I don't think you're a tightwad, Bill. Either that or all of us here are homogeneous for the tightwad gene. Why lease when you can own has been my motto.
I think AC is trying to figure out how to climb out of it's financial hole. Development costs to meet mandated regulations are separating the big boys from the little boys now. The quality of the program doesn't decide it's success. Regulations help the best capitalized firms outcompete with the barely profitable firms. AC can't afford to be the old simple AC anymore where JB didn't need to make a killing on pricing. PriMed may want to invest for a while, but AC has to pencil out while adding all the MU bells and whistles.
My
guess is that AC doesn't really want to be linked too closely with Office Ally as the PM of choice. Nothing against Office Ally, but the free software direction is not going to pay the bills for the development needed to meet all the government regulations in ehrs. I think AC has to tie itself to mid-level pm vendors, and gradually increase it's ehr prices. The practice that chooses Office Ally may be going in the opposite direction from AC.
I think that AC definitely wants to push the hosted AC in the cloud version to improve revenues, so that's why their partner is a cloud PM, and their alternative with kareo is a cloud PM. Yet almost all AC users prefer the local installation, I'm guessing. Does anyone know if MEDfx can be purchased for client/server?
As to the price, it is a little better than kareo if it includes clearinghouse fees and has the same features. Assuming the PM is worth it compared to kareo, this would make some sense for practice that doesn't want to have any IT or hardware expenses beyond workstations and printers.
http://www.kareo.com/blog/2011/02/whats-the-true-cost-of-medical-billing-software/AC in the cloud charges $100/mo for one connection, $300/mo for 5 connections, $500/mo for 10 connections, and a volume discount scale for more connections. So a practice could pay $600/mo for ehr and pm with 5 "licenses". This may be a good cash flow way to start a practice or to make it easy to move to or add another location, but I wonder what percentage of current users would make that trade. Maybe if your IT expenses are really high or not reliable could be another reason.
My guess is that almost everyone here already has an adequate main computer/server set up and don't want to lease a pm when they could own one. If you already have a server for AC, or believe in controlling AC in house such that you need to get a "main computer", then $298/mo for MEDfx will put you into the red after about 18 months compared to most mid-level client/server PMs.
