The 10 Largest EHR Vendors in 2026: Market Share, Pricing, and What Sets Them Apart

The EHR Market in 2026: What You Need to Know

The U.S. electronic health record market is projected to exceed $19 billion by 2027, and it is more consolidated than ever. A handful of vendors control the vast majority of the hospital market, while the ambulatory space remains more fragmented — though private equity is rapidly rolling up mid-tier vendors.

This consolidation matters for your purchasing decision. Vendor stability, investment trajectory, and long-term viability should factor into your evaluation alongside features and price. A vendor losing market share may offer aggressive discounts today but underinvest in R&D tomorrow. A vendor gaining share may have leverage to raise prices — but also has the revenue to fund innovation.

We've ranked these 10 vendors by a combination of market share, installed base size, revenue, and market influence. For each, we provide the data you actually need: who they serve best, what they charge, what makes them different, and where they fall short. All pricing reflects 2025-2026 market data and should be used as a planning range — actual quotes will vary based on your specific requirements.

For a deeper look at how deployment model affects your total cost, see our cloud vs. on-premise EHR comparison. For a structured approach to running your evaluation, follow our EHR selection process guide.

Master Comparison Table

Before diving into each vendor, here is the landscape at a glance. This table summarizes the key differentiators across all 10 vendors to help you quickly identify which platforms are worth a closer look for your organization.

1. Epic Systems

Overview

Epic Systems is the undisputed market leader in electronic health records. Founded in 1979 by Judy Faulkner — who still leads the company as CEO — Epic has grown from a small Wisconsin startup into the platform that holds medical records for over 250 million patients. The company is privately held with no outside investors, which gives it unusual long-term strategic freedom. Epic has never been acquired and has never acquired another company, preferring to build everything in-house.

Epic's dominance is not just historical — it is accelerating. The company won approximately 70% of new hospital EHR contracts awarded in 2024, a staggering win rate that is pulling further ahead of competitors. Epic has been named Best in KLAS for 15 consecutive years, a streak unmatched by any other health IT vendor.

Target Market

Large health systems, academic medical centers, integrated delivery networks, and major hospital chains. Epic also serves mid-size hospitals through its Community Connect program, which allows smaller facilities to access Epic through a larger health system's instance at a significantly reduced cost.

Deployment & Pricing

Epic offers cloud, on-premise, and hybrid deployment models. Historically on-premise, Epic has invested heavily in cloud-hosted and Azure-based deployments in recent years. Pricing for a full hospital implementation typically ranges from $10 million to $30 million or more, depending on the number of beds, modules, and customization required. Epic does not publish list pricing — every deal is custom-negotiated.

Key Differentiators

• Most comprehensive platform — Epic covers inpatient, outpatient, emergency, surgery, pharmacy, lab, radiology, revenue cycle, population health, and patient engagement in a single integrated system.
• Best interoperability — Epic's Care Everywhere network enables data exchange across Epic sites and non-Epic sites via CommonWell and Carequality. Its FHIR API implementation is among the most mature in the industry.
• MyChart patient portal — The most widely adopted patient portal in the U.S., with over 190 million activated accounts.
• AI investment — Epic has integrated generative AI for clinical documentation, inbox management, and decision support, partnering with Microsoft and Nuance.

Pros and Cons

2. Oracle Health (Cerner)

Overview

Oracle Health — formerly Cerner Corporation — has been a major EHR vendor since 1979. Oracle acquired Cerner in June 2022 for $28.3 billion, one of the largest health IT acquisitions in history. The acquisition was intended to combine Cerner's healthcare domain expertise with Oracle's cloud infrastructure and database technology to create a next-generation health platform.

The reality has been more turbulent. Oracle Health holds approximately 21.7-22.9% of the hospital EHR market, making it the clear #2 behind Epic. However, the company lost 74 hospital sites in 2024 as client satisfaction has declined during the post-acquisition integration. Oracle is actively migrating the Cerner platform to Oracle Cloud Infrastructure (OCI), a multi-year effort that has introduced uncertainty for existing clients.

