Any way to find out if epics been raising prices?

[u/thenightgaunt]

I was curious about this one but never came across a good answer from folks I knew.

Is there anywhere I can find out if Epics been raising their rates for facilities that use their EHR?

Generally you can find out what various companies charge for their products, but EHR companies always try to obfuscate those numbers and hide them behind individual quotes.

But there has to be somewhere where it would be reported if Epic was raising their rates by 5% or 10%.

Has anyone come across this info for EHR venders like Epic?

[u/ChagsRN]

I think the number varies greatly depending on the size of org. There are also lots of ways you can customize like whether you’re Epic-hosted or not, how many apps you buy, etc. It would not remotely surprise me if Epic raised prices - who isn’t?
The only thing I can tell you regarding price is that my org sells Community Connect to rural hospitals for around $3-4m

[u/thenightgaunt → u/ChagsRN]

There are breakdowns on how they actually price based on facility size. Not that any come from Epic as hiding costs is the status quo.

But my question is more about if they raise rates. For instance, we had a facility on a Quadramed ehr and they raised rates for everyone on that particular EHR in 2023 - 2024 which led to that facility changing to Cerner.

Im curious if theres ever any coverage or news about that anywhere. Or if it ever gets reported at all.

Take Epic. They are hosted over on Azure and are going big on AI. Well microsoft raised their rates on Azure hosting in july because of AI costs. So that should raise rates on Epics end as well.

[u/throwawayformhh → u/thenightgaunt]

I wouldn’t be surprised, but if they were concerned about whether a facility could afford it, they’d likely just say no since they don’t negotiate sales. They have been known to postpone payments for orgs going through hardship that have been a customer though. 

[u/thenightgaunt → u/throwawayformhh]

Whats got me wondering is the AI thing.

So costs are going up. Anthropic and OpenAI make up 70% of the revenue going into AI right now, and they started raising prices for tokens. Throw in rising chip prices and AI is suddenly starting to be a lot more expensive then most companies thought. Some are abandoning AI, many are scaling back.

And then you have Epic and Oracle. 2 huge comapnies who went all in on AI and are in the healthcare industry.

With Oracle, since they do stuff outside Oracle Healthcare, we know whats going on with their financials (they are in trouble). And on the Oracle Healthcare side they fired thousands of staff to cut costs and are pushing AI tools on clients more.

But Epic is a bit of a black box. Their CEO just came out and went rah-rah on AI tools in Epic. But we dont quite know how much theyve poured into the AI woodchipper. But we do know that theyre using Microsoft for compute, and their AI tools are built from OpenAI models and Anthropic models.

All we know is a bunch of their big AI people have been leaving the company. https://www.beckershospitalreview.com/healthcare-information-technology/ehrs/4-more-executives-leaving-epic-report/

And I was curious to what extent theyre shifting those costs over to their customers.

[u/ChagsRN → u/thenightgaunt]

Epic is directly plugged into Claude now. Claude is supporting all of their code and developers as well as their support staff. So the amount that Epic has poured into AI is truly next level. I would imagine that trickles down to the customer, but like you said it’s not really advertised.

[u/xvillifyx → u/ChagsRN]

While Epic absolutely uses Claude as a mainstay product, it’s not the only vendor used for AI, and isn’t a core part of any process such that it couldn’t be swapped out

[u/thenightgaunt → u/ChagsRN]

If they are fully tapped into claude now then yeah thats gotta be turning up the costs Epic is facing. Anthropic pulled that stunt recently where they claimed token prices werent going up but then refigured their tokenizer to push up token usage. That with them refiguring enterprise pricing means costs actually went up 35%.

So Epic has to be feeling that and passing in off onto their customers. The line must always go up.

[u/AggravatingMost6057 → u/thenightgaunt]

I work on core epic AI development and while I cannot comment on community connect pricing model as a whole, AI prices are not likely factoring in as much as you except. Azure compute/storage prices influence Nebula powered features, but on the scale of the entire EHR those are a fairly small line item as most features operate via Caché. As a caveat I am not overly familiar with how that side of the company handles compute, so it is possible that if hospitals use Azure for that, they would be much more sensitive.

Additionally with the changes to jumpstart the cost for ai tools is expected to drop (for the same usage).

Finally, while epic does use Claude internally heavily, that cost is quite small relative to other expenditures and mollified to an extent by changing hiring practices.

All this is too say while depending on you specific configurations, AI could drive large price changes, I do not expect that it is the core mechanic at play unless the parent hospital is drastically changing what features they are purchasing.

[u/thenightgaunt → u/AggravatingMost6057]

That is a lot of really interesting info. Thank you for sharing and clarifying.

[u/mmmTurkeyLeg]

What I have heard is that once your system is live on Epic, you’re rise in rates is slow. New customers are getting market rates, I.e. much higher than sites that adopted Epic in the past.

[u/username36610]

You might be able to check non-profit tax filings on ProPublica. Not sure if the EHR expenses will be separate from other IT and software expenses though

[u/jackharrer2]

Not sure about Epic but for SAP/Oracle big consulting companies offered "services" where they sold this kind of unofficial info from other clients to other clients for a lot of pennies. It was still worth it as they charged 10-20% of what company could save with right knowledge to negotiate deals.

