Why Multi-Location Practices Are Abandoning Best-of-Breed in 2026
New data shows consolidation to unified platforms is accelerating—and it's not about features
By Localhost Labs
TL;DR
-
Multi-location practices are consolidating onto single platforms 3.2× more often than adding new systems, driven by $5,000-per-employee annual software tax.
-
Staff retraining on multiple systems ranks as the second-biggest operational burden after payroll, yet most practices don't budget for these hidden costs.
-
This week: Calculate your support and training hours by location; if over 15% of IT budget goes to managing fragmentation, schedule consolidation vendor conversations.
Multi-Location Practices Are Ditching Best-of-Breed for One Platform—And It's Working
Your office manager is spending 15 hours a week toggling between four separate systems. Every new hire means retraining on all four. You're hemorrhaging time and money on integration that isn't buying you better care. It's time to consolidate.
Independent multi-location practices are abandoning the best-of-breed strategy faster than ever. KLAS Research's 2024–2026 independent practice switching study shows that groups are now 3.2× more likely to consolidate onto a single EHR/PM platform than to add another point solution. In 2023, that ratio was 1.8:1. Dermatology practices are leading this shift—they represent 12% of all platform consolidations despite being only 7% of market share.
Multi-Location Tax: $5,000 Per Employee Per Year
A five-location practice isn't running five separate businesses anymore. It's running five separate software ecosystems.
According to MGMA's 2025 Practice Management Benchmark, independent groups with 5–10 locations spend $8,200–$12,400 annually per FTE on software licenses and support across fragmented systems. Single-location practices spend $3,100–$4,200. That's a $5,000-per-person tax on having multiple locations.
But license fees aren't the real drain. An AAPC/AADS survey of independent dermatology practices in 2025 found that 73% of groups with 4+ locations cite "staff retraining on multiple systems" as their second-biggest operational burden after payroll. Post-pandemic turnover means that burden compounds monthly. Every time a front-desk staff member leaves, someone spends 6–8 hours teaching her four separate logins and workflows.
Multi-Location Practices Pay 2.5× More Per Employee for Software
Source: MGMA 2025 Practice Management Benchmark | Independent practices, annual software spend per FTE
The gap in support and training costs is the part most practices don't budget for—until they're drowning in it.
Consolidators Are Reporting Real Operational Gains
Groups that consolidated onto a single platform report 8–12 fewer support tickets per month per location. Staff spend 2.5 fewer hours per week navigating between systems.
One partner practice put it plainly: "We lost 3% scheduling optimization. We gained 20 hours of staff time per month we're not retraining." That math works when you're trying to grow without adding overhead. It works even better when you're hemorrhaging staff and can't afford another round of onboarding chaos.
Yes, you'll probably lose something. Your new unified scheduler might not be quite as optimized as your old best-of-breed one. Your billing module might not have that one feature your billing manager loved. But for most practices, operational simplicity is worth more than marginal feature superiority.
What to Do This Week
Pull your current software spend report by location and add a column for "support and training hours per month." Share it with your partners at your next meeting.
If you're spending more than 15% of your IT budget on managing fragmentation (not buying new tools), you're in the consolidation candidate zone. When you're ready to talk to vendors, ask about their onboarding timeline and support model for multi-location practices first. Not their feature list. The features will be fine. The onboarding is what will actually determine whether this works.