Ever looked at your monthly EHR bill and wondered how it got so high? You start with a couple of providers, then add a few more, and suddenly you are paying more in SaaS fees than you are taking home. Modernizing Medicine is slick, but the price tag and contract can feel like a ball and chain.
It is not just the upfront cost, either. That $800+ per provider per month adds up fast, especially with a $3,000 deposit and a 36-month contract that is tough to escape. If you have tried to scale back users mid-term or wrangle a refund, you know what I mean. There is a reason so many practices are searching for Modernizing Medicine alternatives, and not just for price. The real question: rent forever, or build something you own?
Here are the 9 strongest alternatives for primary care in 2026. Kareo (Tebra), AdvancedMD, and DrChrono are solid choices for many. But if you want to stop renting and actually own your system, keep reading for the Devaims option at the end.
Why primary care clinics look for Modernizing Medicine alternatives
Steep monthly fees: $800+ per provider per month is standard, and it stacks up as you grow. The cost curve is relentless.
Rigid contracts: Modernizing Medicine locks you into a 36-month term with a $3,000 deposit. Cutting back users or exiting early is rarely painless.
Tricky user reductions: You cannot easily drop licenses mid-contract. Many clinics find themselves paying for seats they do not need.
Expensive add-ons: Features you assumed were included, like advanced reporting or telehealth, often require extra fees.
Reputation hits: A $45 million federal settlement in 2022 did not help confidence. Many are rethinking their options for Modernizing Medicine alternatives.
Quick comparison of the best Modernizing Medicine alternatives
| Tool | Best for | Starting price | You own it? |
|---|---|---|---|
| Kareo (Tebra) | Small to midsize practices | $300/mo per provider | No |
| AdvancedMD | Integrated billing & practice management | $749/mo per provider | No |
| DrChrono | iPad-first workflows | $250/mo per provider | No |
| Athenahealth | Billing automation | 3-7% of collections | No |
| eClinicalWorks | Budget-conscious clinics | $450/mo per provider | No |
| NextGen Healthcare | Larger organizations | $800/mo per provider | No |
| Practice Fusion | Entry-level EHR | $150/mo per provider | No |
| Elation Health | Primary care focus | $3,600/yr per provider | No |
| Devaims | Ownership-driven practices | One-time build, you own it | Yes |
Always confirm current pricing before you decide. Rates and packages can change quickly.
The 9 best Modernizing Medicine alternatives
1. Kareo (Tebra) (Best for small to midsize practices)
Kareo (Tebra) is the go-to for many independent clinics that want an all-in-one EHR and billing solution without the sticker shock of Modernizing Medicine. It is approachable, widely adopted, and streamlines insurance billing.
Pricing: $300 to $450 per provider per month, including billing tools (Kareo pricing).
- Affordable entry for smaller clinics
- Integrated billing and scheduling
- Easy to onboard staff
- Customer support can be slow
- Performance hiccups during peak hours
- Still a subscription, you never own your system
On software you owned, every new provider would not mean a new monthly fee.
2. AdvancedMD (Best for integrated billing & practice management)
AdvancedMD is feature-rich and designed for clinics that need practice management, telemedicine, and billing under one roof. Its pricing is similar to Modernizing Medicine, but the workflows and add-ons are more modular.
Pricing: Starts at $749 per provider per month, bundled with practice management (AdvancedMD pricing).
- Deep billing tools
- Customizable reporting
- Comprehensive telehealth modules
- Customer service can lag
- Performance drops with heavy use
- Long-term cost rivals Modernizing Medicine
That level of reporting is something you would just have if your system was built for you.
3. DrChrono (Best for iPad-first workflows)
DrChrono is built with mobile in mind, making it a favorite for providers who want to chart on iPad. Compared to Modernizing Medicine, it is more flexible for on-the-go care, but still comes with subscription strings.
Pricing: $250 to $500 per provider per month, with optional add-ons (DrChrono pricing).
