Independent practices

Clinical decision support for independent practices, governed end-to-end.

Health is the governed clinical AI surface your practice already wished lived next to the EHR. It reads patient charts, flags what physicians might miss, checks drug interactions against a licensed clinical database, and routes every recommendation through physician approval. Every action lands in a HIPAA-aligned audit trail you can export for any audit. Designed to deploy in weeks, not eighteen months, and to ship to practices that cannot afford a $500K enterprise EHR build.

Same team. Governed. More capable.

01 Clinical setup

Augment the clinic. Replace the glue tax.

Health augments the multidisciplinary clinical staff that runs an independent physician practice. It does not replace your EHR, your prescribing authority, your malpractice carrier, or your clinical judgment. Physicians still decide what gets prescribed. Practice administrators still own staffing and procurement. Patients still have a licensed practitioner making the clinical call.

What Health replaces in practice is the glue tax: prior auth phone calls that eat thirteen hours a week, inbox triage that runs fifty-two minutes a day per physician, alert-fatigue popups that physicians dismiss out of habit, and a paper trail for AI-assisted decisions that does not exist anywhere when payer or CMS asks for it after the fact.

What you should expect: faster diagnostic capture from charts already in your EHR, less administrative tax per encounter, and a defensible record when someone asks who decided what, on what evidence, under what authority. What you should not expect: autonomous diagnosis without physician sign-off, a magic FHIR-universal connector that works on every EHR, or a HIPAA certification that the regulatory framework does not actually issue. The architecture is designed for HIPAA-aligned deployment under your BAA chain, and the model-provider BAA is in motion.

02 Why independent practices need this

Time-on-EHR is structural. Reimbursement growth is not.

Independent practices are getting squeezed in a measurable way. Sinsky and colleagues found in Annals of Internal Medicine (2016) that for every hour of direct face time with patients, physicians spend nearly two additional hours on EHR and desk work during the clinic day, plus another one to two hours of work after hours. That published time burden has not shrunk. It has compounded as portal message volume and prior authorization complexity have grown.

The economic squeeze runs in parallel. The U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics for May 2024 reports a national median annual wage of roughly $235,930 for Family Medicine Physicians (SOC 29-1215). Medicare reimbursement growth is roughly one to two percent annually, while operating costs at independent practices have grown closer to eleven percent year over year. The math is not survivable indefinitely.

Two structural changes coming in 2026 and 2027 force the buying conversation. The CMS Interoperability and Prior Authorization rule mandates FHIR-based prior authorization APIs across Medicare Advantage, Medicaid, and ACA plans. The 2025 HIPAA Security Rule NPRM proposes that encryption become mandatory rather than addressable, with multi-factor authentication required and AI systems explicitly addressed. Practices either adopt compliant AI infrastructure or absorb reimbursement friction and regulatory exposure.

Hiring another medical assistant or prior auth specialist does not solve this. It lengthens the cost curve and still leaves you without a sealed record when the auditor asks for one. Health is the alternative when you want software-enforced safety gates, human authority preserved in the UI, and ledger-backed evidence on every AI-assisted clinical step.

Primary sources. Sinsky C, Colligan L, Li L, et al. "Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties." Annals of Internal Medicine. 2016; 165(11):753-760: acpjournals.org/doi/10.7326/M16-0961. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2024, Family Medicine Physicians (SOC 29-1215): bls.gov/oes/current/oes291215.htm.

03 Practice capacity model

Same headcount. More patient encounters per provider-day.

Traditional model
  • Same headcount
  • Each new patient panel growth requires hiring more clinical staff to absorb chart review, inbox triage, and prior auth
  • Each new payer or program adds spreadsheet tabs and fax threads for prior auth and audit
  • Scale ceiling equals how many hours a physician can spend on documentation, inbox, and PA after seeing patients
Augmented model
  • Same headcount
  • Existing physicians and MAs absorb more encounters because chart review, drug-interaction screening, and prior auth drafting share one governed surface
  • Additional payers and programs plug into the same FHIR-ready ingest and the same audit export
  • Scale ceiling equals how many governed clinical actions the stack can record per provider-day without losing safety or sign-off quality

Specific capacity numbers depend on your specialty mix, your payer mix, how aggressively you route prior auth and inbox triage through agent assistance, and how strict your safety gates are. The magnitude is what we model together once we see a week of real chart traffic and audit needs. Directionally, practices should see relief first on prior authorization and inbox triage, then on diagnostic capture, then on outcome tracking as calibration data accumulates.

