Most independent practices want to stay independent — but new data shows only those with strong revenue workflows and connected systems are positioned to succeed.

Tebra’s latest research shows 67% of independent practices plan to stay independent over the next 5 to 10 years. But there’s a fracture beneath that confidence: 39% feel less certain about that future than they did just a year ago.

As per our survey, two-thirds of practice owners still see independence in their future. You probably do too.

And it makes sense. Independence is why most practice owners pursue this path in the first place. The autonomy to make your own clinical decisions and run your schedule without answering to a hospital system or a private equity firm matters.

Independence isn’t failing because of lack of demand — it’s being strained by disconnected systems and inefficient workflows. But wanting independence and being operationally equipped for it are 2 different things.

The belief is strong, but many practices don’t yet have the infrastructure to support that belief. Those who thrive in the long term take the infrastructure gap seriously. They’re building it to last using connected tools.

Tebra’s survey also found that 39% feel less certain about staying independent than they did a year ago. And that’s a signal. The commitment hasn’t wavered. But a part of this drop in confidence comes from the operational inefficiencies. For example, reimbursements keep shrinking, and admin tasks keep multiplying. 

Even though many of these practices use technology to remove that burden, they’re not getting the most value from it.

Tip: It’s time to start understanding your actual operations and digging deeper into what’s working and what’s not. Check out our practice efficiency grader to see where you stand.

Three out of four practices say the same thing: Reimbursements are the pressure point. So much so that 21% of practices plan to invest in billing technology to address this problem.

When payer revenue tightens, you feel it everywhere. You can’t make staffing decisions with confidence or upgrade to new technology or equipment because you don’t have the funds to do so.

The very margin that goes towards your practice’s growth shrinks. It’s one of the reasons why 60% of practices say improving reimbursements would increase their confidence in thriving.

You can’t control payer behavior. But you can control how efficiently you capture what’s owed to you.

The practices doing this well focus on a few key levers:

This indicates significant leakage in your revenue which is caused by preventable errors and inefficient billing workflows. More than half of practices are leaving money on the table before claims even reach the payer. 

A clean claim passes through without errors, rejections, or requests for additional information. When your clean-claim rate dips below 90%, you’re doing the following:

In short, claim errors quietly drain revenue, and the cost compounds every month.

When you consider that 65% of practices say their claim rates have stayed the same in the past 12 months, you should make this a focus in 2026.

Tip: Start tracking your clean-claim rates and see why they’re dropping (or improving). Common areas of inefficiency include missing or outdated patient information, incorrect coding, or eligibility issues.

For more than half of practices, claim corrections consume the equivalent of half a workweek every month — time and money that could be deployed toward growth instead. That’s more than half a workweek every month spent fixing things that didn’t go right the first time. Reworking claims has become a silent budget line now.

Let’s say your biller spends 15 hours a month reworking claims at $50/hour. That’s $9,000/year in labor alone.

You can fix this issue by doing a few things differently:

Administrative burden is eroding confidence in the viability of independent practice. It goes to show how much capacity is hiding in fragmented operations. If you ask practice owners what would make the biggest difference, nearly half say the same thing: less paperwork.

Many practices are dealing with so much paperwork that it’s interfering with their ability to cater to patients. If one note takes 30 minutes, multiply that by hundreds of notes across different patients throughout the year. It’s more than “just a few hours” lost to tasks that don’t require clinical expertise.

The practices pulling ahead are finding those leaks. They’re asking:

That’s one of the reasons practices invest in AI and automation tools. In fact, 37% of practices save 6+ hours per week using such tools.

Automation was supposed to be the great equalizer for healthcare. It was a way for smaller practices to do more with less. But for most, the returns have been modest at best.

Five hours is still a significant time period, but it’s far from the transformation practices expected when they signed up. That’s because it always underdelivers when you do it in isolation. 

The modest returns most practices are seeing suggest that the problem is the lack of integration that prevents the benefits of automation from compounding across workflows. Automation’s potential to save time and money comes down to 2 factors: adoption and infrastructure.

Your staff may not be able to adopt the technology if it’s not integrated with the other tools they use. Or the platform itself doesn’t have connected tools and workflows in place to make it easier.

Tip: Choose a platform like Tebra that combines scheduling, billing, and clinical workflows in one place. When your tools connect, you’ll start to see the real benefits of automation.

“I don’t know of any competitor with all the features that Tebra’s platform does and is presented with this level of quality and professionalism. The automated formats available for notes and diagnosis in the EHR look great and serve to reduce manual input and guesswork. This software is an invaluable benefit to have.”

— Dr. Woodrow “Anthony” Roeback, Ph.D., Mind Body and Spirit Counseling Services

In 2026, practices aren’t resisting automation, but they’re stuck trying to figure out how to make it work. Fragmentation of the tech stack is one of the main reasons this happens. More than a third of practices say that when their automation tools don’t have the right integrations, it’s a barrier to adoption. Success comes down to the systems you choose.

When you consider how much money practices like yours invest in technology, with ROI unclear, it’s no surprise that cost is a barrier to adopting or expanding automation initiatives. 

Tip: Prioritize practice management software that either has built-in connected tools or connects with your tools of choice with ease.

A key theme that runs through our survey is the problem of fragmented systems. When your tools don’t talk to each other, your staff is forced to absorb that inefficiency and become the connective tissue. 

Practice management tools don’t share data, sync automatically, or tell you what’s happening in your operations. And it shows up in the form of:

When your systems are disconnected, your staff becomes the glue. They’re compensating for the inefficiencies caused by their tech stack — and that’s not a sustainable model. That’s why it’s critical to invest in the right practice management software.

Every practice that’s thriving at the moment has one thing in common: They’ve invested in tools that work together. Our survey found that:

And the payoff shows up in capacity. Over the past year, 41% of these practices increased their clinical capacity by removing friction.

In short, connected systems drive compounding gains. When your billing, clinical and patient experience tools work together, small efficiencies stack into measurable growth. Eventually, it shows up as increased capacity and sustainable independence.

The tools matter, but the connection between them matters more.

You didn’t build your practice to spend your days chasing claims and toggling between platforms. Independence is supposed to mean freedom, but for too many practices, it has become a grind. To ensure your practice thrives in the long term, build the infrastructure to make it happen.