- Excellent mobile experience
- Easy e-prescribing
- Good for startups or mobile clinics
- Contract flexibility is limited
- Support can be hit or miss
- Advanced features cost extra
If you owned your EHR, mobile features could be tailored to your real workflow.
4. Athenahealth (Best for billing automation)
Athenahealth is a massive player that automates much of the billing and claims process. Its pricing model is unique, you pay a percentage of collections instead of a flat fee, which can get expensive as you grow.
Pricing: 3 to 7 percent of collections, typically $6,000 to $70,000+ per provider annually (Athenahealth pricing).
- Automated claims management
- Large support community
- Integrated patient portals
- Support responsiveness complaints
- System outages can disrupt operations
- Fees scale with your revenue
5. eClinicalWorks (Best for budget-conscious clinics)
eClinicalWorks is known for its lower price point and flexible modules. For practices put off by Modernizing Medicine's cost, it is a popular step down that still delivers the essentials.
Pricing: $450 per provider per month, with optional add-ons (eClinicalWorks pricing).
- Lower base price
- Flexible with add-ons
- Used by a wide range of primary care clinics
- Customer support can be inconsistent
- Occasional system outages
- Some features require extra fees
6. NextGen Healthcare (Best for larger organizations)
NextGen Healthcare is designed for organizations with complex needs and multiple locations. Its price is in the same league as Modernizing Medicine, but with more enterprise tools.
Pricing: $800 per provider per month, plus add-ons (NextGen pricing).
- Enterprise-grade features
- Strong compliance tools
- Scales with your organization
- Customer support challenges
- Performance lags during updates
- Expensive for small clinics
7. Practice Fusion (Best for entry-level EHR)
Practice Fusion is the budget pick for clinics just starting with EHR. It offers a simplified workflow at a fraction of the price you will pay for Modernizing Medicine.
Pricing: $150 per provider per month (Practice Fusion pricing).
- Low entry price
- Straightforward setup
- Cloud-based for easy access
- Limited advanced features
- Support and uptime concerns
- Revenue cycle management not included
With Devaims, you can have a lightweight build that grows as you do, not a pile of unused add-ons.
8. Elation Health (Best for primary care focus)
Elation Health was built for primary care from the start, with a focus on clinical workflow and patient relationships. It is less expensive than Modernizing Medicine, but support and reliability have some users looking elsewhere.
Pricing: $3,600 to $6,000 per provider per year, custom quoted (Elation Health pricing).
- Primary care workflow focus
- Clean, modern design
- Integrated telehealth
- Support can be hard to reach
- Occasional reliability issues
- Annual contract required
9. Devaims (Best for clinics ready to own their EHR)
Devaims is for practices tired of renting and ready to own their technology outright. You define the features, workflows, and integrations, and when the build is done, you get the source code. No seat fees, no forced upgrades, no contract lock-in.
- One-time build cost, then flat maintenance
- You own the code and data, forever
- Fully custom to your clinic's workflow
- No user or provider limits
Other Modernizing Medicine alternatives worth knowing
- Epic: Enterprise EHR, dominant in hospital systems. Expensive, complex, not accessible for small clinics.
- Cerner (Oracle Health): Hospital and large network focus. Overkill for most primary care shops.
- Meditech: Another large-hospital EHR. Only a fit if you are part of a health system.
These options are strong for enterprise buyers, but for independent clinics, the 9 above are a better fit.
How to choose the right Modernizing Medicine alternative
- Budget: Calculate your total cost for 5 years, including add-ons and per-user fees.
- Care model: Do you need deep billing, patient engagement, or something lighter?
- Growth plans: Will your costs double as you add providers, or can you control them?
- Ownership: Are you willing to rent forever, or does owning your EHR matter?
If you want out of the rent cycle, Devaims is the only way to fully own your system, and the math might surprise you.
Stop paying rent on software you could own
You are probably here because every EHR on this list, just like Modernizing Medicine, keeps you on the hook for monthly fees and long contracts. Add up your per-provider costs and it is like renting your own data. Devaims is the way off that treadmill.