04 Cost of growth

Cost of growth, with and without Health.

Illustrative only. Uses U.S. compensation benchmarks for clinical roles and common hiring friction assumptions. Your geography, specialty mix, and total rewards package will move these bands.

Table 1: Cost of growth without Health
Growth cost (hiring)
Estimated annual cost
One additional family medicine physician (BLS median anchor)
roughly $235,000 to $310,000 cash compensation
One additional registered nurse to absorb triage and chart prep
roughly $85,000 to $115,000
One additional medical assistant to absorb intake and refill workflows
roughly $40,000 to $55,000
Recruiter or agency fees if filled through search (often 15 to 25 percent of first-year cash per hire)
roughly $50,000 to $115,000 one-time
Ramp time productivity loss (3 to 9 months not at full output per hire)
roughly $40,000 to $110,000 combined
Net directional cost of growing the clinical bench by three roles
roughly $450,000 to $605,000 first-year all-in

Salary anchors. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2024. Family Medicine Physicians (SOC 29-1215): bls.gov/oes/current/oes291215.htm. Registered Nurses (SOC 29-1141): bls.gov/oes/current/oes291141.htm. Medical Assistants (SOC 31-9092): bls.gov/oes/current/oes319092.htm. Applied here as one of each role with benefits load approximated inside the range rather than as a precise payroll quote.

Table 2: Cost of growth with Health
Growth cost (platform)
Estimated annual cost
Platform subscription or acquisition economics
Pricing on conversation
Additional hires explicitly to replace prior auth and inbox triage
$0 in the augmentation story
Recruiter fees tied to that headcount
$0
Ramp time for the product surface
Days to weeks for clinical onboarding, plus a short engineering window for FHIR ingest, auth, and BAA alignment

There is also a recovered-time dimension that does not appear in the hiring tables. Sinsky's 2016 study and subsequent AMA practice surveys document roughly thirteen hours per week per physician on prior authorization, and roughly fifty-two minutes per day per physician on inbox triage. At independent-practice physician compensation rates, that recovered time is real money and real burnout exposure, not a marketing number.

The cost of augmentation is a fraction of the cost of hiring for the same coverage. The exact delta depends on your specialty mix, your payer mix, your existing EHR vendor, and whether you channel-roll Health under an operator group or acquire it outright. We want to model this with your real inputs, not a generic family-practice calculator.

Footnote. All figures are illustrative benchmarks based on publicly available data and modeled team structures. They illustrate directional capacity expansion, not specific buyer claims. We pressure-test against real inputs in conversation.
05 Who does what

Physicians decide. Agents prep the chart and the recommendation.

What agents and automation handle
What stays human
PhysiciansChart pre-read with ranked anomalies and source-linked evidence chain, draft prior authorization submissions and appeal letters, draft inbox triage responses for routine messages, surface drug-interaction risk narratives in patient-specific context.
Clinical judgment, prescribing decisions, controlled substance authorization, final treatment plan, communication that requires medical license to deliver.
Nursing staffTriage queue with severity ranking, lab-result anomaly summaries, refill request preparation, patient education content drafting tied to the recommended plan.
Patient interaction at the bedside, medication administration, telephone advice that requires nursing license, escalation judgment.
Medical assistantsAppointment prep packets with chart summary and vitals trends, intake form pre-fill from prior encounters, routine refill drafts ready for physician sign-off.
Vitals capture, patient rooming and comfort, in-person handoffs, anything that requires hands on the patient.
Practice administrators and CMOsPHI access log summaries, compliance export generation for CMS and payer audits, multi-provider workload dashboards, calibration metric rollups by provider and specialty.
Hiring decisions, vendor selection, financial decisions, contract negotiation, regulator-facing communication.
Compliance and billingStructured CMS audit exports, HIPAA breach-investigation packages, prior authorization status tracking across payers, BAA chain documentation summaries.
Filing decisions, regulatory interpretation for the practice, payer dispute strategy, what leaves the building to a payer or regulator.

