Seventy-nine percent of independent practice leaders say technology is essential to staying independent, but only 64% are confident the tools they already have can deliver it, according to Veradigm’s 2026 State of Independent Practice report. This confidence gap sits between two numbers and represents a set of problems most practice leaders will recognize, including denied claims that don’t surface for one to two weeks and payer contracts multiplying faster than staff can manage them.
Denials that surface a week late are a major issue, with 41% of practices not learning about a denied claim for one to two weeks. This is a symptom of a lagging operating model, with detection, root cause analysis, and resolution scattered across different people and systems.
Aaron Ledbetter, solutions and growth strategist at Veradigm, attributes the confidence gap to tools aging out mid-adoption, an arms race with payer technology, and the administrative weight of a growing book of payer contracts. He notes that 26% of practices surveyed reached serious acquisition negotiations before deciding to stay independent, with strain getting them to the table and the belief they can still solve it with better tools pulling them back.
Ledbetter argues that scale exposes larger practices to more payer complexity rather than insulating them from it. Larger practices feel it as volatility driven by payer complexity, while solo practices feel it as a staffing problem.
Ledbetter grants that practices are right to be skeptical of new technology, but argues that ambient documentation and background automation of prior authorization, reporting, and denial follow-up can move the electronic health record from a system of record to a system of work.
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Technology should automate quality measure tracking across contracts and surface care gaps before the visit, according to Ledbetter. He also argues that automating documentation, denials, and prior authorization can buy the work-life balance that decides where a physician lands, making it a recruiting advantage for independent practices. This can be especially important for physician recruitment and retention.
For practices with little or no administrative staff, Ledbetter says the answer isn’t hiring but choosing technology that surfaces the right signals in days instead of months.
Ledbetter’s closing case is that this is the first moment technology can look at the entire system of work at once. He notes that health care has spent years throwing people at manual problems and adding complexity in the process, but now technology can help simplify and streamline these processes.
Independent practices will play a significant role in shaping the future of health care. With the right technology and strategies in place, these practices can thrive and provide high-quality care to their patients.