Target Market

Mid-to-large hospitals, health systems, and government/military healthcare. Oracle Health is the EHR vendor for the U.S. Department of Veterans Affairs (VA) modernization program, though that project has faced significant delays, cost overruns, and Congressional scrutiny.

Deployment & Pricing

Oracle Health is transitioning from on-premise and hosted deployments to Oracle Cloud Infrastructure. For a mid-size hospital implementation, expect pricing in the $2 million to $5 million range. Pricing varies significantly based on modules, bed count, and whether you're a new customer or an existing Cerner site migrating to OCI.

Key Differentiators

• Oracle infrastructure investment — Oracle is pouring billions into building a healthcare-specific cloud platform, with promises of AI-driven clinical decision support, autonomous database management, and unified health data.
• Strong acute care foundation — Cerner's Millennium platform has deep inpatient, surgical, and emergency department functionality built over decades.
• Government and military presence — Oracle Health is the EHR of record for the VA and has FedRAMP authorization for government cloud deployments.
• Open platform strategy — Oracle Health has historically been more open to third-party integrations and custom development than some competitors.

Pros and Cons

3. athenahealth

Overview

athenahealth is the leading cloud-native EHR for ambulatory practices. Founded in 1997, the company was a cloud pioneer — building its platform for web-based delivery from the ground up, years before "cloud" became a buzzword in healthcare IT. Today, athenahealth serves over 160,000 providers and is backed by private equity firms Bain Capital and Hellman & Friedman.

athenahealth was named Best in KLAS 2025 for Independent Physician Practice for the second consecutive year, reflecting strong clinician satisfaction and robust functionality for the practices it serves best. The platform's core differentiator is its network model: athenahealth aggregates anonymized data across its entire client base to benchmark performance, identify billing optimization opportunities, and automatically update rules engines based on payer behavior changes.

Target Market

Independent ambulatory practices with 1-75 providers. athenahealth also serves some larger medical groups and health systems through its enterprise offering, but its sweet spot is the independent practice that wants a modern cloud platform with strong revenue cycle management.

Deployment & Pricing

100% cloud-native since inception — there is no on-premise option. Pricing starts at approximately $140+ per provider per month for the EHR, with additional fees for practice management and revenue cycle management services. athenahealth's RCM model charges a percentage of collections (typically 4-7% of net collections), which aligns the vendor's incentive with your practice's financial performance but can become expensive for high-revenue practices.

Key Differentiators

• Network intelligence — Rules engine continuously updated based on payer behavior across 160,000+ providers. If a payer changes a prior authorization requirement, athenahealth's system adapts for all clients.
• Revenue cycle management — One of the strongest integrated RCM offerings in ambulatory EHR, with claims scrubbing, denial management, and patient collections built in.
• Cloud-native architecture — No version upgrades, no patching, no downtime for updates. All clients are always on the latest version.
• Marketplace — App marketplace with 250+ third-party integrations via APIs.

Pros and Cons

4. eClinicalWorks

Overview

eClinicalWorks (eCW) claims the title of the largest cloud-based ambulatory EHR by installed base, with over 850,000 physicians using the platform. The company is privately held and founder-owned, generating approximately $1 billion in annual revenue. eCW has been one of the most aggressive EHR vendors in embracing artificial intelligence, with over 125 AI-powered features and a ChatGPT integration for clinical documentation assistance.

eCW's history is not without controversy. In 2017, the company paid a $155 million settlement to the U.S. Department of Justice for allegedly falsely certifying that its EHR met Meaningful Use requirements. Since then, eCW has invested significantly in compliance and quality — but the settlement remains a factor that buyers should be aware of during due diligence.

Target Market

Ambulatory practices of all sizes, with particular strength in Federally Qualified Health Centers (FQHCs), multi-specialty groups, and primary care practices. eCW's pricing makes it competitive for mid-size practices that need comprehensive functionality without the athenahealth percentage-of-collections model.

