Independent and Under Pressure: What 360 Practice Leaders Told Us in 2026

New national survey data reveals how rising costs, revenue leakage, and acquisition pressure are testing the practices you run every day, and what independent leaders need to stay in control.

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SURVEY SNAPSHOT

Four findings from the 2026 survey of 360 independent, physician-owned ambulatory practice leaders. The full picture is in the reports.

69%

are confident they'll remain independent over the next three to five years

54%

report increased financial pressure over the past 12 months

65%

say clinicians spend an hour or more a day on documentation outside visits

88%

believe AI and automation could improve practice efficiency

Veradigm data on file, March 2026. Based on a survey of 360 independent physician-owned ambulatory practice leaders.

360

Total Respondents Surveyed

94%

Approached About Acquisition or Consolidation

24%

Have High Visibility Into Revenue Leakage 

57%

Say Cost of Care Is the Top Barrier to Patient Engagement

48%

Report denials are on the rise

46%

Say operating costs are the top threat to independence

79%

Say technology is critical to their practice
 

Confidence is high, but so is outside interest

94% approached about acquisition or consolidation in the past two years

Most independent leaders are confident they'll stay independent over the next three to five years. At the same time, acquisition outreach has become routine, and many practices are engaging in real conversations before choosing to stay the course. Independence is no longer assumed. It's actively defended.

 

Money is slipping through the cracks

Only 24% report high or complete visibility into revenue leakage

Financial pressure is building across practices of every size, and most leaders still can't see where revenue is being lost until after it's gone. Denials, underpayments, and delayed collections often go undetected until the financial impact has already landed.

 

Affordability is now a clinical issue

57% identify cost of care as the primary barrier to patient engagement

Cost of care is the single biggest barrier keeping patients from engaging with their own treatment, ahead of time constraints or confusion about medical information. For practices trying to improve outcomes and collections at once, affordability can't stay a side conversation.

THE RESEARCH

Behind the data

A national survey of leaders at independent, physician-owned practices: physicians, clinical leaders, and practice administrators on what it now takes to stay independent.

360

practice leaders surveyed nationally

1–40+

clinicians per practice, solo to large group

11–40

providers — the size where pressure intensifies fastest

What's inside the report

Why independence is something practices now defend, not just declare
Where revenue cycle visibility breaks down, and what late detection costs
How cost of care is reshaping patient engagement and follow-through
The staffing roles practices find hardest to recruit and retain
How automation and AI are being evaluated by practices ready to invest
Cover of The State of the Independent Practice in 2026 whitepaper

The State of the Independent Practice in 2026

Whitepaper · PDF · 21 pages

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See what's really testing independent practices right now: outside interest in acquisition, revenue that's harder to track than it should be, and the financial pressures shaping how practices operate day to day. Complete the form for instant access to both reports, with breakdowns by practice size.