3 Bold Predictions for Health Systems in 2025:
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Epic’s dominance is ending – The EHR giant will face disruption within the decade as nimble competitors and AI-driven solutions reshape the market.
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Rural healthcare is reaching a breaking point – Geographic and economic factors are creating barriers that could lock rural patients out of essential care.
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Consolidation is backfiring – While health systems merge for efficiency, smaller, specialized providers are proving they deliver better patient outcomes and innovation.
Epic Systems Will Be Replaced Within a Decade
Yes, we said it. Epic dominates the EHR market with a nearly 50% market share by bed count. Their integrated platform, billing reliability, and zero-customer-churn reputation have made them the darling of CEOs, CFOs, and CIOs. But here’s the catch: Epic’s strength is also its vulnerability. A monolithic codebase, high switching costs, and a customer focus that prioritizes executives over end users (clinicians, nurses, doctors) create a wide moat, but also a brittle one.
Epic’s platform is built on a single codebase. We believe that this archaic infrastructure has an upper limit of capacity, eventually having to rebuild this codebase from the bottom-up. When this happens, Epic will be vulnerable to smaller, more nimble players that can iterate and adopt external trends with near immediate speed. Externally, as burnout rises and administrative burden erodes bedside care, the next wave of winners will be those who build for the daily user, not just the decision-maker. Emerging challengers are already here, such as:
Tali AI: Ambient voice assistant for clinicians.
Glass Health: AI-powered clinical reasoning and note generation.
Nexus Bedside: Virtual nursing to reduce burnout and staffing costs.
These companies are lean, fast, and laser-focused on solving real pain points. The next EHR leader won’t just manage records—it will eliminate friction, automate the mundane, and empower clinicians.
The Healthcare Gap Is Widening—And Rural Patients Are Falling Through It
The barrier to healthcare access for rural populations is rising rapidly. Without swift innovation from companies and timely capital deployment from venture firms, rural communities risk being left behind.
By 2030, all Baby Boomers will have reached retirement age. Coupled with rising chronic conditions and increasing hospital staff turnover, the healthcare system faces mounting pressure. As urban centers consolidate care and staffing shortages persist, rural providers are at risk of being outcompeted. Patients in these areas may be forced to travel long distances for care–discouraging routine visits and leading to worse long-term outcomes–or rely on telehealth, which requires reliable broadband access that many rural areas lack.
The winners in this space will be those who can solve staffing shortages for rural providers or deliver scalable, accessible telehealth and mobile recovery solutions. Early challengers are already emerging, including:
Humla Health (backed by Exit 156 Capital): An innovative platform connecting nurses with healthcare facilities.
Axle Health: Online healthcare platform focused on in-home healthcare services.
MedArrive: Connects telemedicine with in-home healthcare services.
Rural healthcare isn’t just underserved–it’s on the brink. If you’re an investor, founder, or policymaker, the window to make a meaningful impact is closing fast. The next wave of healthcare innovation must prioritize access, equity, and scalability for rural communities.
Healthcare Consolidation is Reducing Care Quality–Smaller Care Providers Can Provide Massive Value
Both strategic and financial buyers are consolidating physician practices and regional hospitals at record pace, promising efficiency and cost savings. But here’s the truth no one wants to admit: healthcare consolidation is eroding the very care relationships that drive better outcomes.
The consolidation playbook is predictable: acquire, synergize and optimize for billing over care. But healthcare isn’t manufacturing. When consolidation efforts cut access to certain services, patients lose access to the specialized care that drives better outcomes.
The winners in healthcare’s future won’t be the largest systems–they’ll be the smaller providers that are more connected to their patients. Independent practices and smaller health systems are nimble, responsive, and deeply connected to their communities. They adopt new technologies faster, pivot quickly, and maintain doctor-patient relationships proven to improve outcomes while reducing costs. Early leaders are already emerging:
Forward Health: Membership-based primary care operating focused, tech-enabled clinics.
One Medical: Network of small, efficient practices prioritizing convenience and patient satisfaction.
Carbon Health: Urgent care and primary care clinics that rapidly deploy new services without bureaucratic layers.
The bottom line? Healthcare needs competition, not consolidation.
The next wave of healthcare innovation won’t come from creating bigger, more integrated systems. It will come from empowering smaller, more focused providers to deliver exceptional care in their communities.
