athenahealth vs eClinicalWorks at a glance
| athenahealth (athenaOne) | eClinicalWorks | |
|---|---|---|
| Best for | Independent primary care and specialty groups that want EHR, billing and patient engagement in one cloud service | Primary care, specialty, behavioral health, urgent care and community health practices that want a published price |
| Practice size | Independent practices and groups; no size limits published | Solo to large groups; extra implementation fees above 9 providers |
| Starting price | Not published | $499/provider/mo (EHR only) |
| Pricing model | Quote-based; athenahealth says pricing is a percentage of collections, with no long-term contracts | $499 EHR only or $599 with practice management, per provider per month; RCM service at 2.9% of collections |
| Core approach | Integrated cloud suite of EHR, practice management, billing and patient engagement | EHR and PM with healow patient engagement; RCM sold as a service |
| EHR integrations | athenahealth Marketplace of third-party apps; ambient AI partners including Suki | FHIR APIs for provider and patient apps; TEFCA participant; lab and HIE interfaces |
| HIPAA / BAA | Trust Center published; request BAA with contract | BAA terms not published; Cloud page lists HITRUST, ISO 27001, PCI DSS, CSA STAR and TX-RAMP |
| Platforms | Web; athenaOne iOS app (iPhone, iPad); athenaPatient app | Web (Chrome); eClinicalMobile for iOS and Android; eClinicalTouch for iPad; healow patient app |
| Notable strength | Patient self-scheduling, check-in, messaging and telehealth through athenaPatient | Transparent pricing with free data migration and no start-up costs |
| Main drawback | No public pricing; collections-based fees rise with revenue | Sunoh.ai and RCM fees add to the base subscription; training costs extra above 9 providers |
Key differences
Pricing and contracts
eClinicalWorks publishes its prices: $499 per provider a month for the EHR, or $599 with practice management and billing implementation, with no start-up costs and free data migration from an existing EHR. Initial training is included for practices with one to nine providers. athenahealth does not publish athenaOne prices. Its athenaOne page says cost is based on a percentage of collections and that there are no long-term contracts, so the monthly bill moves with revenue. That can help a new practice with low collections and cost more for a busy one. Ask athenahealth for a written per-provider figure so you can compare like with like.
Billing and revenue cycle
Both vendors sell billing help on top of the software. eClinicalWorks offers RCM as a service at 2.9% of practice collections, covering claim creation, denials, appeals at all levels and A/R visibility, with extra fees per patient statement and per message. athenaOne builds practice management and billing into the same cloud platform as the EHR, and its collections-based pricing links the vendor's fee to what the practice collects. Practices that keep a strong in-house biller may prefer eClinicalWorks' software-only tiers. Practices that want the vendor to share responsibility for collections may lean toward athenahealth.
AI documentation
eClinicalWorks builds its own ambient scribe, Sunoh.ai, which the vendor says is fully integrated with eClinicalWorks. It lists at $149 per user a month as a limited-time rate, down from $199, and the vendor notes additional charges may apply. athenahealth takes a partner approach: Ambient Notes became generally available with Suki's ambient technology in May 2025, and Microsoft lists Dragon solutions for athenahealth. With athenaOne you may choose among AI vendors; with eClinicalWorks you get one scribe built for its EHR.
Patient engagement and interoperability
athenaOne offers the athenaPatient app, where patients can view results, message the care team, self-schedule, check in and join telehealth visits when the practice enables those features, plus an iOS app for clinicians. eClinicalWorks uses healow for patient scheduling, check-in, messaging and video visits, and its pricing includes the eClinicalMobile app and a patient portal. On data exchange, eClinicalWorks participates in TEFCA and publishes FHIR developer portals for provider and patient apps. athenahealth offers a Marketplace of third-party apps that connect to athenaOne.
Which should you choose?
Both systems can run a small or mid-sized primary care or specialty practice. The decision usually turns on pricing structure and how much billing you want to hand off.
Choose athenahealth if:
- You want patients to schedule, check in and message the practice through an app
- You prefer a fee that scales with collections over a fixed per-provider fee
- You want a choice of ambient AI partners inside the EHR
Choose eClinicalWorks if:
- You want a published price you can budget before a sales call
- You want outsourced billing at 2.9% of collections
- You want an AI scribe from the same vendor as your EHR
For a simpler system for independent primary care, also consider Elation Health or Practice Fusion.