Deployment & Pricing

eClinicalWorks offers both cloud and client-server deployment models. Pricing ranges from $449 to $599 per provider per month depending on the package selected, with the higher tiers including practice management, billing, patient engagement, and telehealth modules. This flat per-provider pricing is predictable and often more cost-effective than percentage-based models for practices with healthy collections.

Key Differentiators

• Aggressive AI innovation — 125+ AI features including ambient listening, clinical decision support, and ChatGPT-powered documentation assistance. eCW is moving faster than most competitors in AI adoption.
• Comprehensive platform — EHR, practice management, revenue cycle, telehealth (healow), patient engagement, and population health in one system.
• healow ecosystem — Integrated telehealth, patient self-scheduling, check-in, and health record sharing through the healow brand.
• FQHC strength — Deep functionality for community health centers including UDS reporting, sliding fee schedules, and grant management.

Pros and Cons

5. NextGen Healthcare

Overview

NextGen Healthcare has been serving ambulatory practices since 1974, making it one of the longest-tenured vendors in the EHR space. The company was taken private by Thoma Bravo in a $1.8 billion acquisition in 2023. Under PE ownership, NextGen has accelerated investment in cloud migration, artificial intelligence, and specialty-specific content. The platform serves over 100,000 ambulatory providers.

NextGen's defining characteristic is its specialty depth. The platform offers 26 specialty-specific clinical content templates — covering everything from orthopedics to ophthalmology to cardiology — that provide pre-built workflows, order sets, and documentation templates tailored to how each specialty actually practices. This is a genuine differentiator vs. general-purpose EHRs that require extensive configuration to match specialty workflows.

Target Market

Mid-to-large specialty and multi-specialty ambulatory practices. NextGen is particularly strong in practices with 10-200+ providers where specialty-specific workflows are critical and the practice has outgrown simpler small-practice EHRs.

Deployment & Pricing

NextGen offers both cloud and on-premise deployment options. Pricing ranges from $150 to $500 per provider per month depending on modules selected. The base EHR starts at the lower end; adding practice management, patient engagement, analytics, and revenue cycle modules increases the price. NextGen also offers an enterprise version for larger organizations that need more advanced configuration and integration capabilities.

Key Differentiators

• 26 specialty-specific templates — Purpose-built clinical content for the most common ambulatory specialties, reducing configuration time and improving workflow fit.
• AI Ambient Assist — AI-powered ambient listening that converts patient-provider conversations into structured clinical documentation. NextGen reports this feature saves clinicians an average of 2.5 hours per day — a significant productivity and burnout-reduction claim.
• Strong mobile app — Well-regarded mobile experience for charting and order management on the go.
• Thoma Bravo investment — PE backing is funding accelerated product development, cloud migration, and strategic acquisitions.

Pros and Cons

6. MEDITECH

Overview

MEDITECH is one of the oldest EHR vendors in the industry, founded in 1969 — a full decade before Epic and Cerner. The company has evolved through multiple platform generations, and its current flagship product, MEDITECH Expanse, represents a modern, cloud-hosted, web-based platform that has earned strong recognition in the community hospital segment.

MEDITECH's strength is the small-to-mid-size hospital market where Epic is often too expensive and too complex. MEDITECH Expanse has been recognized as Best in KLAS for Community Hospitals with 1-150 beds — a segment that represents hundreds of hospitals across the United States. The company is privately held and employee-owned, which gives it a culture more focused on long-term client relationships than quarterly revenue targets.

Target Market

Small-to-mid-size community hospitals (typically 1-300 beds), critical access hospitals, and community health systems. MEDITECH is particularly strong in rural hospitals and smaller organizations that need a full acute care EHR without the cost and complexity of Epic or Oracle Health.

Deployment & Pricing

MEDITECH Expanse is available as a cloud-hosted solution (MEDITECH as a Service) as well as traditional on-premise deployment. Pricing is custom-quoted based on bed count and modules but is generally positioned as significantly more affordable than Epic or Oracle Health for hospitals in the under-200-bed range. MEDITECH does not publish list pricing.

