Independent practices are still growing in 2026 — but only those using connected systems to reduce administrative burden, improve billing performance, and scale operations efficiently are succeeding.

If you’re running an independent practice in 2026, you’re already feeling the heat of being a practice owner. Tebra’s 2026 State of the Independent Practice report found that 46% of practice owners feel the independent healthcare model is threatened. Only 10% of providers say they don’t feel it is — down from 19% in 2024.

It’s getting harder to stay independent, even though 67% of practice owners still want to do so. And it comes down to 3 factors:

That’s why independent practice owners are looking for better tools to alleviate that burden. We found that thriving practices have one thing in common: They use connected tools to support their practice workflows.

In this article, we’ll show you how 3 practices have turned their operational challenges into growth by fixing each bottleneck.

If you're running an independent practice right now, you're dealing with pressure from multiple directions at once. Some of them include the following:

These pressures aren't going away. But they are solvable if you address the root cause instead of patching symptoms.

The practices that are thriving in 2026 aren't immune to these pressures. But they've found a way to turn them into a systems problem instead of a staffing problem.

Instead of hiring more people to handle more work, providers connect their tools so data flows automatically. For example, they used a connected platform like Tebra that lets them use different product modules together. 

Let’s say a patient fills out an intake form with their personal and insurance details. The platform immediately verifies the eligibility of their insurance and whether it’ll apply to the treatment they’re coming for. Eventually, that data moves into the physician’s charting notes, and everything moves into the billing modules.

In short: when your systems work together, you stop entering the same information three times and stop losing revenue to errors that could’ve been caught upstream

Tebra's survey found that 50% of practices with connected systems say they can grow capacity without adding staff. That's the difference. You're removing the friction that made growth feel impossible without working harder.

A connected healthcare system is one where your EHR, billing, scheduling, patient intake, and communication tools share data automatically. You enter a patient's information once, and it flows through all the integrated or connected tools from one system.

It's a specific way of structuring your practice technology. When you compare that to a disconnected setup, you’ll notice how none of your tools talk to each other. In fact, even if you integrate them with your tools of choice, it’s not always the most “seamless” experience. You end up re-entering data or fixing discrepancies to make it work.

Connected systems eliminate that manual work. They reduce errors because data doesn't get re-keyed. And they give you visibility into your operations because everything lives in one place.

If you're evaluating technology, this is the question that matters: do these tools actually integrate, or are you buying another silo?

Tebra surveyed practice owners across the country to understand what's working and what's holding independent practices back. Here's what we found:

On the state of independence:

On operational challenges:

On what's working:

Most practices are struggling with disconnected tools. But the ones that connect their systems are seeing real results in the form of more capacity, better clean claim rates, faster payments, and less time lost to administrative work.

Dr. Arjun Reyes built his Southern California psychiatry practice on a simple philosophy: Providers shouldn’t burn out delivering care. But as the practice grew to 8 providers serving over 5,000 patients, so did its documentation.

There was a point when each provider was spending 3–5 hours daily on notes alone. That time came directly from patient care, research, and personal well-being — the very things that prevent burnout in the first place. Dr. Reyes noticed his practice management software was holding his practice back. That’s why he adopted Tebra’s connected EHR platform in 2018. 

He adopted Tebra's connected EHR platform in 2018, then added AI Note Assist in 2025. “AI Note Assist is amazing,” says Dr. Reyes. “Using AI Note Assist alone could keep me from retiring. Note-taking is very tedious. I get transcription, organization, and ideas for a working diagnosis, medication background, and research. Now, I spend an hour a day reviewing literature to find better options for my clients.”

Chimezie Chidi built Celebrations Speech Group to help children access the speech therapy they need. As the practice grew to 60 clinicians across 4 Northern California locations, it hit an operational ceiling.

“As we began to grow, there wasn’t enough time to manage the business,” explains Chidi. “Because we couldn’t call back quickly, we lost referrals. We also had trouble scheduling patients and getting paid for the services we were delivering in a timely way.”

Its clinicians were losing ~10 hours per week to manual billing, scheduling, and documentation. Not just that, but its no-show rate was 50%, which meant 750 visits were missed each week. Children who needed consistent therapy were missing it because of these issues. So, Chidi and her team decided to adopt Tebra’s platform to avoid this problem. 

“Without Tebra, I would not be in practice,” says Chidi. “The breaking point would have been not having a way to automate, rinse, and repeat to manage workflow while still delivering quality care.”

When Dr. Fabius Santos started Optimal Psychiatry & Wellness, he did it as a solo provider. But the practice quickly grew, and now he leads a 10-clinician team in Maryland. This kind of growth also comes with its own challenges.

Dr. Santos recognized early on that his EHR wasn’t built for his patients. He explains, “For people with mental health issues, such as depression or anxiety, filling out paperwork is the last thing they want to do. And for me to grow from a solo provider into a practice with multiple clinicians, I needed a system that could scale.”

He switched to Tebra to get ahead of this issue. By leveraging its connected workflows across digital intake, charting, prescribing, and reputation management, he prevented his practice from being derailed operationally in the long run.

Irrespective of the operational challenge you’re facing, the solution looks the same every time. You need a tool or platform with the capabilities to make that happen.

Even in these 3 stories, we saw multiple bottlenecks. These practices were burdened with documentation, scheduling inefficiency, and scaling problems. But each practice was determined to do one thing: stop treating operational symptoms and address the root issue of disconnected systems.

In Tebra’s survey, we found that only 34% of practices have fully connected systems. But 50% of them say they can grow without hiring more staff, and 47% report that automation reduced time to payment.

Automation saves time, but you won’t experience those gains unless your tools actually talk to each other. A single investment in the right tool could help you:

Before investing, always ask: “Do these tools talk to each other, or am I adding another silo?”

That’ll guide your evaluation process.

The 67% of practices that are planning to stay independent are not being naive. They’re recognizing that independence remains viable but only with the right systems in place.

It doesn’t mean you have to overhaul your entire operation. But you can start with the workflow that feels the most broken. For instance, your team might be spending too much time on documentation, which is eating into their evenings with their families.

Pick that and find a platform that helps you with note-taking and labs.

If it fits with your EHR and financial workflows, even better. As long as they’re connected, you’ll experience the benefit of automation in the long run.