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The full homework

We did the homework on every major EMR. Here's where we beat them.

Every major EMR, scored across twelve weighted criteria — the full matrix, laid flat so you can read every row.

rev.health is the only one that ships integrated RCM, a structure-first ambient scribe, resource-graph scheduling, and FHIR/TEFCA-native interoperability in one platform — at published, two-tier pricing.

Every figure below traces to documented public record — DOJ filings, OCR breach reports, class-action settlements, published rate cards — or to our scored evaluation. Verify any row in the live tool.

Weighted overall score ranking, every major EMR A horizontal bar chart ranking rev.health and every major EMR we evaluated by weighted overall score out of 10. rev.health sits on top at 9.8, ahead of athenahealth at 9.30, Medplum at 8.71, and the rest of the field trailing below. WEIGHTED OVERALL SCORE — 12 CRITERIA, OUT OF 10 rev.health 9.8 athenahealth9.30 Medplum8.71 Healthie7.59 Canvas Medical7.29 Akute Health7.04 eClinicalWorks6.67 OpenEMR6.55 Bahmni6.43 OpenMRS6.35 NextGen6.31 DrChrono6.11 LibreHealth6.10 Epic6.02 Elation Health6.01 Jane App5.92 Tebra5.79 SimplePractice5.77 ModMed5.64 GNU Health5.49 Practice Fusion5.45 ERPNext Health5.45 TheraNest5.40 CareCloud5.36 Oracle Health5.31 AdvancedMD5.06 MEDITECH5.03 Veradigm4.93 HospitalRun4.84 Praxis EMR4.53 Greenway4.21 Veritas/Centricity3.44

The full table

Every major EMR, on one screen.

Overall score is the weighted total across our twelve criteria (egress, security, cost-with-RCM, integration friction, cloud-native, FHIR breadth, write-back depth, contract flexibility, software cost, pricing transparency, marketplace, vendor scale). rev.health is pinned at the top and wins every structural column.

Click any column header to sort — rev.health stays pinned on top as the positioned winner.

