The U.S. acute care EHR market has shifted considerably over the past five years.
Per Becker’s reporting of KLAS data, Epic has grown its share of acute care hospitals from 31% in 2021 to 43.7% in 2025. Oracle Health, which acquired Cerner in 2022, has posted net hospital losses each year since.
Here is how the market has moved, year by year:
2021: Epic alone in positive territory
In 2021, Epic commanded 31% of the hospital EHR market and was the only EHR vendor to report a net increase in acute care market share.
2022: Epic accelerates, Oracle absorbs Cerner
By 2022, Epic’s market share reached 35.9%, adding 83 hospitals and 14,330 beds. Oracle completed its acquisition of Cerner that year, rebranding the business as Oracle Health. The vendor added 22 hospitals but lost 4,658 beds, which KLAS attributed to the vendor adding mostly small standalone facilities while larger health systems continued moving to Epic.
2023: Oracle records its largest net hospital loss
Epic captured 39.1% of the EHR market in 2023, adding 153 hospitals and 28,788 beds, 77 of which came from three major health systems. Epic was the only vendor to record a net market share increase that year. Oracle Health recorded its largest net hospital loss on record, and Meditech saw its retention rate fall to its lowest level on record. Overall, 319 hospitals were affected by EHR purchase decisions in 2023.
2024: Epic posts largest net gain on record
In 2024, Epic achieved its largest annual net gain to date, with 10 major health systems choosing the vendor for 108 hospitals, 67 of which came from just two organizations. Epic’s market share reached 42.3% of hospitals and 54.9% of beds. Oracle Health lost a net 74 hospitals. KLAS noted the vendor’s loyalty and relationship ratings had dropped more than 10 points since just before the Cerner acquisition was announced. Total purchase decisions moderated to 272 hospitals, down from 319 the year prior.
2025: Market activity slows, Epic continues to grow
EHR purchase activity declined in 2025. The number of hospitals making purchase decisions dropped roughly 40% compared to 2024 and nearly 50% compared to 2023, according to KLAS. Contributing factors included uncertainty around government reimbursement policy, increased health system investment in AI and operational efficiency tools, and deferred decisions among some Oracle Health customers awaiting clarity on the vendor’s direction.
Epic added 77 hospitals and 18,679 beds. TruBridge was the only other vendor with a net gain, adding two hospitals. Oracle Health shed 56 hospitals and 14,676 beds. Both large health systems — those with more than 10 hospitals — that made enterprisewide EHR decisions in 2025 selected Epic.
Where the market stands
As of end-of-2025 purchasing data, acute care EHR market share by percentage of hospitals was: Epic (43.7%), Oracle Health (21.9%), Meditech (14.7%), TruBridge (7.6%) and Altera Digital Health (2.9%). By percentage of beds, market share was: Epic (56.9%), Oracle Health (20.4%) and Meditech (12.5%).
Meditech saw 84% of its legacy customers stay with the vendor in 2025, its strongest retention rate to date. About 30% of sampled Oracle Health customers told KLAS the platform is not part of their long-term plans, and another 35% are considered vulnerable. KLAS described 2026 as a pivotal year for Oracle Health as it rolls out a new AI-enabled EHR platform. In the 2026 Best in KLAS rankings, Millennium received the lowest scores among ranked acute care EHR solutions across large, midsize and small organizations.
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