Epic holds 43.7% of the acute care EHR market, and a growing share of that expansion runs through hospitals that never signed a direct contract with the company.
Through Epic’s Community Connect program, smaller organizations join a larger health system’s existing Epic instance rather than implementing independently. The program has become a significant channel: Community Connect captured nearly 70% of all hospitals with EHR decisions among smaller hospitals in 2024, according to KLAS Research.
Community Connect is often framed as Epic access for hospitals that otherwise could not afford it.
How it works
Under the model, a larger health system, the “host,” extends its Epic license to a smaller affiliate, the “recipient.” The recipient does not build its own Epic instance. Instead, it joins an environment the host already owns, configures and maintains.
Cost is one of the program’s biggest appeals. Gunnison Valley Health in Gunnison, Colo., received access to an Epic EHR through Aurora, Colo.-based UCHealth.
Angela Kobel, CFO of Gunnison Valley Health, told Becker’s in 2025 that the licensed 24-bed critical access hospital would not have been able to afford Epic without the program.
“Just the sheer cost difference between Epic on your own versus a Community Connect product is significant,” she said.
Iowa City-based University of Iowa Health Care has also been extending its Epic EHR to other hospitals through the program. One of those facilities is Veterans Memorial Hospital in Waukon, Iowa, a 25-bed critical access hospital.
Hospitals pay for the service, with costs depending on their size and scope. Veterans Memorial Hospital, for instance, paid $3.88 million for implementation.
“Not only would Epic be pretty unattainable from a contracting perspective for each site individually, but the technical support needed to run Epic easily overwhelms what a small rural hospital is able to do,” Lee Carmen, associate vice president for information systems and CIO of University of Iowa Health Care in Iowa City, told Becker’s in 2025. “That ensures these small rural hospitals are running the latest and greatest electronic medical record tools, revenue cycle management tools.”
What recipient hospitals give up
The tradeoff is architectural. The host owns and maintains the Epic instance — including the hardware, software updates, order sets, clinical decision support rules and upgrade schedule. The recipient hospital can configure specific workflows within those parameters, but it does not control the environment in which it operates.
KLAS Research has documented this tension directly. In 2023 surveys of Community Connect recipients, organizations reported lower satisfaction with their ability to customize and modify the system compared with hospitals that hold direct Epic contracts.
Who becomes a host
Epic runs an accreditation program that assesses whether host health systems have the controls and capabilities to implement and support Community Connect recipients. There are currently 91 accredited hosts, including Northwestern Medicine in Chicago, Cleveland Clinic, Johns Hopkins Medicine in Baltimore and Providence in Renton, Wash. A smaller subset hold Accredited+ status — including Ochsner Health in New Orleans, Sanford Health in Sioux Falls, S.D., OSF HealthCare in Peoria, Ill., and Atrium Health in Charlotte, N.C. — which qualifies them to work with larger and more complex recipient sites.
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