Vendor Category Overall Pricing signal Integrated RCM? Resource-graph scheduling? Structure-first ambient scribe? FHIR / TEFCA-native? Notable risk / weakness
rev.health Winner Integrated platform 9.8 $399/MD-DO · $299/PA-NP/mo + 3.5% of collections — published Yes — turn-key, in-platform Yes — minute-level, rooms/MAs/equipment Yes — coded facts + audio provenance Yes — FHIR R4 + TEFCA-ready, native None on record — built greenfield for the 2026–2027 regulatory floor.
athenahealthCloud RCM suite9.30 ~$140/prov/mo + 4–7% of collections; no public rate card Bundled, not turn-keyNo — calendar grid Add-on (athenaAmbient)Yes RCM requires an in-house billing coordinator for denial follow-up — a $35–60K/yr hidden hire; $18.25M FCA kickback settlement (not security).
eClinicalWorksCloud RCM suite6.67 $449–599/prov/mo + 2.9% RCM (transparent) Yes (2.9%)No Add-on (Sunoh.ai +$149)Yes $155M DOJ False Claims Act settlement (2017) over misrepresented certification + audit logs; ongoing OIG corporate integrity agreement; egress via support case.
NextGen HealthcareCloud RCM suite6.31 $150–500/prov/mo signal; quote-based Separate RCM service tierNo Add-on +$125/prov/mo (Nabla)Yes (Mirth) 2023 ransomware breach exposed ~1.05M individuals; $19.375M class action settled October 2025.
AdvancedMDCloud RCM suite5.06 $429/prov/mo EHR; encounter-based options Service tier (3–8%)No No native scribeYes Solid integrated billing but dated UX; per-module pricing and an aging interface for a 5-year horizon.
CareCloudCloud RCM suite5.36 $349/prov/mo; RCM add-ons (Concierge 3–7%) Add-on (Concierge)No No native scribeYes Mixed reviews on support; RCM is a separate service line, not the core pipeline.
Greenway HealthCloud RCM suite4.21 Quote-based; ~$500/prov/mo signal Service tierNo No native scribeYes PE-owned (Intergy / Prime Suite) with legacy-product churn; quote-based, opaque pricing.
Tebra (Kareo + PatientPop)Cloud RCM suite5.79 $125–450/prov/mo by tier Kareo billing serviceNo No native scribeYes Bolted-together Kareo+PatientPop merger; billing and marketing modules priced and run separately.
Elation HealthLightweight cloud6.01 ~$300–450/prov/mo; transparent egress No — billing is a 2nd vendorNo Add-on (assist, est.)Yes (FHIR-first) Clinician-loved charting but no integrated RCM — the revenue cycle becomes a second contract, second login, and an interface you own.
DrChrono (EverHealth)Lightweight cloud6.11 $199–499/prov/mo tiers Billing add-onNo No native scribeYes iPad-first but acquired into EverCommerce/EverHealth (2021) — roadmap subordinated to a roll-up.
Practice Fusion (Veradigm)Lightweight cloud5.45 $149/prov/mo; was free + ad-supported until 2018 No integrated RCMNo No native scribeYes $145M DOJ settlement (2020) over kickbacks tied to clinical-decision-support design while free + ad-supported.
Praxis EMRLightweight cloud4.53 $219–259/prov/mo for 48–60mo, then $70/mo support No (3rd-party bespoke)No No native scribeNo — not FHIR-native 48–60-month lock-in; concept-processor model with no shown path for ambient scribe, RPM, or modern integrations.
MedplumHeadless FHIR8.71 Open-source (Apache 2.0); cloud tiers from $0 up No — you build itNo — bring your own UI No — backend onlyYes (FHIR-native core) A headless backend, not a turn-key clinic EHR — you build the entire clinical UX, scribe, scheduling, and RCM yourself.
Canvas MedicalAPI-first EHR7.29 Quote-based, ~$400–600/prov/mo; Python SDK No turn-key RCMNo No native scribeYes Powerful for custom workflows but you supply the integrations; cost-with-RCM scores low (4/10).
HealthieAPI-first EHR7.59 Starts ~$129/prov/mo; API + scheduling + telehealth No integrated RCMNo No native scribeYes Built for wellness/virtual-first builders, not insurance-billing primary care; RCM and coding are bring-your-own.
Akute HealthAPI-first EHR7.04 ~$200–300/prov/mo; modern UX + open API No turn-key RCMNo No native scribeYes Newer, lightweight entrant; small vendor scale (3/10) and no integrated revenue cycle or scribe.
EpicLegacy enterprise6.02 $1K–1.5K/prov/mo via Community Connect (host-sponsored) Host's RCM or in-houseNo — calendar grid 3rd-party (DAX add-on)Yes 40+-provider floor and host-sponsored egress; 2–18-month integration cycle and $18K–80K per integration project — a non-starter for an independent practice.
Oracle Health (Cerner)Legacy enterprise5.31 Enterprise; quote-based Enterprise RCMNo 3rd-party add-onYes Health-system-scale; irrelevant cost and complexity for an independent 2-doc practice (cost-with-RCM 1/10).
MEDITECH ExpanseLegacy enterprise5.03 Enterprise; quote-based Enterprise RCMNo No native scribeYes Community-hospital-focused; out of scope for outpatient independent primary care.
Veradigm (Allscripts)Legacy enterprise4.93 Quote-based; $400–900/prov/mo signal Service tierNo No native scribeYes Big legacy footprint, mixed reviews, repeated ownership churn; opaque quote-based pricing.
Veritas / Centricity (legacy GE)Legacy enterprise3.44 Legacy quote-based; declining product line NoNo No native scribeNo — FHIR bolted on Managed-decline product (renamed athenaPractice/athenaFlow); dated client-server architecture, new sales essentially nil — included for completeness only.
Modernizing Medicine (ModMed)Specialty EHR5.64 ~$549/prov/mo; specialty-tuned RCM service add-onNo No native scribeYes Specialty-first (derm/ortho/GI, EMA) — not built for primary care; high per-provider cost.
SimplePracticeSpecialty EHR5.77 $69–99/prov/mo solo plans No medical RCMNo No native scribeNo — not FHIR-native Behavioral-health focused; not FHIR-native (3/10 breadth) and out of scope for medical primary care billing.
TheraNestSpecialty EHR5.40 $39–79/prov/mo by client volume No medical RCMNo No native scribeNo — not FHIR-native Mental/behavioral-health niche; minimal interoperability and no medical revenue cycle.
Jane AppSpecialty EHR5.92 $54–99/prov/mo No medical RCMNo No native scribeNo — not FHIR-native Allied-health darling (PT/chiro) outside primary-care scope; not FHIR-native (3/10).
OpenEMROpen source6.55 GPL; ONC-certified; pay for hosting/support DIY billing moduleNo No native scribeYes Mature and ONC-certified, but self-host burden + dated UX; only viable with a dedicated sysadmin (cloud-native 3/10).
OpenMRSOpen source6.35 MPL; community-driven (free) Not US-billing out of boxNo No native scribeYes Global-health roots; not US-billing-friendly out of the box and requires heavy self-hosting.
BahmniOpen source6.43 AGPL; OpenMRS + OpenERP + OpenELIS (free) Not US-billing out of boxNo No native scribeYes Hospital-grade OSS distribution with a heavy stack to stand up and maintain.
LibreHealth EHROpen source6.10 MPL 2.0; OpenEMR fork (free) DIY billing moduleNo No native scribeYes OpenEMR fork with a smaller community; self-host burden and limited ecosystem.
GNU HealthOpen source5.49 GPL; built on Tryton ERP (free) Not US-ambulatory billingNo No native scribeNo — not FHIR-native Public-health / hospital management focus; not US-ambulatory-billing oriented and not FHIR-native (4/10).
ERPNext HealthcareOpen source5.45 GPLv3; cloud tier from $50/mo Limited US billing maturityNo No native scribeNo — not FHIR-native ERP-style healthcare module with limited US medical-billing maturity; not FHIR-native (3/10).
HospitalRunOpen source4.84 MIT; offline-first via PouchDB (free) No US billingNo No native scribeNo — not FHIR-native Niche offline-first project whose activity has slowed; not FHIR-native and no US revenue cycle.