Devaims builds custom EHR platforms that you own, code, data, and all. We build to your workflow, integrate with your payers and labs, and when we are done, you get the source code. No seat fees, no forced upgrades, no data held hostage.
- Per-provider fees? Gone. Add as many users as you want.
- Contract lock-in? Not with Devaims. You own the license, not a lease.
- Feature gaps? You define the roadmap and keep everything you pay for.
- Data migration headaches? We handle the transition for you.
| Tool | Ownership | Fees | Contract |
|---|---|---|---|
| Modernizing Medicine | Rented | $800+/mo per provider | 36 months |
| Kareo (Tebra) | Rented | $300-450/mo per provider | Ongoing |
| DrChrono | Rented | $250-500/mo per provider | Ongoing |
| Devaims (owned) | You own it | One-time build, flat maintenance | No contract |
Here is how the 5-year math plays out for a primary care clinic with 5 providers (average add-ons included):
| Year | Rented (Modernizing Medicine) | Owned (Devaims) |
|---|---|---|
| 1 | $48,000 | $30,000 |
| 2 | $96,000 | $31,800 |
| 3 | $144,000 | $33,600 |
| 4 | $192,000 | $35,400 |
| 5 | $240,000 | $37,200 (now ahead) |
For smaller clinics, the break-even may take longer. For groups with 10+ providers, you win even sooner. Devaims works best for practices ready to invest once and never rent again.
How to switch from Modernizing Medicine
- Export your patient and practice data from Modernizing Medicine
- Choose your new EHR or custom platform
- Import data into the new system (test for data integrity)
- Reconnect payment processors, labs, and integrations
- Train staff on new workflows and documentation
- Test both systems in parallel for a transition period
- Review your contract to ensure all obligations are met
With a custom Devaims build, the migration is handled as part of the project.
Frequently asked questions
What is the best Modernizing Medicine alternative for small clinics?
Kareo (Tebra) and Practice Fusion are popular for small clinics due to their lower entry costs and simpler setup. But if you want to stop renting entirely, a custom Devaims build is the only way to truly own your system.
Which Modernizing Medicine alternative is the cheapest?
Practice Fusion offers the lowest monthly rate at $150 per provider, but keep in mind you'll pay extra for advanced features. Over five years, Devaims can actually be cheaper for clinics with several providers.
Is there a free Modernizing Medicine alternative?
There are open-source EHRs such as OpenEMR, but support, compliance, and integrations are DIY. Most clinics opt for a paid platform or a custom build to avoid technical headaches.
What Modernizing Medicine alternative is best for larger organizations?
NextGen Healthcare and Athenahealth scale well for larger groups, but be prepared for higher costs and more complex contracts. Devaims can also build enterprise-grade platforms you own outright.
How do contract terms compare among Modernizing Medicine alternatives?
Most EHRs, including Modernizing Medicine, lock clinics into annual or multi-year contracts. If you want to avoid lock-in, Devaims is the only alternative where you own your code and have no contract obligation.
Can I keep my data if I leave Modernizing Medicine?
You can export your data, but the process may be complex and there may be fees. When you own your EHR with Devaims, your data is always yours.
When should I consider switching to a Modernizing Medicine alternative?
If your costs keep rising, support is not improving, or you want to own your technology, now is the time to look at Modernizing Medicine alternatives.
The bottom line
If you are tired of SaaS rent, rising per-provider fees, or just want to own what you are building your practice on, it is time to rethink your tech stack. Kareo, AdvancedMD, and DrChrono are solid if you want to keep renting, just watch the fees and contracts. But if the numbers have you doing double-takes, here is the single most useful decision rule: add up what you will pay in rent over the next five years. If that number could have built you something better, you already have your answer.
Owning your EHR does not just change your cost structure, it changes your leverage. Stop paying rent for software you could own.
Looking for more? Visit the Devaims blog for more insights, or check out related alternatives posts like Athenahealth alternatives, DrChrono alternatives, and AdvancedMD alternatives.