Key Differentiators

• Community hospital focus — Purpose-built for the operational realities of smaller hospitals where staff wear multiple hats and budgets are tighter.
• Expanse platform — Modern web-based interface that represents a significant upgrade from MEDITECH's earlier generations (MAGIC, Client/Server, 6.x).
• Google Cloud partnership — MEDITECH has partnered with Google for cloud hosting and AI capabilities, including Google Health's clinical AI tools.
• Lower total cost of ownership — For hospitals in its target market, MEDITECH typically offers a significantly lower TCO than Epic or Oracle Health.

Pros and Cons

7. AdvancedMD

Overview

AdvancedMD is a cloud-based EHR and practice management platform designed specifically for independent medical practices. Founded in 1999, the company was acquired by Global Payments in 2018, and subsequently purchased by Francisco Partners, a technology-focused private equity firm. AdvancedMD occupies an important niche: it's more feature-rich than entry-level platforms like Tebra but more accessible and affordable than enterprise systems like athenahealth at scale.

Target Market

Independent medical practices with 2-10 providers. AdvancedMD is well-suited for practices that want a comprehensive cloud platform — EHR, practice management, billing, patient engagement, and telemedicine — from a single vendor, without the complexity of enterprise-grade systems.

Deployment & Pricing

100% cloud-based. Pricing ranges from $229 to $729 per provider per month depending on the tier and modules selected. The base tier includes EHR and practice management, while higher tiers add advanced reporting, patient engagement, telemedicine, and revenue cycle management services. One-time implementation and training fees apply separately.

Pros and Cons

8. Greenway Health (Intergy)

Overview

Greenway Health, backed by Vista Equity Partners, serves over 55,000 providers with its Intergy EHR and practice management platform. The company has roots dating back to 1977 and has built a reputation as a reliable, no-frills EHR for small-to-mid-size ambulatory practices. Greenway earned the KLAS Cybersecurity Transparent designation, reflecting its commitment to security transparency — an increasingly important factor in vendor selection.

Target Market

Small-to-mid-size ambulatory practices, particularly those that prioritize reliable core EHR functionality, good customer support, and affordable pricing over cutting-edge features. Greenway is a solid choice for practices that want a dependable system without paying for functionality they won't use.

Deployment & Pricing

Greenway offers both cloud and on-premise deployment options. Pricing ranges from $100 to $500 per provider per month, making it one of the more affordable options in the mid-tier ambulatory EHR market. The lower end of the range covers basic EHR functionality, while the upper end includes practice management, analytics, and revenue cycle services.

Pros and Cons

9. DrChrono (EverHealth)

Overview

DrChrono was one of the first EHR platforms designed for the iPad, launching in 2009 with a mobile-first philosophy that was ahead of its time. Now part of EverCommerce's EverHealth division, DrChrono remains a cloud-native, mobile-first EHR that appeals to tech-forward small practices and solo practitioners who want a modern, intuitive interface.

DrChrono's iPad-first design means the clinical workflow was built from the ground up for touch interaction — not retrofitted from a desktop application. This gives it a distinctly different feel from legacy EHRs and is a genuine advantage for providers who chart at the point of care using a tablet.

Target Market

Solo practitioners and small practices (1-5 providers) who value modern design, mobile-first workflows, and a streamlined user experience. DrChrono is particularly popular in specialties like dermatology, urgent care, and direct primary care where iPad-based charting fits the clinical workflow naturally.

Deployment & Pricing

100% cloud-based with native iPad and iPhone apps. Pricing starts at $299+ per provider per month. Plans scale based on features — the base tier covers core EHR functionality, while premium tiers add advanced billing, custom forms, API access, and medical billing services.

Pros and Cons

10. Tebra (Kareo)

Overview

Tebra was formed in 2021 through the merger of Kareo (a popular budget-friendly EHR and billing platform) and PatientPop (a patient experience and marketing platform). The combined entity aims to be an all-in-one practice management and growth platform for independent practices. Kareo historically served 107,000+ providers, most of them very small practices or solo providers attracted by its low entry price.