Legend: Yes = native / included · Partial = add-on or separate service tier · No = not offered. Overall scores are weighted totals from our twelve-criterion matrix; the six deep-evaluated vendors (athena, eCW, NextGen, Epic, Elation, Praxis) carry firm scores, the remaining vendors are best-effort screening triangulations from public docs and market signal. rev.health's 9.8 reflects winning every structural criterion in the same rubric. Verify any row in the live interactive tool.

Want the version without our thumb on the scale? We keep a separate, objective scorecard that doesn't include rev.health at all — sortable, with a live cost calculator and public sources on every cell.
See the full, unbiased vendor-by-vendor scorecard →

Vendor by vendor

How we beat each one.

Grouped by tier. For every vendor: their documented weakness, and the specific rev.health counter. No invented settlements or breaches — only the ones already on the record.

Cloud RCM-led suites

7 vendors — the percent-of-collections crowd
athenahealth 9.30

RCM isn't turn-key — practices report hiring an in-house billing coordinator for denial follow-up (a $35–60K/yr hidden hire); 4–7% of collections with no public rate card.

rev.health: 3.5% flat, published, with the full denial pipeline — triage, routing, SLA, appeal drafting — as the platform's job, not your staffing problem.

eClinicalWorks 6.67

$155M DOJ False Claims Act settlement (2017) over misrepresented certification and audit logs, plus an ongoing OIG corporate integrity agreement; full data egress is a support case.

rev.health: certification stated plainly, audit logs as a patient-visible feature, and self-serve egress written into the contract.

NextGen Healthcare 6.31

2023 ransomware breach exposed ~1.05M individuals' SSNs, DOBs, and insurance details; $19.375M class action settled October 2025. Ambient scribe is a $125/prov/mo add-on.

rev.health: the ambient scribe is core product, included; security posture — current and planned — is published rather than discovered in diligence.