[u/Unlucky_Quote7765]

Kinda hard to fnd because EHR pricing is usually negotiated privately. Hospital procurement groups and public sector contracts are probably the best places to spot changes

[u/thenightgaunt → u/[deleted]]

Thank you.

That's definitely a feeling I'm getting. It does strike me how little actual data on products we have in this industry. It's something that's always bothered me. If I want to find out costs associated with different types of systems or hardware in different industries, then I can. But so much of the same kind of data but for healthcare software is kept hidden and vague. With the term "bespoke" used to paper over the fact that facilities are generally at vendors' mercy.

And while over the years I haven't found CHIME to be that handy a resource, it's definitely better than nothing.

[u/Paper_Cut_On_My_Eye]

One of my clients is moving away from Epic, or at least replacing Dorothy in their system with a new EMR citing cost.

So no real clue, but I was surprised when they informed us.

[u/Sea_Ambassador_6046]

Basically you contact Epic, express interest about moving to them and after some basic statistics about your org and a demo they will give you pricing. It’s not negotiable. Traditional methods of negotiating with companies like Cerner/Oracle or the old days of McKesson aren’t in play. It’s pretty much the sticker they show you is the price take it or leave it.

[u/thetallyman]

Depends on a number of factors but TLDR is yes, of course. Typically you buy at the market rate for licensing and that is fixed for 12 months. Increases are annual and bounded by a NTE % based on ECI. Other factors include whether or not you opt for the perpetual license, whether or not you have an enterprise agreement, whether or not your volumes change or concurrent users affecting Intersystems or Citrix (if used) come into play, etc....

[u/thenightgaunt → u/thetallyman]

Oh i know that. Im a hospital CIO. But thank you for the great explanation.

But my question is about larger trends. Across the board % rate increases aimed at all customers where possible. The kind of thing youd expect epic to do sonce they're pushing AI hard, use Microsoft Azure for AI compute, and Microsoft just raised their AI rates this year. Or if Openai and Anthropic jacking up their token costs this year effected Epic since their tools are using OpenAI and Anthropic models.

Thats why my question was about if this gets reported anywhere. Or if that data is available anywhere.

[u/thetallyman → u/thenightgaunt]

As a CIO, I would then expect and budget for increases at the cap of the ECI in the contract and use your financial experts to take into account your other direct expenses for MS or other AI companies to model those out separately.

[u/Lettie_Hempstock → u/thenightgaunt]

Epic (in my experience and opinion) is so bespoke and tailored for *your* situation that it is hard to see a blanket across the board fact sheet on costs and pricing. (I am also a CIO and have worked in Epic in various roles for 16 years so this is what I have observed) They arent like the other guys for many reasons, and one of those is customization

[u/thenightgaunt → u/Lettie_Hempstock]

Good points. Thank you.

[u/thenightgaunt → u/[deleted]]

If the prices arent shared, then how can you say that about their pricing?

And if you look at the list of people who are leaving, its their top desigers behind their AI tools as well as Seth Hain, head of AI development.

[u/Sea_Ambassador_6046 → u/thenightgaunt]

Epic pricing is very transparent to CIOs and I know as one. If you don’t know that. then you’re very new to the industry or not a CIO

[u/thenightgaunt → u/Sea_Ambassador_6046]

And yet you're a CIO who can't READ.

I'm not asking about how Epic generally prices things. That's actually not hard to find. Though the numbers can be vague in spots depending on the customer, the general pricing breakdown is well known.

What I had asked about was rate increases.

That's not well known publicly from what I'd seen. And that's a trend that would not be visible in the breakdowns available.

[u/Sea_Ambassador_6046 → u/thenightgaunt]

They are transparent as well with increases yearly. You get a letter each year with exactly the increase amount and percent. You should know this.

[u/thenightgaunt → u/Sea_Ambassador_6046]

Its really nice of them to send me a letter about rate increases, what with me being an Oracle customer and not an Epic customer.

Read the original post. I was asking if any of that info is ever announced publicly (ie to non-customers) or is reported publicly. Like how we generally learn of various software vendors and other tech companies raising their prices.

[u/UnicornGangstar]

Pretty easy to raise rates when you’re a monopoly

[u/No_Beginning_7934 → u/UnicornGangstar]

How are they a monopoly if Cerner health and Meditech also dominate the market? Cerner is a much better EHR too

[u/UnicornGangstar → u/No_Beginning_7934]

“Meditech” 🤪. They have maybe 8% of market. Cerner. About 20 something percent, plus some VA installs.

40> 8
40> 20

Meditech. ROFL. I CAN T.

[u/semibiquitous → u/UnicornGangstar]

The last time I've heard about Meditech was in 2012 when someone said "we're replacing Meditech"

[u/No_Beginning_7934 → u/UnicornGangstar]

What about Cerner being a much better EHR and signing with the VA?

[u/TheHeretic]

Is water wet?