
- The acute care EHR market is a legal oligopoly, with Epic its dominant player that keeps increasing market share.
- About half of US hospitals use Epic, which is not a monopoly and certainly not one that has provably competed unfairly.
- Epic’s mega-suite strategy echoes Meditech’s early model: tightly integrated systems from a single vendor, which theoretically lowers both cost and risk.
- That approach is now supercharged by Epic’s deep financial and engineering resources, which have allowed it to push into MyChart Bedside, the Cheers CRM, Hello World messaging, Secure Chat for clinicians, and its sprawling analytics suite. Each new product puts Epic head-to-head with a vendor who built it first and maybe better.
- Beyond making its products attractive, Epic also controls the interoperability and app store access of its potential competitors.
- Epic’s dominance, combined with the massive time, expertise, and capital that would be needed to build a competing system, makes new entrants unlikely.
- There’s no sign that the federal government has an interest in challenging Epic’s position. Dominant players in other industries (Adobe, Intuit, Salesforce, Bloomberg, Shopify) have faced little pushback for similar market control.
- I agree with your major point. Epic is not a monopoly and has done nothing illegal, but its dominance in a critical industry sector creates system risk in providing a single point of failure and a potential bottleneck to innovation if the company gets lazy or does something as a money grab, like going public.
- Until regulators or customers decide to penalize popularity, Epic’s dominance is a feature of the landscape, not a bug.
Sponsored Events and Resources
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Acquisitions, Funding, Business, and Stock
HealthStream reports Q1 results: revenue up 1%, EPS $0.14 versus $0.17, falling slightly short of expectations for both and sending shares down nearly 20% Tuesday.
LifeMD reports Q1 results: revenue up 49%, EPS $0.01 versus –$0.19, valuing the virtual primary care company at $342 million.
Sales
- MetroHealth (OH) will implement AI-enhanced inpatient and ambulatory clinical workflow solutions from Pieces Technologies.
People
Revenue cycle solutions vendor Millennia hires Scott Pattillo, MS (Homecare Homebase) as CEO.
Announcements and Implementations
Wilson Health (OH) implements Epic.
OhioHealth Southeastern Medical Center goes live on Epic.
A small Canadian study finds that the medical records ecosystem is a web of commercial data brokers, for-profit providers, and pharmaceutical companies, each of which helps turn patient records into profitable commercial assets. Notably missing from that loop are patients and their best interests. The authors warn that unsupervised distribution of data to drug companies could give them even more leverage to push high-margin, patent-protected drugs.
Government and Politics
Rep. Nikki Budzinski (D-IL), the ranking member of the House Veterans’ Affairs Technology Modernization Subcommittee, warns that federal cutbacks could impact the project’s timeline and success. She notes that some of the VA’s recently cancelled projects are related to the EHR project and some EHR modernization staffers have been laid off or accepted a deferred resignation offer.
A poll finds that fewer than half of Americans have any confidence that federal agencies ensure that safety and efficacy of drugs and vaccines, while even fewer are confident that the federal government could respond well to infection disease outbreaks. The authors found that the level of confidence is shaped by partisan perspectives.
Other
Dr. Jayne’s favorite celebrity-backed subscription lab test company, Function Health, acquires full-body scanning MRI company Ezra. Function will now offer a 22-minute full-body scan for the low, low price of $500 – a third of the cost of Ezra’s lowest-tier offering. A 47-minute scan costs just $2,000. Function co-founder and CMO Mark Hyman, MD says that “[w]hat used to be the domain of the wealthy is now accessible to everybody, including comprehensive imaging.”
Sponsor Updates
- AGS Health will exhibit at CHIACON25 June 1-4 in Long Beach, CA.
- DrFirst wins a Silver Stevie Award in the customer service department of the year category at the annual American Business Awards.
- CereCore releases a new podcast titled “Why IT Governance Leads to Innovation and Growth.”
- Clinical Architecture releases a new episode of “The Informonster Podcast” titled “How Velox Helps Payers Measure Data Usability.”
- Cordea Consulting partners with Amazon Web Services to help healthcare organizations implement Epic’s Isolated Recovery Environment.
- Crossings Healthcare Solutions parent company UHS names former Cerner executive Chris Vernaci associate VP of technology ventures.
- Altera Digital Health announces the activation of Sunrise Surgical Care, its integrated operating theatre system, at Latrobe Regional Health in Australia.
- Redox integrates IntelePeer’s AI-powered automation platform for medical and dental practices with its interoperability network.
- Netsmart adds automated auditing capabilities to its Bells AI platform.
- Capital Rx releases a new episode of “The Astonishing Healthcare Podcast” titled “What’s New with Medicaid PBM? With Jessin Joseph, PharmD, MBA.”