This is not headcount reduction. It is physicians who spend more of the work week on patients and less on the inbox.

06 Practice rollout

One practice in. Multi-provider when calibration is real.

First 30 days
Pilot on one practice and one EHR. Core URL, practice id, and credentials wired. Demo data exercises the diagnostic agent, prescription safety gate, physician review queue, and HIPAA-aligned audit trail. Clinical RBAC and break-glass access validated. Real PHI does not flow on agent paths until the BAA chain is complete.
Day 30 to 90
BAA chain confirmed with the model provider, hosting, and any sub-processors that touch PHI. Diagnostic agent runs on real patient charts under human-led authority. Physician review queue used daily. Audit export sampled weekly against your compliance checklist. Outcome hooks capture physician confirm or dismiss on every flagged finding.
Month 3 to 6
Inbox triage agent and prior authorization agent activated where the EHR permits. Multi-provider rollout across the practice. Calibration data accumulating per provider and per condition category. Authority modes graduate from human-led to human-in-the-loop on routine, high-confidence categories where calibration justifies it.

You ramp on your own clinical calendar.

07 Trust we sign

Hard commitments on PHI. Hard limits on autonomous action.

What we do

Your data does not train any model

Project0 does not use your patient data, clinical decisions, charting, billing records, or any operational data to train, fine-tune, or improve any model. This is contractual.

Your data stays in your control

Patient stores live in your HIPAA-aligned cloud project with the BAA chain you sign. You hold admin access to those stores. You set retention, residency, and access controls in line with your compliance posture.

Deletion is real

Operational deletes follow your retention policy. Append-only audit semantics mean historic decisions are tamper-evident by design, which is different from silent erase. Patient-record deletion follows your patient-rights process and your records-retention obligations.

Sub-processor transparency

Sub-processor list (cloud hosting, model provider under BAA, observability under BAA or with PHI scrubbed) is documented and extended under your entity at acquisition or engagement.

What we do not do

Access your systems without authorization

No clinical access to chart data without your administered identity, your access scopes, and your audit logging. Break-glass entries are justified, alerted, and reviewable.

Make decisions without physician approval

Physician-in-the-loop is the default authority mode. The diagnostic agent recommends, the physician decides, the system records. Agent-autonomous mode applies only where calibration and protocol explicitly permit it for low-risk, high-confidence categories.

Lock you in

Acquisition path is designed so the BFF surface is portable and the Core dependency is concentrated in a thin server client and BFF proxy. FHIR ingest stays on your EHR vendor, not on a proprietary clinical lock-in.

Compete with your practice

We sell governed clinical infrastructure to run independent practices, not a competing care brand that would sit on top of your patient relationships.

08 Channel or acquire

Pilot, channel-roll, or acquire.

Expect a 30 to 60 day pilot on one practice (often one specialty, one EHR, one site) with weekly checkpoints on clinical safety, audit completeness, and physician adoption. A full engagement typically runs about eighteen months under a Founding Partner style agreement so we can sequence BAA chain confirmation, FHIR integration, calibration accumulation, and any Phase 1.5 protocol work with your roadmap. Founding Partner pricing is conversation-led because practice size, specialty mix, and payer mix swing cost more than seat count does.

Integration load on your side is intentionally BFF-first plus FHIR-first: plan for a small number of focused engineering hours per week from your IT or EHR integration lead during the pilot to validate auth, FHIR scopes, practice id wiring, and access logging, then taper as runbooks stabilize. Clinical onboarding is faster than new hires because the dashboard already speaks clinical language and the audit trail is the same one your compliance officer would have asked for anyway.

Strategic buyers, corp dev, and family offices interested in acquiring Health as a going concern: see project0.io/acquire.

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Health is built on Project0 infrastructure.