FTC's early look at Epic turns hospital IT's deepest dependency into a planning problem

The Federal Trade Commission is examining Epic Systems for potential antitrust violations as part of a broad inquiry into the company's business practices, according to four people recently contacted by investigators who spoke with STAT ^[1]. The significance is not the odds of a case, which are unknowable and low near-term, but that two contract terms most hospitals treat as fixed features of the landscape are now open regulatory questions.

According to one of those people, the government appears to be running two lines of inquiry ^[3]. The first concerns Epic's agreements barring its employees from working for a wide range of health care businesses that compete with it directly or indirectly ^[3]. The second concerns Epic's use of its market position and its leverage over hospital customers to block rival technology companies from reaching patient data those rivals need to operate ^[3]. State attorneys general have joined calls with interview subjects or contacted their private lawyers for information, all three people who spoke with STAT said ^[4].

Temper the timeline. The probe is early and may never lead to charges ^[2], federal investigators do not appear close to filing and could examine Epic for years without doing so ^[5], and the FTC declined to comment ^[13]. What the people contacted did report is that the intensity of interest and the number of entities involved have been ramping up in recent months ^[6].

The dependency is the point. Epic handles electronic medical records for 57% of inpatient hospital beds in America ^[7], roughly 82% of Americans have at least one record stored by the company ^[8], and its annual revenue reached $5.7 billion in 2024, up from $3.3 billion in 2020 ^[9] - a 73% increase in four years ^[10]. Judith Faulkner started the company in a Madison, Wisconsin basement in 1979 with $70,000 scraped together from friends, family, and acquaintances ^[20].

Epic did not affirm or deny being contacted. "We're leaders in interoperability to support patient care, and we do not engage in anticompetitive behavior," a spokesperson said, citing being the first EHR enterprise to connect to the national record-sharing network, newly announced standards for exchanging diagnostic images, and more than 1,000 developer connections ^[11][12].

The private litigation shows what the second line of inquiry looks like from a vendor's chair. CureIS Healthcare, which makes software for managed care organizations, alleged in a 2025 suit that Epic began blocking its access to data held inside customers' own Epic instances after deciding CureIS was a direct competitor to Epic's Tapestry product ^[14][15]. CureIS says access to customer information, including that of Advocate Health, was denied, and that Epic pressured shared customers by saying it "wasn't comfortable" with CureIS reaching its systems on data security grounds, an explanation CureIS asserts is false ^[16][17]. The complaint also describes an "Epic-first policy" requiring customers to abandon preexisting third-party tools and forgo non-Epic solutions ^[18].

Watch whether a state attorney general moves before the FTC does, since the state track is already active ^[4]. Watch the CureIS docket for what discovery surfaces about the Epic-first policy ^[18]. And if you are a hospital CIO or a vendor whose product reads from an Epic instance, start documenting access denials and their stated rationales with dates; that record is the raw material investigators are collecting ^[3].