AdvancedMD 5.06

Integrated billing exists but the UX is dated and the RCM runs 3–8% as a service tier on top of $429/prov/mo software.

rev.health: a modern, ambient-native clinical surface and one published 3.5% RCM rate — no service-tier markup, no legacy interface.

CareCloud 5.36

RCM is a separate Concierge service line (3–7%) and support reviews are mixed; the revenue cycle isn't the product's spine.

rev.health: eligibility → documentation → coding → claim → remittance is a single pipeline in one system — the spine, not a bolt-on.

Greenway Health 4.21

PE-owned (Intergy / Prime Suite) with legacy-product churn and quote-based, opaque pricing (~$500/prov/mo signal).

rev.health: one greenfield platform, published two-tier pricing, and a roadmap aimed at the 2026–2027 regulatory floor — not a managed-decline portfolio.

Tebra (Kareo + PatientPop) 5.79

A Kareo+PatientPop merger where EHR, billing, and marketing are stitched modules priced separately ($125–450/prov/mo).

rev.health: EMR + PM + turn-key RCM + scribe + portal in one record with one bill — no seams between merged products.

Lightweight cloud tools

4 vendors — loved charting, missing the revenue cycle
Elation Health 6.01

Genuinely well-liked primary-care charting, but no integrated RCM — billing means a second vendor, second contract, second login, and an interface you own.

rev.health: the encounter, codes, claim, remittance, and patient statement are one pipeline in one system — nothing to bolt on.

DrChrono (EverHealth) 6.11

iPad-first EHR acquired into the EverCommerce/EverHealth roll-up (2021) — roadmap subordinated to a portfolio; billing is an add-on.

rev.health: a single-purpose, independent platform where RCM and the ambient scribe are core, not acquired modules awaiting attention.

Practice Fusion (Veradigm) 5.45

$145M DOJ settlement (2020) over kickbacks tied to clinical-decision-support design during its free, ad-supported era; no integrated RCM.

rev.health: CDS is evidence-linked and conflict-free, monetization is transparent subscription + flat RCM — never ads or sponsored alerts.

Praxis EMR 4.53

48–60-month lock-in and a concept-processor model with no shown path to ambient scribe, RPM, or modern integrations; not FHIR-native.

rev.health: month-to-month flexibility, FHIR-native by design, and the ambient scribe + integrations are the product, not a "you don't need those" excuse.

API-first & headless-FHIR platforms

4 vendors — great primitives, no turn-key clinic
Medplum 8.71

A headless FHIR backend (Apache 2.0), not a clinic EHR — you build the entire clinical UX, scheduling, scribe, and revenue cycle yourself.

rev.health: the same FHIR-native correctness, delivered turn-key — billable visits in weeks, not a from-scratch build project.

Canvas Medical 7.29

Programmable EHR with a Python SDK, but no turn-key RCM and a low cost-with-RCM score (4/10) once you add the integrations yourself.

rev.health: the customization you'd code is already shipped — structured scribe, resource-graph scheduling, and integrated RCM out of the box.

Healthie 7.59

Built for wellness and virtual-first builders; coding and insurance RCM are bring-your-own, not the core product.

rev.health: purpose-built for insurance-billing primary care — coding, eligibility, and claims are first-class, not adapters.

Akute Health 7.04

Lightweight modern entrant with small vendor scale (3/10) and no integrated revenue cycle or ambient scribe.

rev.health: the same modern UX with the full clinical-to-financial pipeline and ambient scribe included from day one.

Legacy / enterprise systems

5 vendors — built for health systems, not independents
Epic 6.02

Best-in-class interop, but a 40+-provider floor, host-sponsored egress, 2–18-month integration cycles, and $18K–80K per integration — a non-starter for an independent practice.

rev.health: enterprise-grade FHIR interop with no host, no integration toll, and a launch measured in weeks at independent-practice pricing.

Oracle Health (Cerner) 5.31

Health-system scale; cost-with-RCM scores 1/10 for an independent practice and the complexity is wildly disproportionate.

rev.health: the interoperability that matters without the enterprise weight — sized and priced for a 1–5 clinician practice.

MEDITECH Expanse 5.03

Community-hospital-focused; out of scope for outpatient independent primary care.

rev.health: outpatient-native by design — the workflows match the day an independent practice actually runs.

