Cybersecurity review comes first on 2027 practice purchase lists, at 78%, and revenue-cycle automation follows at 70%. Black Book Research reported both shares among practices that plan large technology or outsourcing purchases, in a September 2026 survey of 1,184 practice leaders.
Only 11% of those practices expect a major practice management or EHR replacement evaluation. Black Book found that practices move faster on targeted automation and outsourcing projects than on large platform changes.
What practices plan to buy in 2027
Black Book released the results on September 24, 2026, ahead of the MGMA Annual Conference. The respondents were practice executives, administrators, finance leaders and technology decision-makers. The nine shares add up to 317%, so respondents named more than one area.
| Purchase area | Share of practices with large 2027 plans |
|---|---|
| Cybersecurity, managed IT or infrastructure services (under review) | 78% |
| Revenue-cycle automation, billing or claims management, as software or outsourced service | 70% |
| Value-based care technology, analytics or outsourced support | 41% |
| Patient access, scheduling, digital intake or patient communication | 37% |
| AI-enabled administrative or clinical workflow applications | 32% |
| Analytics, financial intelligence or practice-performance management | 19% |
| More outsourced administrative or revenue-cycle functions | 16% |
| Provider workflow, documentation or specialty clinical-system improvements | 13% |
| Major practice management or EHR replacement evaluation | 11% |
Source: Black Book Research, September 2026 preconference flash survey of 1,184 respondents, released September 24, 2026. Base: organizations that plan large technology or outsourcing investments through 2027.
Only cybersecurity and revenue-cycle automation pass 50%. The lowest four areas sit at 19% or less. AI ranks fifth of the nine, and its 32% share is less than half of the 70% for revenue-cycle automation.
The pressure behind the purchases
The same survey measured operating pressure. Among the nearly 1,100 unique medical practice respondents, 94% reported higher operating expenses without a comparable rise in reimbursement.
Revenue cycle work is an improvement area for 91%, who named denials, payment delays or revenue-cycle productivity as a 2027 priority. 89% put payer administrative requirements, prior authorization, reimbursement complexity or claims follow-up among their largest sources of avoidable work.
Labor is a major concern for 82%, who cited staffing shortages, labor costs or trouble to keep experienced administrative teams. 72% said it became harder in the past 12 months to recruit and retain qualified revenue-cycle, billing, scheduling or administrative staff.
MGMA polls also cover labor. In a July 8, 2025 poll, 65% of practice leaders named labor the area with the biggest cost increase in 2025. By September 2025, MGMA reported, 64% of groups targeted base-pay increases of 1% to 3% for 2026 and 23% planned 4% to 6%.
On technology risk, 79% reported more executive concern about cybersecurity, technology resilience or third-party technology risk. 58% said disconnected systems, duplicate entry or weak integration between applications still create material staff inefficiency.
MGMA polls show the same cost and cash pressure
MGMA polled medical groups on costs on June 23, 2026 and received 251 applicable responses. 84% of groups reported year-to-date operating costs above the same point in 2025. 8% reported about the same and 8% reported a decrease.
Among groups with higher costs, the average increase was about 11%, and most answers fell between 5% and 20%. The share of groups with higher costs has fallen three years in a row. MGMA said the average increase sat between 10% and 12.5% in 2023, 2024 and 2025.
| Year of MGMA Stat poll | Groups that reported higher year-to-date operating costs |
|---|---|
| 2023 | 95% |
| 2024 | 92% |
| 2025 (June 10) | 90% |
| 2026 (June 23, 251 responses) | 84% |
Source: MGMA Stat, "Operating costs keep climbing for medical practices in 2026," June 24, 2026. Base: medical groups that answered each poll.
On revenue, the MGMA poll of June 30, 2026 drew 221 groups. 47% reported higher year-to-date revenue, 14% about the same, and 36% a decrease. A year earlier, 56% reported higher revenue and 30% reported a decrease.
MGMA also polled on days in A/R. On July 28, 2026, 32% of 203 groups said days in A/R were higher than a year ago. 43% said about the same and 22% said lower.
A January 6, 2026 MGMA poll asked where revenue leaks. 48% of leaders named denials and appeals as their largest source of leakage. 23% named front-end issues.
How practices will judge each purchase
Buyers want proof of results. 85% of technology decision-makers said proposals increasingly require a measurable first-year productivity, financial or staffing outcome. 70% said a documented implementation and migration approach now materially influences vendor selection.
Integration matters to most buyers. 93% of technology decision-makers favor a solution that works with their current systems over one that needs many new interfaces or manual reconciliation. Among practices that evaluate AI, 96% said integration with the EHR, practice management and revenue-cycle systems will be a major purchase criterion. 89% said they will require a defined operational or financial measure before they expand an AI project.
In the same release, Black Book cited its Clinician Reality Index 2026, a survey of 1,919 clinicians across care settings. 81% needed at least one daily workaround. 65% lost at least 30 minutes per day or shift to avoidable digital work. Among clinicians who already use AI, only 19% reported a meaningful net reduction in work.
Large platform changes take longer. 78% of organizations that evaluate a replacement of a major core platform said the evaluation now takes longer than their last major purchase. Black Book linked this to migration burden and disruption to physician productivity.
Black Book also compared independent groups with corporate-owned practices. Independent groups more often ranked immediate administrative labor reduction, better collections and simpler vendor management first. Black Book advised practices to set baselines before a contract starts, for example staff time per completed transaction and days to payment.
Budget and decision dates
MGMA asked a related budget question in an October 28, 2025 poll of 213 groups. Leaders named workforce as the biggest new 2026 budget item at 37%. Health IT followed at 30%, then revenue cycle at 12%, patient access at 12% and other areas at 9%.
Black Book asked practices that expect a material purchase within 12 months when they will decide. 17% expect a decision by the end of the first quarter of 2027 and 20% during the second quarter, a combined 37%. 33% expect to buy in the late second half of 2027. 17% are still in early evaluation with no date. Black Book gave no figure for the other 13%.
Smaller workflow products, AI applications and outsourced services move through purchase cycles faster than EHR or practice management replacements, according to Black Book.
Sources
- Black Book Research, Black Book Announces Top Medical Group Technology and Services Vendors as Physician Practices Accelerate 2027 Technology, AI and Outsourcing Decisions, September 24, 2026
- MGMA Stat, Operating costs keep climbing for medical practices in 2026, June 24, 2026
- MGMA Stat, Revenue growth narrows as costs climb: the 2026 squeeze on medical practices, July 2, 2026
- MGMA Stat, Days in A/R holds steady for most practices, but payer pressure persists in 2026, July 30, 2026
- MGMA Stat, Where medical groups are putting new dollars in 2026 budgets, October 29, 2025
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