Blog Posts
- Six Key Takeaways from the AGS Health Partner Summit 2025 (AGS Health)
- Easing healthcare challenges with a responsible approach to innovation and AI (Wolters Kluwer Health)
- Strength in Every Story: Celebrating Mental Health Awareness Month (Netsmart)
- Mastering IT Governance: Strategies, Insights and Innovations for Growth (CereCore)
- Top Priorities for Private Practices: Hire More Staff & Spend More Time with Patients (AdvancedMD)
- Get your sea legs: How low risk AI paves the way for further adoption (Altera Digital Health)
- 6 keys that drive success in value-based care (Arcadia)
- The Impact of Product Discovery: Why We Start with Curiosity at Artera (Artera)
- Why this benefit leader switched to a more modern, transparent PBM (Capital Rx)
- The Importance and Opportunity of Veterans as Cybersecurity Professionals (Censinet)
- 5 Takeaways from KLAS Research’s “Data & Analytics Platforms 2025” Report (Dimensional Insight)
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Function’s cheap scan isn’t as cheap when you include the required membership at $499/yr, so it discounted Ezra’s Full Body Flash scan (I think that was it) down from $1500. Ezra increased the pricing by at least $500 per scan earlier this year, though, so the discount is less than it appears.
Also, a monopoly isn’t defined as owning a massive % of the market, you just need to “monopoly power” in the market, although a higher % of control is a good argument to say a company has monopoly power. They then have to find that the company used its monopoly power to exclude other companies that could threaten it (https://www.ftc.gov/advice-guidance/competition-guidance/guide-antitrust-laws/single-firm-conduct/monopolization-defined). One could argue that Epic definitely does that with small companies, refusing to integrate with them meaningfully and then copying their functionality into Epic. I’m sure they would say “market forces drive where our product goes next” but that’s what they all say. That said, the US legal system doesn’t seem to care much about that type of monopoly, although the recent cases against Apple and Meta indicate it hasn’t totally stopped caring.
I think it’s clear Epic has market power and is using that power in ways that primarily serve its interests. The government can take action even if Epic doesn’t meet the definition of monopoly. State governments do so all the time in healthcare. Epic could be just as big and just as competent without stifling innovation. That could look like more direct government involvement in opening up the EHR, lowering complexity so that smaller orgs/technology companies can compete, or blocking healthcare mergers in general.
Epic is on a path to becoming a Utility and regulated like one including price controls. We’ll see their business model can make room for a federal partner.
Lets keep in mind that when it comes to Epic’s “dominance” that it really was a 2 horse race up until 2017 when Neal Patterson died (Co-founder of Cerner). Until then, Cerner was actually leading in terms of #Beds/Installs across the globe, not Epic. Then Cerner became the laughing stock with its piss poor integration of Soarian, never really creating a competent Revenue Cycle platform (ProFit stunk and RevElate is crap as well), over-customization lead to failed upgrades, the list goes on and on.
So, my point is that Epic isn’t some MSFT/Amazon that never really had any competition, Epic’s #1 competitor just made fatal mistake after fatal mistake until it has basically just died. I mean Cerner, at this point, is nothing more than the DOD/VA, CommunityWorks and a handful of IDN’s (CHS, Tenet, Ascension) and even some of those are already thinking of leaving (Looking at you Baptist South Florida and maybe even CHS)
Epic is doing whatever anyone in a position of strength would do. They are enjoying the cash cow they have created. They are also doing what they can to stifle anyone who can disrupt not only their business model, but also their future roadmap.
10 years from now, there will have been less innovation in healthcare because of Epic, not more.
I think this is the danger. Any organization in a position of monopoly or near-monopoly status, tends to relax and get comfortable. It’s easier to reinforce their market position through business, financial and marketing means, than to deliver increasing value to customers.
And the organization tends to get years’ worth of notice of significant challenges. Leading to long-term responses (often legal, political, and lobbying).
This isn’t inevitable, but since it is based upon human nature? I’d say it happens 99.9% of the time.
I always said, Microsoft was a pretty good company when faced with real dangers and immediate challenges. They were responsive. As soon as the competitive environment let up, Microsoft would ease off the accelerator and lose focus. That’s just one prominent example.
>Beyond making its products attractive, Epic also controls the interoperability and app store access of its potential competitors.
This is the only thing on your list that rises to the level of potentially anti-competitive behavior. I don’t think anything will be done about Epic, not in any short or medium term. I have yet to see any evidence they are “stifling innovation”. I have yet to see any evidence that Epic is “refusing to integrate meaningfully” with anyone. I have yet to see evidence that Epic is “copying functionality”. If people had such evidence, they would be shouting it from the rooftops. Unfortunately for everyone else, Epic is just better than they are, and due to the barriers to entry, no new challengers will rise up anytime soon. If you are hoping that government enforcement action will be the downfall of Epic, don’t hold your breath. It’s much more likely that the equity ownership fractures just enough to force the company to go public for a huge payout. And even that is probably decades away.
So when does HISTalk become EpicTalk? At 60% market share? 70% 80%?…
HISTalk is already epic
At 80% HIStalk goes out of business, because their sponsors have been cloned poorly and crushed; and their readers are out of work. Be careful what you wish for!