How technology could help independent medical practices stay independent

Independent medical practices are facing growing pressure in 2026, and many leaders say technology is central to surviving it. Yet the same practices that view technology as essential do not always trust the tools they already use. That gap was a focus of Veradigm’s 2026 State of Independent Practice report and of a conversation with Aaron Ledbetter, M.P.P., M.H.S.A., a solutions and growth strategist at Veradigm.

The report points to an operating environment that is becoming more difficult for physicians and their staff. Ledbetter described a setting in which denied claims can go unnoticed for days, payer contracts continue to multiply, and small teams are left to manage prior authorizations, follow-up calls and after-hours work. In his view, the challenge is not only a shortage of people. It is also that the technology supporting the work has not kept up with the demands of running an independent practice.

The survey found that 79% of respondents consider technology essential to staying independent, but only 64% trust their current tools to deliver. Ledbetter said the difference is partly explained by how quickly tools change. Some products age out before practices have fully adopted them, and payer systems can change in response, creating what he described as an arms race between practice tools and payer features. He also pointed to growing payer contract complexity, which adds another layer of administrative work as a practice expands its book of business.

That strain helps explain why some practices consider selling. According to the report, 26% reached serious acquisition negotiations before deciding to remain independent. Ledbetter said the pressure that pushes them toward the table is usually administrative, operational and financial, and it is often made worse by data that are not available in real time. What brings them back, he said, is a strong desire to keep practicing medicine in the way they believe is best for their patients and their communities.

Delayed awareness of denied claims is one example of how that pressure plays out. In the survey, 40% of practices said they do not learn about a denied claim for one to two weeks. Ledbetter called that timing a symptom of a lagging operating model. Detection, root cause analysis and resolution are often spread across different people and different systems, and much of the work is still manual. He also noted that 58% of practices run a hybrid revenue cycle model split between internal staff and outside vendors that do not always communicate well with one another.

In Ledbetter’s view, the answer is to move detection earlier and bring data closer to real time. Because denial drivers can come from eligibility, coding, documentation, prior authorization and payer policy, he said there is no single fix. Instead, the process has to be coordinated across the full revenue cycle. The recurring problem is not one workflow alone, but a lack of early visibility and too many manual handoffs.

The pressure is not limited to one size of practice. Ledbetter said larger groups tend to feel the effects as financial volatility, while smaller practices experience them as administrative overload, but both are facing different versions of the same underlying issue: less room for error. In the survey, 82% of practices reported increased financial pressure, and 60% described that pressure as significant. Larger groups may have more payer contracts to manage, which brings more complexity. In solo practices, the problem can become personal quickly if one staff member is out and the rest of the team has to absorb the work.

Artificial intelligence and automation are often mentioned as possible answers, and 88% of respondents said those tools could meaningfully improve efficiency. Ledbetter said skepticism is understandable, since physicians have heard similar promises before. What feels different now, he said, is that some newer solutions, including ambient documentation and automation for prior authorization and denial follow-up, can work in the background instead of forcing another step into an already crowded workflow.

That shift, he said, may reshape the electronic health record itself. Rather than acting only as a system of record that captures what happened, he expects more systems to become a system of work that helps with coding, claims and prior authorization in real time. He said that would be a game changer for independent physicians.

Technology may also help practices take part in value-based care. Nearly half of respondents said administrative requirements are the top barrier to participation, ahead of clinical complexity and financial risk. Ledbetter said keeping track of the moving parts almost requires a small army of people. A practical response, he said, would be to automate quality-measure tracking, reduce manual abstraction and surface care gaps before the patient arrives. He also argued that practices are already doing some of the work, but they are not always getting credit for it. In his view, the system needs to help them capture that credit so they can get paid for closing quality gaps, reducing total cost of care and earning shared savings.

Staffing remains a major concern as well. Physicians were identified as the hardest position to recruit and retain, and the same competition extends to nurses, medical assistants and advanced practice providers. Independent practices are often competing with employed settings that can offer a guaranteed paycheck. What they can offer instead is the freedom to practice medicine their own way. Ledbetter said automation can help make that pitch stronger. A physician choosing between a manual environment and one where documentation, prior authorization and denial follow-up are automated may see the difference in work-life balance, and that can affect recruiting and retention.

For smaller practices without dedicated operations teams, Ledbetter said the realistic path is not necessarily adding more people. Instead, he believes practices need technology that automatically surfaces the right signals, days instead of weeks later, so operating discipline becomes part of the system rather than another task placed on the physician. He also expects more practices to join independent provider associations, pooling resources and gaining more leverage with vendors and payers.

Ledbetter closed by saying health care has often relied on putting more people onto problems that were already highly manual, which can add burden without fixing the underlying issue. In his view, technology is now fast enough to look across the full system of work. He said people have long predicted that automation would change health care, and he acknowledged that the promise has been repeated for years. Still, he said it feels different now.