Veradigm (Allscripts) 4.93

Big legacy footprint, mixed reviews, repeated ownership churn, and opaque quote-based pricing ($400–900/prov/mo signal).

rev.health: a single modern codebase, published pricing, and stable independent ownership — no carve-out churn.

Veritas / Centricity (legacy GE) 3.44

Managed-decline product (renamed athenaPractice/athenaFlow); dated client-server architecture, FHIR bolted on, new sales essentially nil.

rev.health: a cloud-native, FHIR-native platform on an upward roadmap — the opposite of a sunset product.

Specialty EHRs

4 vendors — tuned for another discipline
Modernizing Medicine (ModMed) 5.64

Specialty-first (derm/ortho/GI, EMA) at ~$549/prov/mo — not built for primary care.

rev.health: primary-care-native workflows and lower, published pricing — no specialty templates you'll never use.

SimplePractice 5.77

Behavioral-health focused, not FHIR-native (3/10 breadth), no medical RCM — out of scope for primary care billing.

rev.health: FHIR-native interop and full medical revenue cycle — built for the insurance-billing primary-care visit.

TheraNest 5.40

Mental/behavioral-health niche with minimal interoperability and no medical revenue cycle.

rev.health: closed-loop referrals, real interoperability, and integrated medical claims — the primary-care surface a niche tool can't cover.

Jane App 5.92

Allied-health darling (PT/chiro) outside primary-care scope; not FHIR-native (3/10).

rev.health: FHIR-native and primary-care-built — the record follows the patient across consented practices, which an allied-health silo can't do.

Open-source EHRs

7 vendors — free software, expensive operations
OpenEMR 6.55

Mature and ONC-certified, but a self-host burden, dated UX, and cloud-native 3/10 — only viable with a dedicated sysadmin.

rev.health: nothing to host, patch, or staff — cloud-native and managed, so the savings go to care, not server upkeep.

OpenMRS 6.35

Global-health roots; not US-billing-friendly out of the box and requires heavy self-hosting.

rev.health: US revenue cycle is the core, not a custom build — turn-key claims from the first visit.

Bahmni 6.43

Hospital-grade OSS distribution (OpenMRS + OpenERP + OpenELIS) with a heavy stack to stand up and maintain.

rev.health: one managed platform — no multi-component stack to integrate, secure, and keep alive.

LibreHealth EHR 6.10

OpenEMR fork with a smaller community; self-host burden and a limited ecosystem.

rev.health: a vendor-backed platform with a real ecosystem, included scribe, and turn-key RCM — no DIY maintenance.

GNU Health 5.49

Public-health / hospital-management focus, not US-ambulatory billing, and not FHIR-native (4/10).

rev.health: FHIR-native and ambulatory-billing-native — designed for exactly the practice GNU Health isn't.

ERPNext Healthcare 5.45

ERP-style healthcare module with limited US medical-billing maturity; not FHIR-native (3/10).

rev.health: purpose-built clinical + financial platform — medical billing and FHIR are first-class, not an ERP afterthought.

HospitalRun 4.84

Niche offline-first project whose activity has slowed; not FHIR-native and no US revenue cycle.

rev.health: an actively developed, FHIR-native, fully-billing platform — the opposite of a stalled offline experiment.

Cloud RCM suite

athenahealth 9.30

Pricing: ~$140/provider/mo plus 4–7% of collections; no public rate card.

Documented weakness

RCM is bundled but not turn-key. Practices report hiring an in-house billing coordinator for denial follow-up — a $35–60K/yr hidden cost the pricing page never mentions. Public record also includes an $18.25M False Claims Act kickback settlement (a commercial-conduct matter, not a security breach).

The rev.health counter

3.5% flat, published, with the full denial pipeline — triage, routing, SLA, appeal drafting — run as the platform's job, not your staffing problem. Scheduling is a calendar grid there; resource-graph, minute-level here. The ambient scribe (athenaAmbient) is an add-on there; included here.

Verify the score in the live interactive tool →

Cloud RCM suite

eClinicalWorks 6.67

Pricing: $449–599/provider/mo plus 2.9% RCM (transparent).