Tebra occupies the budget end of the EHR market — it's the most affordable option on this list for practices that need basic EHR and billing functionality without the full feature depth of more expensive platforms. The merger with PatientPop added a unique angle: integrated online reputation management, patient marketing, and web presence tools that no other EHR vendor bundles natively.

Target Market

Very small practices (1-3 providers), solo practitioners, and startup practices that need the most affordable path to a compliant EHR with basic practice management. Also attractive to practices that value integrated patient marketing and online reputation tools.

Deployment & Pricing

100% cloud-based. Pricing starts as low as $10 to $100+ per month for basic EHR functionality, making Tebra the most affordable entry point on this list. However, pricing has increased since the Kareo/PatientPop merger, and add-on modules (billing, patient engagement, marketing) can significantly increase the total monthly cost. Be sure to get an all-in quote for the modules you actually need.

Pros and Cons

A Note on Behavioral Health EHR Vendors

The 10 vendors above dominate the general medical EHR market, but they are not the best choices for every specialty. Behavioral health, substance abuse treatment, and mental health practices have fundamentally different documentation, billing, and workflow requirements — and are often better served by specialty-specific EHR vendors that understand those differences.

If your practice focuses on behavioral health, we strongly recommend reading our dedicated behavioral health EHR comparison, which covers the leading vendors in this space:

• TherapyNotes — The most popular EHR for solo and small behavioral health practices, known for excellent documentation templates and a clean interface.
• SimplePractice — Cloud-native platform popular with private practice therapists, with strong telehealth and client engagement features.
• Valant — Purpose-built for psychiatric and behavioral health practices with a focus on measurement-based care and outcomes tracking.
• Netsmart — Enterprise-grade behavioral health platform serving larger organizations, community mental health centers, and addiction treatment facilities.
• AZZLY Rize — Cloud-native, purpose-built for substance abuse treatment and behavioral health, with integrated billing and treatment planning designed for the unique workflows of addiction treatment programs.

General-purpose EHRs can be configured for behavioral health, but the documentation workflows, progress note formats (DAP, SOAP, BIRP), treatment plan templates, and substance abuse-specific billing requirements (ASAM levels, authorization workflows) are significantly more mature in specialty platforms. See our full behavioral health EHR comparison for detailed vendor profiles.

How to Choose: A Framework by Practice Type

With 10 vendors and widely varying price points, the right choice depends entirely on your organization type, size, and strategic priorities. Here's a quick decision framework:

If You're a Solo or Startup Practice

If You're a Small-Mid Ambulatory Practice (2-25 Providers)

If You're a Large Ambulatory Practice or Multi-Specialty Group (25+ Providers)

If You're a Hospital (Any Size)

Regardless of which vendor you're evaluating, follow a structured selection process. Our EHR selection process guide walks you through requirements gathering, vendor shortlisting, demonstrations, reference checks, and contract negotiation — step by step. And once you've chosen, use our EHR implementation checklist to plan a successful go-live.

Frequently Asked Questions

The Bottom Line

The EHR market in 2026 is dominated by a few giants at the top — Epic and Oracle Health in hospitals, athenahealth and eClinicalWorks in ambulatory care — with a competitive mid-tier of specialty and niche vendors serving specific practice types and sizes. Private equity is reshaping the landscape, with Thoma Bravo (NextGen), Bain/Hellman & Friedman (athenahealth), Francisco Partners (AdvancedMD), and Vista Equity Partners (Greenway) all investing aggressively in their portfolio companies.

The most important thing is not choosing the "best" vendor — it's choosing the right vendor for your specific organization. A solo practice doesn't need Epic. A 500-bed academic medical center shouldn't be running Tebra. Match the vendor's target market to your reality, validate pricing against your budget, check references from practices similar to yours, and plan your implementation carefully.

If you're in the process of evaluating EHR vendors, we recommend starting with our step-by-step EHR selection guide to structure your evaluation, then using the vendor profiles above to build your shortlist, and finally reading our cloud vs. on-premise comparison to decide on your deployment model. For specialty practices — particularly behavioral health — always evaluate specialty-specific vendors alongside the general-purpose platforms listed here.