Documented weakness

$155M DOJ False Claims Act settlement (2017) over misrepresented ONC certification and audit-log behavior, plus an ongoing OIG corporate integrity agreement. Full data egress runs through a support case. The ambient scribe is a Sunoh.ai add-on (+$149).

The rev.health counter

Certification stated plainly, audit logs surfaced as a patient-visible feature, and self-serve egress written into the contract — your data leaves when you do.

Verify the score in the live interactive tool →

Cloud RCM suite

NextGen Healthcare 6.31

Pricing: $150–500/provider/mo signal; quote-based.

Documented weakness

2023 ransomware breach exposed ~1.05M individuals' SSNs, dates of birth, and insurance details; a $19.375M class action settled in October 2025. RCM is a separate service tier; the ambient scribe (Nabla) is a $125/provider/mo add-on.

The rev.health counter

The ambient scribe is core product, included. Security posture — current and planned — is published rather than discovered in diligence, and every chart read is audited and patient-visible.

Verify the score in the live interactive tool →

Lightweight cloud

Elation Health 6.01

Pricing: ~$300–450/provider/mo; transparent egress.

Documented weakness

Genuinely well-liked primary-care charting — but no integrated RCM. Billing means a second vendor, a second contract, a second login, and an interface you own and reconcile.

The rev.health counter

The encounter, codes, claim, remittance, and patient statement are one pipeline in one system — nothing to bolt on, nothing to reconcile across vendors.

Verify the score in the live interactive tool →

Lightweight cloud

Praxis EMR 4.53

Pricing: $219–259/provider/mo for 48–60 months, then $70/mo support.

Documented weakness

A 48–60-month lock-in and a concept-processor model with no shown path to an ambient scribe, RPM, or modern integrations. Not FHIR-native.

The rev.health counter

Month-to-month flexibility, FHIR-native by design, and an ambient scribe plus integrations as the product — not a "you don't need those" excuse.

Verify the score in the live interactive tool →

Legacy enterprise

Epic 6.02

Pricing: $1K–1.5K/provider/mo via Community Connect (host-sponsored).

Documented weakness

Best-in-class interoperability, but a 40+-provider floor, host-sponsored egress, 2–18-month integration cycles, and $18K–80K per integration project — a non-starter for an independent practice.

The rev.health counter

Enterprise-grade FHIR interop with no host, no integration toll, and a launch measured in weeks — at independent-practice pricing.

Verify the score in the live interactive tool →

Methodology

Don't take our word for it. Check ours.

This page is a flattened view of a working diligence tool. Every score, weight, cost model, and certification status is open for inspection.

What's behind these numbers

  • A 45×30 scoring matrix — vendors × criteria, each cell scored 1–10 with a written rationale
  • A TCO calculator that models total cost with RCM at your collections, provider count, and patient-card mix
  • A certification-maturity matrix across HITRUST, SOC 2, ONC, DirectTrust, ISO 27001, PCI, and QHIN status
  • Per-vendor demo-prep checklists and recorded-demo notes from the six deep-evaluated finalists
  • Twelve weighted criteria: egress (15%), security (15%), cost-with-RCM (10%), integration friction (10%), and eight more

The six finalists (athenahealth, eClinicalWorks, NextGen, Epic, Elation, Praxis) carry firm scores from full diligence passes; the remaining 25 are best-effort screening triangulations from public docs and market signal, clearly flagged as such in the tool.

Open the live interactive tool

Sort the table by any criterion, retune the weights to your own priorities, run the cost calculator, and drill into any single vendor's detail page.

revhealth-compare.netlify.app →

For the narrative version of the headline cases — the DOJ filings, the breach, the hidden-hire math — see Why switch. For our own posture, see Security & compliance.

Two-tier pricing, in plain sight: rev.health is $399/mo per physician and $299/mo per PA/NP, plus 3.5% of collections for fully integrated, turn-key RCM. No hidden billing hire, no per-module add-ons, no quote-to-find-out. That's the whole number — and it's why we sit on top of the field.

Get early access Read the narrative comparison →